Actual Versus Perceived Risk of Cervical Cancer Among College Women Smokers

Cervical cancer is a well-established smoking-related illness, but many at-risk women are unaware of this link. Objective: The authors designed this study to (1) investigate the relationship of smoking behavior with the history of abnormal Pap test results, sexual history, and perceived risk of cervical cancer and (2) determine whether self-classified smoking status (and hence perceived risk) corresponds with actual smoking behavior in a college student population. Participants and Method Summary: College women students (N = 135) completed a survey assessing smoking history, health history, sexual risk behavior, and risk awareness. Results: Relative to those who had not smoked in the past month, current smokers (n = 36, or 27% of the total sample) perceived themselves to be at higher risk for developing cervical cancer, but did not demonstrate increased awareness of specific cervical cancer risk factors, including smoking. Twenty-eight percent (10 of 36) of past-month smokers did not define themselves as current smokers. Conclusion: The authors conclude that antismoking and health-related messages targeting smokers may misfire for individuals who do not define themselves as smokers but are nonetheless at risk for smoking-related consequences and escalating use.     

Attitudinal and behavioral differences between cigarette users who do and do not identify as “smokers”

Objective: The current research aimed to understand differences in smoking-related identity among college students and to illustrate the distinct characteristics of nonidentified smokers (NIS). Participants: Students from 2 colleges in Massachusetts (N = 538; April 2016). Methods: Respondents reported by online survey whether or not they had smoked a cigarette in the past 30 days and if they self-identified as smokers. Nonsmokers (NIS) and identified smokers (IS) were then compared on their smoking attitudes and behavior. Results: NIS made up 12.5% of the sample and 64% of all tobacco users. NIS perceived themselves as less addicted and were more confident in their ability to quit smoking. They also were less likely to smoke alone, buy their own cigarettes, or have friends who smoked. Conclusions: College health officials can best motivate NIS to quit smoking by focusing on peer norms and the potential of long-term addiction.     

A qualitative study of attitudes, beliefs, and practices among 40 undergraduate smokers

OBJECTIVE: Because little is known about college-age smokers, the authors conducted a qualitative study to better understand this population. PARTICIPANTS: Forty college student smokers from 12 Pacific Northwest colleges participated in the study. METHODS: The authors identified themes and built models to ascertain important factors related to smoking and smoking cessation. Four models emerged: smoking facilitators, smoking barriers, cessation facilitators, and cessation barriers. RESULTS: The authors observed physical, psychological, and social influences across models, and social influences were strongly associated with both smoking and cessation. Many smokers were unlikely to define themselves as regular smokers. Most smokers had made prior quit attempts. CONCLUSIONS: College students are a unique category of smoker and colleges can play a role in helping them achieve cessation.     

Intent to receive an HPV vaccine among university men and women and implications for vaccine administration

OBJECTIVE AND PARTICIPANTS: In 2006, the authors examined intention to receive an HPV vaccine among 340 college students. METHODS: A total of 138 men and 202 women completed questionnaires. The authors measured intention by asking participants how likely they would be to accept an HPV vaccine that prevented against (1) all HPV, (2) cervical cancer but not genital warts, (3) genital warts but not cervical cancer, and (4) both genital warts and cervical cancer. RESULTS: Men and women reported high intent to receive an HPV vaccine, although women did so at a significantly higher rate (77.5% vs 88.6%, respectively; p < .01). Men were less willing to receive a vaccine that prevents cervical cancer alone than they were to receive one that prevents cervical cancer and genital warts (34.1% vs 77.5%, p < .001). Intent to receive the vaccine was significantly greater among participants who reported more than 5 sex partners and correctly answered 2 or 3 HPV knowledge questions. CONCLUSIONS: Interest varied according to sexual history, according to knowledge about HPV, and (in men) according to vaccine target.     

Depressive symptoms and cigarette smoking in a college sample

OBJECTIVE AND PARTICIPANTS: The authors examined (1) the relationship between depressive symptoms and cigarette smoking in a college sample and (2) the role of smoking self-efficacy (one's perceived ability to abstain from smoking) in explaining the relationship between depressive symptoms and cigarette smoking. METHODS: Predominantly first-year college students at a large public university completed a self-report inventory indexing depressive symptoms, cigarette smoking, and smoking self-efficacy. RESULTS: Findings indicated that students high in depressive symptoms smoked significantly more cigarettes per day than did those with low depressive symptoms. Further, among current smokers, smoking self-efficacy explained the relationship between depressive symptoms and cigarette smoking. CONCLUSIONS: These findings add to accumulating evidence that depressive symptoms are a risk factor for increased cigarette smoking in college students. The authors discuss implications for university-based smoking cessation and prevention programs.     

