RESUMEN
Almost 20% of Californian smokers do not smoke daily. Although occasional (non-daily) smoking occurs during uptake, a stable pattern of occasional smoking may imply a milder level of nicotine addiction. We use a longitudinal population sample of smokers interviewed in both 1990 and 1992 to evaluate the stability of occasional smoking. Further, we use 1992 data, including smokers only interviewed in 1992, to compare occasional smokers who have (ever-daily) and have not (never-daily) smoked daily for at least 6 months, and contrast them to daily smokers for key variables associated with addiction. All our analyses exclude uptake smokers. Two-thirds of never-daily occasional smokers in 1992 also smoked occasionally in 1990, compared to only about 40% of ever-daily occasional smokers. Never-daily occasional smokers smoke less than ever-daily ones. They are more often under age 40 years, of Hispanic origin, and were more likely to begin regular smoking beyond their teen years. Demographically, ever-daily occasional smokers were similar to daily smokers except for being more educated. However, both ever-daily and never-daily smokers differed from daily smokers with respect to long-term quitting history, plans to quit, confidence they could quit, and belief they are addicted to cigarettes. Our findings suggest that occasional smoking can be a stable pattern for long periods. Occasional smokers, particularly never-daily ones, appear to be much less addicted to nicotine than daily smokers.
Asunto(s)
Fumar/epidemiología , Adulto , Actitud Frente a la Salud , California/epidemiología , Demografía , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Fumar/psicología , Factores de TiempoRESUMEN
Low-cost generic cigarettes grew dramatically in market share between 1990 and 1993, raising concerns that some smokers might view generics as an alternative to quitting. We report sociodemographic predictors of generic brand choice among a cross-sectional sample of California smokers and investigate changes in brand choice in a longitudinal sample of California smokers between 1990 and 1992. We also focus on brand preferences among California adolescents. One third of smokers who switched cigarette brands between 1990 and 1992 switched to generics. Non-Hispanic whites, rural residents, and lower income smokers were twice as likely to buy generics as other smokers were. Heavy cigarette consumption was strongly associated with smoking generic cigarettes. Women appeared more price-sensitive in cigarette purchasing than men did, and generic brands were the most frequently purchased cigarettes for female smokers older than age 45. Generics were less popular among adolescents than among adults. Generic cigarettes provide a low-cost alternative to price-sensitive smokers, but further studies are needed to establish the role and influence of generic cigarettes on smoking prevalence and public health. Medical Subject Headings (MeSH): smoking, smoking cessation, adolescent behavior, women, prevalence.
Asunto(s)
Fumar/economía , Adolescente , Conducta del Adolescente , Adulto , California/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fumar/epidemiología , Cese del Hábito de FumarRESUMEN
OBJECTIVE: Compare 5-year melanoma survival rates to rates in medical literature. DESIGN: Retrospective. SETTING: Hospital in Tijuana, Mexico. PATIENTS: White adult patients (N = 153) with superficial spreading and nodular melanoma, aged 25-72 years. INTERVENTION: Gerson's diet therapy: lactovegetarian; low sodium, fat and (temporarily) protein; high potassium, fluid, and nutrients (hourly raw vegetable/fruit juices). Metabolism increased by thyroid; calorie supply limited to 2600-3200 calories per day. Coffee enemas as needed for pain and appetite. MAIN OUTCOME MEASURE: 5-year survival rates by stage at admission. RESULTS: Of 14 patients with stages I and II (localized) melanoma, 100% survived for 5 years, compared with 79% of 15,798 reported by Balch. Of 17 with stage IIIA (regionally metastasized) melanoma, 82% were alive at 5 years, in contrast to 39% of 103 from Fachklinik Hornheide. Of 33 with combined stages IIIA + IIIB (regionally metastasized) melanoma, 70% lived 5 years, compared with 41% of 134 from Fachklinik Hornheide. We propose a new stage division: IVA (distant lymph, skin, and subcutaneous tissue metastases), and IVB (visceral metastases). Of 18 with stage IVA melanoma, 39% were alive at 5 years, compared with only 6% of 194 from the Eastern Cooperative Oncology Group. Survival impact was not assessed for stage IVB. Male and female survival rates were identical for stages I-IIIB, but stage IVA women had a strong survival advantage. CONCLUSIONS: The 5-year survival rates reported here are considerably higher than those reported elsewhere. Stage IIIA/B males had exceptionally high survival rates compared with those reported by other centers.
Asunto(s)
Melanoma/dietoterapia , Melanoma/mortalidad , Neoplasias Cutáneas/dietoterapia , Neoplasias Cutáneas/mortalidad , Adulto , Anciano , Terapias Complementarias , Femenino , Humanos , Masculino , Melanoma/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Neoplasias Cutáneas/patología , Tasa de SupervivenciaRESUMEN
OBJECTIVES: In the face of rising costs of surveillance systems, it is time to reexamine the feasibility of including proxy respondents in surveys designed to provide population estimates of smoking prevalence. METHODS: Data are from the California. Tobacco Surveys, which are random-digit dialed telephone surveys. One adult provided demographic information and smoking status for all household residents. Additionally, some adults were selected for in-depth interviews that also included smoking status questions. We matched information from proxy respondents and self-respondents and evaluated smoking status discrepancies between them relative to demographic and other factors (n = 2930 matched pairs) in 1992. We address the potential bias these discrepancies might introduce into the population estimate of smoking prevalence. RESULTS: Overall, the discrepancy between proxy report and self-report was 4.3%, and it increased particularly when the self-respondent reported nondaily smoking or recent quitting. Discrepancies acted in both directions, and the net bias was that the screener survey overestimated smoking prevalence by 0.1% in 1992 (0.3% in 1990). CONCLUSIONS: Smoking status questions can be added to ongoing surveys such as the census or labor force surveys; one adult could provide smoking status for all household members.