added 3 research items
Social Climate Research
Although Mississippi does not have statewide smoke-free legislation, 157 municipalities in Mississippi have smoke-free ordinances. This study compares hospital admission rates for acute cardiovascular, stroke, and pulmonary events for counties with and without smoke-free county seats.
JUUL e-cigarettes can rapidly deliver nicotine to the brain, are not complicated to maintain and use, and can be used discreetly. These features may be attractive to adult cigarette smokers looking for a product to replace cigarettes, but may also attract nonsmoking youth and young adults. JUUL has changed the e-cigarette landscape in a short span of time, yet little is known about JUUL use among young adults. The current study assessed awareness and nicotine perceptions of JUUL, and the prevalence of trial and frequency of use of JUUL among undergraduate students at three Mississippi universities. We also examined misclassification issues in survey assessment of e-cigarette and JUUL use.
Past 30-day e-cigarette use doubled among U.S. adolescents over the past year. Many attribute this increase to the popularity of pod-based e-cigarettes. JUUL Labs launched sales of these products in 2015, producing an e-cigarette that could approximate combustible cigarettes' rapid delivery of nicotine to the brain in a device that is easy to maintain and use. These features may be appealing to adult cigarette smokers looking for a product to replace cigarettes, but the tech sleekness, ease of discreet use, and flavors may also attract nonsmoking youth and young adults.The current study compares use of JUUL among young adults at three universities and among the general population of adults in Mississippi.
Although previous research has found smoking rates to be higher among residents of rural areas, few studies have investigated rural-urban differences in exposure to environmental tobacco smoke (ETS). This study contrasted the social climate surrounding ETS among Americans who resided in 5 levels of county urbanization. Data were collected via telephone interviews administered to a representative sample of 3,009 civilian, noninstitutionalized adults over age 18 in the United States. Households were selected using random digit dialing procedures. Compared to residents of urban counties, rural residents reported fewer restrictions on smoking in the presence of children and lower incidences of smoking bans in households, family automobiles, work areas, convenience stores, fast-food restaurants, and restaurants. Interestingly, when rural-urban variations in knowledge and attitudes about ETS were examined, the magnitude of rural-urban differences was smaller or nonexistent for these indicators. Moreover, logistic regression models indicated that none of these rural-urban differences in knowledge and attitudes persisted after statistically controlling for region, smoking status, gender, race, age, and education factors. This suggests that the observed rural-urban differences in ETS bans could not be explained adequately by rural-urban differences in knowledge and attitudes about the dangers of ETS. The policy implications of this research point to a greater need in rural America for programs focusing on the restriction and elimination of ETS. They also suggest that programs focusing only on influencing the levels of ETS knowledge and attitudes among the general population may not be adequate in producing the desired change.
The U.S. Department of Housing and Urban Development (HUD) recently issued rules requiring that federally funded authorities administering public housing must have smoke-free policies. Importantly, this requirement does not extend to Section 8 housing. Under the Section 8 program, public housing vouchers provide subsidies for private rental housing to low-income residents. This study examines support for smoke-free policy options in Section 8 housing. Using a nationally representative survey of adults, we asked 3,070 respondents to agree or disagree with two potential policies. The majority (71%) supported prohibiting indoor smoking everywhere inside buildings that have Section 8 housing units. Alternatively, respondents were less supportive (38%) of a policy to prohibit smoking only inside units with Section 8 subsidies, and allowing smoking in nonsubsidized units. Prohibiting smoking in all units in multiunit housing (MUH) buildings would help protect the health of both the 2.2 million households who receive Section 8 subsidies and their neighbors.
Background: Marketing and availability of e-cigarettes has increased in recent years. We assessed nonsmokers’ susceptibility to e-cigarette use. Methods: Within a representative sample of U.S. adults, we assessed susceptibility to e-cigarette use among never-triers by asking “Do you think you will smoke an e-cigarette in the next year?” Those responding other than “Definitely not” were considered “susceptible” to e-cigarette use. Results: Of 2,677 eligible respondents, 1,693 (63%) completed the survey and 1,225 had never tried an e-cigarette. Of these, 711 (42.0%) were never smokers and 348 (20.6%) were former smokers. Former smokers were more often (15.8%) than never smokers (6.3%) to be susceptible to e-cigarette use (p<.001). Young adults (18-24y) were more often susceptible, irrespective of smoking status: among never smokers, 17.5% of 18-24 year olds were susceptible, compared to 6.4% of those 25-44y, 3.6% of those 45-64y, and, 2.2% of those 65+ (p<.001). Of former smokers, 53.8% of 18-24 year olds were susceptible, while 26.7% of those 25-44y, 10.7% of those 45-64y, and 7.9% of adults 65+ were susceptible (p<.001). Conclusion: Over 20% of young adult never and former smokers who have never tried e-cigarettes are susceptible to using them in the future. The substantial number of vulnerable young adult nonsmokers illustrates the imperative for sales and marketing regulation to protect nonsmokers from being recruited to e-cigarette use and possible nicotine addiction. Until the risks of e-cigarettes are better defined, it is irresponsible to allow an unrestrained industry to encourage uptake of a potentially hazardous product.