Is Being Popular a Risky Proposition?

Longitudinal associations between social preference, perceived popularity, and risk behaviors (smoking, alcohol use, and sexual activity) were examined in a sample of high school students. Social preference did not predict any of the risk behaviors assessed, although the interaction between gender and social preference was predictive of sexual behavior. Perceived popularity in Grade 10 was predictive of increased alcohol use and sexual activity in Grade 12 for both boys and girls. A reciprocal relationship was found for boys, in which smoking in Grade 10 also predicted gains in perceived popularity over time. Furthermore, results suggested that gains in perceived popularity may be associated with subsequent losses in social preference over time, lending support for the “cycle of popularity” observed by Eder. Implications are discussed, including the personal impact of risk behaviors on perceived popular teens, as well as the broader influence their behavior may have on their less popular counterparts.     

RISK BELIEFS AND SMOKING BEHAVIOR

We analyze smoking risk beliefs and smoking behavior using individual data from 1997 for the United States and 1998 for Massachusetts. Smokers and adults more generally overestimate the lung cancer risks of smoking and the mortality risks and life expectancy loss. Higher risk beliefs decrease the probability of starting to smoke and increase the probability of quitting among those who begin. Better educated smokers have lower and more accurate risk beliefs, but education decreases the probability of smoking. Higher state cigarette taxes correlate with risk beliefs but not with smoking status. The uninsured are especially likely to remain current smokers. ( JEL I12, I18, D80)     

Reciprocal relationships among alcohol use, risk perception, and sexual victimization: a prospective analysis

OBJECTIVE: The authors' purpose in this study was to assess longitudinally the relationships among alcohol use, risk perception, and sexual victimization. PARTICIPANTS: Three hundred and seventy-two women from 2 midsized universities made up the sample. METHODS: Participants filled out questionnaires regarding history of sexual victimization, alcohol use, and perceived personal risk for sexual assault in the following 2 months. The authors then reassessed participants at 2 follow-up periods. RESULTS: The pattern of results suggested that that the relationship between alcohol use and sexual victimization was complex and that alcohol use may moderate the relation between history of victimization and revictimization for women with sexual assault histories. In particular, results indicated an increase in risk for sexual revictimization with increases in alcohol use for women with a history of sexual victimization. The data did not, however, support a reciprocal relationship between sexual assault and drinking (eg, in that a sexual victimization during one time period did not predict drinking behaviors in subsequent time periods). CONCLUSIONS: These results underscore the importance of both alcohol and sexual assault programming on college campuses.     

Depressive Symptoms and Cigarette Smoking in a College Sample

Objective and Participants: The authors examined (1) the relationship between depressive symptoms and cigarette smoking in a college sample and (2) the role of smoking self-efficacy (one's perceived ability to abstain from smoking) in explaining the relationship between depressive symptoms and cigarette smoking. Methods: Predominantly first-year college students at a large public university completed a self-report inventory indexing depressive symptoms, cigarette smoking, and smoking self-efficacy. Results: Findings indicated that students high in depressive symptoms smoked significantly more cigarettes per day than did those with low depressive symptoms. Further, among current smokers, smoking self-efficacy explained the relationship between depressive symptoms and cigarette smoking. Conclusions: These findings add to accumulating evidence that depressive symptoms are a risk factor for increased cigarette smoking in college students. The authors discuss implications for university-based smoking cessation and prevention programs.     

Perceived personal immunity: Beliefs about susceptibility to AIDS

Subjects aged 18–25 were surveyed regarding their beliefs about susceptibility to getting AIDS. Males generally viewed their probability of contracting AIDS under conditions of risky sexual behavior to be significantly lower than did females. Subjects’ risk status was classified based on their recent self‐reported condom use and the number of different partners with whom they had sexual intercourse during the past year. High‐risk males perceived themselves to be at significantly lower risk than others who engaged in the same practices. High‐risk females perceived themselves to be at equal risk to others who engaged in unprotected sex with numerous partners. Condom use was significantly related to subjects’ socioeconomic status. These findings indicate that information about factors that augment risk for contracting HIV may, in and of itself, be insufficient to foster adequate preventive behaviors among many sexually active individuals.     

