The relationship between individual expectations and behaviors: Mortality expectations and smoking decisions

Using data from the Health and Retirement Study, we assess the accuracy of subjective beliefs about mortality and objectively estimated probabilities for individuals in the same sample. Overall, subjective beliefs and objective probabilities are very close. However, there are differences conditional on behaviors, with current smokers being relatively optimistic and never smokers relatively pessimistic in their assessments. In the aggregate, individuals accurately predict longevity, but at the individual level, subjective beliefs provide information in addition to the estimated objective probabilities in predicting actual events, which may arise from the effect of past or anticipated decisions on these beliefs.

Smoking,information sources,and risk perceptions—New results on Swedish data

Using data on Swedish adolescents, this study examines (1) perceptions of the addictiveness and mortality risk of smoking, (2) the effects of these perceptions on smoking behaviour, and (3) the role of various smoking risk information sources. The average respondent believed that 46 out of 100 smokers would die from diseases caused by their smoking. As to addictiveness perceptions, the average respondent believed that 68 out of 100 smokers trying to quit would not succeed. Both a higher perceived addictiveness and a higher perceived mortality risk were negatively related to smoking participation. The results showed substantial variation in the weight that the teenagers attached to the various information sources.

Life course transitions in early adulthood and SES disparities in tobacco use

A huge literature has documented adult socioeconomic disparities in smoking but says less about how these disparities emerge over the life course. Building on findings that smoking among adolescents differs only modestly by parental SES, we utilize a life course perspective on social differentiation to help explain the widening disparities in smoking in young adulthood. Our theory suggests that achieved socioeconomic status and the nature and timing of adult role transitions affect age-based trajectories of smoking and widen disparities in adult smoking. The analyses use data from the National Longitudinal Study of Adolescent Health, which follows a representative national sample over four waves from ages 11–17 in 1994/1995 to 26–34 in 2007/2008. The results show divergent age trajectories in smoking by parental education and that achieved socioeconomic status and life course roles in young adulthood account in good part for differences in the age trajectories. The findings demonstrate the value of the life course perspective in understanding processes of increasing stratification in health behavior and health during the transition to adulthood.     

老年肺心病患者高危死亡因素分析

目的探讨老年肺心病患者死亡的高危因素.方法回顾性分析198例住院老年肺心病患者临床资料,并进行相关因素分析.结果1.死亡组平均年龄、病程、吸烟指数、体重指数(BMI)、入院时氧合指数(PaO2/FiO2)、二氧化碳分压(PaCO2)、pH、ls用力呼气容积占预计值百分比(FEV1%)和FEV1/用力肺活量(FEV1/FVC)与缓解出院组比较,具有显著性差异;2.缓解出院组以单纯性酸碱失调为主,且以呼酸为多,而死亡组主要表现为混合性酸碱失调.结论测定相关指标,加强监护与治疗,对老年肺心病患者预后至关重要.     

Understanding the links between education and smoking

This study extends the theoretical and empirical literature on the relationship between education and smoking by focusing on the life course links between experiences from adolescence and health outcomes in adulthood. Differences in smoking by completed education are apparent at ages 12–18, long before that education is acquired. I use characteristics from the teenage years, including social networks, future expectations, and school experiences measured before the start of smoking regularly to predict smoking in adulthood. Results show that school policies, peers, and youths’ mortality expectations predict smoking in adulthood but that college aspirations and analytical skills do not. I also show that smoking status at age 16 predicts both completed education and adult smoking, controlling for an extensive set of covariates. Overall, educational inequalities in smoking are better understood as a bundling of advantageous statuses that develops in childhood, rather than the effect of education producing better health.     

Implementation fidelity and adolescent smoking: The X:IT study—A school randomized smoking prevention trial

BackgroundAssessing the actual implementation of multi-component interventions can provide important knowledge for future interventions. Intervention components may be implemented differently, knowledge about this can provide an understanding of which components are essential and therefore must be included. The aim of this study was to examine the implementation of one, two, or all three main intervention components at the individual level and to assess the association to current smoking among 13 year-olds in the X:IT study.MethodsData stems from a cluster-randomized controlled trial in 94 Danish elementary schools (51 intervention; 43 control schools). Implementation was measured by aspects of adherence, dose, quality of delivery, and participant responsiveness based on questionnaire data from 4161 pupils at baseline (mean-age: 12.5 years) and 3764 pupils at first follow-up eight months later. Coordinator responses from 49 intervention schools were also included. Associations between individual level implementation of the three main components and pupil smoking were examined through a 3-level logistic regression model.ResultsAlthough implementation fidelity for the three main intervention components was good, only one third (38.8%) of pupils in intervention schools were exposed to full implementation of the intervention. Among these pupils odds ratio for smoking was 0.25 (95% CI: 0.15 – 0.42).ConclusionsSchool-based programs can be very effective if carefully implemented. Future school-based smoking preventive initiatives should include multiple components, and seek to enhance implementation quality of all components.     

Work and other factors influencing coronary health and sickness absence

Two major problems encountered in studies of the impact of work on health are the determination of which diseases and health states may be affected, and the separation of work from other factors affecting health. The greatest burden of ill-health may be due to the psychosocial work environment, rather than exposure to traditionally studied environmental agents. A common concern is with coronary heart disease (CHD). The author and his colleagues have been studying CHD, mental health and sickness absence, this last as a measure which combines social, psychological and physical functioning. Two longitudinal studies were conducted on civil servants, with the major aim of investigating the effect on health of occupational and other socioeconomic influences on white-collar workers. It was found that the lowest risk of CHD was in administrators, and the highest risk in the lower socioeconomic groups. Type A behaviour was higher in higher grades of worker. Lower-grade workers had less healthy lifestyle habits. It may not be possible to separate the effect of work from other influences on an individual, and it could be that the point of intervention should be not the individual but the environment.     

The needs of women and their partners regarding professional smoking cessation support during pregnancy: A qualitative study

BackgroundDespite the health risks of smoking, some women continue during pregnancy. Professional smoking cessation support has shown to be effective in increasing the proportion of pregnant women who quit smoking. However, few women actually make use of professional support.AimTo investigate the needs of women and their partners for professional smoking cessation support during pregnancy.MethodsSemi-structured interviews were held with pregnant women and women who recently gave birth who smoked or quit smoking during pregnancy, and their partners, living in the north of the Netherlands. Recruitment was done via Facebook, LinkedIn, food banks, baby stores and healthcare professionals. The interviews were recorded, transcribed and thematically analysed.Results28 interviews were conducted, 23 with pregnant women and women who recently gave birth, and five with partners of the women. The following themes were identified: 1) understanding women’s needs, 2) responsibility without criticism, and 3) women and their social network. These themes reflect that women need support from an involved and understanding healthcare professional, who holds women responsible for smoking cessation but refrains from criticism. Women also prefer involvement of their social network in the professional support.ConclusionFor tailored support, the Dutch guideline for professional smoking cessation support may need some adaptations. The adaptations and recommendations, e.g. to involve women and their partners in the development of guidelines, might also be valuable for other countries. Women prefer healthcare professionals to address smoking cessation in a neutral way and to respect their autonomy in the decision to stop smoking.