Parental Smoking and the “Epidemic” Spread of Cigarette Smoking1

“Epidemic” models of transitions between stages of cigarette smoking describe the spread of smoking behavior through face-to-face encounters. An epidemic model was successfully fitted that allowed epidemic parameters to be conditioned on the smoking status of adolescents' parents. Model comparisons supported the conclusion that the transition from nonsmoker to trier involved social contacts, whereas the transition from trier to regular smoker was best modeled as a constant rate (i.e., did not depend on the population prevalence of smokers). The transition rate from nonsmoker to trier was more rapid in children of smoking parents than in children of nonsmoking parents. Adolescents with and without smoking parents did not differ in the rate of transition from trier to regular smoking.     

Adolescent Nonsmokers,Triers, and Regular Smokers' Estimates of Cigarette Smoking Prevalence: When Do Overestimations Occur and by Whom?1

The present study tested three assumptions often made by smoking prevention researchers and practitioners regarding the nature and causes of smoking prevalence estimates. Specifically, it is often assumed that (a) adolescent prevalence estimates of all levels of smoking are inflated, (b) youths at different stages of smoking onset all overestimate smoking prevalence, and (c) the predictors of these estimates are the same for youths at different stages of smoking onset. Measures of smoking behavior based on self-reports using a bogus pipeline procedure, estimates of cigarette smoking prevalence (trying behavior and weekly use), and reports of smoking in significant others were obtained by the same youths when they were in eighth and ninth grades. Results indicated that, taken over all youths, estimates of trying cigarettes were accurate, whereas estimates of weekly use were inflated. When responders were defined by their stage of smoking onset, either as a nonsmoker, trier, or regular smoker, analyses revealed that triers were accurate regarding prevalence estimates of trying, whereas non-smokers made gross underestimations and regular smokers made overestimations of trying. All groups of youths overestimated prevalence of weekly smoking. Analyses of variance revealed that both youths' smoking status and interpersonal smoking environment additively predicted prevalence estimates, and estimates of smoking prevalence were relatively higher in youths who began to smoke, or increased their levels of smoking, within the next year. Thus, previous assumptions were partially confirmed. Future research and prevention programming should focus more on regular smoking as the focus of normative smoking distortion effects and correction efforts.     

Nonsmokers' Attributions for the Outcomes of Smokers: Some Potential Consequences of the Stigmatization of Smokers1

The current research examines intergroup attributional biases made by nonsmokers for the outcomes of smokers. Nonsmokers were asked to make attributions for either the success or failure of either an in-group member (a nonsmoker) or an out-group member (a smoker). Overall, subjects attributed the preponderance of cause for the outcomes to external or unstable (approximately 80%) rather than internal (approximately 20%) factors. However, results confirmed the expected in-group protective and in-group enhancing attributions on the part of nonsmokers. Specifically, nonsmokers attributed a significantly higher proportion of success to external factors and a lower proportion of success to internal factors when the target was a smoker compared to when the target was a nonsmoker. The implications of these results for smokers and smoking policy are discussed.     

A population study of low-rate smokers: quitting history and instability over time.

This study used 1 longitudinal and 2 cross-seconal population surveys to compare stability of low-rate daily smokers (less than 5 cigarettes per day) with other daily smokers and occasional smokers. Few low-rate smokers maintained consumption level; 36% retained smoking status after 20 months, compared with 82% and 44% for regular daily and occasional smokers, respectively. In a dynamic process, established smokers quit smoking and/or modified (decreased or increased) consumption. Low-rate and occasional smokers quit at higher rates than regular daily smokers (odds ratios 3:1) but were replenished by new members, many converted from regular daily smoker. The overall trend is an increasing proportion of low-consumption smokers while smoking prevalence declines. The dynamic process has implications for tobacco control efforts and for addiction theory.     

