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CHARACTERISTICS OF LATINO SMOKERS IN DIFFERENT STAGES OF CHANGE LIVING IN MINNESOTA
A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL
OF THE UNIVERSITY OF MINNESOTA BY
JOSÉ WILLIAM CASTELLANOS
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY
STEPHEN SCHONDELMEYER, PH.D., ADVISOR
MAY, 2011
© José William Castellanos, 2011
i
Acknowledgements
I would like to express my sincere gratitude to those who have encouraged and
helped me complete my doctoral program and this dissertation. First, I wish to recognize
my advisor Dr. Stephen Schondelmeyer for his friendship and invaluable guidance and
patience during this journey. Without his support and wisdom it would have not been
possible to complete this dissertation.
I owe great thanks to Dr. Jon Schommer, the Director of Graduate Studies of
Social and Administrative Pharmacy and my thesis committee chair, for his thoughtful
comments, recommendations and advice. He always had the proper words to encourage
me when I most needed it.
I want to express a special gratitude to Dr. Bob Cipolle, a fine friend and
committee member, who always cared when I needed it. His kindness, wisdom, and
understanding constantly provided me support and confidence to reach my goals.
I recognize Dr. Steven Foldes, a friend and colleague from the Diverse Racial
Ethnic Groups and Nations (DREGAN) Project, also a committee member, who
facilitated my access to the data set and assisted me through the complexities of
community based participatory research.
I would also like to express my appreciation to Dr. Michael Oakes, who guided
me throughout the design and methodological approaches of the dissertation.
ii
I wish to thank Dr. Peter Morley for his friendship and sophisticated intellect,
who through endless conversations helped me to think about new roles and new personal
and professional challenges.
I recognize my colleagues and staff at the College of Pharmacy for their
friendship and support.
I would like to thank my friend Dr. Gabriela Vazquez for her practical
recommendations about the methodology and analysis.
I immensely appreciate Lauren Haun for her useful recommendations in the
revision of this dissertation.
Special gratitude is expressed to Comunidades Latinas Unidas En Servicio
(CLUES), Blue Cross Blue Shield of Minnesota, and CLEARWAY-MN, for their
generous funding, support, and implementation of the DREGAN project and for
facilitating my access to the data set, as well as allowing me the time and space to
complete this study.
Finally, I would like to express immense gratitude to my family, especially to my
beloved sons Camilo José, Francisco Javier, and William Ricardo, my sisters Claudia
Mireya and Martha Socorro, my brother, Juan Luis, my nephews Julian Guillermo and
Johan Dario, and my dear friend Lupita Alba, for their unconditional love, emotional
support and permanent encouragement to finish this dissertation.
iii
Dedication
In memoriam of my parents, Blanca Luisa and José Guillermo.
iv
Abstract
Introduction
Tobacco use among Latino communities living in Minnesota is a cause of concern
due to their vulnerabilities. Recent immigrants face the stress of acculturation,
immigration- related issues, inadequate health insurance access, lack of family and social
networks, lack of knowledge about the short-and long-term consequences of exposure to
second-hand smoke (SHS), and the absence of culturally-appropriate and linguistically-
competent tobacco cessation programs.
Tobacco cessation interventions have traditionally been designed and
implemented for the mainstream population and then translated to be used among
minority communities. This approach does not recognize the unique characteristics of
smokers from other cultures and ethnic groups. For this reason, in order to develop
culturally-appropriate and linguistically-competent smoking cessation interventions, it is
necessary to understand and address the complexities of Latino tobacco users.
In order to understand these characteristics, the Stages of Change (SOC) model
was used to classify Latino smokers and former smokers into the preparation,
contemplation, pre-contemplation, and maintenance stages of change.
Objectives
The objectives of this study are 1) to describe the characteristics of Latino tobacco
smokers living in Minnesota; 2) to determine if there are significant differences between
v
Latino smokers not willing to quit using tobacco, in the pre-contemplation SOC; Latino
smokers willing to quit using tobacco, in the preparation SOC; and Latino former
smokers in the maintenance SOC; by socioeconomic status and level of acculturation;
self reported physical and mental health, consumption of fruits and vegetables, and
physical activity; beliefs regarding smoking, positive aspects of smoking, and knowledge
of tobacco-related diseases; attitudes and level of exposure to SHS; and the level of
cigarette addiction and willingness to quit smoking; finally, the study will 3) identify
significant characteristics of Latino smokers that would be relevant to develop culturally-
competent and linguistically-appropriate tobacco cessation interventions.
Methods
This research is a cross sectional study, using secondary data from the Diverse
Racial and Ethnic Groups and Nations (DREGAN) project, focused on adults, eighteen
years old or older who self-identified as Latino or Hispanic, or born in a Latin-American
country or who have a parent or grandparent born in a Latin-American country, who
agreed to respond to the survey questionnaire. Minors of eighteen years old, who are not
Latino or from Latino origin, or qualified respondents who refused to answer the survey
questionnaire were excluded from the study.
Definition of variables
The SOC algorithm was used to address if there were relevant relationships
between the independent variables and the SOC that could be used to design culturally-
vi
appropriate tobacco cessation programs. Using the DREGAN dataset, an analysis dataset
was created by recoding and combining participant survey responses.
Statistical analysis
SPSS version 19.0 software was used to conduct all statistical analyses, including
descriptive, bivariate and multivariate analysis.
Descriptive statistics were performed to summarize the characteristics of the
respondents. Percents, means, and standard deviation of the means were calculated for
continuous variables. Numbers and percentages were calculated for categorical variables.
The continuous variables were compared using one-way analysis of the variance
(ANOVA), the dichotomous categorical variables were compared using Chi-square test,
and the thricotomuos categorical variables were analyzed using order logistic regression.
Variables that were moderately associated with the comparisons categories (p<0.1) were
identified and analyzed using logistic regression controlling for age and gender to
examine their association with smokers in the different stages of change.
Results
The study reported that current smokers are more likely to be men than ever
smokers. Smokers in the maintenance SOC tend to be older than smokers in the
preparation and pre-contemplation SOC, as well as those in the preparation compared to
smokers in the contemplation and pre-contemplation SOC. Smokers in the maintenance
SOC are more likely to be married or live in a marriage-like relationship than current
vii
smokers. Smokers who answered that they were uncomfortable asking for help to quit
smoking are more likely to live with children under 18 years old.
Never smokers are more likely to answer the survey in Spanish than ever
smokers. Smokers who believed that they were unlikely to succeed if they wanted or
decided to quit smoking are less likely to have friends from the same ethnic background
than those who believed they were likely to succeed. Similarly, smokers in the
preparation SOC are less likely to believe that smoking facilitates friendship than those in
the pre-contemplation SOC.
It was also found that never smokers and smokers in the maintenance SOC,
compared to ever and current smokers, are less likely to be exposed and have their
children exposed to SHS, be comfortable with others smoking around them, live in a
house and ride in a car in which someone smokes; as well are more likely to live in a
home and prefer to work where smoking is not allowed. Similarly, a lower percentage of
smokers in the preparation SOC rode in a car in which someone smoked during the
previous week and was exposed to SHS compared to smokers in the contemplation and
pre-contemplation SOC.
However, smokers who believed they were unlikely to succeed if they wanted to
quit smoking are more likely to live in a house where someone smokes. Never smokers
compared to ever smokers are less likely to report stressful events, major injury or illness
during the previous year, and a belief that smoking relieves stress. Similarly, never
smokers and smokers in the preparation SOC are less likely to believe that smoking
provides pleasure than ever smokers and those in the pre-contemplation SOC, and
viii
smokers who answered they were unlikely to succeed if they decided to quit smoking are
less likely to believe that people smoke because they want to.
Smokers who answered they were unlikely to succeed if they wanted to quit
smoking are less likely to exercise adequately than those who answered they were likely
to succeed. On the contrary, smokers who disagree with the belief that the only way to
stop smoking is through will power are more likely to report a major injury or illness
during the previous year, and are more likely to have a normal body mass index (BMI)
than those who agreed.
Never smokers and smokers in the preparation SOC are less likely to report major
change in the health of a relative during the previous year than current and smokers in the
pre-contemplation SOC; similarly, smokers in the preparation SOC are less likely to
report major change in family reunions during the previous year than smokers in the pre-
contemplation SOC, and are more likely to report interesting things in their daily life than
those in the pre-contemplation SOC.
It was also found that never smokers and smokers in the maintenance SOC,
compared to ever and current smokers, are more likely to believe that there are no
positive aspects of smoking, and live in a home and work where smoking is not allowed.
Similarly, never smokers are more likely to report happiness than ever smokers. Never
smokers are more likely to believe that smoking causes heart disease than ever smokers.
Similarly, smokers in the maintenance SOC are more likely to believe that
smoking causes more harms than benefits than current smokers. However, smokers who
disagree with the belief that the only way to stop smoking is through will power are less
ix
likely to believe that smoking causes more harms than benefits than those who agreed
with those beliefs.
The study also found that smokers in the maintenance SOC are less likely to
smoke their first cigarette and smoke regularly after their 18th birthday than current
smokers. However, a larger percentage of smokers in the preparation SOC smoked
cigarettes regularly after their 18th birthday compared to those in the contemplation and
pre-contemplation SOC.
Smokers in the preparation SOC are more likely to believe that they would be
very likely to succeed if they want or decide to stop smoking than those in the pre-
contemplation SOC; similarly, a larger percentage of smokers in the preparation SOC
does not enjoy smoking compared to smokers in the contemplation and pre-
contemplation SOC. Finally, as expected, smokers who disagree with the belief that the
only way to stop smoking is through will power are more likely to feel very comfortable
asking for help to stop smoking than those who agreed with that belief.
Conclusions
The results show that Latino smokers living in Minnesota share some of the
characteristics described by previous studies including high level of exposure to SHS, the
trend to quit smoking when older, to smoke cigarettes and are not willing to quit when
are exposed to stressful events, the belief that smoking facilitates friendship and provides
pleasure, enjoyment of smoking, and negative expectations for successfully quitting
smoking. These hypotheses should be tested in prospective intervention studies of
x
smoking cessation interventions using the SOC algorithm, taking into account the
prevalence of smoking differences between women and men and the causes of smoking.
As the most accessible health care practitioner, pharmacists are in a privileged
position to provide smoking cessation interventions, especially to Latino recent
immigrants who do not know how to navigate the complex health care systems in the
U.S. By learning the unique characteristics of Latino smokers, pharmacists will be able to
address their needs and increase the possibilities for successful outcomes.
xi
Table of Contents
Page No
Acknowledgements……………………………………………………………………….i
Dedication………………………………………………………………………………..iii
Abstract……………………………...…………………………………………………...iv
Table of Contents………………………………………………………………………..xi
List of Tables……...…………………………………………………………………...xxii
List of Graphics...……………………………………………………………………..xxvi
List of Appendices...…………………………………………………………………xxvii
Chapter I. Introduction...……………………………………………………………….1
Significance of the problem…………………………………………………………...1
History of tobacco use...………………………………………………………………2
The Latino population in Minnesota...………………………………………………...5
Health care barriers facing Latino communities in Minnesota………………………..9
Public health priorities for Latino communities in Minnesota………………………12
Objectives of the Study………………………………………………………………12
Significance of the Study……….……………………………………………………13
Chapter II. Literature Review...……………………………………………………….15
Nicotine addiction……………………………………………………………………15
xii
Tobacco-related diseases ……………………………………………………………17
Tobacco-related mortality……………………………………………………………20
Smoking prevalence among the U.S. adult population…...………………………….21
Smoking prevalence among the U.S. Latino adult population………...…………….21
Smoking prevalence by gender among the U.S. adult population…...……...……….22
Smoking prevalence by gender among the U.S. Latino adult population……….......22
Smoking prevalence by country of origin among the U.S. adult Latino population...23
Smoking prevalence among the Minnesota adult population…...…………….……..23
Smoking prevalence by gender among the Minnesota adult population…...………..23
Smoking prevalence among the Minnesota adult Latino population…...………........24
Smoking prevalence by age………………………………………….....………........24
Smoking prevalence by marital status……………………………….....………........25
Smoking prevalence by level of education…….…………………….....………........25
Smoking prevalence by income…..………………………………….....………........26
Smoking prevalence by level of acculturation.…...………………….....………........27
Self-reported health status and smoking.................………………….....………........28
Mental health disorders and smoking.....................………………….....………........30
Smoking and stress……………….………………………………….....………........30
Smoking and weight, Body Mass Index (BMI), consumption of vegetables and fruits,
and physical activity…….…….…….……………………………….....………........31
Smoking and friendship….……….………………………………….....………........34
Smoking and knowledge of tobacco-related diseases.........………….....………........34
xiii
Exposure to second-hand smoke............................………………….....……….........35
Smoking bans………………….….………………………………….....………........36
Quitting Smoking……..……….….………………………………….....………........38
Chapter III. Theoretical Framework and Hypotheses……...………………………..39
Stages of change model……………………………………………………………...39
Hypotheses……..……………...….………………………………….....………........40
Hypothesis 1……..…..………...….………………………………….....………........40
Hypothesis 2……..…..………...….………………………………….....………........42
Hypothesis 3…....……………...….………………………………….....………........44
Hypothesis 4……..…..………...….………………………………….....………........46
Hypothesis 5……..…..………...….………………………………….....………........48
Chapter IV. Methodology..…………………………………………………………….51
Study Design..………………………………………………………………………..51
The Diverse Racial Ethnic Groups and Nations (DREGAN) Project………………..51
DREGAN research design…………………………………………………….……..52
DREGAN survey instrument design………….……………………………….……..52
Survey instrument description………….…….……………………………….……..53
DREGAN survey methodology ………..…….……………………………….……..53
Sample description……..…..………...….…………………………………...............54
Interviewers training…..…..….……...….…………………………………...............55
xiv
Data collection…..…………………………………………………………………..56
Study statement research question…….……………………………………………..56
Survey inclusion criteria……………………………………………………………..57
Survey exclusion criteria……………………………………………………………..57
Definition of variables………………...……………………………………………..57
Statistical analysis.…………………………………………………………………..62
Institutional Review Board (IRB) approval………………………...………………..63
Chapter V. Results...……………………………………………………………………64
Sample characteristics…………………………………………………………..…....64
Demographic characteristics of the sample..………..…………………………...64
Self-reported health status ..……..……………………………………….………65
Acculturation ..……..…………………………………………………………….67
Smoking status..………………………..………………………………………...69
Smoking beliefs………………..………………………………………………...70
Second-hand smoke behaviors……...…………………..………………………..71
Smoking behavior………...……..………………….…………………………....71
Socioeconomic characteristics given smoking status and stages of change………....75
Comparison by socioeconomic status variables between never smokers and ever
smokers…………………...…………………………….………………………..75
Comparison by socioeconomic status variables between current and former
smokers………………...…………………………….……………………..…....76
xv
Comparison by socioeconomic status variables between former smokers in the
maintenance SOC, current smokers willing to quit, in the preparation SOC, and
current smokers no willing to quit, in the pre-contemplation SOC………….......77
Comparison by socioeconomic status variables between smokers in the
preparation and pre-contemplation SOC……..….……………………………....78
Comparison by socioeconomic status variables between smokers in the pre-
contemplation, contemplation, and preparation SOC…………...……….….…...78
Comparison by socioeconomic status variables given likelihood of success if
wanted to quit smoking……….………………….……………………………....79
Comparison by socioeconomic status variables given believes about the
likelihood of success if decided to quit smoking…….……………………..…....80
Comparison by socioeconomic status variables given level of comfort asking for
help…………………………………………………….……...…………….…....80
Comparison by socioeconomic status variables given level of agreement about the
belief that the only way to stop smoking is through will power…….…….…......81
Summary results for hypothesis one……………......…………….……......………...82
Self-reported health status given smoking status and stages of change………...........84
Comparison by self-reported health status among never smokers and ever
smokers……….......................……………………….……...…………………...84
Comparison by self-reported health status among former smokers and current
smokers……………………………………………….……...…………………..85
xvi
Comparison by self-reported health status among former smokers in the
maintenance SOC, current smokers willing to quit, in the preparation SOC, and
current smokers no willing to quit, in the pre-contemplation SOC………….…..86
Comparison by self-reported health status among smokers in the preparation and
pre-contemplation SOC……………………………….……...………………….86
Comparison by self-reported health status among smokers in the pre-
contemplation, contemplation, and preparation SOC…...……………………….88
Comparison by self-reported health status given likelihood of success if wanted to
quit smoking……………...……………………….……...……………………...88
Comparison by self-reported health status given likelihood of success if decided
to quit smoking……………………………………………...…………………...89
Comparison by self-reported health status variables given level of comfort asking
for help…….………………………………………….……...…………………..89
Comparison by self-reported health status variables given level of agreement
about the belief that the only way to stop smoking is through will power….…...90
Summary results for hypothesis two……………..…………….……...……………..91
Beliefs about smoking variables given smoking status and stages of change……….94
Comparison by beliefs about smoking variables among never smokers and ever
smokers…………………………………………………………………………..94
Comparison by beliefs about smoking variables among former and current
smokers…………………………………………………………………………..95
xvii
Comparison by beliefs about smoking variables among former smokers in the
maintenance SOC, current smokers willing to quit, in the preparation SOC, and
current smokers no willing to quit, in the pre-contemplation SOC……………...96
Comparison by beliefs about smoking variables among smokers in the preparation
and pre-contemplation SOC……………………………………………………...97
Comparison by beliefs about smoking variables among smokers in the pre-
contemplation, contemplation, and preparation SOC…………………………....98
Comparison by beliefs about smoking variables given likelihood of success if
