nntpp-announce Messages: Lists

Background: Cigarette smoking prevalence among gay men is twice that of population levels. A pilot community-level intervention was developed and evaluated aiming to meet UK Government cessation and cancer prevention targets. METHODS: Four 7-week withdrawal-oriented treatment groups combined nicotine replacement therapy with peer support. Self-report and carbon monoxide register data were collected at baseline and 7 weeks. N = 98 gay men were recruited through community newspapers and organizations in London UK. RESULTS: At 7 weeks, n = 44 (76%) were confirmed as quit using standard UK Government National Health Service monitoring forms. In multivariate analysis the single significant baseline variable associated with cessation was previous number of attempts at quitting (OR 1.48, p = 0.04).

Conclusions: This tailored community-level intervention successfully recruited a high-prevalence group, and the outcome data compares very favorably to national monitoring data (which reports an average of 53% success). Implications for national targeted services are considered.

2) Quit Attempts among African American Teenage Smokers Seeking Treatment: Gender Differences

Moolchan ET, Schroeder JR.

Prev Med. 2004 Dec;39(6):1180-6.

Background: African Americans experience disproportionate smoking-related mortality. Because established smoking during youth predisposes to adult smoking and serious health consequences, characterizing ethnic differences in adolescent smokers' self-quit attempts may inform ethnic-specific approaches to youth smoking cessation. Methods. African American and European American teenage smokers applying to a teenage smoking cessation study (2000-2003) provided smoking-related data, including characteristics of previous cessation attempts and prior use of nicotine replacement therapy (NRT). Tobacco dependence was assessed using the Fagerstrom Test of Nicotine Dependence (FTND). Results. Of 980 (15.5 +/- 1.3 years, 41.8% African American, 59.9% female) participants, African Americans boys were significantly less likely than European American boys to report a prior quit attempt (OR = 0.35, 95% CI 0.17-0.73, P = 0.0049) or to have used NRT (OR = 0.60, 95% CI 0.36-0.998, P = 0.049) after adjusting for years smoked and FTND score. African American girls were more likely to report a prior request for cessation treatment than European American girls after adjusting for FTND and years smoked (OR = 2.19, 95% CI 1.37-3.48, P = 0.001).

Conclusions: While increasing education and outreach to African American boys and enhancing access to formal cessation programs for African American girls who smoke may be beneficial, our findings warrant extension to non-treatment-seeking teenage smokers.

3) Montana Doctor Stresses Link between Smoking, Heart Disease

By John Heys, Staff writer

Charleston, WV Gazette

December 7, 2004

Just one cigarette can increase the risk of a heart attack — for smokers and those around them — according to a physician from Montana who spoke in Charleston, WV on Monday. Dr. Richard P. Sargent made headlines in 2003 when he and two research partners studied the number of hospital admissions for heart attacks in Helena, Mont., before and after a strict smoking ban approved by voters went into effect.

Sargent gave the keynote address at the start of a two-day conference held by the West Virginia Division of Tobacco Prevention at the Embassy Suites in downtown Charleston, WV. Citing his own work and other researchers’ findings, Sargent said Monday tobacco’s effects on the heart are just as alarming as its connection to lung and other cancers — for those who smoke and those around them. “It’s not just the barfly,” Sargent said. “It’s every one of us.” Cigarette smoke makes the heart work harder at the same time it robs the muscle of its strength, he said. The habit makes the heart “weaker and stiffer,” Sargent said: arteries grow thicker, plaque forms more rapidly and the process cells use to make energy is stunted. The result is a doubling of the risk for heart attack in the 48 hours after exposure to cigarette smoke, said Sargent, who helped lead the effort to pass Helena’s stronger smoking ban in 2002. Sargent’s study found a 40 percent drop in hospital admissions for heart attacks in the six months after Helena’s new ban became law in 2002 compared to previous rates. At the same time, rates in areas near Montana’s capital without smoke-free regulations showed no change.

Although many tobacco prevention advocates have lauded Sargent’s results, the study had some limitations, noted by its authors. The researchers did not measure how much the exposure to secondhand smoke changed as a result of the smoking ban. The sample size for the research was also small, and the study was not a randomized controlled trial.

Sargent presented the results of the Helena study in April 2003 at meeting of the American College of Cardiology. The study was published a year later in the British Medical Journal.

