If we want more evidence-based practice, we need more practice-based evidence.*

CHAPTER 4:
BEHAVIORAL AND ENVIRONMENTAL ASSESSMENT

Table of Contents

Headlines, Timelines, & Milestones

Archived Headlines

Supplementary References

Other References

Supplementary Websites


Headlines, Timelines, & Milestones


 

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Archived Headlines


SUPPLEMENTARY REFERENCES

Arnold , K. (1999). Alternative Medicines Gain in Popularity, Merit Closer Scrutiny. JOURNAL OF NATIONAL CANCER INSTITUTE 91: 1104-1105.
    FULL-TEXT

Bachman, J. G., Freedman-Doan, P., O'Malley, P. M., Johnston, L. D., & Segal, D. R. (1999). Changing patterns of drug use among US military recruits before and after enlistment.  AMERICAN JOURNAL OF PUBLIC HEALTH 89 (5): 672-677.
    ABSTRACT: Objectives. The US armed forces adopted "zero tolerance" policies concerning illicit drug use in 1980 and later developed policies to discourage tobacco and alcohol abuse. This article examines drug use among young active-duty recruits both before and after enlistment compared with non-military age-mates, and documents historical shifts in such drug use across 2 decades. Methods. Analyses employed longitudinal panel data from 20 nationally representative samples of high school seniors (cohorts of 1976-1995), each surveyed just before graduation and again within 2 years. Separate analyses for men (n = 12 082) and women (n = 15 345) contrasted those who entered military service college, and civilian employment. Results. Illicit drug use declined more among young military recruits than among their civilian counterparts. Analyses of male recruits at multiple time periods showed (1) declines in the prevalence of marijuana use and cocaine use after the initiation of routine military drug testing and (2) lower proportions of smokers of half a pack or more of cigarettes per day who entered service after the initiation of tobacco bans during basic training. Conclusions. Recent military drug policies appear to deter illicit drug use among enlistees and discourage some smokers from enlisting.

Baker, D., & North, K. (1999). Does employment improve the health of lone mothers? SOCIAL SCIENCE & MEDICINE 49 (1): 121-131, July.

Bauman, A., Smith, B., Stoker, L., Bellew, B., & Booth, M. (1999). Geographical influences upon physical activity participation: evidence of a 'coastal effect'. AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 23 (3): 322-324, June.
    ABSTRACT: Objective: To examine the association between geographical proximity to the coast and physical activity participation levels. Method: Using stratified random sampling, a telephone survey was carried out in 1994 with 1000 adults in each of the 16 health service regions in New South Wales (N = 16178). Physical activity levels were measured through self-report of the frequency and duration of walking, moderate and vigorous activities in the two weeks preceding the survey. Logistic regression modeling was carried out to examine the association between physical activity and 'coastal' location of residence, adjusting for age, sex, employment status, education level and country of birth. Results: After adjusting for other demographic factors, respondents who lived in a coastal postcode were 23% less likely to be classified as sedentary, 27% more likely to report levels of activity considered adequate for health, and 38% more likely to report high (vigorous) levels of physical activity than those who lived inland. Each of these associations was significant at the 0.05 level. Conclusions: Characteristics of the physical environment in coastal postcodes are related to physical activity participation. Implications: Physical environments may contribute to physical activity participation. Further efforts to conceptualize and measure these environmental influences is warranted. Public health efforts to promote physical activity should consider aspects of the physical environment as part of any intervention.

Berlow, E. L. (1999). Strong effects of weak interactions in ecological communities. NATURE 398 (6725), MAR 25.

Bernstein, M. S., Morabia, A., & Sloutskis, D. (1999). Definition and prevalence of sedentarism in an urban population.  AMERICAN JOURNAL OF PUBLIC HEALTH 89 (6): 862-867.
    ABSTRACT: Objectives. The present study sought to formulate a precise definition of sedentarism and to identify activities performed by active people that could serve as effective preventive goals. Methods. A population-based sample of 919 residents of Geneva, Switzerland, aged 35 to 74 years, completed a 24-hour recall. Sedentary people were defined as those expending less than 10% of their daily energy in the performance of moderate- and high-intensity activities (at least 4 times the basal metabolism rate). Results. The rates of sedentarism were 79.5% in men and 87.2% in women. Among Sedentary and active men, average daily energy expenditures were 2600 kcal (95% confidence interval [CI] = 2552, 2648) and 3226 kcal (95% CI = 3110, 3346), respectively; the corresponding averages for women were 2092 kcal (95% CI = 2064, 2120) and 2356 kcal (95% CI = 2279, 2440). The main moderate- and high-intensity activities among active people were sports (tennis, gymnastics, skiing), walking, climbing stairs, gardening, and (for men only) occupational activities. Conclusions. The definition of sedentarism outlined in this article can be reproduced in other populations, allows comparisons across studies, and provides preventive guidelines in that the activities most frequently performed by active people arts the ones most likely to be adopted by their sedentary peers.