Smoking and psychological health in relation to country of origin

In English-speaking, Western-Anglo countries, where smoking has become stigmatized in recent decades as a result of widespread anti-smoking campaigns, smokers commonly report poorer psychological health on average than nonsmokers do. This may be indirectly related to the strong pressures to quit in such countries, as poorer psychological health is associated with a reduced likelihood of quitting, thus leading to a selection bias for smokers with relatively poorer psychological health. In the present study, 147 smoker and nonsmoker participants either came from Western-Anglo countries where smoking has become stigmatized (Australia, Canada, USA) or countries in regions where smoking remains relatively more accepted (Asia, Latin America, Europe). Smokers and nonsmokers were assessed on a widely used self-report measure of anxiety, depression, and stress. Multivariate analysis revealed a significant interaction between smoker status (smoker, nonsmoker) and country of origin (Western-Anglo, other) on psychological health ratings, with univariate analysis showing a significant interaction on anxiety scores. Among those from Western-Anglo countries, smokers reported significantly higher levels of anxiety than nonsmokers did, whereas there was no difference in anxiety between smokers and nonsmokers from other countries. There was no difference in the number of cigarettes smoked per day between the samples of smokers, indicating very similar levels of nicotine intake in the two groups. The findings support the notion that a selection bias for smokers with relatively poorer psychological health is occurring in Western-Anglo countries.     

College students’ prejudicial biases against instructors who smoke cigarettes

In an investigation of students’ prejudicial biases against instructors who smoke, 61 female and 16 male undergraduates watched and listened to a 20-min lecture about parasomnias, completed a survey asking for instructor evaluation ratings and ratings of perceived learning, and completed a lecture-retention test with multiple-choice questions to assess actual learning. In a between-subjects design, the lecture was given by either a man or woman, who was portrayed as a smoker or nonsmoker. The instructors’ sex and smoking status did not affect the students’ perceived or actual learning (all p’s > .05). However, a significant interaction on the instructor evaluation ratings revealed that students rated the female instructors equivalently (p = .78), but rated the smoker male instructor significantly lower than the nonsmoker male instructor (p = .01). These findings suggest that students hold prejudicial biases against male instructors who smoke, but that these biases do not affect student learning.     

SMOKING AND SELF-CONCEPT IN YOUNG ADULTS: AN IDIOGRAPHIC METHOD OF MEASUREMENT

An idiographic repertory grid method of measuring self-concept was used in a nomothetic design to study the relation between smoking behavior and four components of self-concept: real self, ideal self, social self, and ideal social self. Personal constructs were elicited from 32 smoker and 32 nonsmoker male and female college students. Differences between smokers and nonsmokers on all four components of self-concept supported the criterion-related validity of the measures. Implications were discussed for the assessment method and clinical practice.     

Evaluation of the school-based smoking-prevention program "BE smokeFREE"

This article examines the impact of the school-based smoking-prevention program "BE smokeFREE" on adolescent smoking. A national representative sample of 99 schools (195 classes, 4,441 students) was used when the intervention started in November 1994. Schools were allocated to one of four groups: a comparison group (A) and three intervention groups (B, C, and D). Group B received the most comprehensive intervention. A baseline (autumn 1994) and three follow-up data collections (1995, 1996, and 1997) were conducted. There were no significant differences in smoking habits among the four groups at baseline. The smoking habits in the group that was involved in the most comprehensive intervention (group B) changed more favourably than those of students in the comparison schools over the three follow-up data collections. At the third follow-up, the proportion of students smoking weekly or more in the comparison group was 29.2%, compared with 19.6% in the model intervention group. The two less comprehensive interventions (no teacher in-service courses in group C, and no involvement of parents in group D) appeared to be less effective than the model intervention. Multilevel multiple logistic regression analyses, comparing changes in smoking habits between students in group B with those among students in the comparison schools, confirm the conclusion that the comprehensive intervention was the most effective. This school-based intervention, based on a social influence approach, proved to be effective at reducing smoking rates among participants.     

