The National Youth Tobacco Survey (NYTS) datasets are available for public use, so that researchers and public health managers can explore the data in detail. In addition, states can compare their estimates of prevalence of youth tobacco use with national data.
Health Education Behavior, August 2015. Objectives. Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Method. We examined risk perception responses among a nationally representative sample of young adults (age 18-34 years; n = 2,871, including tobacco and non–tobacco users) from the 2011 National Young Adult Health Survey. Results. Most (57.8%) respondents believed that e-cigarettes were less risky than cigarettes. Respondents were more likely to rate combustible products hookah (24.5%) and cigars (13.9%) as being less risky compared to noncombustible snus (10%) and other smokeless tobacco (SLT) products (7.1%) relative to cigarettes. Few (2.5%) rated menthol cigarettes as less risky. For e-cigarettes, hookah, and SLT, less risky beliefs were significantly higher among ever or current versus never product users. Between 22% and 33% of all respondents believed that SLT, snus, menthol cigarettes, and cigars were more risky than cigarettes, but differences in this belief between current and nonusers of these products were small and insignificant. Younger young adults were more likely to rate e-cigarettes and hookah as being “less risky” and rate cigars and SLT as being “more risky” than older young adults. Conclusion. The public’s views of comparative tobacco risk perceptions vary widely by tobacco product type and age-group. While “less risky” perceptions may be associated with product use, perceptions that products are “more risky” than cigarettes may not necessarily dissuade people from their use.
Substance Use & Misuse (August 5, 2016, Epub ahead of print). Overt and frequent discouragement seems to be less effective in stimulating young people to take an active role in the dialogue with their peers about smoking.
In this paper, the researchers conduct a policy review of current clean indoor air act (CIAA) legislation at the state level, as well as identify legislation pertaining specifically to waterpipe tobacco smoking. To complete this review, they examine state-by-state policy with waterpipe use and allowable exposure. This review provides valuable information for current legislative initiatives and has implications for needed future waterpipe tobacco smoking policy.
This toolkit was developed for a broad continuum of public health care organizations and treatment facilities, particularly those organizations serving persons with mental illnesses and addictions. The materials are intended for administrators, direct providers, and support staff of organizations considering or implementing tobacco-free policies.
From the Ballot Box to the Grocery Store, Nielsen’s fifth report on the Latino consumer in the annual Diverse Intelligence Series, shows that Hispanic power and influence is surging.
The National Youth Tobacco Survey (NYTS) datasets are available for public use, so that researchers and public health managers can explore the data in detail. In addition, states can compare their estimates of prevalence of youth tobacco use with national data.
Multiunit housing residents are at risk of secondhandsmoke exposure from adjoining units and commonareas. We developed this case study to documentstate-level strategies undertaken to address this risk.We explored program documents to identify facilitators,barriers, and outcomes. Three states (Montana,Michigan, and Nebraska) provided detailed informationon multiunit housing efforts in the study timeframe. We conducted a qualitative analysis usinginductive coding to develop themes. Several facilitatorsrelating to existing infrastructure included traditionaland nontraditional partnerships, leadershipand champions, collecting and using data, efficientuse of resources, and strategic plans. We also reportexternal catalysts, barriers, and outcomes. Significantstate leadership and effort were required to providelocal-level technical assistance to engage traditionaland nontraditional partners. Information needs wereidentified and varied by stakeholder type (i.e., healthvs. housing). States recommend starting with publichousing authorities, so they can become resources foraffordable and subsidized housing. These lessons andresources can be used to inform smoke-free multiunithousing initiatives in other states and localities.
The Master Settlement Agreement An Overview provides answers to several common questions about the largest civil litigation settlement in U.S. history, the tobacco Master Settlement Agreement (MSA).
This pilot study was conducted to explore the associations between stressors related to homelessness and modifiable health risk factors (poor diet, insufficient physical activity, and overweight/obesity) and to provide direction for future research. Participants (N = 57) were homeless adults enrolled in a smoking cessation program. Analyses were conducted to characterize the sample as well as the relations between relevant stressors (discrimination, chronic stress, and fear and mistrust) and health risk factors. Inadequate daily consumption of fruits, vegetables, and fiber was common. High-fat diet and insufficient physical activity were also prevalent, and the majority of participants were overweight/obese. Participants commonly endorsed discrimination, fear of victimization, mistrust of others, and several other stressors. Greater endorsement of stressors was associated with a high-fat diet. Results suggest that lifestyle interventions and policy changes may be warranted in homeless shelters to attenuate the potential effects of stressors on high-fat dietary consumption among smokers.