wanted to quit smoking…………………………………………………………..98
Comparison by beliefs about smoking variables given likelihood of success if
decided to quit smoking………………………………………………………….98
Comparison by beliefs about smoking variables given level of comfort asking for
help…………………………………………………………………………….....99
Comparison by beliefs about smoking variables given level of agreement about
the belief that the only way to stop smoking is through will power……..……....99
Summary results for hypothesis three……………………………………………....100
Behaviors about second-hand smoke variables given smoking status and stages of
change…...…….……………………………………………………………………102
Comparison by behaviors about second-hand smoke variables among never and
ever smokers………………...…………………………………………….……102
Comparison by behaviors about second-hand smoke variables among former and
current smokers……………...…………………………………………….……104
xviii
Comparison by behaviors about second-hand smoke variables among former
smokers in the maintenance SOC, current smokers willing to quit, in the
preparation SOC, and current smokers no willing to quit, in the pre-contemplation
SOC………………………………………………………………………..……105
Comparison by behaviors about second-hand smoke variables among smokers in
the preparation and pre-contemplation SOC……………………………..…..…107
Comparison by behaviors about second-hand smoke variables among smokers in
the pre-contemplation, contemplation, and preparation SOC……………..……107
Comparison by behaviors about second-hand smoke variables given believes
about the likelihood of success if wanted to quit smoking…...…………...……108
Comparison by behaviors about second-hand smoke variables given believes
about the likelihood of success if decided to quit smoking………………….....108
Comparison by behaviors about second-hand smoke variables given level of
comfort asking for help…………………………………………………..…..…109
Comparison by behaviors about second-hand smoke variables given level of
agreement about the belief that the only way to stop smoking is through will
power……………………………………………………………………....……109
Summary results for hypothesis four………………………………………….……110
Behaviors about smoking and beliefs about stopping smoking variables given
smoking status and stages of change……….........……………………..……..……112
Comparison by behaviors about smoking and beliefs about stopping smoking
variables among never and ever smokers………………………..…………..…112
xix
Comparison by behaviors about smoking and beliefs about stopping smoking
variables among former and current smokers……………………………..……113
Comparison by behaviors about smoking and beliefs about stopping smoking
variables among smokers in the maintenance, preparation, and pre-contemplation
SOC...…….……………………………………………………..………………113
Comparison by behaviors about smoking and beliefs about stopping smoking
variables among smokers in the preparation and pre-contemplation SOC…..…114
Comparison by behaviors about smoking and beliefs about stopping smoking
variables among smokers in the pre-contemplation, contemplation, and
preparation SOC…………………………………………..……………….……115
Comparison by behaviors about smoking and beliefs about stopping smoking
variables given believes about the likelihood of success if wanted to quit
smoking…………………………………………………………………………116
Comparison by behaviors about smoking and beliefs about stopping smoking
variables given believes about the likelihood of success if decided to quit
smoking………................................................................................................…116
Comparison by behaviors about smoking and beliefs about stopping smoking
variables given level of comfort asking for help……………..……………...…117
Comparison by behaviors about smoking and beliefs about stopping smoking
variables given level of agreement about the belief that the only way to stop
smoking is through will power.…….………………………….....………….…117
Summary results for hypothesis five……………..……………….…..………….…118
xx
Chapter VI. Discussion and Conclusions...…………………………………………..121
Key findings...……………………………………………………………………....121
Socioeconomic characteristics…….…………………………………………....121
Relevant comparisons given socioeconomic status………………………….....123
Relevant comparisons given self-reported health status……………………......125
Relevant comparisons given beliefs about smoking…………………………....126
Relevant comparisons given behaviors about second-hand smoke………….....127
Relevant comparisons given behaviors about smoking and beliefs about stopping
smoking….…………………………………………………….....…………..…129
Discussion………………………………………………………………………......130
Smoking prevalence……………………………………….....……………....…130
Smoking and socioeconomic variables…...……………….....……………....…130
age………………………………………………..…………………......131
Marital status…………...………………………..………………….......131
Acculturation…………………...………………………..……………...131
Smoking addiction……………………………...………………………..……..133
Exposure to SHS behavior……………………...………………………..……..134
Smoking beliefs and behaviors…………….…...………………………..……..136
Smoking and stressful events…………………...………………………..……..138
Expectations about quitting and confidence to succeed………..………..……..139
Quitting smoking and smoking restrictions…...………………………..…..…..140
xxi
Limitations……………………………………………………………………….....140
Recommendations………………………………………………………………......141
Conclusions……………………………………………………………………........144
References………………………..………………………………………………….....145
Appendices………...……………..………………………………………………….....159
xxii
List of Tables
Table 1. Sample disposition and response rate………………………………………......55
Table 2. Demographic characteristics of the sample………….………………………....65
Table 3. Self reported health status, physical activity, and stress……………………......66
Table 4. Summary of health variables…………………………………….…………......67
Table 5. Summary of acculturation categorical variables……………………………......68
Table 6. Acculturation scales……………………………………………...…………......69
Table 7. Self-reported smoking behavior………………………………...…………........69
Table 8. Smoking status……………………………..…………………...…………........70
Table 9. Smoking beliefs…......……………………..…………………...…………........70
Table 10. Second-hand smoke behaviors………………………………...…………........72
Table 11. Smoking outcomes continuous variables……………………...…………........72
Table 12. Smoking Behavior....……………………..…………………...…………........74
Table 13. Former smokers........……………………..…………………...…………........74
Table 14. Statistically significant differences between never smokers and ever smokers
given socioeconomic status ………………………….………………..……........76
Table 15. Statistically significant differences between former and current smokers given
socioeconomic status …………………………………..………..…………........77
Table 16. Statistically significant differences between smokers in the maintenance,
preparation, and pre-contemplation SOC given socioeconomic status….............78
Table 17. Statistically significant differences between smokers in the preparation,
contemplation, and pre-contemplation SOC given socioeconomic status.............79
xxiii
Table 18. Statistically significant differences by likelihood to succeed if wanted to quit
smoking given socioeconomic status.……………….…...…………....................80
Table 19. Statistically significant differences by likelihood to succeed if decided to quit
smoking given socioeconomic status.……………….…...…………....................80
Table 20. Statistically significant differences by level of comfort asking for help to quit
smoking given socioeconomic status.……………………….…...…....................81
Table 21. Statistically significant differences by agreement about the belief that the only
way to stop smoking is through power given socioeconomic status.…..…………..…....82
Table 22. Statistically significant differences between never smokers and ever smokers
given self-reported health status……………….…….………………..……........85
Table 23. Statistically significant differences between former and current smokers given
self-reported health status ……………………………..………..………….........86
Table 24. Statistically significant differences between smokers in the preparation and pre-
contemplation SOC given self-reported health status …………...…………........87
Table 25. Statistically significant differences by likelihood to succeed if wanted to quit
smoking given self-reported health status………………………………..............88
Table 26. Statistically significant differences by level of comfort about asking for help to
quit smoking given self-reported health status.…….............................................89
Table 27. Statistically significant differences by agreement about the belief that the only
way to stop smoking is through will power given self-reported health status…...91
Table 28. Statistically significant differences between never smokers and ever smokers
given beliefs about smoking.……...……………..….…...…………....................95
xxiv
Table 29. Statistically significant differences between former and current smokers
given beliefs about smoking ………………….....….…...…………....................96
Table 30. Statistically significant differences between smokers in the maintenance,
preparation, and pre-contemplation SOC given beliefs about smoking. ..............97
Table 31. Statistically significant differences between smokers in the preparation and pre-
contemplation SOC given beliefs about smoking……………......…………........97
Table 32. Statistically significant differences by likelihood to succeed if decided to quit
smoking given beliefs about smoking………………..…………………..............99
Table 33. Statistically significant differences by agreement about the belief that the only
way to stop smoking is through will power, given beliefs about smoking….….100
Table 34. Statistically significant differences between never and ever smokers given
behaviors about second-hand smoke…………...….…...………........................103
Table 35. Statistically significant differences between former and current smokers
given behaviors about second-hand smoke……..….…...………........................105
Table 36. Statistically significant differences between smokers in the maintenance,
preparation, and pre-contemplation SOC given behaviors about second-hand
smoke…….………………………………………………….…….....................106
Table 37. Statistically significant differences between smokers in the preparation,
contemplation, and pre-contemplation SOC given behaviors about second-hand
smoke...................................................................................................................108
Table 38. Statistically significant differences by likelihood to succeed if wanted to quit
smoking given behaviors about second-hand smoke……………………...........108
xxv
Table 39. Statistically significant differences by likelihood to succeed if decided to quit
smoking given behaviors about second-hand smoke……………………...........109
Table 40. Statistically significant differences between former and current smokers
given behaviors about smoking and beliefs about stopping smoking ………….113
Table 41. Statistically significant differences between smokers in the maintenance,
preparation, and pre-contemplation SOC given behaviors about smoking and
beliefs about stopping smoking ………………………………………………..114
Table 42. Statistically significant differences between smokers in the preparation and
pre-contemplation SOC given behaviors about smoking and beliefs about
stopping smoking……………………………………………………………….115
Table 43. Statistically significant differences between smokers in the preparation,
contemplation, and pre-contemplation SOC given behaviors about smoking and
beliefs about stopping smoking…………..............…………………………….116
Table 44. Statistically significant differences by agreement about the belief that the only
way to stop smoking is through will power given behaviors about smoking and
beliefs about stopping smoking……...………………………...……………….117
xxvi
List of Graphics
Graphic 1. Total U.S. cigarette consumption 1900 – 2006………….…….………………5
Graphic 2. Per Capita U.S. adult cigarette consumption 1900 – 2006……...…………….5
xxvii
List of Appendices
Appendix A. U.S. Smoking status by selected demographic variables 1965 – 2006…..160
Appendix B. DREGAN phone bilingual survey………..……………………………....162
Appendix C. DREGAN face to face bilingual survey………..………………………...191
Appendix D. Study variables………………………………....………………………...245
Appendix D 1. Dependent variables……….……..……....………………………...246
Appendix D 2. Hypothesis 1 Independent variables………....……………………..246
Appendix D 3. Hypothesis 2 Independent variables………....……………………..247
Appendix D 4. Hypothesis 3 Independent variables………....……………………..247
Appendix D 5. Hypothesis 4 Independent variables………....……………………..247
Appendix D 6. Hypothesis 5 Independent variables………....……………………..248
Appendix E. Demographic characteristics of the sample…………………………........249
Appendix E 1. Demographic characteristics of the sample categorical variables….250
Appendix E 2. Demographic characteristics of the sample continuous variables….252
Appendix F. Self-reported health status, physical activity, and stress variables…….....253
Appendix F 1. Self-reported health status, physical activity, and stress categorical variables………………………………………………………………………..…...254 Appendix F 2. Self-reported health status, physical activity, and stress continuous variables…………………………………………………………………..………...256
Appendix G. Summary of acculturation categorical variables……..…...……………...257 Appendix H. Smoking beliefs ……..…………………………………………………...262
xxviii
Appendix I. Second-hand smoke behaviors………..…………………………………...264
Appendix J. Smoking behaviors…………………...…………………………………...265
Appendix K. Group comparisons given socioeconomic status……….............……......267
Appendix K 1. Never and ever smokers given socioeconomic status………...........268
Appendix K 2. Former and current smokers given socioeconomic status………….268
Appendix K 3. Smokers in the maintenance, preparation, and pre-contemplation
SOC given socioeconomic status…...........................................................................268
Appendix K 4. Smokers in the preparation and pre-contemplation SOC given
socioeconomic status.................................................................................................269
Appendix K 5. Smokers in the preparation, contemplation, and pre-contemplation
SOC given socioeconomic status...............................................................................269
Appendix K 6. Likelihood to succeed if wanted to quit smoking, given
socioeconomic status.……………………................................................................270
Appendix K 7. Likelihood to succeed if decided to quit smoking given
Socioeconomic status.…………….…………...……….…...…………....................270
Appendix K 8. Level of comfort asking for help to quit smoking given
Socioeconomic status.…………………….………………...….…...…....................270
Appendix K 9.Agreement about the belief that the only way to stop smoking is
through power given socioeconomic status.…..……................................................271
Appendix L. Group comparisons given self-reported health status……………...…......272
Appendix L 1. Never and ever smokers given self-reported health status………....273
Appendix L 2. Former and current smokers given self-reported health status …….273
xxix
Appendix L 3. Smokers in the maintenance, preparation, and pre-contemplation
SOC given self-reported health status…............................................…………........274
Appendix L 4. Smokers in the preparation and pre-contemplation SOC given
self-reported health status………………………………………...…………...........274
Appendix L 5. Smokers in the preparation, preparation, contemplation, and pre-
contemplation SOC given self-reported health status…………........…………........275
Appendix L 6. Likelihood to succeed if wanted to quit smoking given
self-reported health status…………………………..…………..…………..............275
Appendix L 7. Likelihood to succeed if decided to quit smoking given
self-reported health status……………………………..………..…………..............276
Appendix L 8. Level of comfort about asking for help to quit smoking given self-
reported health status.…….......................……….....................................................276
Appendix L 9. Agreement about the belief that the only way to stop smoking is
through will power given self-reported health status.……............……....................277
Appendix M . Group comparisons given beliefs about smoking.…………......……..…278
Appendix M 1. Never and ever smokers given beliefs about smoking.……....……279
Appendix M 2. Former and current smokers given beliefs about smoking ………..279
Appendix M 3. Smokers in the maintenance, preparation, and pre-contemplation
SOC given beliefs about smoking..............................................................................280
Appendix M 4. Smokers in the preparation and pre-contemplation SOC given beliefs
about smoking……………......……………………………………………..............280
xxx
Appendix M 5. Smokers in the preparation, contemplation, and pre-contemplation
SOC given beliefs about smoking……………..................................…………........281
Appendix M 6. Likelihood to succeed if wanted to quit smoking given beliefs about
smoking………………………………………………………………......................281
Appendix M 7. Likelihood to succeed if decided to quit smoking given beliefs
about smoking………………….……………………………………………….......282
Appendix M 8. Level of comfort asking for help to quit smoking given beliefs
about smoking……………………………………………………………................282
Appendix M 9. Agreement about the belief that the only way to stop smoking is
through will power given beliefs about smoking….……………..………………....283
Appendix N. Group comparisons given behaviors about second-hand smoke………...284
Appendix N 1. Never and ever smokers given behaviors about second-hand
smoke……………………………………………………………………………….285
Appendix N 2. Former and current smokers given behaviors about second-hand
smoke……..……...…...……….................................................................................285
Appendix N 3. Smokers in the maintenance, preparation, and pre-contemplation
SOC given behaviors about second-hand smoke….…………….…….....................285
Appendix N 4. Smokers in the preparation, and pre-contemplation SOC given
behaviors about second-hand smoke.........................................................................286
Appendix N 5. Smokers in the preparation, contemplation, and pre-contemplation
SOC given behaviors about second-hand smoke.......................................................286
xxxi
Appendix N 6. Likelihood to succeed if wanted to quit smoking given behaviors
about second-hand smoke……………………….…………………………….……286
Appendix N 7. Likelihood to succeed if decided to quit smoking given behaviors
about second-hand smoke………………….………………………..………...........287
Appendix N 8. Level of comfort asking for help to quit smoking given behaviors
about second-hand smoke………………….…………………………..……….......287
Appendix N 9. Agreement about the belief that the only way to stop smoking is
through will power given behaviors about second-hand smoke…………….……...287
Appendix O. Group comparisons given behaviors about smoking and beliefs about
stopping smoking …………………..……………………………………………....288
Appendix O 1. Never and ever smokers given behaviors about smoking and beliefs
about stopping smoking ………………………………………………………...….289
Appendix O 2. Former and current smokers given behaviors about smoking and
beliefs about stopping smoking ……………………………………………...…….289
Appendix O 3. Smokers in the maintenance, preparation, and pre-contemplation
SOC given behaviors about smoking and beliefs about stopping smoking….……..289
Appendix O 4. Smokers in the preparation and pre-contemplation SOC given
behaviors about smoking and beliefs about stopping smoking……………….…....290
Appendix O 5. Smokers in the preparation, contemplation, and pre-contemplation
SOC given behaviors about smoking and beliefs about stopping smoking…….......290
Appendix O 6. Likelihood to succeed if wanted to quit given behaviors about
smoking and beliefs about stop smoking………………………………………..….291
xxxii
Appendix O 7. Likelihood to succeed if decided to quit given behaviors about
smoking and beliefs about stop smoking…………………...…………………...….292
Appendix O 8. Level of comfort asking for help to quit given behaviors about
smoking and beliefs about stop smoking…………………...……………………....293
Appendix O 9. Agreement about the belief that the only way to stop smoking is
through will power given behaviors about smoking and beliefs about stopping
smoking……………………………………………………………………………294
1
CHAPTER ONE
INTRODUCTION
Significance of the problem
The combination of the addictive substance nicotine with potent mutagens,
including polonium-210, has made tobacco the principal human poison of the last century
(U.S. Department of Health, 1979; Ravenholt, 1990). Tobacco use is considered the
primary cause of preventable deaths in the world. In the United States, it is associated
with more than 430,000 deaths per year since 1999. In Minnesota, the Department of
Health reported more than 5,600 deaths per year attributable to tobacco use and exposure
to second-hand smoke (SHS) since 2002 (Minnesota Department of Health, the
Minnesota Partnership for Action Against Tobacco (MPAAT), Blue Cross and Blue
Shield of Minnesota (Blue Cross), and the University of Minnesota, 2004).