Burton, M. V., Warren, R., Price, D., & Earl, H. (1998). Psychological predictors of attendance at annual breast screening examinations. BRITISH JOURNAL OF CANCER 77 (11): 2014-2019.
    ABSTRACT: This retrospective analysis of psychological predictors of attendance studied the women from the annual screening arm of the United Kingdom Coordinating Committee on Cancer Research (UKCCCR) trial of annual screening mammography for the early detection of breast cancer. Some women attended screening at the first invitation in year 1 (attendees), others did not attend for screening at any time (non-attendees), whereas a third group delayed attending until year 2 (ambivalent attendees). A total of 147 women were recruited to the study: 80 attendees, 28 non-attendees and 39 ambivalent attendees. It proved extremely difficult to contact non-attendees to take part in the study. Non-attendees were significantly more depressed on the Hospital Anxiety and Depression Scale; had experienced more miscarriages, stillbirths or terminations of pregnancy; were less knowledgeable about mammography; and were displeased to have received an invitation to screening. Whereas non-attendees are unlikely ever to attend breast screening because of their long-standing altitudes and preferred coping styles, ambivalent attendees may become more amenable to screening with the passage of time. In this study such women were persuaded to attend in year 2 with a simple, cost-effective intervention: an additional invitation letter after a year.

Chochinov, A.  (1998). Alcohol "on board," man overboard--boating fatalities in Canada.  CANADIAN MEDICAL ASSOCIATION JOURNAL 159(3): 259-261.

Cole, D. C., Eyles, J., Gibson, B. L., & Ross, N. (1999). Links between humans and ecosystems: the implications of framing for health promotion strategies. HEALTH PROMOTION INTERNATIONAL 14 (1): 65-72.
    ABSTRACT: To explore potential links between ecosystems and human health, we set out three ways of seeing or frames: environmental hazards and burden of illness; ecosystem conditions and human well-being; and environmental justice and human core values. Each frame provides a basis for making connections but also poses certain challenges: expanding research methods, linking with other conditions of human well-being and clarifying value bases. We discuss actions which build on the strengths of the different frames to deal with the challenges: linking with those seeking greater ecosystem protection focusing on clean production strategies emphasizing environmental degradation as one aspect of social justice and building on concerns such as reproduction which are closer to human core values Health promotion practitioners and policy makers can flexibly use the frames in arguing for the betterment of both ecosystems and humans.

Ferron, C., Narring, F., Cauderay, M., & Michaud, P. A. (1999). Sport activity in adolescence: associations with health perceptions and experimental behaviours. HEALTH EDUCATION RESEARCH 14 (2): 225-233.
    ABSTRACT: Despite the relevance of this research topic from a public health perspective, there is currently a lack of objective data on European adolescents' sport activity, notably the associations between their sport habits and their health attitudes and behaviours, which may have important consequences both in terms of somatic (cardiovascular) health and mental health. The objective of the present study was to determine the direction and strength of the associations between the frequency of sport and health variables; in particular, perceptions of health, self image, substance use and experimental behaviours. Data were collected as part of the 1993 Swiss Multicentric Adolescent Survey on Health. In this survey, anonymous self-administered questionnaires were distributed to a national representative sample of 10000 in-school adolescents (15-20 years of age). Univariate analyses explored the relationships between the level of sport activity and health variables; then logistic regression analyses examined the strength of these relationships. According to the results, half of the sample do sports more than twice a week, boys more often as part of a sports club. Differences between non-athletic and athletic adolescents describe the latter as having less somatic complaints, more confidence in their future health, a better body image, a lesser tendency to attempt suicide, a higher frequency of use of the car seat belt, and a lower use of tobacco, wine and marijuana. Links between the frequency of sport activity and the locus of control related to health, general satisfaction with life or sexual behaviours are less strong. It must be noticed that the cross-sectional data collection precludes the establishment of a causal relationship between exercise and health behaviours. However, the existing links underline the coexistence of positive health characteristics and sport activity, suggesting that an incitement to get involved in physical activity may be a necessary component of a comprehensive prevention approach among adolescents.