An E-mail assessment of undergraduates' attitudes toward smoking.

Responses from 513 of 1,000 randomly selected undergraduate students who were sent an e-mail questionnaire, about cigarette smoking were analyzed. Thirteen percent of the respondents identified themselves as smokers. No statistically significant differences were observed between smokers and nonsmokers and year in college, sex, age, race, or having attended public or private high schools. Ninety-eight percent of the respondents considered themselves knowledgeable about adverse health consequences of smoking, yet 39.1% of current smokers seriously considered stopping smoking, and 11.5% of current nonsmokers intended to start smoking. The preferred quitting method of smokers and ex-smokers was stopping all at once ("cold turkey"). Fifty-two percent of the smokers did not want professional assistance to stop smoking; 40% of the nonsmokers wanted information on second-hand smoke.     

Characteristics of social smoking among college students

Social smoking is a newly identified phenomenon in the young adult population that is poorly understood. We investigated differences in social smoking (smoking most commonly while partying or socializing) and other smoking within a convenience sample of college smokers (n = 351) from a large midwestern university. Results revealed that 70% of 351 current (past 30-day) smokers reported social smoking. No significant difference was found in motivation to quit between smoking groups. However, a significant difference was found between groups in confidence to quit, the number of days smoked, and the number of cigarettes smoked on those days. More social smokers than expected did not perceive themselves as smokers. Logistic regression analysis revealed that lower physical and psychological dependence and higher social support scores predicted social smoking.     

Social context and adolescent health behavior: does school-level smoking prevalence affect students' subsequent smoking behavior?

This paper examines the links between individual adolescent smoking behavior and actual and perceived smoking behavior in the individual's school cohort. We hypothesized that students enrolled in schools with higher smoking prevalence among students in their grade are more likely to smoke subsequently. We also expected perceived school-level prevalence of smoking to have a greater impact than actual prevalence because the former is a more direct measure of perceived norms. Adjusting for demographics, actual school-level prevalence at baseline (grade 7) was strongly associated with smoking frequency one year later. However, the association disappeared after adjusting for individual smoking frequency at baseline. School-level prevalence did not moderate the association between individual's baseline and subsequent smoking frequency. Perceived prevalence of smoking among grade 8 students and two measures tapping the behavior of smaller peer groups--cigarette offers and exposure to friends and other peers who smoke--were associated with increased risk of smoking.     

Risk Factors of Sexual Harassment by Peers: A Longitudinal Investigation of African American and European American Adolescents

The present research explores risk factors for, and longitudinal associations of, sexual harassment by peers during adolescence. Eight‐hundred and seventy‐two African American and European American adolescents (65.4% African American, 51.1% females) were assessed during the summer after the eighth grade (mean age=14.2 years) and then again in the 11th grade (mean age=17.1 years). At the first assessment, adolescents were asked about their experiences with sexual harassment, their psychological reactions to sexual harassment, and also about their peer relationships, perceived pubertal timing, problem behavior, and mental health. At the second assessment, adolescents reported on their problem behavior and mental health. In general, youth who associated with peers who were involved in problem behavior were at risk for victimization. Among females, those who perceived themselves to be experiencing early pubertal development were also at risk. Additionally, for some adolescents, sexual harassment predicted later adjustment difficulties.     

Using social norms theory to explain perceptions and sexual health behaviors of undergraduate college students: an exploratory study

The authors and associates conducted a social norms-based intervention targeting high-risk sexual behaviors among undergraduate students at 4 college campuses. Social norms theory predicts that widely held misperceptions may encourage risky behavior in a misguided attempt to conform to perceived norms and that information correcting these misperceptions will lead to a decrease in such behaviors. Students overestimated their peers' levels of sexual activity, numbers of partners, incidence of sexually transmitted infections, and rates of unintended pregnancies, but underestimated rates of condom use. Rates of HIV test taking, however, were accurately estimated. Although some components of sexual risk behaviors lend themselves well to social norms-based interventions, others, specifically inconsistent condom use and avoiding HIV tests, do not. Although no changes in reported beliefs or practices were apparent at the end of a 9-month intervention period, longer or modified interventions may be needed to make a fair assessment of the efficacy of this approach.     