Tobacco use among Latino communities in Minnesota is a cause of concern due
to the vulnerabilities of this population, particularly recent immigrants who face the
stresses of acculturation, immigration-related issues, inadequate health insurance
coverage, lack of family and social networks, and the absence of culturally-appropriate
and linguistically-competent tobacco cessation programs.
Tobacco cessation interventions have traditionally been designed and
implemented for the mainstream communities and then translated to be used among
minority populations. This approach does not recognize the unique characteristics of
smokers from other cultures and ethnic groups. For this reason, in order to develop
2
culturally-appropriate and linguistically-competent tobacco cessation interventions, it is
necessary to understand and address the complexities of Latino tobacco users.
This research contributes to the better understanding of the characteristics of
Latino smokers living in Minnesota.
History of tobacco use
Considered a sacred plant by natives of the Americas, tobacco has been used for
medicinal, ritual, and economic purposes for more than 5,000 years. According to Musk
and De Klerk (2003), tobacco has been snuffed, smoked, chewed, eaten, drunk, smeared
over bodies, and used in eye drops and enemas; tobacco was also blown onto warriors’
bodies before battle, over fields for agricultural success, over women’s bodies for
fertility, and it has been offered in ritual ceremonies. The Native Americans primarily
smoked tobacco using pipes, although some sniffed tobacco dust through a tube.
The first contact of the Western civilization with tobacco occurred on the islands
of present day Cuba and Haiti by Christopher Columbus and his crew in November 1492
(Ravenholt, 1990), and later by Cortes in what today is Mexico (Crawford, 1853);
however, they did not understand the spiritual, ritual, and social contexts of its use.
Known during some years as “paetum” (Ravenholt, 1990), it is widely accepted
that the Spaniards took the name “tobacco” from the name of the pipe the natives of the
Caribbean used to smoke tobacco leaves (Crawford, 1853).
After the conquest of the natives of the Americas, Spaniards and the Portuguese
extensively cultivated tobacco in the West Indies and in the territory of present day
3
Brazil. They introduced tobacco to Europe and the Philippines in the sixteenth century.
Jean Nicot, the French ambassador to Lisbon, sent tobacco seeds as medicine to Queen
Catherine de Medici and the House of Lorraine, initiating tobacco use and cultivation in
France in 1559 (Ravenholt, 1990). At that time, only pharmacists were authorized to sell
tobacco in Europe, and only based on medical prescriptions (Austin, 1979).
Sir John Hawkins transported tobacco to England from his second expedition to
Florida in 1565; twenty years later, Sir Walter Raleigh, upon his return from his first
expedition to Virginia, introduced the practice of smoking tobacco to England. By 1607,
with the establishment of the namesake colony King James I on the James River in
Virginia, and upon the initiative of John Rolfe, tobacco quickly became Virginia’s
principal crop and export. By the end of the sixteenth century, the Portuguese were
trading tobacco in Africa, India, the Spice Islands, Japan, Macao, China, and other places
in Asia. By the seventeenth century, tobacco was widely used in all trading nations in
Europe, Asia, and Africa (Ravenholt, 1990) and after salt, tobacco likely became one of
the most universally consumed products (Crawford, 1853). While pipe smoking
continued to be the most popular form of tobacco use among the lower classes, snuffing
was a more popular option in Europe among the upper classes during the 1700s
(Ravenholt, 1990).
Throughout the nineteenth century, soldiers and tourists introduced cigarette
smoking and expanded tobacco use in Europe and America. British soldiers returning
from Wellington’s Napoleonic campaigns in the Iberian Peninsula (1808-14) introduced
cigarette smoking to England, and its use increased after the Crimean War (1853-6).
4
Tourists returning from Europe later brought the practice of cigarette smoking to the U.S.
Chewing tobacco, however, remained the most common form of tobacco use during the
nineteen century. In the U.S., tobacco use increased after the American Civil War (1861-
5) (Ravenholt, 1990).
During the nineteenth century, thanks to the development of the cigarette rolling
machine by James Bonsack and Washington Duke and Sons in 1884, U.S. cigarette
production expanded from 1.3 million cigarettes in 1880 to 2.5 billion cigarettes in 1900.
By 1890, Duke’s factory produced 90% of American cigarettes, leading to an antitrust
dismemberment in 1911 (Ravenholt, 1990). In the twentieth century, tobacco use
continued its ascendant trend; in the U.S., annual cigarette consumption per adult
increased from 54 cigarettes in 1900 to 4,345 cigarettes in 1963; a peak of 640 billion
cigarettes were produced in 1981 (Smith & Fiore, 1999).
After 1964, annual cigarette consumption has decreased in the U.S. as a
consequence of the release of 29 Surgeon General reports on tobacco and health,
extensive educational public health campaigns warning about the dangers of tobacco use
and exposure to SHS, as well as a better understanding of the potent addictive properties
of nicotine, the active ingredient in tobacco. Tobacco continues, however, to be
considered the most serious and widespread form of addiction in the world (Pollin &
Ravenholt, 1984).
Graphics 1 and 2 show the cigarette consumption trend in the U.S. from 1900 to
2006.
5
Graphic 1
Total U.S. Cigarette Consumption 1900 - 2006
Source: Source: http://www.cdc.gov/tobacco/data_statistics/tables/economics/consumption/ accessed March 27, 2011.
Graphic 2 Per Capita U.S. Adult Cigarette Consumption 1900 - 2006
Source: Tobacco Outlook/TBS-260/April 28, 2006. Economic Research Service, USDA.
The Latino population in Minnesota
Some authors have found diverse terminology for defining the Latino population;
the most commonly used definitions include “Mexican” and “Mexican-American”
6
(Acuña, 1988). Lillie-Blanton, Leigh, and Alfaro-Correa (1996), refer to those of
“Hispanic origin,” “Spanish-speaking,” “Spanish-surnamed,” “Spanish-origin,”
“Spanish-American,” “Spaniards,” “Hispanos,” (Ulrich, 1999), “Chicano,” “Hispanic,”
“Latino,” and the population’s self-identified terms “Mexicana” and “Mexicano”
(Valdes, 2000). “Hispanic” and “Latino” are the most accepted terms to identify
members of the populations who trace their origin to Latin-American countries. This
study uses the term “Latino” to identify the population which recognizes its Latin-
American ancestry or has immigrated to the U.S. from Latin-American countries.
Since the nineteenth century, Latinos have come to Minnesota employed by
farmers, then by the sugar beet industry, and in the twentieth century by the food
processing, landscape, and leisure industries primarily in hotels, bars and restaurants.
During the last decades of the twenty century, some Latinos from Central America and
South America came to Minnesota as political refugees. Latinos have also been coming
to Minnesota under the family reunification program and as students.
Migrant workers in Minnesota tend to migrate with their families from their home
community in the Rio Grande Valley along the Texas-Mexico border, directly to a
Minnesota location in the Northeast or Southern regions. Most of them are of Mexican
descent, and are U.S. citizens or permanent residents of Texas (Ulrich, 1999). The sugar
beet-growing region of the Red River Valley, straddling the Minnesota-North Dakota
border was, and continues to be, a major destination for Latino seasonal workers;
however, advances in sugar beet production, such as improved seeds and herbicides, have
reduced the demand for migrant workers (Ulrich, 1999).
7
The south-central and southeast regions of the state, where canneries process
sweet corn, green peas, and other vegetables, are also destinations of migrant workers.
Typically, processing facilities recruit workers through company representatives or
through hired labor contractors who travel to southern Texas and northern Mexico each
winter to enroll workers (Contreras, Duran & Gilje, 2001).
Migrant workers, like most Latinos, come to Minnesota to improve their family’s
quality of life. Originally, they provided the seasonal workforce necessary to thin sugar
beets, pick strawberries, cut asparagus, and perform the hand labor necessary to produce
the wide variety of perishable fruits and vegetables grown in the state. Later, as
agricultural production practices became more mechanized and specialized, field work
shifted to driving trucks, operating machinery in the fields, and processing and packaging
seasonal vegetable crops. In Minnesota, many migrant workers now perform field work
and factory work, and more are employed in nursery settings in the expanding ornamental
crop industry (Ziebarth & Byun, 2002). The estimated value added annually to the local
economy due to the presence of the Latino labor force employed in agricultural industries
is approximately $24.7 million (Ziebarth & Byun, 2002).
The first Latinos in the Twin Cities metropolitan area settled on the west side of
the Mississippi river in Saint Paul in the late 1880s, during the winter season, while
waiting to work in agriculture during the spring, summer and fall seasons. Other Latinos
settled in neighborhoods around Lake Street in South Minneapolis, and on the East Side
of Saint Paul. Recently, Latinos have settled in the Frogtown area in Saint Paul. Hispanic
Advocacy and Community Empowerment through Research (HACER) has observed
8
Latino enclaves throughout the metropolitan area, including Ecuadorians and Peruvians
in the northeast area of Minneapolis and Salvadorans in Richfield. Ulrich (1999)
observed that first-generation Latinos tend to settle in the city, while the second
generation is moving to the suburbs. Suburban residents tend to be older and have higher
incomes and educational levels than Latinos living in the city. Of city residents, Latinos
in St. Paul tend to have lived in Minnesota longer than Latinos in Minneapolis, by a
median time period of 13 years in St. Paul vs. four years in Minneapolis, and are more
likely to have been born in the United States. In addition, St. Paul residents are far more
likely to own their own home than those living in Minneapolis (Ulrich, 1999).
Among Latinos currently living in Minnesota, almost 90% of the population of
Mexican descent and 74% of other Latino ancestry are native-born U.S. citizens, and over
half (54%) of the population of Mexican descent and 31% of other Latino origin are
native-born Minnesotans. Approximately three percent of Minnesota’s Mexican born
residents and nine percent of other Latinos living in Minnesota are naturalized U.S.
citizens. In 1990, 93% of the population of Mexican descent and 83% of other Latino
ancestry living in Minnesota were U.S. citizens (Compean, 1995).
Census data from the year 2000 (U. S. Census Bureau, 1990, 2000) show that
Latinos in Minnesota are immigrating from different countries, including Mexico
(66.7%), Puerto Rico (4.6%), Cuba (1.8%), and other Latin American countries (26.9%).
Approximately 53.6% of the Latino population is located in the Twin Cities metropolitan
area. The city with the largest Latino population is Minneapolis, with 29,175 Latinos
representing 7.6% of its population; St. Paul follows with 22,715 Latinos, about 7.9% of
9
its population; Faribault has 4,084; Northfield has 3,488; and Willmar has 2,911 Latinos,
representing 15.9% of its population.
The 2000 census also shows that Latinos have become the largest minority in the
U. S. They are a significant work force that contributes to the economic progress of the
country. In Minnesota, the Latino population has grown 466% since the 1980 census, and
166% during the 1990s, from a population of 53,884 in 1980 to 143,382 in 2000,
representing 2.9% of the total population.
The Latino population is vulnerable to high morbidity and mortality rates, due to
the low utilization of health services and the fact that about 30% of Mexican- Americans
do not have health insurance or are under-insured. In addition, the health care barriers
affecting the Latino population add to their vulnerability and increase the need for
developing sound risk factor reduction programs, including prevention of tobacco use and
the implementation of smoking cessation programs (Trevino & Moss, 1984). Previous
studies do not reflect the reality of the tobacco problem in the Latino community of
Minnesota. Most of the studies have a margin of error higher than 2.9%, which prevents
the results from being generalized to the Latino population living in Minnesota.
Health care barriers facing Latino communities in Minnesota
According to HACER, many Latinos find it difficult to understand the dynamics
of the U.S. health care system and the concept of health insurance. Latinos who are
enrolled in Medical Assistance and Minnesota Care meet obstacles when it comes to
finding out more information about these programs. They must communicate
10
predominantly with English-speaking program officers. Lack of materials in Spanish and
the shortage of Spanish-speaking case-workers is a common complaint. Some Latinos
have stated that they, or others whom they know, have assumed they were not eligible for
services before applying for the programs. These assumptions were based on rumors,
eligibility requirements from other states where they previously lived, and expectations
about income qualifications (Smaida & Blewett, 2002).
Information is often shared by word-of mouth between community and family
members. Many Latinos fear encounters with government institutions because, despite
being residents or American citizens, many have concerns about the role of the U.S.
government and fear of deportation. It is because of this situation that government
sponsorship or government involvement in public health care programs is often a concern
for Latinos. The cost of health care, including the cost of premiums, deductibles, and co-
pays is a significant barrier to health care services as reported by focus group
participants. Many individuals find the cost of private and even some public insurance
programs to be prohibitive. Even when their employers offer insurance options, many
individuals feel they cannot afford to purchase them. They often have to make difficult
financial decisions and must weigh the need for health care against other basic needs.
This leads to access problems and infrequent use of clinics and health care services
(Castellanos, Flores & Giles, 2004).
In rural settings, geographic location is more often an issue than in the
metropolitan area. In such areas, Latinos have transportation difficulties, and it has been
11
noted that the only available health care facility is sometimes located a long distance
from their homes.
There are numerous issues that affect Latinos’ health, including housing
problems, occupational safety, and problems affecting the more vulnerable members of
their communities such as the elderly and community members suffering from chronic
diseases. Several Latinos have stated that they feel knowledgeable about the need for
health promotion and prevention services, but believe that prevention is not always
financially possible if it means extra visits to the clinic for screenings (Castellanos, Flores
& Giles, 2004).
There is a general clash of cultures, lack of comprehensible information, and a
limited understanding of Latino cultural issues by public health and health care
professionals. Together, these limitations create a situation that is extremely frustrating to
Latinos who are new to Minnesota. Some Latinos associate any trip to the doctor or
hospital with significant out-of-pocket costs. This dilemma often leads to difficult
choices, like whether to pay the rent or pay for the health care service.
In urban areas, neighborhood and housing issues such as a lack of affordable
housing are more often related as a cause of health care access barrier than in rural areas.
Latinos living in rural areas report employer discrimination and occupational hazards as
health care access barriers more often than their metropolitan counterparts do. In
addition, Minnesota’s weather is also a challenge, especially during the winter season, for
a population who migrated from tropical and subtropical latitudes. (Castellanos, Flores &
Giles, 2004).
12
Public health priorities for Latino communities in Minnesota
The Minnesota Department of Health has determined the following to be Hispanic Latino
Health Priority Areas: diabetes, healthy youth development, HIV/AIDS and STDs,
immunization for children and adults, breast and cervical cancer, cardiovascular disease,
unintentional injuries and violence, and infant mortality (Minnesota Department of
Health, Office of Minorities and Multicultural Health. Eliminating Health Disparities
Initiative, 2003). Tobacco use and environmental exposure to tobacco smoke do not
appear to have been seen as a priority problem among Latino communities, because these
communities have not been exposed to decades of public health campaigns and warnings
emphasizing tobacco use and SHS exposure dangers (Blue Cross and Blue Shield of
Minnesota, ClearWay Minnesota, & Comunidades Latinas Unidas en Servicio, 2006). In
addition, the tobacco industry is targeting the Latino population, particularly women and
the youth, to expand its market, which has been reduced among mainstream communities
in the U.S.
Objectives of the Study
The objectives of the study are:
1. To describe the characteristics of Latino cigarette smokers living in
Minnesota.