Fintor, L. (1999). Exercise and Breast Cancer Risk: Lacking Consensus. JOURNAL OF NATIONAL CANCER INSTITUTE 91: 825-827.
    FULL-TEXT

Glanz, K., Lew, R.A., Song, V., & Cook, V.A. (1999). Factors associated with skin cancer prevention practices in a multiethnic population. HEALTH EDUCATION & BEHAVIOR 26 (3): 344-359.
    ABSTRACT: A better understanding of factors influencing sun protection practices can improve the design and evaluation of skin cancer prevention programs. These data are from a cross-sectional survey of 756 parents with children in Grades 1 through 3, and 176 recreation program staff members in a multiethnic population in Hawaii. Questionnaires asked about skin cancer prevention practices (sunscreen use, covering up, shade seeking), knowledge, benefits and barriers, policies; and staff norms for prevention. The most important correlates of children's prevention practices were their parents' sun protection habits. Multiple regression models-which included knowledge, beliefs, program policies, and covariates related to sun protection-explained a total of between 38% and 41% of the variance in children's sun safety habits, 22% to 25% of parents' habits, and 24% of recreation staff members' sun safety habits. The models were less successful at predicting the use of hats, shirts, and shade seeking and a composite sun protection habits index; Parents and caregivers' knowledge, beliefs, and behaviors, as well as recreation program policies, are strong predictors of sun protection practices among children in Grades 1 to 3 in a multiethnic sample.

Gill, T. M., Williams, C. S., Robison, J. T., & Tinetti, M. E. (1999). A population-based study of environmental hazards in the homes of older persons.   AMERICAN JOURNAL OF PUBLIC HEALTH 89 (4): 553-556.
    ABSTRACT: Objectives. This study sought to estimate the population- based prevalence of environmental hazards in the homes of older persons and to determine whether the prevalence of these hazards differs by housing type or by level of disability in terms of activities of daily living (ADLs). Methods. An environmental assessment was completed in the homes of 1000 persons 72 years and older. Weighted prevalence rates were calculated for each of the potential hazards and subsequently compared among subgroups of participants characterized by housing type and level of ADL disability. Results. Overall, the prevalence of most environmental hazards was high. Two or more hazards were found in 59% of bathrooms and in 23% to 42% of the other rooms. Nearly all homes had at least 2 potential hazards. Although age-restricted housing was less hazardous than community housing, older persons who were disabled were no less likely to be exposed to environmental hazards than older persons who were nondisabled. Conclusions. Environmental hazards are common in the homes of community- living older persons.

Graham, H., & Der, G. (1999). Smoking and women's health. Influences on women's smoking status. The contribution of socioeconomic status in adolescence and adulthood. EUROPEAN JOURNAL OF PUBLIC HEALTH 9 (2): 137-141.
    ABSTRACT

Haapanen-Niemi, N., Miilunpalo, S., Vuori, I., Pasanen, M., &Oja, P. (1999). The impact of smoking, alcohol consumption, and physical activity on use of hospital services.  AMERICAN JOURNAL OF PUBLIC HEALTH 89 (5): 691-698.
    ABSTRACT: Objectives. This study investigated the associations of smoking, excess alcohol consumption, and physical inactivity with the use of hospital care. Methods. A cohort of 19- to 63-year-old Finnish men (n = 2534) and women (n = 2668) were followed prospectively for 16 pears. Number of hospital days was extracted from the national hospital discharge registry, while data concerning exposure variables were derived from the baseline questionnaire. Results. After adjustment for confounders, male smokers had 70% (95% confidence interval [CI] = 49%, 95%) and female smokers had 49% (95% CI = 29%, 71%) more hospital days due to any cause than did those who had never smoked. Men consuming a moderate amount of alcohol had 21% (95% CI = 10%, 31%) fewer hospital days due to any cause than did nondrinkers. Men who had the lowest energy expenditure during leisure-time physical activity had 36% (95% CI = 15%, 63%) more hospital days than the most active men. The figure for women was 23% (95% CI = 4%, 44%). Conclusions. Smoking was strongly associated with an increased use of hospital services. The associations of alcohol consumption and leisure-time physical activity with use of hospital care depended on the diagnosis under study.

