Smoking and Cessation Behaviors Among Young Adults of Various Educational Backgrounds

HealthPartners Research Foundation, Minneapolis, MN 55440, USA.
American Journal of Public Health (Impact Factor: 4.55). 09/2007; 97(8):1421-6. DOI: 10.2105/AJPH.2006.098491
Source: PubMed


We sought to determine whether the educational backgrounds of young adult smokers (aged 18 to 24 years) affect their cessation attitudes or behaviors in ways that could be used to improve smoking interventions.
We surveyed 5580 members of the HealthPartners health plan and conducted a follow-up survey 12 months later of current and former smokers. Respondents were divided into subgroups according to educational level.
Higher levels of education were associated with lower smoking rates (16% among students in 4-year colleges, 31% among those in technical or 2-year colleges, and 48% among those with a high school education or less) as well as less frequent or heavy smoking. However, number of quit attempts in the past year, level of interest in quitting, and smoking relapse rates did not vary according to educational level. Seventy-three percent of those who had attempted to quit had not used some form of assistance.
Rates of smoking among young adults, especially those at low educational levels, are relatively high. However, most members of this age group are interested in quitting, regardless of educational background.

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Available from: Raymond G Boyle, Nov 07, 2014
    • "Trying to quit without assistance other than the Tobacco Status Project intervention was much more popular than using a cessation aid such as medication among young adults. This is congruent with previous studies among young adults [54] and adolescents [55] and highlights the need to incorporate evidence-based treatment into media that are widely accessed by young people such as Facebook. Electronic cigarettes were used more frequently as a cessation aid than nicotine replacement therapy, even though clear evidence for their effectiveness is still lacking [56,57] and their use was not recommended in the intervention. "
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    ABSTRACT: Background: Young adult smokers are a challenging group to engage in smoking cessation interventions. With wide reach and engagement among users, Facebook offers opportunity to engage young people in socially supportive communities for quitting smoking and sustaining abstinence. Objective: We developed and tested initial efficacy, engagement, and acceptability of the Tobacco Status Project, a smoking cessation intervention for young adults delivered within Facebook. Methods: The intervention was based on the US Public Health Service Clinical Practice Guidelines and the Transtheoretical Model and enrolled participants into study-run 3-month secret Facebook groups matched on readiness to quit smoking. Cigarette smokers (N=79) aged 18-25, who used Facebook on most days, were recruited via Facebook. All participants received the intervention and were randomized to one of three monetary incentive groups tied to engagement (commenting in groups). Assessments were completed at baseline, 3-, 6-, and 12-months follow-up. Analyses examined retention, smoking outcomes over 12 months (7-day point prevalence abstinence, ≥50% reduction in cigarettes smoked, quit attempts and strategies used, readiness to quit), engagement, and satisfaction with the intervention. Results: Retention was 82% (65/79) at 6 months and 72% (57/79) at 12 months. From baseline to 12-months follow-up, there was a significant increase in the proportion prepared to quit (10/79, 13%; 36/79, 46%, P<.001). Over a third (28/79, 35%) reduced their cigarette consumption by 50% or greater, and 66% (52/79) made at least one 24-hour quit attempt during the study. In an intent-to-treat analysis, 13% (10/79) self-reported 7-day abstinence (6/79, 8% verified biochemically) at 12-months follow-up. In their quit attempts, 11% (9/79) used a nicotine replacement therapy approved by the Food and Drug Administration, while 18% (14/79) used an electronic nicotine delivery system to quit (eg, electronic cigarette). A majority (48/79, 61%) commented on at least one Facebook post, with more commenting among those with biochemically verified abstinence at 3 months (P=.036) and those randomized to receive a personal monetary incentive (P=.015). Over a third of participants (28/79, 35%) reported reading most or all of the Facebook posts. Highest acceptability ratings of the intervention were for post ease (57/79, 72%) and thinking about what they read (52/79, 66%); 71% (56/79) recommended the program to others. Only 5 participants attended the optional cognitive-behavioral counseling sessions, though their attendance was high (6/7 sessions overall) and the sessions were rated as easy to understand, useful, and helpful (all 90-100% agreed). Conclusions: A Facebook quit smoking intervention is attractive and feasible to deliver, and early efficacy data are encouraging. However, the 1.5-fold greater use of electronic cigarettes over nicotine replacement products for quitting is concerning.