2. To determine if there are significant differences between Latino smokers not
willing to quit smoking, in the pre-contemplation Stage of Change (SOC);
13
Latino smokers willing to quit smoking, in the preparation SOC; and Latino
former smokers, in the maintenance SOC. Differences will be evaluated by
socioeconomic status and level of acculturation; self-reported physical and
mental health, consumption of fruits and vegetables, and physical activity;
beliefs regarding smoking and positive aspects of smoking, and knowledge of
tobacco-related diseases; attitudes and level of exposure to SHS; and the level
of cigarette addiction and willingness to quit smoking.
3. To identify the significant characteristics of Latino smokers that would be
relevant to develop culturally-competent and linguistically-appropriate
tobacco cessation interventions.
Significance of the study
This study addresses, for the first time, the relevant characteristics of Latino
smokers living in Minnesota. Frequently, characteristics of smokers from minority
populations in the state of Minnesota have been generalized from studies targeting the
mainstream population; minority populations have been included, but the sample sizes
and the margins of error have precluded generalization of these results to those
populations. No previous studies to determine the characteristics of Latino smokers have
been conducted in Minnesota.
The Latino population of Minnesota has unique characteristics, such as broader
ethnic and cultural diversity, that must be taken into account in order to design, develop,
14
and implement culturally and linguistically-appropriate tobacco control interventions and
smoking cessation programs.
15
CHAPTER TWO
LITERATURE REVIEW
Nicotine Addiction
Nicotine, discovered by Gaspare Cerioli in Italy and Louis Nicholas Vauquelin in
France in 1807, was isolated by Ludwig Heinrich Reimann and Karl Wilhelm Heinrich
Posselt in Germany in 1828 (Goodman, 1994). Nicotine is an alkaloid that mimics the
effects of acetylcholine, increases the flow of dopamine, and boosts the activity of the
brain's reward system, producing pleasure. Nicotine also induces cravings to keep it in
the bloodstream at sufficient levels to maintain its effects. As with other psychotropic
substances, the brain develops tolerance; therefore, in order to have the same level of
effect, users increase their dose of nicotine continuously to prevent withdrawal
symptoms. These include: heart rate and blood pressure changes, sleeping problems,
brain wave disturbances, and anxiety (Nestler & Malenka, 2004).
Addiction involves the progression from acute use to the development of drug-
seeking behavior, vulnerability to relapse, and the decreased, slowed ability to respond to
naturally rewarding stimuli (Koob & Kreek, 2007). Nicotine is as addictive as heroin and
cocaine. In 1988, the Surgeon General Report on Nicotine Addiction defined addiction as
“the compulsive use of a drug that has psycho-activity and that may be associated with
tolerance and physical dependence (i.e., may be associated with withdrawal symptoms
after the cessation of drug use)” (Department of Health and Human Services, 1988). The
report describes tobacco addiction as requiring daily cigarette consumption, difficulty
16
going a day without smoking, and a high likelihood of withdrawal symptoms after
cessation of smoking. Denial, rationalization, and reinforcement are key elements in the
addictive process (Hurt & Robertson, 1998).
According to Connolly, Alpert, Wayne, and Koh (2007), "Cigarettes are finely-
tuned drug delivery devices, designed to perpetuate a tobacco pandemic.” The
concentration of nicotine per cigarette sold in the U.S. increased by 11% from 1999 to
2005; on average, each cigarette contains 13.46 mg of nicotine, of which 1.79 mg are
metabolized as cotinine (Connolly, Alpert, Wayne, & Koh, 2007). The average blood’s
cotinine concentration in addicted smokers is about 300 ng per milliliter. The cotinine
level normalized for cigarette consumption is 14 ng per milliliter per cigarette, or 70 ng
per milliliter for a person who smokes five cigarettes per day. Benowitz and Henningfield
(1994) estimated a level of 50 to 70 ng of cotinine per milliliter, five cigarettes per day, as
the cut off point for the addictive threshold.
The revised fourth edition of the Diagnostic and Statistical Manual of Mental
Disorders –Test Revision (American Psychiatric Association, DSM-IV-TR, 2000),
includes nicotine dependence and nicotine withdrawal as substance-related disorders,
characterized by tolerance, withdrawal syndrome, patterns of compulsive use, desire to
cut down or regulate use, spending a great deal of time obtaining, using or recovering
from its effects, spending more time with substance-using friends, and continuing to use
the substance despite recognizing its contributing role to psychological or physical
problems. Once dependence is established, evidence suggests that tobacco motivation is
strongly influenced by a reduction in withdrawal symptoms, an expectation of stress
17
reduction, and conditioned reinforcement. Nicotine motivation may also be influenced by
modulation in stimulus incentive value (Baker, Brandon, & Chassin, 2004).
Tobacco-related diseases
According to the 2006 Report of the Surgeon General, tobacco smoke contains, in
addition to the addictive nicotine, more than 4,000 chemicals of which more than 60 are
recognized carcinogens. These include: acetaldehyde, acrolein, aromatic amines,
benzene, butadiene, carbon monoxide, cyanide, formaldehyde, hydroquinones, ketones,
nitrosamines, phenols, cadmium, chromium, hydrazine, lead, nickel, and the radioisotope
polonium-210. These substances, when absorbed, affect almost all the organs and
systems of the human body, particularly the cardiovascular, respiratory, and
gastrointestinal systems (U.S. Department of Health and Human Services, 2006).
Tobacco-related diseases have been described for more than four centuries.
Between 1603 and 1640, Ahmed I and his successor, Murad IV, Sultans of the Ottoman
Empire, banned smoking as a threat to public morals and health (Grehan, 2006). In 1604
in Oxford, England, King James I displayed “black brains and black viscera,” allegedly
obtained from the bodies of smokers (Whelan, 1984); in 1634, the Patriarch of Moscow
forbade the sale of tobacco (Price, 1961). More than one century later, Dr. John Hill
described the cancer of “the nasal passages” of a tobacco snuffer in 1761, followed by
Benjamin Rush’s description of the negative effects of smoking in 1798 (Rush, 1806). In
1851 in France, Jean Piaget described leukoplakia on the tongue of a pipe-smoking
patient (Ravenholt, 1990).
18
During the twentieth century, scientific evidence associates tobacco use with
cancer, cardiovascular diseases, respiratory diseases, and with the complication of many
other health problems. Fritz Lickint published the first statistical evidence linking lung
cancer and smoking in Germany in 1929 and introduced the term “passive smoking” in
1936; three years later, Oschner and DeBakey reported the association between smoking
and lung cancer, which has been validated consistently throughout the twentieth century
(Mackay, Eriksen, & Shafey, 2006).
In the early 1950s, scientific publications in the U.S. confirmed that tobacco is an
etiologic factor for bronchogenic carcinoma (Wynder & Graham, 1950; Doll & Hill,
2004). Due to the significant evidence linking tobacco and serious health problems, the
U.S. Surgeon General has published 29 reports on smoking and health, including:
Tobacco and Health (1964), Nicotine Addiction (1988), The Health Benefits of Smoking
cessation (1990), Tobacco Use among U.S. Racial and Ethnic Minority Groups (1998),
Women and Smoking (2001), The Health Consequences of Smoking (2004), and The
Health Consequences of Involuntary Exposure to Tobacco Smoke (2006). The first report
on Tobacco and Health confirmed that cigarette smoking is causally related to lung
cancer, oral cancer, cancer of the larynx, cancer of the esophagus, cancer of the urinary
bladder, chronic bronchitis, pulmonary emphysema, coronary disease, peptic ulcer, lower
birth weight, and accidental fires in the home (U.S. Department of Health, Education, and
Welfare. Public Health Service, 1964).
Further reports recognized that tobacco use is addictive and is the cause of cancer
in directly exposed tissues, such as the lips, mouth, nasopharynx, trachea, and bronchi. In
19
addition, prospective studies have shown the role of tobacco in causing cancers in many
other organs and tissues, including the pancreas, liver, spleen, stomach, kidneys, cervix,
prostate, skin, and bone marrow, and as a cause of acute myeloid leukemia (Ravenholt,
1990).
Studies have also documented the close relationship between cigarette smoking
and early coronary disease, atherosclerosis, and premature death from cardiovascular
diseases (Sargent, Shepard, & Glantz, 2004). In 1983, the U.S. Department of Human
Services acknowledged the temporal relationship between trends in cigarette smoking
and mortality from coronary heart disease, lung cancer, emphysema, chronic pulmonary
obstructive disease, cardiovascular diseases, cavities, halitosis, and other disorders.
According to the 2001 Surgeon General’s Report on Women and Smoking,
tobacco use negatively affects pregnancy outcomes, fertility, and contraception. Smoking
is also associated with higher rates of stillbirth and neonatal death, and is linked with
ectopic pregnancy and spontaneous abortion. Infants born to mothers who smoke during
pregnancy tend to have lower birth weight, and are small for their gestational age.
Obesity and smoking have been associated with birth defects and miscarriages. (U. S.
Department of Human Services, 2001). The report associates smoking with infertility,
alerts that smoking may be detrimental to in-vitro fertilization, and warns that women
who smoke and use contraceptives are at especially high risk for heart and cardiovascular
diseases (Sonfield, 2003).
In 2005, the Office of Environmental Health Hazard Assessment (OEHHA) of the
State of California found that SHS exposure is causally associated with respiratory
20
illnesses, infertility, cancer in young patients, perinatal problems, and cardiovascular
diseases. The assessment describes how SHS causes respiratory illnesses and lung cancer,
and its adverse impact on human reproduction, sudden infant death syndrome (SIDS),
increased respiratory tract infections, increased middle ear infections, and perinatal and
postnatal manifestations of developmental toxicity, resulting in low birth weight,
impaired lung function and growth, and pre-term delivery. Also, SHS causes acute lower
respiratory tract infections and other chronic respiratory symptoms in children including
bronchitis and pneumonia, asthma induction and exacerbation in children and adults; eye
and nasal irritation in adults; nasal sinus cancer; breast cancer in younger, primarily pre-
menopausal women; and acute and chronic coronary heart disease (OEHHA, 2005).
The health effects assessment also describes how there is some evidence of a
causal association of SHS exposure and the following conditions: spontaneous abortion,
intrauterine growth retardation, and adverse impact on cognition and behavior. Other
reported effects include allergic sensitization, infertility, elevated risk of stroke in adults,
decreased pulmonary function, exacerbation of cystic fibrosis, chronic respiratory
symptoms, and nasopharyngeal and cervical cancer in adults, as well as brain cancer and
lymphomas in children, (OEHHA, 2005).
Tobacco-related Mortality
During the period 1997- 2001, the Centers for Disease Control (CDC) estimated
an annual average of 437,902 deaths, 259,494 among men and 178,408 among women,
attributable to smoking in the U.S. Among adults, 158,529 (39.8%) of these deaths were
21
attributed to cancer; 137,979 (34.7%) to cardiovascular diseases; and 101,454 (25.5%) to
respiratory diseases. The three leading specific causes of smoking-attributable death were
lung cancer (123,836), chronic obstructive pulmonary disease (COPD) (90,582), and
ischemic heart disease (86,801). In the same period, smoking during pregnancy resulted
in an estimated 910 infant deaths annually. It is estimated that 38,112 lung cancer and
heart disease deaths annually were attributable to exposure to SHS, and 918 deaths were
also estimated from smoking-attributable fires (CDC, 2005).
Smoking prevalence among the U.S. adult population
Data from the CDC show that since 1965, the prevalence of cigarette smoking
among the U.S. population 18 years of age and older has consistently decreased, dropping
from 42.4% in 1965 to 20.8% in 2006. At the same time, the percentage of those who
never smoked has consistently increased from 44% in 1965 to 58.2% in 2006. During the
same period, the percentage of former smokers has changed from 13.6% in 1965 to 21%
in 2006 (CDC, 1992, 1999, 2000, 2001, 2004, 2005, 2007). A comprehensive description
of the cigarette consumption prevalence in the U.S. is shown in Appendix A.
Smoking prevalence among the U.S. adult Latino population
According to the National Health Interview Surveys (NHIS), the smoking
prevalence among the U.S. Latino population has consistently decreased from 34.3% in
1978 to 15.2% in 2006. Mirroring this reduction, the percentage of the Latino population
who has never smoked has increased from 52.9% to 72.1% in the same period. The
22
percentage of former smokers, however, has remained around 13% during the same
period, with a variation from 17.2% in 1985 to 12.7% in 2006.
Smoking prevalence by gender among the U.S. adult population
In the U.S., there is a higher prevalence of smoking among adult men who have
experienced a greater reduction in smoking prevalence, compared to women. From 1955
to 2006, smoking prevalence among adult men decreased from 68% to 23.9%; during the
same period, the smoking prevalence among adult women decreased from 32.4% to
18.0% (US Surgeon General, 1964; CDC, 2007).
Smoking prevalence by gender among the U.S. adult Latino population
Similarly, the “Morbidity and Mortality Weekly Report” (MMWR) shows
significant gender differences in the smoking prevalence and its reduction among U.S.
Latino populations, from 30.9% in 1990 to 20.1% in 2006 for men and from 16.3% in
1990 to 10.1% in 2006 for women respectively.
In 1989, in San Francisco, California, a study reported a smoking prevalence of
32.4% among Latino men and 16.8% among Latino women (Marin, Perez-Stable, &
VanOss, 1989). Five years later, in 1994, the reported smoking prevalence among Latino
men and women was 26% and 8% respectively (Perez-Stable, Marin, & VanOss, 1994).
In 2001, the smoking prevalence reported for Latino men and women living in the eight
cities with the largest concentration of Latino communities in the U.S. were 25% and
12.1% respectively (Perez-Stable et al., 2001).
23
Smoking prevalence by country of origin among the U.S. adult Latino populations
In addition to gender, studies have also found differences in the prevalence of
smoking among Latino populations by country of origin and age. According to the
Hispanic Health and Nutrition Examination Survey (HHANES), during the period 1982 –
1984, among Mexican, Puerto Rican, and Cuban populations in the U.S., approximately
40% of men and 26% of women were current smokers (Haynes, Harvey, Montes,
Nickens, & Cohen, 1990). In 1999, the reported smoking prevalence for Latino men and
women from Cuba, Puerto Rico and Mexico combined were 26.2% and 14.3%
respectively (CDC, 1999).
Smoking prevalence among the Minnesota adult population
Data from the Behavioral Risk Factor Surveillance System (BRFSS) show in
Minnesota a similar trend reduction of the smoking prevalence than in the U. S.
population, from 26.5% in 1984, to 18% in 2006.
Smoking prevalence by gender in the Minnesota adult population
Data from the Minnesota Adult Tobacco Survey (MATS) show a higher
prevalence of smoking among men compared to women as follows: 24% among men and
20.3% among women in 1999, 21.5% and 16.9% in 2003, and 18.6% and 15.5% in 2007
respectively (ClearWay Minnesota, Blue Cross and Blue Shield of Minnesota, and
Minnesota Department of Health, 2008).
24
Smoking prevalence among the Minnesota adult Latino population
The prevalence of tobacco use among adults 18 years and older in Minnesota’s
Latino population has not been assessed consistently state-wide. In Hennepin County
however, data from the Survey of the Health of Adults, the Population, and the
Environment (SHAPE) showed a reduction in the adult Latino population’s prevalence of
tobacco smoking, from 21.2% in 1998 to 13.6% in 2006 (Hennepin County Human
Services and Public Health Department, 2008).
Smoking prevalence by age
According to the CDC, data from 1965 to 2006 show how the number of smokers
has decreased for all age-groups as follows: Young adults, 18 to 24 year old, from 45.5%
in 1965 to 23.9% in 2006; 25 to 44 year old, from 51.2% in 1965 to 23.5% in 2006; 45 to
64 year old, from 41.6% in 1965 to 21.8% in 2006; and 65 year old and oldest, from
17.9% in 1965 to 10.2% in 2006. The 65 year old and oldest age group has consistently
reported the lowest prevalence of smoking.
As reviewed previously, in the U. S., the smoking prevalence difference by
gender remains in all age groups. For example, in 2006 the reported smoking prevalence
by gender and age group was: 18 to 24 year old (men, 29.5%; women, 19.3 %); 25 to 44
year old (men, 26%; women, 21%); 45 to 64 year old (men, 24.5%; women, 19.3%); and
65 year old and older (men, 12.6%; women, 8.3%) (CDC, 2007).
25
For the Latino populations, comprehensive data of smoking prevalence by age
group is not available. Some studies suggest a greater prevalence of smoking among
younger Latinos. According to the HHANES report, between 1982 and 1984, the age-
adjusted smoking rates were 42.5% for Mexican-Americans, 39.8% for Puerto Ricans,
and 41.6 % for Cubans. The age-adjusted rate for 20 to 34 year old Cuban-American men
was 50.1%, compared with 23.8% for Mexican-American women (Haynes, Harvey,
Montes, Nickens, & Cohen, 1990). Another study from HHANES found that age-specific
prevalence rates were lower for women than for men; however, when compared by age,
women in some age-cohorts have a higher prevalence of smoking (Escobedo &
Remington, 1989).
