Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco
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Comparative Study
Determination of carcinogenic tobacco-specific nitrosamines in mainstream smoke from U.S.-brand and non-U.S.-brand cigarettes from 14 countries.
Tobacco-specific nitrosamines (TSNAs) comprise one of the major classes of carcinogenic compounds in mainstream cigarette smoke. As part of collaborative efforts between the World Health Organization and the U. S. ⋯ In only one country, Brazil, were the carcinogenic TSNA levels in mainstream smoke from Marlboro cigarettes significantly lower than in the locally popular brand. However, carcinogenic TSNA levels in mainstream smoke from Brazilian Marlboro cigarettes were usually lower than those in mainstream smoke from the Marlboros purchased in the other 13 countries, suggesting a reason for the difference. The wide range of mainstream smoke carcinogenic TSNA levels measured in the present study (8.7-312 ng/cigarette) suggest that manufacturers can lower the carcinogenic TSNA levels and that, for similar filter ventilation, carcinogenic TSNA levels in the tobacco filler of a cigarette are a useful indicator of the corresponding levels in mainstream smoke.
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The present study examined the relationship between recent smoking cessation activities and sociodemographic characteristics, smoking intensity, and tobacco control policies among daily smokers in the United States. The study used the U. S. ⋯ The results indicate that certain types of smokers are more likely to attempt to quit and to have success and that the characteristics of these smokers differ. Price policies can have an important role in helping daily smokers to quit. Further research is needed regarding the role of quantity smoked.
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Average daily cigarette consumption has decreased, and some evidence suggests that the rate of "some day" smoking has increased; however, relatively little is known about low-level smokers. The present analysis describes and compares low-level versus heavier smokers, using cross-sectional and longitudinal data. Data from the Community Intervention Trial for Smoking Cessation (COMMIT) were used in this analysis. ⋯ Those who smoked full-priced premium brands and who worked in a completely smoke-free worksite were more likely to be low-level smokers. Compared with heavier smokers, low-level smokers had similar rates of making a future quit attempt, lower use rates of nicotine replacement therapy, and higher cessation rates. Low-level smokers may be a growing segment of the smoker population and have different characteristics, health risks, and intervention needs compared with their heavier smoking counterparts.
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This study is the first to characterize tobacco-related content in pharmacy school curricula in the United States. A national survey mailed to 83 U. S. schools of pharmacy assessed the extent to which tobacco is addressed in required coursework, educational methods of instruction, perceived importance of addressing tobacco in the doctor of pharmacy degree program, perceived adequacy of current levels of tobacco education in curricula, and perceived barriers to enhancing the tobacco-related content. ⋯ Key barriers to enhancing tobacco training are lack of curriculum time and lack of clinical clerkship sites focusing on tobacco interventions. Pharmacy faculty members perceive tobacco cessation training to be important, yet a mismatch exists between the perceived importance and the perceived adequacy of current levels of training in pharmacy school curricula. The results of this study will serve as a baseline measure against which future, parallel assessments will be compared as faculty at schools of pharmacy across the United States work together toward enhancing the tobacco cessation training of student pharmacists.
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U. S. Public Health Service (USPHS) clinical guidelines for tobacco treatment recommend that providers routinely counsel smokers using a five-step algorithm (5A's): ask about tobacco use, advise smokers to quit, assess interest in quitting, assist with treatment, and arrange follow-up. ⋯ Satisfaction with overall health care increased as counseling intensity increased. Patient reports of smoking cessation interventions delivered during primary care practice are associated with greater patient satisfaction with their health care, even among smokers not ready to quit. Providers can follow USPHS guidelines with smokers without fear of alienating those not yet considering quitting.