    No preview · Article · Dec 2015 · Journal of Medical Internet Research
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    • "In NSW, the most common aid used in quit attempts is NRT (approximately 33%), followed by bupropion (13.2%), with very small proportions of smokers reporting that they used behavioural aids such as telephone helplines [4,8]. Despite the increasing availability and marketing of pharmacological and behavioural interventions, population studies consistently show that the largest proportion of smokers who permanently quit smoking do so without any form of assistance [3,6,8-12]. That is, the most common method used by people who have successfully stopped smoking remains unassisted cessation (cold turkey or reducing before quitting). "
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    ABSTRACT: Increasing rates of smoking cessation is one of the most effective measures available to improve population health. To advance the goal of increasing successful cessation at the population level, it is imperative that we understand more about smokers' use of cessation methods, as well as the helpfulness of those methods in real-world experiences of quitting. In this survey of recent quitters, we simultaneously examined rates of use and perceived helpfulness of various cessation methods. Recent quitters (within 12 months; n = 1097) completed a telephone survey including questions relating to 13 cessation methods. Indices of use and perceived helpfulness for each method were plotted in a quadrant analysis. Socio-demographic differences were explored using bivariate and multivariate analyses. From the quadrant analysis, cold turkey, NRT and gradual reduction before quitting had high use and helpfulness; GP advice had high use and lower helpfulness. Prescribed medication and online programs had low use but high helpfulness. Remaining methods had low use and helpfulness. Younger quitters were more likely to use unassisted methods such as cold turkey; older or less educated quitters were more likely to use assisted methods such as prescribed medication or advice from a general practitioner. The majority of recent quitters quit cold turkey or cut down before quitting, and reported that these methods were helpful. Efforts to influence population smoking prevalence should attempt to provide support and motivation for smokers choosing these methods, in addition to assessing the effectiveness and accessibility of other methods for smokers who need or choose them.
    Full-text · Article · Jul 2011 · BMC Public Health
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    • "Gilpin and Pierce [13], in their more extensive study of the whole US population from 1950 to 1990, also showed an increasing incidence of smoking cessation, but also noted that the age group which had higher quit rates varied over the years, for example, middle aged smokers (35–50), had a higher quit rate that younger smokers in 1960–1965. Solberg et al. [14] studied the educational background of young adult smokers (age 18–24 years) in the US, and concluded that the level of interest in quitting, number of quit attempts, and relapse rates did not depend on educational level, although higher educational level was associated with a lower proportion of smokers. Macy et al. [15], studying a similar group, showed that 33% of long-term quitters who had quit for over 1 year, had relapsed by 5 years. "
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    ABSTRACT: The greatest risk factor for lung cancer is smoking, the second largest factor being raised radon levels at home. Initiatives to stop smoking and reduce domestic radon levels have met with some success, but in both cases a significant proportion of those affected have not taken action. The two risk factors combine, so that those who smoke and live in a house with high radon levels are at higher risk than if exposed to only one of the two threats. There is the potential for combined public health campaigns to better target those affected. Using postal questionnaires, we collected demographic information of those in Northamptonshire, UK, a radon Affected Area, who participated in Smoking Cessation Programmes, and compared these to a recent study by our group of those who had taken action to reduce radon. The comparison suggests that these two groups are significantly different, and in some cases differ from the general population. In addition, those who continue to quit smoking at 1 year were more likely to have children under 18 at home, and live with a parent or partner compared to those who had relapsed after the previous assessment at 4 weeks. There is merit in extending Smoking Cessation Programmes to include advice on reducing the risks from radon.
    Full-text · Article · Dec 2009 · Health Policy
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