Smoking prevalence by marital status
A recent report shows that compared to the married, the likelihood of smoking is
significantly greater for single (continually never-married and continually divorced or
separated) men and women (Umberson & Liu, 2006).
Smoking prevalence by level of education
Some studies show that as the level of education increases, the ethnic differences
in smoking decrease and become negligible among those who completed college. A high
percentage of less-educated white men (92.5%) and most less-educated white women
(73.1%) were either current or former daily smokers (Winkleby, Schooler, Kraemer, Lin,
& Fortmann, 1995). Similarly, a study reported that Latino respondents with 12 years of
26
education or less increased their odds of smoking (OR = 1.17, 95% CI = 1.01, 1.35)
(Perez-Stable et al. 2001).
Data from the CDC show that since 1970, smoking prevalence among the adult
population with less than 12 years of education decreased from 37.5% to 26.6% in 2004
(Appendix A. Smoking Prevalence among U.S. adult population with less than 12 years
of education, 1970 – 2004). A study that analyzed data in California from 1979 to 1990
found large differences in smoking prevalence rates between Latino and white pairs with
lower levels of education. White men and women with less than a high school degree
were approximately twice as likely to be current, daily cigarette smokers compared with
similarly educated Latino men and women, 52.7% white men vs. 30.1% Latino men and
46.1% white women vs. 20.6% Latino women (Winkleby, Schooler, Kraemer, Lin, &
Fortmann, 1995).
Smoking prevalence by income
Data from the CDC show a higher smoking prevalence among the adult
population below the poverty level. Although there is a reduction in the smoking
prevalence for the total population since 1983, the difference remains stable. For the adult
population above the level of poverty the smoking prevalence decreased from 31.5% in
1983 to 20.4% in 2006; similar change was observed for the adult population below the
poverty level, from 40.2% in 1983 to 30.6% in 2006. During the same period, the
percentage of those who never smoked increased in both groups, from 45.8% in 1983 to
57.3% in 2006 for the adult population above the poverty level, and from 47.7% in 1983
27
to 55.8% in 2006 for the adult population below the level of poverty (CDC, 2007). A
comprehensive description of smoking prevalence in the U.S. is shown in appendix A.
Recent studies show that smoking behavior in developed countries is strongly
related to socioeconomic status (SES), with a higher prevalence among lower SES and
less educated populations, the unemployed, and single mothers. During the last 30 years,
the prevalence of smoking was reduced by more than 50% in the upper socioeconomic
levels of British society, but there were not significant changes in the most disadvantaged
groups. Smoking cessation rates in the Great Britain have an inverse relationship with
social deprivation (Fagerström, 2002).
Smoking prevalence by level of acculturation
Several studies have shown that among Latino populations, there are differences
between gender and level of acculturation. For example, in 1989 in San Francisco,
California, a telephone survey found that the age-adjusted overall smoking prevalence
among Latinos was 25.4%, with more men (32.4%) than women (16.8%) smoking, and
also that the age-adjusted smoking prevalence was higher among less acculturated men
(37.5%) compared with the more acculturated (26.7%). It was, however, higher among
more acculturated women (22.6%) compared with the less acculturated women (13.6%)
(Marin, Perez-Stable, & Vanoss, 1989).
Data from the 1995–1996 and 1998–1999 Current Population Survey Tobacco
Use Supplement showed that Latino immigrants exhibited significantly lower smoking
prevalence rates than non-immigrants. However, rates varied according to country of
28
origin (Baluja, Park, & Myers, 2003). Perez-Stable et al. (2001) found that smoking rates
were not significantly different by national origin among men, but Puerto Rican women
had higher rates of smoking than women from other Latino American countries. In
addition, they found that Central American men and women had the lowest smoking
rates. Foreign-born respondents were less likely to be smokers (odds ratio = 0.77, 95% CI
= 0.66 - 0.90) than U.S.-born respondents, and a high level of acculturation was
associated with the highest likelihood to be smokers for women (OR = 1.12, 95% CI =
1.00 - 1.25) and the lowest for men (OR = 0.86, 95% CI = 0.78 - 0.95). Puerto Rican and
Cuban respondents were more likely to be current smokers and to smoke more than 20
cigarettes per day. Older, U.S.-born, and more-educated Latino respondents were less
likely to be current smokers. Respondents of Puerto Rican and Cuban origin were more
likely to smoke. They concluded that acculturation has different effects on smoking
behavior by gender (Perez-Stable, et al.., 2001). Other researchers described how
acculturation, as indicated by English language use, increases the risk of smoking among
Latino adolescents which, associated with smoking-related psychosocial variables, may
lead to an increased risk of experimentation with smoking (Unger, Cruz, Rohrbach,
Ribisl, et al., 2000).
Self-reported health status and smoking
Several studies have found an inverse relationship between smoking and self
reported health status. Yaffe (2006) reported, after adjusting for demographics and other
health status measures, that perceived health status was affected significantly by smoking
29
status; the coefficient of smoking varied from -0.43 in the univariate model to -0.26 when
all the explanatory variables such as pain, any physical limitation, and high blood
pressure, were included in the model. Another study that examined the relationship
between smoking status and health-related quality of life (HRQOL) from the West
Virginia 2001 BRFSS found that compared to current smokers, non-smokers had greater
odds of reporting good, very good or excellent health (OR = 1.80, 95% CI = 1.34 - 2.34);
lower odds of reporting 14 or more days of poor mental health during the previous month
(OR = 0.48, 95% CI = 0.36 - 0.63); and lower odds of reporting 14 or more days of poor
physical health during the previous month (OR = 0.57, 95% CI = 0.43 - 0.76). Similarly,
non-smokers and former smokers had lower odds of reporting 14 or more days of activity
limitations during the previous month (non-smokers OR = 0.39, 95% CI = 0.27 - 0.55;
and former smokers OR = 0.62, 95% CI = 0.43 - 0.89) (Mody & Smith, 2003). The same
authors found similar significant associations in a cross-sectional analysis with self-
reported data from the U.S. 2001 BRFSS (Mody & Smith, 2006). Smoker status was also
found to negatively influence health self-rating (Wright, 1987).
A study using data from the Southwestern sample of the Hispanic Health and
Nutrition Examination Survey (HHANES) found that younger Mexican-American men
who smoke more than 10 cigarettes per day were more likely to report greater activity
limitation due to poor health, and that non-smoking middle-aged men and women
generally reported better health than lighter smokers (Lee & Markides, 1991).
30
Mental health disorders and smoking
Mental health diseases, including schizophrenia, depression, and drug abuse of
cocaine, heroin and alcohol are considered risk factors for nicotine addiction. Studies
have found that smokers are more likely to have a history of major depression and are
much less likely to quit than those with no history of depression, probably due to a
common genetic predisposition to the two disorders (Fagerström, 2002).
Smoking and stress
Several studies have found that smoking response to stress differs by gender and
stressor. For example, one study found that interpersonal loss events are associated with
continued abstinence, while women were more likely than men to relapse or continue
smoking in response to an adverse financial event. Health events were associated with the
increased likelihood of quitting for men than for women (McKee, Maciejewski, Falba, &
Mazure, 2003). A study found that Mexican-American women who smoke reported
higher levels of depressive symptoms (Lee & Markides, 1991). Similarly, another study
found that current smokers were more likely to report an increased level of depressive
symptoms compared with non-smokers (Ridner, 2005)
Studies have found that smoking is used to relieve stress; however, its effects vary
by gender. For instance, negative health and financial events have been described as
important risk factors for women and tobacco use. Men are more likely to quit smoking
in the presence of a health event, while women were more likely than men to continue
smoking in the presence of an adverse financial event (McKee, Maciejewski, Falba, &
31
Mazure, 2003). Smoking has been self-reported as relaxing and helping to reduce stress
(Kassel, Stroud, & Paronis, 2003). Nicotine dependence, however, appears to aggravate
stress. Parrot (1999) reported that smokers need nicotine to feel normal, and that their
stress level is higher than that of non-smokers.
Smoking, weight, Body Mass Index (BMI), consumption of vegetables and fruits,
and physical activity
Previous studies consistently reported that one of the reasons young adults smoke
is to control their body weight. (Rigotti, Lee, & Wechsler, 2000; Wee, Rigotti, Davis, &
Phillips, 2001). Some studies show that smokers have a lower weight than non-smokers
and suggest that smokers believe that smoking helps control their body weight. Smokers
are also more concerned about body weight than non-smokers (Wiseman, Turco, Sunday,
& Halmi, 1998). Some authors suggest that nicotine could have weight-control activity
(Wack & Rodin, 1982). Other authors suggest that men are less likely than women to
believe that smoking helps to control their weight (McKee, Nhean, Hinson, & Mase,
2006).
Another study found that for each point lower on the Body Discrepancy Score,
subjects were 19 percent more likely to smoke (Jackson, 2007). Some researchers have
found that a negative body image may decrease the number of cigarette cessation
attempts. In addition, weight gain during smoking cessation may adversely affect body
image and lead to an increased risk for relapse. (King, Matacin, White, & Marcus, 2005).
32
Among Latinos, a study using data from the Southwestern sample of the Hispanic
Health and Nutrition Examination Survey (HHANES) found less consistent findings
regarding smokers having lower body weight than non-smokers among Mexican-
Americans (Lee & Markides, 1991).
Studies suggest that body image and eating related disorders play a significant
role in smoking initiation (Stice & Shaw, 2003). A study found that smokers who use
media more than 4 hour per day do not have an increased risk for obesity or overweight,
contrary to non-smokers, who have 3.9 times greater risk for obesity and 1.6 times
greater risk of being overweight (Yore, Fulton, Nelson, & Kohl, 2007). Some authors
recognize that smoking is associated with weight control among middle age and older
smokers (Ward, Klesges, & Vander Weg, 2001).
Studies have consistently found that current smokers have lower BMI than former
smokers and those who have never smoked, independent of their dietary intake and
physical activity (Klesges, Eck, Isbell, Fulliton, Hanson, 1990; Klesges, Meyers, Klesges,
& LaVasque, 1989; Wack & Rodin, 1982). Goss and Grubbs (2005) found that smoking
has a greater effect on reducing BMI, disregarding fruit and vegetable consumption. A
study found that acculturation did not influence exercise and smoking status, but is
associated with adoption of some less desirable dietary habits. (Mainous III, Diaz, &
Geesey, 2008). Among rural Latinos in Yakima County, Washington, it was found that
socioeconomic status is not related to dietary behavior or smoking (Thompson,
Coronado, Solomon, McClerran, Neuhouser, & Feng, 2002).
33
Similarly, dietary and physical activity variables seem to be poor predictors of
post tobacco-cessation weight change (French, Hennrikus, & Jeffery, 1996). However,
the relationship between BMI and smoking status remains by gender (Eck, Hackett-
Renner, & Klesges, 1992). It has been reported, after adjustment for age, BMI, dietary
and alcohol intakes, and physical activity, that current smokers have a greater amount of
central adiposity, than former smokers and those who have not smoked (Troisi, Heinold,
Vokonas, & Weiss, 1991).
Obesity has been reported to be more prevalent among former smokers, men and
women, and less prevalent among women smokers (Lahti-Koski; Pietinen, Heliövaara, &
Vartiainen, 2002).
Some studies show, in general, that smokers are less likely to self-report physical
activity and to adhere to physical activity goals than never smokers and former smokers.
Former smokers tend to increase their physical activity. A study found that former and
never smokers are engaged in leisure time physical activity more frequently than current
smokers (French, Hennrikus, & Jeffery, 1996). One study on middle age women reported
less physical activity for current smokers compared to former smokers and never
smokers. Similarly, it was found that former smokers significantly increased physical
activity (Perkins, Rohay, Meilahn, Wing, Matthews, & Kuller, 1993). A study of physical
activity and physical activity adherence in the elderly based on smoking status showed
that smokers walked significantly shorter distances than non-smokers. In addition,
smoking status was found to be a significant predictor of adherence to physical activity
goals (Cooper, Resor, Stoever, & Dubbert, 2007).
34
Smoking and friendship
Several studies of close friends and group influence on adolescent cigarette
smoking have found that friendship predicted transition into current cigarette use
(Urberg, Degirmencioglu, & Pilgrim, 1997). Similarly, other researchers found that
among Hispanic seventh-graders, friends who smoke influenced smoking initiation
directly and indirectly. Researchers show that, while parental smoking affected smoking
initiation only indirectly, parental approval of smoking played a significant mediating
role for girls but not for boys (Flay, Hu, Siddiqui, Day, et al, 1994). In order to decrease
smoking initiation and prevent relapse on college campuses, Ridner (2005) recommended
developing strategies to alter social environments and decrease the exposure of students
to others who model smoking behaviors. Some studies have found that peer influence
changes smoking behavior, particularly in eighth grade boys. When the measure of peer
influence was the proportion of friends who smoke, the effect of peer influence was
stronger for 11th graders (Urberg, Cheng, & Shyu, 1991).
Smoking and knowledge of tobacco-related diseases
Several studies describe how knowledge of tobacco-related diseases influences
tobacco use. For instance, a study found that women, older respondents, respondents with
lower levels of education, and current smokers have lower awareness of the health
consequences of smoking (Brownson, Jackson-Thompson, Wilkerson, Davis, Owens, &
Fisher, 1992; Price & Everett, 1994). Other studies reported that people who confer more
35
importance to the health consequences of smoking were less likely to smoke. For those
who do not attribute importance to effects on their health, this belief was not found to
have an impact on their smoking behavior (Krosnick, Chang, Sherman, Chassin, &
Presson, 2006). Smoking cessation could involve the acceptance that smoking causes
disease and acknowledge information about the diseases caused by smoking (Chapman,
Wong, & Smith, 1993).
Other studies found that smokers tend to minimize their risk for lung cancer when
comparing themselves with other smokers. For example, smokers assess their risk of lung
cancer to be similar to that of non-smokers; they believe that this risk is unrelated to the
number of cigarettes smoked, that the consequences of smoking can be reversed by
exercise or consumption of vitamins, and that lung cancer is principally determined by
the genes of the individual (Weinstein, Marcus, & Moser, 2005). Smokers have similar
beliefs for myocardial infarction, hypertension, angina, or family history of
cardiovascular diseases, even if they actually suffer the disease. These beliefs were more
likely to be found among the older, less educated, and light smokers (Ayanian & Cleary,
1999).
Exposure to second-hand smoke (SHS)
Some studies show that 74% of current smokers are more likely to accept
smoking in restaurants and 42% found it to be acceptable in indoor work areas. Thirty-
four percent of non-smokers accept smoking in restaurants, and 18% accept smoking at
indoor work areas (CDC, 2001). The majority of the population recognized, however,
36
that exposure to SHS is dangerous; for example, in 2000, more than 66% of smokers,
88% of non-smokers, 80% of men, 86% of women, 79% of the population below the
level of poverty, and 84% at or above the level of poverty believed that SHS is harmful.
In 2001, 95% of the adult population in the U.S. agreed that SHS is harmful to children,
and in 2002 – 2004, 86% believed that SHS was harmful to adults (U. S. Department of
Health and Human Services, 2006).
Data from the Hispanic Health and Nutrition Examination Survey (HHANES)
showed that more than 22% of non-smoking Latino women of reproductive age were
exposed to SHS in the workplace, and a similar percentage was exposed to SHS at home.
Young Mexican-American, Puerto Rican, and Cuban-American women were the
populations with the highest exposure to SHS at home or in the workplace (Pletsch,
1994).
Glantz and Jamieson (2002) found that, controlling for age, ethnicity, and
education, smokers were less likely than non-smokers to consider smoking risky, and that
the only statistically significant variable to predict planning to quit smoking or having
actually quitted was the believe that SHS harmed non-smokers.
Smoking bans
Data from the 1994 National Health Interview Survey and Year 2000 Objectives
supplement, showed that 35% of children under 18 years old were exposed to SHS at
homes where residents or visitors smoke on a regular basis (Schuster, Franke, & Pham,
2002). The percentage of adults, smokers and non-smokers, who support smoking bans
37
in public and private places increased during the period 2000 – 2001 (McMillen,
Winickoff, Klein, & Weitzman, 2003).
Regarding banning smoking at home or in the car, in 1999 a study found that in
the general population, 76% of adults has home-smoking bans and 66% have car-
smoking bans. Among Latinos, the percentages were similar; 79.9% reported home-
smoking bans and 66.6% reported car-smoking bans. Among the deciding factors for
lower smoking-bans at home or in the car, researchers described not having children in
the home, having more friends who smoke, and lower household income (Norman,
Ribisl, Howard-Pitney, & Howard, 1999). Similarly, the presence of nonsmoking adults
and children was associated with smoking restrictions in homes of inner-city smokers
(Okah, Choi, Okuyemi, & Ahluwalia, 2002).