To examine disparities and changes over time in the population-level distribution of smokers along a cigarette quitting continuum among African American smokers compared with non-Hispanic Whites. Methods. Secondary data analyses of the 1999, 2002, 2005, and 2008 California Tobacco Surveys (CTS). The CTS are large, random-digit-dialed, population-based surveys designed to assess changes in tobacco use in California. The number of survey respondents ranged from n = 6,744 to n = 12,876 across CTS years. Current smoking behavior (daily or nondaily smoking), number of cigarettes smoked per day, intention to quit in the next 6 months, length of most recent quit attempt among current smokers, and total length of time quit among former smokers were assessed and used to recreate the quitting continuum model. Results. While current smoking rates were significantly higher among African Americans compared with non-Hispanic Whites across all years, cigarette consumption rates were lower among African Americans in all years. There were significant increases in the proportion of former smokers who had been quit for at least 12 months from 1999 (African Americans, 26.8% ± 5.5%; non-Hispanic Whites, 36.8% ± 1.6%) to 2008 (African Americans, 43.6% ± 4.1%; non-Hispanic Whites, 57.4% ± 2.9%). The proportion of African American former smokers in each CTS year was significantly lower than that of non-Hispanic Whites. Conclusions. Despite positive progression along the quitting continuum for both African American and non-Hispanic White smokers, the overall distribution was less favorable for African Americans. The lower smoking consumption levels among African Americans, combined with the lower rates of successful smoking cessation, suggest that cigarette addiction and the quitting process may be different for African American smokers.
Health Education & Behavior, August 2015. Objective. Evaluate the second flight of the U.S. Tips From Former Smokers (Tips) campaign. Method. Data were analyzed from an online consumer panel of U.S. adult smokers before (n = 1,404) and after (n = 1,401) the 2013 Tips campaign launch. Generalized estimating equation models assessed whether the Tips advertisement recall was associated with knowledge about smoking-related risks in the Tips advertisements, awareness and use of a toll-free quitline and cessation websites, and quit attempts. Results. Seventy-one percent of participants at Wave 2 reported that they recalled seeing at least one Tips advertisement. Smokers who recalled seeing a Tips advertisement were more likely to (a) show increases over baseline in knowledge of health risks such as amputation 65% versus 34%, p < .001; blindness 27% versus 12%, p < .001; and (b) to be aware of a quitline (41% vs. 30%, p < .001) and cessation website (28% vs. 20%, p < .001). Recall of Tips advertisements was also associated with greater likelihood of reporting having visited cessation websites (odds ratio [OR] = 1.62, 95% confidence interval [CI] = 1.27-2.06), having called a quitline (OR = 2.28, 95% CI = 1.61-3.24), and having made a quit attempt (OR = 1.18, 95% CI = 1.00-1.39), although these results were only statistically significant in the unadjusted models. Conclusions. The 2013 Tips campaign was successful in increasing knowledge of health risks and awareness of tobacco cessation resources.
Secondhand tobacco smoke is considered a developmental neurotoxicant especially given underdeveloped vital systems in young children. An ecological test of its negative influence on brain development can be made by examining the prospective association between early childhood household smoke exposure and later classroom behavior. Using a longitudinal birth cohort, we examined the unique contribution of household tobacco smoke exposure to children’s subsequent classroomengagement at age 10. From child ages 1.5 to 7 years, parents of 2,055 participants from the Quebec Longitudinal Study of Child Development reported on household smoking by themselves and other home occupants. At age 10, fourth-grade teachers reported on the child’s classroom engagement. In terms of prevalence, 58% of parents reported that their children were never exposed to smoke in the home, while 34% and 8% of children were exposed to transient and continuous household smoke, respectively. Compared with never exposed children, those who were exposed to transient and continuous household smoke scored 13% and 9% of a standard deviation lower on classroom engagement in fourth grade, standardized B = -.128 (95% confidence interval = -.186, -.069) and standardized B = -.093 (95% confidence interval =-.144, -.043), respectively. Compared with their never exposed peers, children exposed to transient and continuous early childhood household smoke showed proportionately less classroom engagement, which reflects task-orientation, following directions, and working well autonomously and with others. This predisposition poses risks for high school dropout, which from a population health perspective is closely linked with at-risk lifestyle habits and unhealthy outcomes.
his study identified inconsistencies in physical activity(PA) reported at screening and baseline of a 6-monthhealth promotion intervention and explored how theseinconsistencies influenced intervention effectiveness inAfrican American and Hispanic women. Participantscompleted a telephone screener to determine eligibilityfor a PA intervention. Inactive participants (=90 minutesof PA/week) were invited to a baseline assessment,where they completed the International PhysicalActivity Questionnaire, measuring work, transportation,gardening/housework, and leisure-time PA.Women returned after 6 months to complete an identicalpost-intervention assessment. Despite beingscreened as inactive, baseline Questionnaire data indicatedthat 85.0% of participants (N = 274, M age = 44.6years, M body mass index = 34.8 kg/m2) were active(>90 minutes of PA/week). Women who reported anywork-related PA were 20.9 times more likely to beactive at baseline than those who did not (p < .001).Participants who were inactive at both screening andbaseline reported greater increases in domestic andgardening PA and total PA from baseline to postintervention(ps < .05). Overweight/obese ethnic minoritywomen may misreport being physically inactive duringscreening if specific questions about type of PA are notincluded. Post hoc analyses controlling for screeninginaccuracies may improve effectiveness of PA interventionsand help intervention programs reach womenwho may benefit the most.