吸烟者感知吸烟社会规范与社交性吸烟行为的关系：身份认同和关系观的作用

考察吸烟者身份认同和关系观在感知吸烟社会规范与社交性吸烟行为关系中的作用。对1016名吸烟者进行问卷调查,结果表明：（1）感知吸烟社会规范显著正向预测社交性吸烟;（2）身份认同对感知吸烟社会规范和社交性吸烟关系起部分中介作用;（3）关系观正向调节感知吸烟社会规范和社交性吸烟的关系,而对感知吸烟社会规范和身份认同关系的调节不显著。研究支持了感知吸烟社会规范影响社交性吸烟的身份认同机制和文化价值观调节机制。     

Social influences on smoking in middle-aged and older women

The purpose of this study was to examine the role of 2 types of social influence--general social support and living with a smoker--on smoking behavior among middle-aged and older women in the Women's Health Initiative (WHI) Observational Study. Participants were postmenopausal women who reported smoking at some time in their lives (N=37,027), who were an average age of 63.3 years at baseline. Analyses used multiple logistic regression and controlled for age, educational level, and ethnicity. In cross-sectional analyses, social support was associated with a lower likelihood and living with a smoker was associated with a higher likelihood of being a current smoker and, among smokers, of being a heavier smoker. Moreover, in prospective analyses among baseline smokers, social support predicted a higher likelihood and living with a smoker predicted a lower likelihood of smoking cessation 1-year later. Further, in prospective analyses among former smokers who were not smoking at baseline, social support predicted a lower likelihood and living with a smoker predicted a higher likelihood of smoking relapse 1-year later. Overall, the present results indicate that social influences are important correlates of smoking status, smoking level, smoking cessation, and smoking relapse among middle-aged and older women.     

An Attributional Analysis of Gender and Cancer-Related Stigma

This experiment examined the impact of gender on cancer-related stigma from Weiner’s (An attributional theory of motivation and emotion. Springer, New York, 1986) attributional perspective. Undergraduates (n?=?204; 59% female; 71% White) and community members (n?=?85; 62% female; 64% White) in the northeastern U.S. were assigned randomly to listen to an audiotaped interview of a target person with lung cancer in which gender and smoking status (nonsmoker, smoker, or unspecified) were manipulated. Participant and target gender predicted participants’ perceptions of disease controllability and anger toward the target person. The target person’s smoking status also predicted participants’ perceptions of disease controllability and emotional responses to the target person. Findings partially support Weiner’s (An attributional theory of motivation and emotion. Springer, New York, 1986) theory and suggest that the relationship between gender and cancer-related stigma deserves further investigation.     

A Q-methodological study of smoking identities

In contrast to the psychological literature on adolescent smoking, little research has investigated the social identities of adult smokers. This study aimed to identify shared ‘smoking identities’ amongst a sample of 64 British smokers from different socio-economic groups using Q-methodology. Participants were asked to sort 70 items concerning smoking and smokers according to their agreement/disagreement with them. The 64 Q-sorts were then subjected to a by-person factor analysis yielding six factors, with the first four interpretable factors being presented here. Each factor is understood to represent a distinct ‘identity position’. The first two, the ‘addicted’ smoker, and the ‘in control’ smoker, oriented around a biomedical model of smoking as an addictive health risk. The final two, the ‘no big deal’ smoker and the ‘proud’ smoker reflected alternative understandings and values. The identity positions also differed in the extent to which smoking was considered a core part of self-identity. Unpacking the ‘smoking identities’ of current smokers offers the opportunity to devise targeted health promotion.     

An association between the DAT1 polymorphism and smoking behavior in young adults from the National Longitudinal Study of Adolescent Health.

Associations between smoking behavior and polymorphisms in the dopaminergic genes (DAT1 and DRD2) were tested by using within- and between-family measures of allelic transmission in 2,448 young adults from the National Longitudinal Study of Adolescent Health. The 9-repeat allele of the dopamine transporter gene polymorphism (DAT1) was inversely associated with smoking in samples that included all subjects and only those who had initiated smoking, accounting for approximately 1% of the variance. Never smokers and current nonsmokers had an excess transmission of the 9-repeat allele compared with regular smokers, suggesting a protective effect of the 9-repeat allele, which is hypothesized to alter synaptic dopamine levels.     