A study of Latino mothers in the southwestern U.S., found that those who were
born in the U.S., are currently smokers, or have the presence of another adult smoker in
the household, were associated with significantly increased odds of not having a home-
or-car smoking ban (Gonzales, Malcoe, Kegler, & Espinoza, 2006). More recently, in San
Diego, California, a survey of the Mexican-American population found that home bans
on smoking are more likely among individuals who do not smoke, live with children, and
are more acculturated to U.S. society. These individuals reported greater aversion to SHS,
and/or more social pressure against indoor smoking. Similarly, smoking bans were less
likely among Mexican-Americans who live with smokers (Martinez-Donate, Hovell,
Hofstetter, González-Pérez, Adams, & Kotay, 2007).
38
Quitting smoking
Studying the reasons for smoking is necessary in order to devise smoking
cessation therapies (Leventhal & Avis, 1976), as well as to understand the relevant role of
reinforcement in the genesis, maintenance, and recovery from tobacco addiction
(Higgins, Heil, & Lussier, 2004). Another study found that a successful long-term
cessation program should individualize the approach and identify interesting and/or
pleasurable stimuli to replace smoking (Moghaddam, & Ferguson, 2007).
In England, a study using the Transtheoretical Model, found that variations in
intentionality and anticipated ease of quitting were associated with individual factors
such as smoking intensity, parental smoking, age, length of time as a smoker, the nature
of the counseling, household composition, and household income. The study also shows
that being older, of high socioeconomic status, employed, having a stable relationship
with a non-smoking partner, and being motivated to quit were associated with successful
smoking cessation. The intention to quit and one’s personal rating of the likelihood of
success are also strong predictors of eventual cessation. (Twigg, Moon, Szatkowski, &
Iggulden, 2009). Similarly, Loon, Tijhuis, Surtees, and Ormel (2005) found that older,
married, and heavy smokers are more likely to quit smoking.
39
CHAPTER THREE
THEORETICAL FRAMEWORK AND HYPOTHESES
Stages of Change (SOC) model
The SOC model, developed from the original Transtheoretical Model developed
by Prochaska and DiClemente (1983), includes a set of five classifications to describe
smokers and former smokers. The first three stages describe the various phases during
which current smokers decide to quit smoking. The first stage is the pre-contemplation
stage, which comprises smokers who are least motivated to quit. The second, or the
contemplation stage, represents an intermediate level of motivation to quit smoking,
while the third, or preparation stage, comprises smokers possessing the highest
motivation to quit. The action stage is defined as the first six months post-cessation. The
final, maintenance stage, is defined as cessation beyond six months; former smokers are
classified in this SOC. (Herzog, Blagg, & Moffitt, 2007).
Zimmerman, Olsen, and Bosworthan (2000), define the five SOC as follows:
Pre-contemplation stage: In this stage, patients do not even consider changing
their behavior. Smokers who are “in denial” may not see that the advice to quit applies to
them personally.
Contemplation stage: At this stage, patients are ambivalent about changing.
During this stage, patients assess barriers and the benefits of change.
Preparation stage: During the preparation stage, patients prepare to make a
specific change. They may experiment with small changes as their determination to
40
change increases. Switching to a different brand of cigarettes, for example, could signal
that they have decided to change.
Action stage: Any action taken by a smoker demonstrates the desire for a lifestyle
change to stop smoking.
Hypotheses
Variables included in the hypotheses have been adopted and developed from the
extensive review of the available publications in tobacco control and smoking cessation.
A better understanding of the relationship between these variables and smoking status is
necessary to develop tobacco control and smoking cessation programs for Latino
communities.
Hypothesis 1: There are significant differences by socioeconomic status, including
gender, age, marital status, level of education, and income, and level of acculturation
between Latino former smokers, classified in the maintenance SOC; Latino smokers who
are willing to quit smoking, classified in the preparation SOC; and those who are not
willing to quit smoking, classified in the pre-contemplation SOC.
H1.1: Latino men who smoke are more likely to be willing to quit smoking than
Latino women who smoke.
H1.2: Latino smokers who are not willing to quit smoking are younger than Latino
former smokers and Latino smokers who are willing to quit smoking.
41
H1.3: Latino smokers who are not willing to quit smoking are more likely to be
single than Latino former smokers and Latino smokers who are willing to quit
smoking.
H1.4: Latino smokers who are not willing to quit smoking are less likely to live
with minors (under de age of 18) than Latino former smokers and Latino smokers
who are willing to quit smoking.
H1.5: Latino smokers who are not willing to quit smoking have a lower level of
education than Latino former smokers and Latino smokers who are willing to quit
smoking.
H1.6: Latino smokers who are not willing to quit smoking are more likely to be
unemployed than Latino smokers who are willing to quit smoking.
H1.7: Latino smokers who are not willing to quit smoking are more likely to have
lower income than Latino former smokers and Latino smokers who are willing to
quit smoking.
H1.8: Latino smokers who are not willing to quit smoking are more likely to live in
rural areas than Latino smokers who are willing to quit smoking.
H1.9: Latino smokers who are not willing to quit smoking are more likely to
answer the survey in Spanish than Latino former smokers and Latino smokers
who are willing to quit smoking.
H1.10: Latino smokers who are not willing to quit smoking are more likely to have
fewer years living in the U.S. than Latino former smokers and Latino smokers
who are willing to quit smoking.
42
H1.11: Latino smokers who are not willing to quit smoking are more likely to be
home country oriented than Latino former smokers and Latino smokers who are
willing to quit smoking.
H1.12: Latino smokers who are not willing to quit smoking are more likely to have
more friends with the same cultural background than Latino former smokers and
Latino smokers who are willing to quit smoking.
Hypothesis 2: There are significant differences between Latino former smokers,
classified in the maintenance SOC; Latino smokers who are willing to quit smoking,
classified in the preparation SOC; and those who are not willing to quit smoking,
classified in the pre-contemplation SOC. These differences pertain to self-reported health
status, interesting things in their life, happiness, physical activity, stress, consumption of
vegetables and fruits, and body mass index (BMI).
H2.1: Latino smokers who are not willing to quit smoking are more likely to self-
report fair or poor physical health during the previous year than Latino former
smokers and Latino smokers who are willing to quit smoking.
H2.2: Latino smokers who are not willing to quit smoking are less likely to self-
report interesting things in daily life during the previous month than Latino
former smokers and Latino smokers who are willing to quit smoking.
H2.3: Latino smokers who are not willing to quit smoking are less likely to report
that they are happy with their personal life during the previous month than Latino
former smokers and Latino smokers who are willing to quit smoking.
43
H2.4: Latino smokers who are not willing to quit smoking are less likely to report
that they are healthy compare to other people their age than Latino former
smokers and Latino smokers who are willing to quit smoking.
H2.5: Latino smokers who are not willing to quit smoking are more likely to report
injury or illness affecting daily routine during the previous year than Latino
former smokers and Latino smokers who are willing to quit smoking.
H2.6: Latino smokers who are not willing to quit smoking are less likely to self-
report physical activity during the previous week than Latino former smokers and
Latino smokers who are willing to quit smoking.
H2.7: Latino smokers who are not willing to quit smoking are less likely to self-
report adequate exercise during the previous week than Latino former smokers
and Latino smokers who are willing to quit smoking.
H2.8: Latino smokers who are not willing to quit smoking are more likely to self-
report stressful events during the previous month than Latino former smokers and
Latino smokers who are willing to quit smoking.
H2.9: Latino smokers who are not willing to quit smoking are more likely to self-
report a major personal injury or illness during the previous year than Latino
former smokers and Latino smokers who are willing to quit smoking.
H2.10: Latino smokers who are not willing to quit smoking are more likely to self-
report change of residence during the previous year than Latino former smokers
and Latino smokers who are willing to quit smoking.
44
H2.11: Latino smokers who are not willing to quit smoking are more likely to self-
report major change in the health of a family member during the previous year
than Latino former smokers and Latino smokers who are willing to quit smoking.
H2.12: Latino smokers who are not willing to quit smoking are more likely to self-
report major change in the number of family get-togethers during the previous
year than Latino former smokers and Latino smokers who are willing to quit
smoking.
H2.13: Latino smokers who are not willing to quit smoking are less likely to self-
report adequate fruit and vegetable consumption during the previous week than
Latino former smokers and Latino smokers who are willing to quit smoking.
H2.14: Latino smokers who are not willing to quit smoking have a lower BMI than
Latino former smokers and Latino smokers who are willing to quit smoking.
Hypothesis 3: There are significant differences in beliefs regarding smoking, positive
aspects of smoking, and knowledge of tobacco-related diseases between Latino former
smokers, classified in the maintenance SOC; Latino smokers who are willing to quit
smoking, classified in the preparation SOC; and those who are not willing to quit
smoking, classified in the pre-contemplation SOC.
H3.1: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking facilitates friendship than Latino former smokers and Latino
smokers who are willing to quit smoking.
45
H3.2: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking provides pleasure than Latino former smokers and Latino
smokers who are willing to quit smoking.
H3.3: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking relieves stress than Latino former smokers and Latino
smokers who are willing to quit smoking.
H3.4: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking helps to focus on activities than Latino former smokers and
Latino smokers who are willing to quit smoking.
H3.5: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking helps to lose weight than Latino former smokers and Latino
smokers who are willing to quit smoking.
H3.6: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking has positive aspects than Latino former smokers and Latino
smokers who are willing to quit smoking.
H3.7: Latino smokers who are not willing to quit smoking are less knowledgeable
that smoking causes lung cancer than Latino former smokers and Latino smokers
who are willing to quit smoking.
H3.8: Latino smokers who are not willing to quit smoking are less knowledgeable
that smoking causes heart disease than Latino former smokers and Latino smokers
who are willing to quit smoking.
46
H3.9: Latino smokers who are not willing to quit smoking are more willing to
believe that people smoke because they want to than Latino former smokers and
Latino smokers who are willing to quit smoking.
H3.10: Latino smokers who are not willing to quit smoking are more likely to
believe that people smoke because it is a habit than Latino former smokers and
Latino smokers who are willing to quit smoking.
H3.11: Latino smokers who are not willing to quit smoking are less likely to
believe that people who smoke cannot control whether they smoke or not than
Latino former smokers and Latino smokers who are willing to quit smoking.
H3.12: Latino smokers who are not willing to quit smoking are more likely to
believe that it is okay to smoke as long as you are healthy than Latino former
smokers and Latino smokers who are willing to quit smoking.
H3.13: Latino smokers who are not willing to quit smoking are less likely to
believe that smoking causes more harms than benefits than Latino former smokers
and Latino smokers who are willing to quit smoking.
Hypothesis 4: There are significant differences in the attitudes and level of exposure to
SHS between Latino former smokers, classified in the maintenance SOC; Latino
smokers who are willing to quit smoking, classified in the preparation SOC; and those
who are not willing to quit, classified in the pre-contemplation SOC.
47
H4.1: Latino smokers who are not willing to quit smoking are more likely to feel
comfortable when others smoke around them than Latino former smokers and
Latino smokers who are willing to quit smoking.
H4.2: Latino smokers who are not willing to quit smoking are more likely to live in
a house where someone smokes than Latino former smokers and Latino smokers
who are willing to quit smoking.
H4.3: Latino smokers who are not willing to quit smoking are more likely to ride
in a car with a smoker than Latino former smokers and Latino smokers who are
willing to quit smoking.
H4.4: Latino smokers who are not willing to quit smoking are more likely to live in
a household where smoking is allowed than Latino former smokers and Latino
smokers who are willing to quit smoking.
H4.5: Latino smokers who are not willing to quit smoking are more likely to work
where someone smokes in their work area than Latino former smokers and Latino
smokers who are willing to quit smoking.
H4.6: Latino smokers who are not willing to quit smoking are more likely to work
where smoking is allowed in common areas than Latino former smokers and
Latino smokers who are willing to quit smoking.
H4.7: Latino smokers who are not willing to quit smoking are more likely to prefer
to work in a workplace where smoking is allowed than Latino former smokers
and Latino smokers who are willing to quit smoking.
48
H4.8: Latino smokers who are not willing to quit smoking are more likely to be
exposed to SHS than Latino former smokers and Latino smokers who are willing
to quit smoking.
H4.9: Latino smokers who are not willing to quit smoking are more likely to live
with minors exposed to SHS than Latino former smokers and Latino smokers who
are willing to quit smoking.
Hypothesis 5: There are significant differences between Latino smokers willing to quit
smoking, classified in the preparation SOC, and Latino smokers not willing to quit
smoking, classified in the pre-contemplation SOC, in the perception of smoking as a
behavior, the level of cigarette addiction, smoking when facing stressful events, the level
of comfort when exposed to SHS, the likelihood of success if they want or decided to quit
smoking, the age at which the smoking began, the attempt to quit smoking, the likelihood
of asking for help to quit smoking, and the likelihood of quitting using will power.
H5.1: Latino smokers who are not willing to quit smoking are more likely to
perceive smoking as a habit than Latino smokers who are willing to quit smoking.
H5.2: Latino smokers who are not willing to quit smoking are more likely to
smoke every day than Latino smokers who are willing to quit smoking.
H5.3: Latino smokers who are not willing to quit smoking are more likely to
smoke the first cigarette within 30 minutes after waking up than Latino smokers
who are willing to quit smoking.
49
H5.4: Latino smokers who are not willing to quit smoking are more likely to
report that they smoke more when facing stressful events than Latino smokers
who are willing to quit smoking.
H5.5: Latino smokers who are not willing to quit smoking are more likely to feel
comfortable smoking around others than Latino smokers who are willing to quit
smoking.
H5.6: Latino smokers who are not willing to quit smoking are more likely to enjoy
smoking than Latino smokers who are willing to quit smoking.
H5.7: Latino smokers who are not willing to quit smoking are less likely to think
they would be successful if they want to stop smoking than Latino smokers who
are willing to quit smoking.
H5.8: Latino smokers who are not willing to quit smoking are less likely to think
they would succeed if they decided to stop smoking than Latino smokers who are
willing to quit smoking.
H5.9: Latino smokers who are not willing to quit smoking are less likely to feel
comfortable asking for help to stop smoking than Latino smokers who are willing
to quit smoking.
H5.10: Latino smokers who are not willing to quit smoking are more likely to
think that the only way they would be able to stop smoking is through their own
will power than Latino smokers who are willing to quit smoking.
50
H5.11: Latino smokers who are not willing to quit smoking are more likely to have
smoked their first cigarette at a younger age than Latino smokers who are willing
to quit smoking.
H5.12: Latino smokers who are not willing to quit smoking are more likely to
report smoking cigarettes regularly at a younger age than Latino smokers who are
willing to quit smoking.
H5.13: Latino smokers who are not willing to quit smoking are more likely to
smoke a larger number of cigarettes daily than Latino smokers who are willing to
quit smoking.
H5.14: Latino smokers who are not willing to quit smoking are less likely to quit
smoking for a day or more, one or more times during the last year, than Latino
smokers who are willing to quit smoking.
51
CHAPTER FOUR
METHODOLOGY
Study design
This research is a cross sectional study, using secondary data from the Diverse
Racial and Ethnic Groups and Nations (DREGAN) project.
The Diverse Racial Ethnic Groups and Nations (DREGAN) Project
The DREGAN project was a community-based participatory research and action
project implemented to better understand the unique cultural characteristics of tobacco
use, to determine the prevalence of smoking and other health risk behaviors, and to
develop and implement intervention projects designed to reduce tobacco use among
Minnesota’s Latino, Hmong, Cambodian, Vietnamese, and Laotian communities.
Since 2002, the project developed a partnership between Comunidades Latinas
Unidas en Servicio (CLUES), Blue Cross and Blue Shield of Minnesota, and The
Minnesota Partnership for Actions Against Tobacco (MPAAT), now known as ClearWay
Minnesota. Since its beginning, a research team was integrated by researchers from all
the partner organizations and an advisory committee was appointed with community
leaders, Latino researchers, and representatives of Latino community based
organizations. The advisory committee provided feedback to the research process from its
beginning to the publication of the final report. Researchers from the Center for Survey
Research in Public Health at the University of Minnesota (CSRPH) joined the DREGAN
52
project in 2004. The author of this study was the coordinator of the DREGAN project at
CLUES.
DREGAN research design
The DREGAN quantitative research project was a cross-sectional survey of adults
eighteen years old or older living in Minnesota, who were self-identified as Latino or
Hispanic, were born in a Latin-American Country or had a parent or grandparent born in
a Latin-American country.