Higgins, Joan Wharf (Institute of Health Promotion Res., Univ. British Columbia, 6248 Biological Sciences Rd., Vancouver BC V4T 1Z4) and Marjorie MacDonald, The School-Based Prevention Model: A Training Handbook.  Prepared for the Alcohol and Drug Programs, BC Ministry of Health, by M.A. MacDonald and Associates, Victoria, BC, Oct. 1992.

This handbook reflects the commitment of the BC Ministry of Health's commitment to having coordinators working in the 54 School-Based Prevention Projects (SBPP) use the PRECEDE model, adapted to their understanding and backgrounds, in planning uniquely for and with each school, to achieve participation in planning among teachers, students and administrators, and to tailor programs to the needs of each school. UBC carried out evaluation of the SBPP (see papers by Marjorie MacDonald and Terri Buller-Taylor who also used data from this project for their doctoral dissertations at UBC).

Hoegh, H.J., Davis, B.D., & Manthe, A.F. (1999). Sun avoidance practices among non-Hispanic white Californians.  HEALTH EDUCATION & BEHAVIOR 26 (3): 360-368.
    ABSTRACT: This study measures self-reported sun avoidance practices, use of protective clothing, and use of sunscreen among 4,749 non-Hispanic white adults living in households in California. Data are from the California Behavioral Risk Factor Survey, a population-based telephone survey of health behaviors and attitudes. The average: respondent spent at least 15 minutes in the sun on 21.4 days out of the last 30 days. Regular use of protective clothing was reported by 30.7%, regular use of sunscreen by 22.2%, and regular sun avoidance by 17.1% of the respondents. Results varied by month, gender, skin tone, age, education, and presence of children in the household: Health strategies should target younger adults (especially men), households with children and adults with less than a high school education. Because of relatively low rates of sun avoidance behaviors overall, a general population campaign also is warranted.

Hofford, CW and Spelman, KA.  The community action plan: incorporating health promotion and wellness into alcohol, tobacco and other drug abuse prevention efforts on the college campus.  Journal of Wellness Perspectives 12(2): 70-79, 1996.

The U of Oklahoma Comprehensive Prevention Program has developed the CommOUnity Action Plan to educate university groups about wellness and the technology of health promotion, and to demonstrate how each is related to alcohol, tobacco and other drug (ATOD) abuse prevention.  By using this plan, each group becomes better able to facilitate their own prevention, health promotion and wellness activities.  The plan framework, based on the Precede-Proceed Model represents an opportunity for participating campus groups to assess the health status of their group, design and develop a health enhancing activity, and carry out that activity with minimal help from the program staff.  The program staff is, subsequently, more free to promote each groupís activities to the rest of the campus and to facilitate collaboration among diverse campus groups.

Huang, Y., Macera, C. A., Kronenfeld, J. J.   (1998).  Physical fitness, physical activity,and functional limitation in adults aged 40 and older.   MEDICINE AND SCIENCE IN SPORTS AND EXERCISE  30 (9): 1430-1435.

Hunnicutt, David M. (Univ. Nebraska at Lincoln), Christina Perry-Hunnicutt, Ian M. Newman, Joe L. Davis, and Janet Crawford, "Use of the Delphi Technique to Support a Comprehensive Campus Alcohol Abuse Initiative," Journal of Health Education 24(2):88-96, 1993.

Based in part on Precede-Proceed model.

Joachim, G. (1998). Sources of Variability in the Reproducibility of Food Frequency Questionnaires.  NUTRITION AND HEALTH 12(3): 181. 

Jones, A. P., Bentham, G., Harrison, B. D. W., Jarvis, D., Badminton, R. M., & Wareham, N. J. (1998).  Accessibility and health service utilization for asthma in Norfolk, England. JOURNAL OF PUBLIC HEALTH MEDICINE 20 (3): 312-317.
   