Osteoporosis knowledge and attitudes: a cross-sectional study among college-age students

OBJECTIVE: The authors' purpose in this study was to investigate the influence of knowledge of osteoporosis, attitudes regarding osteoporosis, and knowledge of dietary calcium on dairy product intake in both male and female college-age students. PARTICIPANTS: The authors conducted this cross-sectional study on 911 men and women enrolled in 2 demographically similar universities. METHODS: A modified osteoporosis knowledge questionnaire assessed participant's general osteoporosis knowledge and perceived disease risk. RESULTS: The authors found that knowledge of osteoporosis and calcium did not significantly influence dairy product intake. Attitude regarding osteoporosis was a significant predictor of dairy product intake in men but was not significant for the women. CONCLUSIONS: The authors recommend development and implementation of educational programs designed to increase awareness of calcium-rich food sources as well as other risk factors of this crippling disease.     

The Quest for the Elusive Female Orgasm

Public health information and educational interventions regarding human papillomavirus (HPV) have focused on the link between vaginal sex and cervical cancer among women. Many people are unaware that HPV can be transmitted through oral sex or that HPV causes oral cancers. Given that HPV infections and unprotected oral sex are increasing, research on oral sex-related HPV risk is important. This study examined the effect of a brief informational intervention regarding HPV and oral sex on the sexual risk cognitions of young adults. College students (N = 238) read information on HPV, oral sex, and oral cancer or no information. Participants then completed measures of oral sex and HPV knowledge, oral sex willingness, HPV vaccination likelihood, and risk perceptions. Participants who read the information on HPV and oral sex and cancer (compared to those who did not) reported greater knowledge, perceived risk and concern, and lower willingness to engage in oral sex. These effects were only significant among women. However, men reported a higher likelihood of future HPV vaccination compared to women who had not yet received the vaccine. Focusing on oral sex and cancer, this study adds to research investigating ways to reduce HPV infections.     

Trial and lifetime smoking risks among African American college students

The authors surveyed 614 African American university students to determine the magnitude of cigarette use, identify risk factors, and develop models to predict smoking. More than half (58.3%) of the participants had smoked at least once, and 9.3% of that group were lifetime smokers. Among the lifetime smokers, 71.3% had smoked during the 30 days preceding the survey. More women (66.8%) than men (56.1%) had tried smoking and were classed as lifetime smokers. Residence, parental, and peer smoking (current and childhood) were associated with trying smoking; age, race/ethnicity, and marital status were additional factors for becoming a lifetime smoker. The risk of being a lifetime smoker was reduced when neither friends nor parents of the student smoked and the student viewed spirituality as important. The results of this study add to the growing understanding of health risk behaviors among African Americans and can be useful in reducing smoking.     

The Influence of Trauma History and Relationship Power on Latinas’ Sexual Risk for HIV/STIs

ABSTRACT

A community sample of Latinas completed surveys that included measures of sexual abuse and intimate partner violence history, relationship power, negotiating power regarding condom use, perceived HIV/sexually transmitted infection (STI) risk for sexual partner, and sexual behavior. More than half of the women reported a history of intimate partner violence in the past year and/or sexual abuse in their lifetime. Intimate partner violence was correlated with lower overall sexual relationship power scores, while sexual abuse was correlated with lower condom-use negotiating power. More extensive intimate partner violence had the strongest association with higher HIV/STI risk, while controlling for relationship status, sexual abuse, and relationship power.     

Assessing college students' autonomy over smoking with the Hooked On Nicotine Checklist

OBJECTIVE, PARTICIPANTS, AND METHODS: In this study, the authors explored the psychometric properties of the Hooked on Nicotine Checklist (HONC) among 300 college students who were current smokers. The HONC is a 10-item survey instrument designed to measure diminished autonomy over smoking, a key aspect of dependence. Autonomy is diminished when symptoms present a barrier to cessation. RESULTS: Internal consistency was high (alpha = .89), as was concurrent validity. Students who began smoking earlier and heavier smokers reported more symptoms than did those who started later and smoked less. After controlling for smoking frequency, the HONC was predictive of the likelihood of a failed cessation attempt, with each additional symptom doubling that likelihood. CONCLUSIONS: College health professionals could use the HONC to help new smokers recognize their symptoms of diminished autonomy. The HONC may serve as a recruiting tool for cessation programs, which could benefit such early-phase smokers.