A culturally-appropriate instrument that included measures of acculturation, as
well as knowledge and attitudes toward smoking and quitting tobacco use, was developed
by the DREGAN research team with feedback from the Advisory Committee (Blue Cross
and Blue Shield of Minnesota, ClearWay Minnesota, Comunidades Latinas Unidas en
Servicio, 2006).
DREGAN survey instrument design
The DREGAN survey instrument included questions from the 2003 Minnesota
Adult Tobacco Survey (Minnesota Department of Health, the Minnesota Partnership for
Action Against Tobacco, Blue Cross and Blue Shield of Minnesota, and the University of
Minnesota, 2004), the 2004 Behavioral Risk Factor Surveillance System, and the
DREGAN qualitative research conducted by Blue Cross and Blue Shield of Minnesota,
ClearWay Minnesota, and Comunidades Latinas Unidas en Servicio (2006).
The survey items were developed through an iterative process based upon the core
53
issues identified in the previous qualitative study. This process occurred within a
participatory framework. The instrument was refined through input from the advisory
committee and tested using cognitive interviewing. Once approved, the final instrument
was translated into Spanish with the focus on a cultural and conceptually-equivalent
rather than a linguistically-equivalent translation. Community groups were active in the
translation process. Their input was sought to ensure conceptual equivalence as well as
consultation on language. The final versions of the instrument were reviewed and
approved by the DREGAN research and management teams (Appendix B DREGAN
Phone Bilingual Survey and Appendix C Face to Face Bilingual Survey).
Survey Instrument Description
The survey instrument included the following topics: Phenotype, fluency,
orientation, latent variable, Latino community variables, theory test, health behavior,
exercise/nutrition, smoking, benefits of smoking, addiction or choice, harms of tobacco,
smoking items, prior smoking, quitting/other smoking related items, use of other tobacco,
household rules around smoking and SHS exposure, employment, refugee history,
demographics, household information (Appendix B DREGAN Phone Bilingual Survey
and Appendix C Face to Face Bilingual Survey).
DREGAN Survey methodology
Households were probabilistically sampled, using random digit dialing, for
telephone and face to face interviews. Once a household was randomly selected, a letter
54
was sent informing the household that it was selected and that a phone call would be
made for the interview. Approximately two weeks later, a phone call was made to the
household asking for the person 18 years old or older with the most recent birthday. If the
person was available, a short telephone screening interview determined if the person was
eligible to be included in the study. Face-to-face interviews were then conducted with
eligible respondents who agreed to participate.
Trained community members, fluent in both English and Spanish, conducted all
interviews in the participant’s language of choice. In July 2006, the DREGAN project
investigators shifted solely to the use of telephone interviews in order to increase the
response rate and minimize the potential social desirability bias of face-to-face
interviews. A $10.00 gift certificate and a thank-you note were mailed to each respondent
who completed the survey. The Computer-Assisted Telephone Interviewing (CATI)
program was used for the telephone screening and the face-to-face survey.
Sample description
A random sample was selected from a Latino surname list obtained from
Marketing Systems Group, a survey-sampling vendor, for the three Minnesota
geographical regions with the larger concentrations of Latino populations. The 11 county
metropolitan region include the counties of Anoka, Carver, Chisago, Dakota, Hennepin,
Isanti, Ramsey, Scott, Sherburne, Washington and Wright; the six southern counties
included Olmsted, Goodhue, Blue Earth, LeSuer, Nicollet, and Waseca. The sampling
also included the three northwestern counties of Polk, Norman, and Clay (Blue Cross and
55
Blue Shield of Minnesota, ClearWay Minnesota, Comunidades Latinas Unidas en
Servicio, 2008).
The number of respondents was calculated given the following assumptions: the
size of the estimate percent of smokers (P= 30%); the design effect (DE= 2.2); and the
desired precision (SE=2%). Estimates of the sample size were calculated using the
formula:
N = (P × (1− P) × DE) ÷ SE2
A minimum sample size of about 1,155 was calculated to make precise estimates
for major sub-groups of interest. For many estimates where the sample size is greater, the
level of precision will exceeded ±4% (Rockwood, Virnig, Constantine, Miazga, &
Turner, 2007). Table 1 shows the sample disposition and the response rates.
Table 1 Sample Disposition and Response Rate
Population Purchased List Community List Total Sample Ineligible Completes Response Rate Hmong 1605 0 1605 803 563 70% Cambodian 842 351 1193 679 355 69% Vietnamese 1140 0 1140 598 358 66% Laotian 223 484 707 257 352 78% Latino 3375 0 3375 1760 805 50% Total 7185 835 8020 4097 2433 62%
Rockwood, Virnig, Constantine, Miazga, and Turner (2007)
Interviewers training
Bilingual interviewers were selected and trained by the CSRPH managing
director. Each interviewer received four hours of general interview training, four hours of
project-specific training followed by computer training and an individual practice
session, a certification in English with a supervisor and also an additional training on
56
field interviewing. Interviewers also received the general Interviewer Manual and a set of
question-by-question specific protocol for the DREGAN Study (Rockwood, Virnig,
Constantine, Miazga, & Turner, 2007).
Data Collection
Data collection started in January 2006 and ended in March 2007. The Latino
survey achieved a 50% response rate. More than half (55%) were face-to-face interviews.
Most interviews (69%) were conducted in Spanish. The DREGAN Latino data set
includes 805 face-to-face or telephone interviews. Data were weighted for probability of
selection, age, and gender based on 2000 census data for the Latino population (Blue
Cross and Blue Shield of Minnesota, ClearWay Minnesota, Comunidades Latinas Unidas
en Servicio, 2008).
Study statement research question
The objectives of this study are to describe the characteristics of Latino tobacco
smokers living in Minnesota, to determine if there are significant differences between the
following groups: Latino smokers not willing to quit using tobacco, in the pre-
contemplation SOC; Latino smokers willing to quit using tobacco, in the preparation
SOC; and Latino former smokers in the maintenance SOC; differences will be evaluated
in term of socioeconomic status and level of acculturation; self reported physical and
mental health, consumption of fruits and vegetables, and physical activity; beliefs
regarding smoking, positive aspects of smoking, and knowledge of tobacco-related
57
diseases; attitudes and level of exposure to SHS ; and the level of cigarette addiction and
willingness to quit smoking. The goal is to identify significant characteristics of Latino
smokers that would be relevant to develop culturally-competent and linguistically-
appropriate tobacco cessation interventions.
Survey inclusion criteria
This study focuses on adults eighteen years old or older, who were self-identified
as Latino or Hispanic or born in a Latin-American country, or who had a parent or
grandparent born in a Latin-American country. All participants voluntarily agreed to
respond the survey questionnaire.
Survey exclusion criteria
Minors of eighteen years old, those who were not Latino or from Latino origin or
qualified respondents, who refused to answer the survey questionnaire, were excluded
from the study.
Definition of variables
The SOC algorithm was used to address if there were relevant relationships
between the independent variables and the SOC that could be used to design culturally-
appropriate tobacco cessation programs. Using the DREGAN dataset, an analysis dataset
was created by recoding and combining participant survey responses. The dependent
variables created are described below, including the original DREGAN data set variable
58
name, its original value, and the new assigned value. A complete description of the
variables used in this study is found in Appendix D, Study Variables.
The first dependent variable created from the DREGAN data set was ever smoker,
a dichotomous variable with the categories never smokers and ever smoker. Never
smoker (esmoker=0) was defined in the DREGAN data set as a respondent who never
smoked and did not meet the criteria for former or current smoker. Ever smoker
(smoker=1) was defined in the DREGAN data set as a respondent who met the criteria
for former smoker or current smoker as it is described in the variable smoker status.
The second dependent variable created from the DREGAN data set was smoker
status (dfs), a dichotomous variable with the categories former smoker and current
smoker. Former smoker (dfs=0) was defined in the DREGAN data set as FSMOKER=1,
using the BRFSS and MATS criteria, that includes respondents who have ever smoked a
cigarette, have smoked at least 100 cigarettes in their life, and have not smoked a
cigarette in the last six months. Respondents in this category are in the final stage,
maintenance, of the SOC algorithm. Current smokers (dfs=1), who are in the previous
SOC, were defined in the DREGAN data set as respondents who meets the BRFSS and
MATS criteria of having ever smoked a cigarette, having smoked at least 100 cigarettes
in their life, and currently smoking every day or some days.
The third dependent variable created from the DREGAN data set was former-
willingness to quit smoking (fwtq), a trichotomous variable created to determine if there
were differences between: a) former smokers, b) current smokers willing to quit smoking,
and c) current smokers not willing to quit smoking, defined as follows. a) former smoker
59
(fwtq=0), default category, was defined in the DREGAN data set (FSMOKER=1) by
respondents in the final stage, maintenance, of the SOC algorithm, b) current smoker
willing to quit smoking (fwtq=1) was comprised of respondents for whom the sum of
their responses to questions s57 (recoded into rs57 to conserve the same sequence as the
answers to questions s58 and s59), s58, and s59 were equal or lower than six.
Respondents in this category were classified into the stage of preparation of the SOC
algorithm, c) current smoker not willing to quit (fwtq=2) was defined as respondents for
whom the sum of responses to questions rs57, 58 and 59 was higher than six.
Respondents in this category were grouped into the pre-contemplation SOC.
Answers to question s57 “Which of the following best describes how do you
feel?” were weighted as follows: 1=I would like to stop smoking for some other reasons;
2=I want to stop smoking; 3=I would like to stop smoking, but don’t want to go through
the process; 4=I don’t want to stop smoking; 5=I don’t think about stopping smoking.
Answers to question s58 “If you wanted to stop smoking, how likely do you think you
would be to succeed?” were weighted as follows: 1=very likely; 2=somewhat likely;
3=somewhat unlikely; and 4=very unlikely. Answers to question s59 “If you decided to
stop smoking, how likely do you think you would be to succeed?” were weighted as
follows: 1=very likely; 2=somewhat likely; 3=somewhat unlikely; and 4=very unlikely.
The fourth dependent variable was willingness to quit (wtq), a dichotomous
variable, created from the previous variable to determine if there were differences
between current smokers classified in the preparation SOC (wtq=1) and those in the pre-
contemplation SOC (wtq=2).
60
The fifth dependent variable was pre-contemplation, contemplation, and
preparation SOC (s573G), a trichotomous variable, created from the data set to determine
if there were differences between smokers classified in the three SOC prior to taking
actions to quit smoking as follows: a) respondents of question s57 (“Which of the
following best describes how do you feel?”) were categorized as smokers in the pre-
contemplation SOC (s573G=0) if they answered “I don’t think about stopping smoking”
or “I don’t want to stop smoking;” b) smokers were categorized into the stage of
contemplation of the SOC algorithm (s573G=1) if they answered “I would like to stop
smoking, but don’t want to go through the process;” and c) smokers were categorized in
the preparation SOC (s573G=2) if they answered “I want to stop smoking” or “I would
like to stop smoking for some other reason.”
The sixth dependent variable, smokers who want to stop smoking (s582GT), was a
dichotomous variable created from question s58 of the survey to measure if there were
differences between respondents who answered the question “If you wanted to stop
smoking, how likely do you think you would be to succeed?” Those who answered very
likely or somewhat likely were classified as smokers who want to stop smoking
(s582GT=1); respondents who answered very unlikely or somewhat unlikely were
classified as smokers who do not want to stop smoking (s582GT=0).
The seventh dependent variable, smokers decided to stop smoking (s592GT), was
a dichotomous variable created from question s59 of the survey to determine if there were
differences between respondents who answered the question “If you decided to stop
smoking, how likely do you think you would be to succeed?” Respondents who answered
61
very likely or somewhat likely, were categorized as smokers who decided to stop
smoking (s592GT=1), and those who answered very unlikely or somewhat unlikely, were
classified as smokers who have not decided to stop smoking (s592GT=0).
The eighth dependent variable, asking for help to stop smoking (s602GT), was a
dichotomous variable created from question s60 of the survey to measure if there were
differences between respondents who answered to the question “How comfortable would
you be asking for help to stop smoking?” Respondents who answered very comfortable
or somewhat comfortable were categorized as smokers comfortable asking for help to
stop smoking (s602GT=1), and those who answered somewhat uncomfortable or very
uncomfortable were categorized as smokers uncomfortable asking for help to quit
smoking (s602GT=0).
The ninth and last dependent variable, will power (rs61), was a dichotomous
variable created from question s61 of the survey to determine if there were differences
between respondents who answered to the statement “The only way I would be able to
stop smoking is through my own will power.” Respondents who answered strongly agree
or somewhat agree were categorized as smokers who agree with the belief that the only
way they could be able to stop smoking is through their own will power (rs61=1), and
those who answered somewhat disagree or strongly disagree were categorized as smokers
who disagree with the belief that the only way they could be able to stop smoking is
through their own will power (rs61=0).
62
Statistical analysis
SPSS version 19.0 software was used to conduct all statistic analyses, including
descriptive, bivariate and multivariate analysis.
Descriptive statistics were performed to summarize the characteristics of the
respondents. Percents, means, and standard deviation of the means were calculated for
continuous variables. Numbers and percentages were calculated for categorical variables.
The continuous variables were compared using one-way analysis of the variance
(ANOVA), the dichotomous categorical variables were compared using Chi-square test,
and the thricotomuos categorical variables were analyzed using order logistic regression.
Variables that were moderately associated with the comparisons categories (p<0.1) were
identified and analyzed using logistic regression controlling for age and gender to
examine their association with smokers in the different stages of change. No further
multivariable models were explored due to the limited size of the sample. The 95%
confidence interval of the odds ratios for each variable and its P-value were calculated. In
order to determine whether the probability of having a particular effect of the
independent variables is associated with the different stages of change described
previously and to predict the probability and the magnitude of the effect in the dependent
variables, logistic regression was used as follows: A first set of comparison was made
between respondents who have never smoked and those who have ever smoked. A
second set of comparison was made between former smokers, who are in the
maintenance SOC, and current smokers who are in the previous stages of change. A third
set of comparisons was made between former smokers, who are in the maintenance SOC;
63
current smokers willing to quit, who are in the preparation SOC; and those not willing to
quit smoking, who are in the pre-contemplation SOC. A fourth set of comparison was
made between smokers in the preparation and pre-contemplation SOC. A fifth set of
comparison was made between smokers in the pre-contemplation, contemplation, and
preparation SOC. A final sets of comparisons were made between smokers who
responded they would be likely and those who responded they would not be likely to
succeed if they wanted to stop smoking; smokers who responded they would be likely
and would not be likely to succeed if decided to stop smoking; smokers who responded
they would feel comfortable and those who responded they would feel uncomfortable
asking for help to stop smoking; and smokers who responded they believed and those
who responded they did not believe the only way they would be able to stop smoking is
through their own will power.
Institutional Review Board (IRB) approval
The University of Minnesota Institutional Review Board (IRB), Human Subjects
Committee, determined that this study (0608E91768) was exempt from review under
federal guidelines 45 CFR Part 46.101(b) category # 4, existing data; records review;
pathological specimens.
64
CHAPTER FIVE
RESULTS
Sample characteristics
A comprehensive description of the characteristics of the sample is shown in
Appendices E to J. The Standard Deviation of the mean is shown in parentheses. A star
(*) symbol in the tables represents a p value = or < .005.
Demographic characteristics of the sample
The DREGAN survey was answered by 805 respondents, either by face-to-face or
by telephone interviews, from January, 2006 to March, 2007. Males were 51.3% of the
sample, the mean age of the respondents was 37.9 (12.6) years and their age range was
from18 to 91 years. The majority (87.7%) of the respondents was older than 24 years old;
71.9% were married or living in a marriage-like relationship; and 70.7% reported living
with children younger of 18 years old in their home. On average, respondents reported
four (1.9) people living per household. 61.2% of the participants completed high school
or some level of higher education; 83.8% had at least one current job, and the household
mean income was $54,860 (58,014).
The majority (88%) of the respondents self-identified as Latino, Hispanic or
Hispanic-American, and 12% as American. 55.4% of the respondents were born in
Mexico, 24.3% in the U.S., and 20.3% in other Latin-American countries. Of the
respondents born outside the U.S. the mean age of entry to the country was 23.8 (9.9)
65
years and on average they have been in the U.S. for 12.7 (10.3) years. The majority
(84.6%) of the respondents learned Spanish as their first language, and 66.6% of the
surveys were answered in Spanish. Table 2 describes selected continuous demographic
variables of the survey respondents. Appendices E 1 and 2 present a comprehensive
description of the demographic characteristics of the sample.