ABSTRACT

Knowles, J. (1999). Nicotine withdrawal and road accidents. NATURE 400 (6740 ), 8 July.
    Go to (free-registration required): http://www.nature.com/server-java/Propub/nature/400128A0.abs_frameset

Koivusilta, . L. K. Rimpela, A. H., & Rimpela, M. K. (1999). Health-related lifestyle in adolescence-origin of social class differences in health? HEALTH EDUCATION RESEARCH 14(3): 339-355.
    ABSTRACT

Kraft, D. P. (1988). "The Prevention and Treatment of Alcohol Problems on a College Campus," Journal of Alcohol and Drug Education 34: 37-51.

Author's abstract: Efforts in reduction of alcohol problems at the University of Massachusetts at Amherst continue to focus on the prevention and treatment of drinking problems as they build on the understanding gained from 10 years experience with their Demonstration Alcohol Education Program and with other campus programs. Prevention of alcohol problems must concentrate on changing behaviors related to student drinking. Programs need to focus on reducing alcohol problems, not solely on preventing alcoholism. Intervention strategies must address both individual and group behaviors. A theoretical model of behavior change, such as the Theory of Reasoned Action (Fishbein and Ajzen, 1975) can guide interventions and their subsequent evaluation. At the University of Massachusetts, the public health model called PRECEDE is used to suggest systematic ways of changing individual and group forms of behavior. A schematic model of prevention strategies can be used to generate ideas for the activities and methods of a program. On an individual basis, it has been difficult to measure or confirm program effects at the University. On a group level, important changes have occurred in the planning of nondrinking parties and the availability of alternative drinks. Peer confrontation with alcohol abusers has become more frequent. On the institutional level, consistent alcohol policies and support for those with alcohol problems has increased. Basic lessons learned from the operation of this program generally indicated the long-term commitment required, the need to focus on specific problems rather than general admonitions, and the need for combinations of regulatory and educational strategies. 18 references.

Laden, F., & Hunter, D. J. (1998). Environmental risk factors and female breast cancer.   ANNUAL REVIEW OF PUBLIC HEALTH 19: 101-123.
    ABSTRACT

Markens, S., Browner, C. H., & Press, N. (1999). 'Because of the risks': how US pregnant women account for refusing prenatal screening. SOCIAL SCIENCE & MEDICINE 49 (3): 359-369, August.

McNeil, C. (1999). Can Guidelines Be Integrated Into Everyday Practice? The NCCN in Year 4.  JOURNAL OF THE NATIONAL CANCER INSTITUTE 91: 753-755.
    FULL-TEXT

Nelson, N. J. (1999). Purple Carrots, Margarine Laced With Wood Pulp? Nutraceuticals Move Into the Supermarket.  JOURNAL OF THE NATIONAL CANCER INSTITUTE 91: 755-757.
    FULL-TEXT

Niaura, R., Marcus, B., Abrams, D.  (1998).  Exercise, smoking cessation, and short-term changes in serum lipids in women: a preliminary investigation.   MEDICINE AND SCIENCE IN SPORTS AND EXERCISE  30 (9): 1414-1418.

O'Malley, P.M., & Johnston, L.D. (1999). Drinking and driving among US high school seniors, 1984-1997.   AMERICAN JOURNAL OF PUBLIC HEALTH 89 (5): 678-684.
    ABSTRACT: Objectives. This article reports the prevalence of, and tens in, driving after drinking and riding in a car with a driver who has been drinking among American high school seniors, based on data from more than a decade (1984-1997) of annual national surveys. Methods. Logistic regressions were used to assess the effects of demographic factors (gender, region of country, population density, parental education and race/ethnicity) and selected "lifestyle" factors (religious commitment high school grades, truancy, illicit drug use, evenings out per week, and miles driven per week). Results. Rates of adolescent driving after drinking and riding with a driver who had been drinking declined significantly from the mid-1980s to the early or mid-1990s, but the declines have not continued in recent years. Rates of driving or riding after drinking were higher among high school seniors who are male, White, living in the western and northeastern regions of the United States, and living in rural areas. Truancy, number of evenings out, and illicit drug use all related significantly positively with the dependent variables, whereas grade point average and religious commitment had a negative relationship. Miles driven per week related positively to driving after drinking.