CONTINGENT REINFORCEMENT FOR CARBON MONOXIDE REDUCTION: WITHIN-SUBJECT EFFECTS OF PAY AMOUNT

The relationship between reinforcer amount and daytime smoking reduction in smokers offered money for reduced afternoon breath carbon monoxide (CO) levels was examined. Twenty-three hired regular smokers with average baseline CO levels of about 30 ppm were exposed in random order to five sliding scale payment schedules that changed daily or weekly. Money was available for afternoon CO readings between 0 and 21 ppm with pay amount inversely related to the absolute CO reading obtained. Maximum pay amount for readings below 7 ppm varied among $0, $1.50, $3, $6, and $12 per day. Contingent reinforcement promoted CO and daytime cigarette reduction within individuals with the amount of behavior change related to the amount of payment available. Average CO levels decreased from 30 to 15 ppm as a function of pay amount whereas self-reported daytime cigarettes decreased from 12 to 5 per day. Average minutes of cigarette abstinence prior to the afternoon study contact increased from 62 to 319 minutes as a function of pay amount, whereas the percentage of available money earned increased from 22% to 48%. Nontargeted evening cigarette use also decreased during periods of daytime smoking reduction. The orderly effects of this contingent reinforcement intervention on daytime smoking of regular smoker volunteers suggest that this is a sensitive model for continued evaluation of factors that influence smoking reduction and cessation.     

吸烟利弊权衡对戒烟计划的预测作用：一个有调节的中介模型

考察吸烟利弊权衡对戒烟计划的预测,以及戒烟意愿的中介作用和未来取向的调节作用。对340名吸烟者进行问卷调查结果的统计分析发现：（1）吸烟利弊权衡显著正向预测戒烟计划;（2）戒烟意愿对吸烟利弊权衡和戒烟计划的关系起完全中介作用;（3）未来取向负向调节吸烟利弊权衡和戒烟计划的关系,但对吸烟利弊权衡和戒烟意愿关系的调节不显著。这些结果说明,吸烟者戒烟计划发展经历前决策和前行动阶段,且该过程受未来取向的调节。     

What is the right thing at the right time? Interactions between stages and processes of change among smokers who make a quit attempt.

C. A. Perz, C. C. DiClemente, and J. P. Carbonari (1996) claim support for the transtheoretical model notion that success in smoking cessation involves doing the right thing at the right time: emphasising experiential change processes during the contemplation and preparation stages and shifting to behavioral process activities during action. A key methodological limitation of Perz et al. was their failure to control for stage of change, a measure that has been shown to be predictive of cessation. This study replicates the prospective findings of Perz et al. in a different data set, then controls for stage of change when it is predictive of cessation, and finds that the measures of "appropriate" change process use developed by Perz et al. no longer predict cessation. The authors conclude that stage of change, in particular the distinction between smoking and not smoking, is more important than change process use in predicting cessation outcomes.     

Childhood self-regulatory skills predict adolescent smoking behavior

Cigarette smoking is the primary preventable cause of premature death. Better self-regulatory capacity is a key psychosocial factor that has been linked with reduced likelihood of tobacco use. Studies point to the importance of multiple forms of self-regulation, in the domains of emotion, attention, behavior, and social regulation, although no work has evaluated all of these domains in a single prospective study. Considering those four self-regulation domains separately and in combination, this study prospectively investigated whether greater self-regulation in childhood is associated with reduced likelihood of either trying cigarettes or becoming a regular smoker. Hypotheses were tested using longitudinal data from a cohort of 1709 US children participating in the Panel Study of Income Dynamics – Child Development Supplement. Self-regulation was assessed at study baseline when children ranged in age from 6 to 14 years, using parent-reported measures derived from the Behavior Problems Index and Positive Behavior Scale. Children ages 12–19 self-reported their cigarette smoking, defined in two ways: (1) trying and (2) regular use. Separate multiple logistic regression models were used to evaluate odds of trying or regularly using cigarettes, taking account of various potential confounders. Over an average of five years of follow-up, 34.5% of children ever tried cigarettes and 10.6% smoked regularly. Higher behavioral self-regulation was the only domain associated with reduced odds of trying cigarettes (odds ratio (OR) = .85, 95% confidence interval (CI) = .73–.99). Effective regulation in each of the domains was associated with reduced likelihood of regular smoking, although the association with social regulation was not statistically significant (ORs range .70–.85). For each additional domain in which a child was able to regulate successfully, the odds of becoming a regular smoker dropped by 18% (95% CI = .70–.97). These findings suggest that effective childhood self-regulatory skills across multiple domains may reduce future health risk behaviors.