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The smoking habit of a close friend or family member—how deep is the impact? A cross-sectional study

1 , 2 , 3 , 1 , 4

BMJ Open

BMJ Publishing Group

Preventive Medicine, Public Health

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      Abstract

      ObjectivesTo assess the risk of becoming a smoker in adulthood associated with parental smoking as well as the smoking of siblings and close friends.DesignA cross-sectional study.Setting4 oral healthcare centres in Finland and a follow-up.ParticipantsAn age cohort born in 1979 (n=2586) and living in four Finnish towns. Of those reached by the 2008 follow-up, 46.9% (n=1020) responded.Primary and secondary outcome measuresSmoking behaviour at the age of 29. Smoking behaviour at the age of 13 and smoking behaviour of family members and close friends.ResultsSmoking of a current close friend was strongly associated with participants’ own smoking (OR 5.6, 95% CI 3.6 to 8.8). The smoking of a close friend during schooldays was similarly associated (OR 2.9, 95% CI 1.8 to 4.5). Smoking among men was associated with the smoking behaviour of mothers and siblings while that among females was not.ConclusionsThe impact of a smoker as a close friend is greater than that of a smoking parent or sibling in school age when it comes to smoking behaviour in adulthood. This should be taken into consideration when attempting to prevent smoking initiation or continuation.Trial registrationAt clinicaltrials.gov (NCT01348646).

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      Most cited references 27

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      Mortality in relation to smoking: 50 years' observations on male British doctors.

      To compare the hazards of cigarette smoking in men who formed their habits at different periods, and the extent of the reduction in risk when cigarette smoking is stopped at different ages. Prospective study that has continued from 1951 to 2001. United Kingdom. 34 439 male British doctors. Information about their smoking habits was obtained in 1951, and periodically thereafter; cause specific mortality was monitored for 50 years. Overall mortality by smoking habit, considering separately men born in different periods. The excess mortality associated with smoking chiefly involved vascular, neoplastic, and respiratory diseases that can be caused by smoking. Men born in 1900-1930 who smoked only cigarettes and continued smoking died on average about 10 years younger than lifelong non-smokers. Cessation at age 60, 50, 40, or 30 years gained, respectively, about 3, 6, 9, or 10 years of life expectancy. The excess mortality associated with cigarette smoking was less for men born in the 19th century and was greatest for men born in the 1920s. The cigarette smoker versus non-smoker probabilities of dying in middle age (35-69) were 42% nu 24% (a twofold death rate ratio) for those born in 1900-1909, but were 43% nu 15% (a threefold death rate ratio) for those born in the 1920s. At older ages, the cigarette smoker versus non-smoker probabilities of surviving from age 70 to 90 were 10% nu 12% at the death rates of the 1950s (that is, among men born around the 1870s) but were 7% nu 33% (again a threefold death rate ratio) at the death rates of the 1990s (that is, among men born around the 1910s). A substantial progressive decrease in the mortality rates among non-smokers over the past half century (due to prevention and improved treatment of disease) has been wholly outweighed, among cigarette smokers, by a progressive increase in the smoker nu non-smoker death rate ratio due to earlier and more intensive use of cigarettes. Among the men born around 1920, prolonged cigarette smoking from early adult life tripled age specific mortality rates, but cessation at age 50 halved the hazard, and cessation at age 30 avoided almost all of it.
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        Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys.

        Despite the high global burden of diseases caused by tobacco, valid and comparable prevalence data for patterns of adult tobacco use and factors influencing use are absent for many low-income and middle-income countries. We assess these patterns through analysis of data from the Global Adult Tobacco Survey (GATS). Between Oct 1, 2008, and March 15, 2010, GATS used nationally representative household surveys with comparable methods to obtain relevant information from individuals aged 15 years or older in 14 low-income and middle-income countries (Bangladesh, Brazil, China, Egypt, India, Mexico, Philippines, Poland, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam). We compared weighted point estimates and 95% CIs of tobacco use between these 14 countries and with data from the 2008 UK General Lifestyle Survey and the 2006-07 US Tobacco Use Supplement to the Current Population Survey. All these surveys had cross-sectional study designs. In countries participating in GATS, 48·6% (95% CI 47·6-49·6) of men and 11·3% (10·7-12·0) of women were tobacco users. 40·7% of men (ranging from 21·6% in Brazil to 60·2% in Russia) and 5·0% of women (0·5% in Egypt to 24·4% in Poland) in GATS countries smoked a tobacco product. Manufactured cigarettes were favoured by most smokers (82%) overall, but smokeless tobacco and bidis were commonly used in India and Bangladesh. For individuals who had ever smoked daily, women aged 55-64 years at the time of the survey began smoking at an older age than did equivalently aged men in most GATS countries. However, those individuals who had ever smoked daily and were aged 25-34-years when surveyed started to do so at much the same age in both sexes. Quit ratios were very low (<20% overall) in China, India, Russia, Egypt, and Bangladesh. The first wave of GATS showed high rates of smoking in men, early initiation of smoking in women, and low quit ratios, reinforcing the view that efforts to prevent initiation and promote cessation of tobacco use are needed to reduce associated morbidity and mortality. Bloomberg Philanthropies' Initiative to Reduce Tobacco Use, Bill and Melinda Gates Foundation, Brazilian and Indian Governments. Copyright © 2012 Elsevier Ltd. All rights reserved.
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          Peers and adolescent smoking.

           K Kobus (2003)
          There is a considerable body of empirical research that has identified adolescent peer relationships as a primary factor involved in adolescent cigarette smoking. Despite this large research base, many questions remain unanswered about the mechanisms by which peers affect youths' smoking behavior. Understanding these processes of influence is key to the development of prevention and intervention programs designed to address adolescent smoking as a significant public health concern. In this paper, theoretical frameworks and empirical findings are reviewed critically which inform the current state of knowledge regarding peer influences on teenage smoking. Specifically, social learning theory, primary socialization theory, social identity theory and social network theory are discussed. Empirical findings regarding peer influence and selection, as well as multiple reference points in adolescent friendships, including best friendships, romantic relationships, peer groups and social crowds, are also reviewed. Review of this work reveals the contribution that peers have in adolescents' use of tobacco, in some cases promoting use, and in other cases deterring it. This review also suggests that peer influences on smoking are more subtle than commonly thought and need to be examined more carefully, including consideration of larger social contexts, e.g. the family, neighborhood, and media. Recommendations for future investigations are made, as well as suggestions for specific methodological approaches that offer promise for advancing our knowledge of the contribution of peers on adolescent tobacco use.
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            Author and article information

            Affiliations
            [1 ]Department of General Practice, University of Tampere , Tampere, Finland
            [2 ]JYTA, Tunkkari Health Care Center , Veteli, Finland
            [3 ]Social and Health Services , Vaasa, Finland
            [4 ]Center of General Practice, Pirkanmaa Hospital District , Tampere, Finland
            Author notes
            [Correspondence to ] Dr Antti J Saari; antti.j.saari@ 123456uta.fi
            Journal
            BMJ Open
            BMJ Open
            bmjopen
            bmjopen
            BMJ Open
            BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
            2044-6055
            2014
            18 February 2014
            : 4
            : 2
            24549158
            3931984
            bmjopen-2013-003218
            10.1136/bmjopen-2013-003218
            Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

            This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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            preventive medicine, public health

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