Paine, L. L., Lang, J. M., Strobino, D. M., Johnson, T. R. B., DeJoseph, J. F., Declercq, E. R., Gagnon, D. R., Scupholme, A., & Ross, A. (1999). Characteristics of nurse-midwife patients and visits, 1991. AMERICAN JOURNAL OF PUBLIC HEALTH 89 (6): 906-909.
    ABSTRACT: Objectives. This study describes the patient populations seen by and visits made to certified nurse-midwives (CNMs) in the United States. Methods. Prospective data on 16729 visits were collected from 369 CNMs randomly selected from a 1991 population survey. Population estimates were derived from a multistage survey design with probability sampling. Results. We estimated that approximately 5.4 million visits were made to nearly 3000 CNMs nationwide in 1991. Most visits involved maternity care, although fully 20% were for cafe outside the maternity cycle. Patients considered vulnerable to poor access or outcomes made 7 of every 10 visits. Conclusions. Nurse-midwives substantially contribute to the health care of women nationwide, especially for vulnerable populations.

Pescatello, L. S., & Murphy, D. (1998). Lower intensity physical activity is advantageous for fat distribution and blood glucose among viscerally obese older adults. MEDICINE AND SCIENCE IN SPORTS AND EXERCISE 30 (9): 1408-1413.

Roeper, P.J., & Voas, R.B. (1999). Underage drivers are separating drinking from driving. AMERICAN JOURNAL OF PUBLIC HEALTH 89 (5): 755-757.
    ABSTRACT: Objectives. From 1985 to 1995, drivers younger than 21 years experienced a 50% drop in fatal crashes involving alcohol. This study addresses whether the decrease is explained by young drivers' drinking less or by their separating drinking from driving. Methods. Nighttime roadside surveys were conducted in 3 communities to test drivers' breath and administer questionnaires on drinking practices. From 1992 to 1996, 34 898 drivers (21% of whom were younger than 21 years) were interviewed. Results. Although drivers younger than 21 years were more likely to have consumed 6 or more drinks on at least 1 occasion during the previous month, a smaller percentage of younger drivers than of older drivers had blood alcohol concentrations of 0.01 or higher. Conclusions. Younger drivers are more likely than drivers older than 21 years to separate drinking from driving.

Rylander, R., Axelsson, G., Megevand, Y., Dahlberg, C., Lijeqvist, T., & Sundh, V. (1999). Dietary habits for non-smoking females living with smokers or non-smokers. EUROPEAN JOURNAL OF PUBLIC HEALTH 9 (2): 142-145.
    ABSTRACT

Sadana, R., & Snow, R. (1999). Balancing effectiveness, side-effects and work: women's perceptions and experiences with modern contraceptive technology in Cambodia. SOCIAL SCIENCE & MEDICINE 49 (3): 343-358, August.

Shepherd, C. K., Power, K. G., & Carter, H.  (1998). Characteristics of responders and non-responders in an infant feeding study. JOURNAL OF PUBLIC HEALTH MEDICINE 20 (3): 275-280.
    ABSTRACT

Thomson, C., Currie, C., Todd, J., & Elton, R. (1999). Changes in HIV/AIDS education, knowledge and attitudes among Scottish 15-16 year olds, 1990-1994: Findings from the WHO: Health Behaviour in School-aged Children Study (HBSC). HEALTH EDUCATION RESEARCH 14(3): 357-370.
    ABSTRACT

Toobert, D. J. Strycker, L. A. Glasgow, R. E. (1998). Lifestyle Change in Women with Coronary Heart Disease: What Do We Know?  JOURNAL OF WOMEN'S HEALTH  7(6): 685-700, AUG 01.

Tucker, K. L. Bianchi, L. A., & Bermudez, O. I.   (1998).  Adaptation of a Food Frequency Questionnaire to Assess Diets of Puerto Rican and Non-Hispanic Adults.   AMERICAN JOURNAL OF EPIDEMIOLOGY 148(5): 507, SEP 01.