Helena’s strong ban on smoking in public places, including bars, restaurants and casinos, went into effect in June 2002. Six months later, a court order suspended it. Although the ban is not currently enforced, most of the city’s restaurants have remained smoke free, Sargent said. Bars and casinos, however, now allow smoking.

Sargent urged audience members Monday to continue their work on tobacco prevention, especially in their communities and with their lawmakers. “Their duty is to protect the health of voters,” Sargent said. In some states, legislators have taken away the authority of local governments and health boards to enact smoking bans.

NNTPP Note: Montana now ranks among the country’s poorest states and is experiencing high unemployment and a lack of industry jobs. In addition, Montana ranks within the top three states in the country with the highest smokeless tobacco use rate.

4) Smoker Psychology Smoking and Socioeconomic Status

Source: TDO: Tobacco Documents Online, 2004-11-19

Date: Jun 1973

This confidential Philip Morris internal report on "smoker psychology" explores the relationship between socioeconomic status and smoking. It finds that: "Lower class panelists smoke more and are much more likely to be smokers than upper class panelists..." It also found that lower class people tend to smoke non-filtered cigarettes (tend to "avoid health filters") and that they also tend to avoid 100 millimeter-length brands.

The writers also observe that lower class people have more incidence of poor mental health, hypothesizing that people use smoking as a "strategy" to combat the stress of low class status as well as poor mental health: "...the incidence of poor mental health is greatest among the lower class...To the extent that smoking is one of the available strategies people can adopt to combat stress, we therefore would expect greater incidence of smoking among the lower social classes." . . .

Despite Philip Morris' internal findings of higher smoking rates among lower socioeconomic classes, as well as its findings that this group also has a higher incidence of both poor mental and physical health, it continued to promote its deadly and addictive products heavily among these groups. One must question whether this violates state charters for incorporation, which generally require that a corporation does not harm the population.

5) NNTPP – Case Studies and Focus Group Summary Now Available

The National Network on Tobacco Prevention and Poverty announces the release of two case studies written in collaboration with two of our national Stakeholder organizations. Tobacco Policy, Cessation, and Education in Correctional Facilities Case Study highlights NNTPP’s collaboration with the National Commission on Correctional Health Care and a joint survey conducted among correctional facilities across the United States to examine tobacco use policies and cessation programming. Integrating Tobacco Control into The Salvation Army’s Substance Abuse Training Curriculum Case Study focuses on NNTPP’s collaboration with The Salvation Army. It describes our efforts to integrate nicotine addition treatment into The Salvations Army’s alcohol and substance abuse treatment programs.

In addition, NNTPP also released a summary report of our focus group data collected in collaboration with West Virginia University-Prevention Research Center titled Smoking Habits and Prevention Strategies in Low Socio-economic Status Populations. The objectives of the focus groups were to review the social and cultural nuances that support/encourage smoking in low SES populations, identify communication channels most effective in reaching this population with tobacco cessation/prevention messages, and to tailor prevention messages to reach low SES adults.

Copies of the case studies and the focus group summary may be obtained by calling the Health Education Council, toll-free at 1(888) 442-2836 or emailing nntpp@healthedcouncil.org ..

6) Funding Update

The American Legacy Foundation has announced funding for several initiatives to support tobacco cessation activities. New awards to nine organizations totaling more than $680,000 are a part of the program “Circle of Friends: Uniting to Be Smoke-Free,” which will support tobacco education, cessation, and prevention efforts involving women. In addition, Legacy will support a collaborative care project developed by the University of New England/Spurwick Center for Research in Portland, ME and Counseling Services, Inc. The effort will address tobacco and its link to mental illness in underserved communities.

7) Upcoming Events

19^th National Conference on Chronic Disease Prevention and Control

Health Disparities: Progress, Challenges, and Opportunities

March 1-3, 2005 – Atlanta, GA

Updates in Correctional Health Care

Presented by the National Commission on Correctional Health Care

April 9-12, 2005 - Flamingo Hotel Las Vegas, NV (773) 880-1460

New England Regional Minority Health Conference

April 10 & 11 and 12, 2005 - Portland, Maine

Information: michellesurdoval@yahoo.com

National Conference on Tobacco or Health

May 4-6, 2005 – Chicago, IL

American Public Health Association Annual Meeting
Evidence-Based Policy and Practice
November 5-9, 2005 - New Orleans, LA
Abstract submission begins: December 17, 2004
Abstract submission deadline: February 7-11, 2005

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