Geoffrey P. Whitfield, PhD, Prabasaj Paul, PhD, Arthur M. Wendel, MD MMWR Surveill Summ 2015;64(No. SS-7) Active transportation, such as by walking or bicycling, is one way that persons can be physically active. Five surveillance systems assess one or more components of active transportation. Among these systems, active transportation was usually more common among men, younger respondents, and minority racial/ethnic groups. Among education groups, the highest prevalence of active transportation was usually among the least or most educated groups, and active transportation tended to be more prevalent in densely populated, urban areas.
Health Promotion Practice, May 2015. Abstract Afterschool programs (ASPs) have potential to provide children moderate to vigorous physical activity (MVPA). The availability and types (e.g., free play or organized activities) of physical activity opportunities, their structure (e.g., presence of lines, elimination games), and staff behaviors (e.g., encouragement, engaged) can influence children’s MVPA. This study explored these factors in 20 ASPs serving over 1,700 elementary-age children. The occurrence, types, and structure of physical activity opportunities, and staff behaviors were collected via the SOSPAN (System for Observing Staff Promotion of Physical Activity and Nutrition). A total of 4,660 SOSPAN scans were completed across 63 complete program days (1,733 during physical activity opportunities). Physical activity opportunities were observed on 60 program days across all 20 sites, with 73% of those opportunities classified as free play. ASPs scheduled an average of 66.3 minutes (range 15-150 minutes) of physical activity opportunities daily. Games played included basketball, tag, soccer, and football. Staff rarely engaged in physical activity promotion behaviors, and the structure of organized games discouraged MVPA. For example, staff verbally promoted physical activity in just 6.1% of scans, while organized games were more likely to involve lines and elimination. Professional development training may enhance staffs’ physical activity promotion and the structure of activity opportunities.
Objectives. The purpose of this study was to evaluate the effectiveness of the Walk Your Heart to Health (WYHH) intervention, one component of the multilevel Community Approaches to Cardiovascular Health Pathways to Heart Health (CATCHPATH) intervention designed to promote physical activity and reduce cardiovascular risk among non-Hispanic Black and Hispanic residents of Detroit, Michigan. The study was designed and implemented using a community-based participatory research approach that actively engaged community residents, health service providers and academic researchers. It was implemented between 2009 and 2012. Method. WYHH was a 32-week community health promoter–facilitated walking group intervention. Groups met three times per week at community-based or faith-based organizations, and walked for 45 to 90 minutes (increasing over time). The study used a cluster randomized control design to evaluate effectiveness of WYHH, with participants randomized into intervention or lagged intervention (control) groups. Psychosocial, clinical, and anthropometric data were collected at baseline, 8, and 32 weeks, and pedometer step data tracked using uploadable peisoelectric pedometers. Results. Participants in the intervention group increased steps significantly more during the initial 8-week intervention period, compared with the control group (ß = 2004.5, p = .000). Increases in physical activity were associated with reductions in systolic blood pressure, fasting blood glucose, total cholesterol, waist circumference and body mass index at 8 weeks, and maintained at 32 weeks. Conclusion. The WYHH community health promoter–facilitated walking group intervention was associated with significant reductions in multiple indicators of cardiovascular risk among predominantly Hispanic and non-Hispanic Black participants in a low-to-moderate income urban community. Such interventions can contribute to reductions in racial, ethnic, and socioeconomic inequities in cardiovascular mortality.
Afterschool programs (ASPs) have become increasingly recognized as a key context to support youth daily physical activity (PA) accrual. The purpose of the present study was to assess the physical and social-motivational climate characteristics of ASPs associated with youth PA, and variations in contextual correlates of PA by youth sex. Systematic observations of 7 ASPs serving underserved youth (minority, low income) was conducted using the System for Observing Play and Leisure Activity in Youth and a social-motivational climate observation tool founded on self-determination theory. For five program days at each site, teams of two coders conducted continuous observations of youth PA (sedentary, moderate, vigorous), five physical features (e.g., equipment availability), eight staff interactions (e.g., encourage PA), and seven motivational climate components (e.g., inclusive). Aligned with previous research, regressions controlling for variations by site indicated that organized PA, provision of portable equipment, and staff PA participation and supervision are key correlates of youth PA. Moreover, as the first study to systematically observe motivational-context characteristics of ASPs, we identified several key modifiable motivational features that are necessary to address in order to increase youth engagement in PA during the out-of-school hours. Among motivational features assessed, “relatedness” components (positive peer relations, inclusive/cooperative activities) were primary correlates of girls’ PA. In contrast, all three motivational features specified by self-determination theory (support for autonomy, mastery/competence, and inclusion/relatedness) were correlated with boys’ PA. Findings are discussed in terms of policy and practice for understanding strengths and needs of ASPs to effectively engage youth in PA.
The Community Preventive Services Task Force (Task Force) issued separate findings for four types of interventions to increase the availability of healthier meals, snacks, and beverages in schools.
This collection includes eight articles written by CPPW awardees that focus on implementation or evaluation of healthy retail initiatives. The collection is supported by a commentary.