Yen, I., & Syme, S. L. (1999). The Social Environment and Health: A Discussion of the Epidemiologic Literature. ANNUAL REVIEW OF PUBLIC HEALTH 20: 287-308.
    ABSTRACT / FULL-TEXT

You, R. X., Thrift, A. G., McNeil, J. J., Davis, S. M.,& Donnan, G. A. (1999). Ischemic stroke risk and passive exposure to spouses' cigarette smoking.  AMERICAN JOURNAL OF PUBLIC HEALTH 89 (4): 572-575.
    ABSTRACT: Objectives. This study investigated the association between ischemic stroke risk and passive exposure to cigarette smoking. Methods. Risk factors among 452 hospitalized cases of first-episode ischemic stroke were compared with 452 age- and sex-matched "neighborhood" controls. Results. The risk of stroke was twice as high for subjects whose spouses smoked as for those whose spouses did not smoke (95% confidence interval = 1.3, 3.1), after adjustment for the subject's own smoking, heart disease, hypertension, diabetes, and education level. These results were confirmed when analysis was limited to those who never smoked. Conclusions. These findings provide evidence that spousal smoking may be a significant risk factor for ischemic stroke.

Zhu, S-H., Sun, J., Billings, S.C., Choi, W. S., Malarcher, A. (1999). Predictors of smoking cessation in U.S. adolescents. AMERICAN JOURNAL OF PREVENTIVE MEDICINE 16 (3): 202-207.
   

Other References

Colorectal Cancer Test Use Among Persons Aged greater than or equal to 50 Years --- United States, 2001.  Morbidity and Mortality Weekly Report, 52(10), March 14, 2003.    

Bronchoscopy-Related Infections and Pseudoinfections --- New York, 1996 and 1998. Morbidity and Mortality Weekly Report 48(26), July 9, 1999.
 

Rubella Outbreak --- Westchester County, New York, 1997--1998. Morbidity and Mortality Weekly Report 48(26), July 9, 1999.
 

Injuries Among Railroad Trespassers --- Georgia, 1990--1996. Morbidity and Mortality Weekly Reports 48 (25), July 2, 1999.
 

Trends in HIV-Related Sexual Risk Behaviors Among High School Students -- Selected U.S. Cities, 1991-1997. Morbidity and Mortality Weekly Report 48 (21), June 4, 1999.
 

Cigarette Smoking During the Last Months of Pregnancy Among Women Who Gave Birth to Live Infants. Morbidity and Mortality Weekly Report, 48 (20), May 28, 1999. 

Laboratory Practices for Prenatal Group B Streptococcal Screening and Reporting. Morbidity and Mortality Weekly Report, 48 (20), May 28, 1999.
 

Physician Advice and Individual Behaviors About Cardiovascular Disease Risk Reduction. MMWR 48 (4), February 5, 1999.

Norwalk-Like Viral Gastroenteritis in U.S. Army Trainees --- Texas, 1998.   Morbidity and Mortality Weekly Report,  48 (11), March 26, 1999.
 

Mass Treatment of Humans Who Drank Unpasteurized Milk from Rabid Cows --- Massachusetts, 1996--1998.  Morbidity and Mortality Weekly Report, 48 (11), March 26, 1999.
 

Stat Bite: Breast Cancer Mortality Rates: U.K., Canada, and U.S., 1950-1994. Journal of the  National Cancer Institute 91: 752,1999. http://jncicancerspectrum.oupjournals.org/cgi/content/full/jnci;91/9/752

SUPPLEMENTARY WEBSITES

Smoking increases fire mortality. A common scenario is of elderly, debilitated, sometimes bed-bound persons accidentally igniting themselves and/or innocent bystanders with cigarette or cigarette lighter ignited fires. Much of US, and probably, increasingly China, fire mortality is made up of the elderly burned in cigarette smoking fires. Much of that data is at FIRE IN THE UNITED STATES 1985 - 1994 (NINTH EDITION) http://www.usfa.fema.gov/pdf/fius/sec6.pdf or http://www.nfpa.org .

SMOKING AMONG ASIAN AMERICANS: A National Tobacco Survey. National Asian Women's Health Organization, 1998. http://www.nawho.org

For descriptions, rationale, methods, and the most recent findings from the US Youth Risk Behavior Surveys of CDC, go to: http://www.cdc.gov/nccdphp/dash/yrbs/ov.htm

Declining Breast Cancer Mortality: What's Behind It? Tom Reynolds J Natl Cancer Inst 1999;91 750-753 http://jncicancerspectrum.oupjournals.org/cgi/content/full/jnci;91/9/750