Many Hispanics live in multi-unit housing (MUH) without smoking restrictions. Tobacco smoke diffuses between units, potentially affecting non-smoking residents. Hispanics for whom English is not their primary language may be particularly vulnerable to tobacco smoke incursions due to language barriers, cultural differences, and concerns with their immigration status that also limits their communication. The objective of this study is to describe tobacco smoke incursions in MUH for Spanish and English speaking Hispanics. We recruited U.S. residents 18+ years living in MUH from a nationally representative online panel. Analyses are limited to Hispanic residents. Variables included demographics, tobacco use, building policies, and frequency of smelling smoke in their unit. Chi-square and logistic regression models were performed on data weighted to adjust for design effects. Completion rate was 60%, resulting in 3,696 U.S. adults, 607 of whom self-reported being Hispanic (50% were male and 44% were administered the survey in Spanish). Compared to English speakers, more Spanish speakers reported smokefree policies for units (57% vs. 41%, p<.01), believed that smoking should not be allowed in units (87% vs. 61%, p<.01), had a child living in the home (66% vs. 37%, p<.01), and did not have a smoker living in the home (84% vs. 69%, p<.01). There were no differences in household rules against smoking inside the home (70% vs. 63%). Among smokefree households, reported unit incursions were significantly higher for Spanish speakers (37% vs. 25%, p<.01). Despite reporting more incursions, Spanish speakers were much less likely to complain to their landlord about these incursions (13% vs. 44%, p<.01). Most of these differences persisted in multivariate models adjusting for age, sex, and child in the home. Many Hispanic residents of MUH experience tobacco smoke incursions into their private homes. Although Hispanics who primarily speak Spanish are more likely to live in buildings in which smoking is not allowed in units, they are more likely to report tobacco smoke incursions into their units. Access to smoke-free housing should be a right for all.
A substantial proportion of homes and automobiles serve as settings for environmental tobacco smoke (ETS) exposure, and many public settings that children frequent are still not smoke-free. Tobacco control efforts are attempting to increase smoking bans. The objective of this study was to describe the knowledge, attitudes, and practices of smokers and nonsmokers regarding smoking bans and child ETS exposure in multiple public and private settings and to report changes from 2000-2001. Cross-sectional data from the annual Social Climate Survey of Tobacco Control were analyzed for changes in knowledge, attitudes, and practices regarding tobacco. These data were collected via automated, random-digit-dialing telephone surveys that were conducted in the summers of 2000 and 2001. The samples were weighted by race and gender to be representative of the US population. Response rates for eligible adults actually contacted were 1501 (75%) of 1876 in 2000 and 3002 (84%) of 3566 in 2001. The majority of adults, both smokers and nonsmokers, support smoking bans in a wide variety of places. The percentage of all respondents reporting the presence of smoking bans in several public and private places increased from 2000-2001: the household (69%-74%), in the presence of children (84%-88%), convenience stores (68%-74%), fast-food restaurants (52%-58%), and non-fast-food restaurants (25%-28%). Support for smoking bans also increased in shopping malls (71%-75%), fast-food restaurants (77%-80%), and indoor sporting events (78%-80%). There were no significant changes in support for smoking bans in convenience stores, restaurants, or outdoor parks. Adults' knowledge of the harm caused by tobacco was unchanged, with the vast majority of adults recognizing the dangers of exposure to ETS from parental smoking (95%) and exposure to ETS in cars (77%). Small improvements in adult attitudes and practices regarding children's ETS exposure occurred from 2000-2001. However, a significant number of adults in the United States still report ignorance of the harmful effects of child ETS exposure, and there was no improvement in reported knowledge in this 1-year period. In contrast, a growing majority of smokers and nonsmokers favor restrictions on smoking in public settings, suggesting that states and communities have public support for broad public smoking restriction policies. There are significant roles that pediatricians can play in preventing children's ETS exposure, through both patient and family education and by moving smoking restriction policies forward on their community's agenda.