Table 2 Demographic Characteristics of the Sample
Continuous Variables N Mean Minimum Maximum SD Age (q26) (s801) 805 37.91 18 91 12.58 Age of Entry to the US (q7) 594 23.82 0 63 9.87 Immigrant's Years Living in the US (q7) 594 12.66 0 90 10.33 Year Migrated to US 594 1,993 1,916 2,006 10.33 Years living in the US 594 12.66 0 90 10.33 Household Last Year Income (q29) 218 54,860.50 1,200 500,000 58,014.54 Number of People Living in Household (s78) 805 4.09 1 15 1.86 Number of Adults Living in Household (s79) 805 2.49 1 10 1.24
Self-reported health status
Self-reported health status, stress, physical activity, consumption of fruits and
vegetables, and BMI variables are described in Appendices F1 and 2.
It was found that 75.1% of the respondents reported excellent, very good or good
health compared to other people of similar age; 66.8% self-reported excellent, very good
or good physical health; and 38.8% reported injury or illness affecting their daily routine
during the prior year. Only 35% of the respondents met the BRFSS’s criteria for adequate
exercise, and 19% reported some degree of stress during the past month. Selected self-
reported health status categorical variables are described in Table 3.
Stress, poor physical health, or depression prevented respondents from
performing their usual activities for an average of two days during the previous month.
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On average, during three days the physical health of the respondents was not good during
the previous month.
Table 3
Self Reported Health Status, Physical Activity, and Stress Categorical Variables N % Health S1 Self Reported Health Status Compared to Other People of Respondent's Age
Excellent 161 20.02 Very good 179 22.26 Good 264 32.84 Fair 178 22.14 Poor 22 2.74 Total 804 100.00
q1 Self Reported Physical Health Excellent 116 14.50 Very good 144 18.00 Good 274 34.25 Fair 218 27.25 Poor 48 6.00 Total 800 100.00
S2 Self Reported Injury or Illness Affecting Daily Routine During the Past 12 Months
Not at all 493 61.20 A little bit 252 31.30 A lot 60 7.50 Total 805 100.00
BRFSS Standard for Adequate Exercise (Moderate or Vigorous) in a Week
0 523 65.00 1 282 35.00 Total 805 100.00
BMI 18.5 – 24.9 207 27.8 <18.5 and = or >25 538 72.2 Total 745 100.00
Stress S32 Self Reported Stress During the Past Month
Extremely 64 7.95 Quite a bit 74 9.19 Some 226 28.07 A little 288 35.78 Not at all 153 19.01 Total 805 100.00
Compared to the minimum daily consumption of five portions of fruits and
vegetables recommended by the U.S. Department of Health and Human Services and the
U.S. Department of Agriculture in 2005, a low consumption of fruits and vegetables was
reported; respondents consumed an average of 1.9 (1.5) servings of fruits and 1.7 (1.2)
servings of vegetables per day over the previous seven days. The respondents mean BMI
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was 28.2 (5.2), determined from their self-reported height and weight. Only 27.8% had a
normal BMI (18.5 – 24.9) (CDC, 2011). Table 4 includes self-reported health status
continuous variables, consumption of vegetables and fruits, and body mass index (BMI).
Table 4 Summary of Health Variables
Continuous Variables N Mean Minimum Maximum SD Health
s30=During the past 30 days, for about how many days did stress, poor physical health, or depression keep you from doing your usual activities? 799 2.42 0 30 6.24 Nutrition
S28 Servings of Fruits Eaten Per Day over the Past Seven Days 804 1.92 0 14 1.49
S29 Servings of Vegetables Eaten Per Day over the Past Seven Days 782 1.65 0 10 1.21
Total Servings Fruits and Vegetables in last Day S28 804 3.53 0 20 2.23 BMI = Body Mass Index 745 28.17 16.1 61.2 5.22
Acculturation
Appendix G includes a comprehensive list of the acculturation variables.
A large majority (95.5%) of the respondents reported understanding U.S.
holidays, 90.3% reported understanding traditional Latino weddings and funerals, 92%
reported understanding Latino traditions, and 77.3% reported understanding American
ways; 79% of the respondents considered it important to practice Latino ways at home,
88.5% of the respondents strongly identified with Latino background, 88.8% reported
that they consider it important to keep in touch or learn about their ethnical and cultural
background, 54.2% spoke Spanish most of the time at home, 81.7% of the respondents
considered it important to speak Spanish and 89.6% considered it important to raise
children as Latinos to keep their Latino identity. Table 5 portraits selected acculturation
variables.
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Table 5 Summary of Acculturation Categorical Variables
Fluency N % Understanding of US Holidays q14a Very well 578 72.3 Somewhat well 185 23.2 Not very well 28 3.5 Not at all 8 1 Total 799 100 Understanding of Traditional Latino Weddings and Funerals Q15 Very well 530 66 Somewhat well 195 24.3 Not very well 55 6.8 Not at all 23 2.9 Total 803 100 Very Good Understanding of American Ways -CS9B Strongly agree 335 42.1 Somewhat agree 251 31.6 Somewhat disagree 167 21 Strongly disagree 42 5.3 Total 795 100 Orientation N % Importance of Practicing Latino Ways at Home q17 Not at all 55 6.9 A Little 113 14.1 Somewhat 204 25.5 Very 428 53.5 Total 800 100 Close Friends from the Same Ethnic Background -Q18b None 86 10.8 A few 211 26.5 Some 184 23.1 A lot 135 16.9 Almost all 181 22.7 Total 797 100 S20a Importance of Keeping in Touch With/Learning About Ethnic/Cultural Background Not at all 17 2.1 A Little 73 9.1 Somewhat 214 26.6 A lot 501 62.2 Total 805 100 S21 Language of Conversations at Home More Spanish than English 436 54.2 More English than Spanish 157 19.5 About the same 212 26.3 Total 805 100 S22b Importance of Raising Children as Latinos to keep Latino Identity Very important 474 59 Somewhat important 246 30.6 Not very important 59 7.3 Not at all important 25 3.1 Total 804 100
Respondents tended to be more home country oriented; in a scale from 1 to 4,
their mean acculturation scale was 3.5 (0.6) for home country culture oriented, and 2.3
(0.8) for U.S. culture oriented. Table 6 shows the acculturation scales.
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Table 6 Acculturation Scales
N Mean Minimum
Maximum S D ORIENTATION 1: CHANGE SINCE IMMIGRATION 611 2.95 1 4.30 0.81 ORIENTATION 2: COMPARISON TO TYPICAL MINNESOTAN 805 4.08 1 6.00 1.31 ORIENTATION 3: HOME COUNTRY WAYS IN HOME 805 3.42 1 4.00 0.63 ORIENTATION 4: FRIENDS 805 2.85 1 5.00 1.00 FLUENCY 1: US CULTURE 805 2.33 1 4.00 0.75 FLUENCY 2: HOME COUNTRY CULTURE 804 3.52 1 4.00 0.60
Smoking status
According to the BRFSS and Minnesota Adult Tobacco Survey criteria, 70.8% of
the respondents were classified as non-smokers, 15.9% as former smokers and 13.3% as
current smokers (20.1% of males and 6.1% of females); 70.5% of the current smokers
reported they were willing to quit. Table 7 shows the self reported smoking behavior of
the respondents and Table 8 shows their smoking status.
Table 7
Self-Reported Smoking Behavior Variables N % s40 Ever Smoked a Cigarette
Yes 555 68.94 No 250 31.06 Total 805 100.00
s42 Self Report of Having Smoked at Least 100 Cigarettes During Entire Life Yes 235 39.43 No 361 60.57 Total 596 100.00
s43 Self Report of Having Smoked a Cigarette in the Past 6 Months Yes 120 51.06 No 115 48.94 Total 235 100.00
s44 Self Reported Smoking Frequency Every day 55 45.83 Some days 52 43.33 Not at all 13 10.83 Total 120 100.00
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Table 8 Smoking Status
No % Non smokers 570 70.81 Former smokers 128 15.90 Current Smokers 107 13.29 Male current smokers 83 20.10 Female current smokers 24 6.12 Total 805 100.00
Smoking beliefs
Respondents are divided about positive aspects of smoking; almost half (51.2%)
of the respondents believed that there are no positive aspects of smoking; however,
29.3% responded that smoking relieves stress, 23.9% that smoking helps to lose weight,
and 24.7% that smoking provides pleasure. The large majority of the respondents
believed that smoking causes cancer (99.1%) and heart disease (93.2%). Table 9
describes selected smoking beliefs variables.
Table 9
Smoking BeliefsVariables N %
Positive Aspects of Smoking s34c Smoking Relieves Stress/Anxiety Yes 226 29.31 No 545 70.69 Total 771 100 s34b Smoking Provides Pleasure Yes 196 24.69 No 598 75.31 Total 794 100 ps34e Smoking Helps to Lose Weight Yes 186 23.88 No 593 76.12 Total 779 100 RECODE: Number of Positive Aspects of Smoking (MAX=5) s34a-e 0 412 51.18 1 178 22.11 2 120 14.91 3 59 7.33 4 25 3.11 5 11 1.37 Total 805 100
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Regarding choice or addiction, 44.1% of respondents believed that smoking is a
choice and 18% believed it is an addiction. 6.5% of the respondents believed that it is
okay to smoke as long as the person is healthy; 7.3% believed that the dangers and
benefits of smoking are equal, and 1.4% reported they believed that smoking has more
benefits than non smoking. A complete description of respondents’ smoking beliefs is
found in Appendix H.
Second-hand smoke behaviors
The majority of respondents (82.7%) feel uncomfortable when other Latinos
smoke around them; is not exposed to SHS at home (90.8%), at work (84.5%) or in the
car (81%); and 91% does not allow smoking at their homes; however, more than half of
them (52.2%) reported being personally exposed to SHS during the previous week, and
36.4% reported exposure to SHS to their children (under 18 years old). Exposure to SHS
was reported in the car (19%), at work (16.4%), at home (9.2%), and at other places
(36%); some respondents were exposed to SHS at various places. Table 10 shows
selected SHS behavior variables. A comprehensive description of behaviors regarding
SHS is shown in Appendix I.
Smoking behavior
Smokers reported smoking an average of 8 cigarettes per day and smoking on
average 9 days during the last month. They also reported smoking the first cigarette at the
age of 15 years old and that they starting smoking regularly when they were 18 years old.
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The average smoker tried to quit smoking 13 times for at least one day during the
previous year. Selected continuous smoking outcomes are shown in Table 11.
Table 10 Second-Hand Smoke Behaviors
Variables N % S62 Comfort Level When Other Latinos Smoke Around You
Very comfortable 72 8.99 Somewhat comfortable 67 8.36 Somewhat uncomfortable 161 20.10 Very uncomfortable 501 62.55 Total 801 100.00
s64 Smoking Inside Home During the Past 7 Days Yes 74 9.19 No 731 90.81 Total 805 100.00
s66 Been in a Car With Someone Who Was Smoking in the Past Seven Days Yes 153 19.01 No 652 80.99 Total 805 100.00
s65 Statement Best Describing Smoking Rules at Home Smoking is not allowed anywhere 732 91.04 Smoking is allowed some places 40 4.98 People can smoke anywhere 17 2.11 Other rule 15 1.87 Total 804 100.00
Number of SHS Exposures In Past 7 Days (MAX=5.) 0 385 47.83 1 263 32.67 2 111 13.79 3 38 4.72 4 8 0.99 Total 805 100.00
Minors of 18 yo exposed to SHS Yes 293 36.40 No 512 63.60 Total 805 100.00
Table 11 Smoking Outcomes Continuous Variables
Continuous Variables N Mean Minimum Maximum SD s45 Self Reported Daily Average of Cigarettes Smoked 55 8.29 1 20 6.08 S46 Self Reported Number of Days Cigarettes Where Smoked during the
Past Month 51 9.27 0 30 7.20 S47 Self reported Average Daily Number of Cigarettes Smoked During the
Past Month 52 3.42 0 20 4.47 S50 Age When First Cigarette Was Smoked 234 15.21 6 35 4.23 S51 Age Began Smoking Cigarettes Regularly 235 18.58 8 37 4.71 S55 Number of Times Quit Smoking for a Day or More in the Past 12 Months 101 13.49 0 100 26.44
A small percentage of the respondents (17%) reported smoking the first cigarette
between the 30 minutes after waking and about half (51.4%) of the current smokers
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responded that they smoked every day. The majority (79.5%) of the respondents smoked
their first cigarette and about half of the respondents (44.9%) started smoking regularly
before they were 18 years old. When facing stress 50% of the respondents increased the
amount of cigarettes smoked; 47% of Latino current smokers felt comfortable smoking
around other Latinos, and a similar percentage (48%) reported enjoying smoking;
however, 54.7% indicated that they wanted to stop smoking. A majority (83.8%) of
current smokers believed they would be somewhat or very likely to be able to stop
smoking if they wanted to quit, and (90.5%) responded they believed they were
somewhat or very likely to succeed if they decided to stop smoking. A similar percentage
(91.4%) somewhat or strongly agreed that they believed the only way they could be able
to stop smoking would be through their own will power; however, 59.4% responded that
they felt somewhat or very comfortable asking for help to stop smoking. The majority
(73%) of respondents have quit smoking for a day or more at least on one occasion
during the previous year. Table 12 shows selected smoking categorical variables. More
detailed results about smoking behavior are shown in Appendix J.
The majority (87.5%) of former smokers stopped smoking more than one year
before they responded to the survey and 29.9% reported that smoking restrictions
influenced their decision to stop smoking. Table 13 shows selected variables of former
smokers.
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Table 12 Smoking Behavior
Variables N % Choice Vs. Addiction Scale -Choice=2 Addiction=8 -s36-37
2 102 12.81 3 102 12.81 4 147 18.47 5 302 37.94 6 73 9.17 7 37 4.65 8 33 4.15 Total 796 100.00
rs44 Smoke cigarettes every day Yes 55 51.40 No 52 48.60 Total 107 100.00
S52 Minutes Between Waking and First Cigarette Within 5 minutes 6 5.70 6 - 30 minutes 12 11.30 31 - 60 minutes 16 15.10 More than 60 minutes 72 67.90 Total 106 100.00
s53 Amount of Smoking When Facing Stress A lot 16 14.95 A little more 37 34.58 The same amount 38 35.51 A little less 6 5.61 A lot less 10 9.35 Total 107 100.00
s54 Level of Comfort Smoking Around Other Latinos Very comfortable 20 19.23 Somewhat comfortable 29 27.88 Somewhat uncomfortable 31 29.81 Very uncomfortable 24 23.08 Total 104 100.00
Table 13
Former Smokers Categorical Variables N %
S48 Elapsed Time Since End of Regular Cigarette Smoking
Never smoke regularly 4 3.10 1 month or less 1 0.80 More than one month but less than 3 months ago 2 1.60 More than three months but less than 6 months ago 4 3.10 More than six months but less than 1 year ago 5 3.90 More than one year but less than 5 years ago 26 20.30 More than 5 years but less than 10 years ago 22 17.20 10 or more years ago 64 50.00 Total 128 100.00
S49 How Much Smoking Restrictions Affect Decision to Quit Smoking None 89 70.10 A little 6 4.70 Some 10 7.90 A lot 22 17.30 Total 127 100.00
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Socioeconomic characteristics given smoking status and stages of change
Results of the comparison of the socioeconomic characteristics between never
smokers and smokers in the different SOC are presented in Appendices K 1 to 9.
Comparison by socioeconomic status variables between never smokers and ever smokers
Appendix K 1 shows the socioeconomic status variables of never and ever
smokers.
When never smokers were compared to ever smokers there were statistically
significant differences by gender, age, living with children under 18 years old,
employment, income, language of the survey, and friends from the same cultural
background. Men were more likely to be ever smokers, 76.6% of ever smokers were men
compared to 40.9% of never smokers, p <.001; 86.1% of never smokers are older than 24
years compared to 91.5% of ever smokers, p=.044; never smokers are more likely to live
with children younger than 18 years (74%) compared to 62% of ever smokers, p=.002;
ever smokers are more likely to be employed (86%) compared to 75.5% of never
smokers, p=.001; ever smokers tend to have higher income than never smokers; 65.9% of
ever smokers reported more than $25,000.00 of annual household income compared to
53.3% of never smoker, p = .001; never smokers tend to respond the survey in Spanish
(70.7%) compared to 56.6% of ever smokers, p<.001; and never smokers tend to have
more friends from their same ethnic background (62.6%) compared to54% of ever
smokers, p=.027.
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When controlling for age and gender, however, significant differences were found
for gender and language of the survey. Ever smokers were more likely than never
smokers to be male (OR=4.859, 95% CI=3.413, 6.918) and to respond the survey in
Spanish (OR=1.582, 95% CI=1.123, 2.229). Table 14 includes the statistical significant
socioeconomic variables of never smokers compared to ever smokers.
Table 14 Statistically Significant Differences Between Never and
Ever Smokers Given Socioeconomic Status
Univariate Multivariate Controlling by age and gender
Never Ever 95% CI
Variable No % No % P
FET OR Lower Upper P H1.1 Gender Male 233 40.88 180 76.60 0.000 4.859 3.413 6.918 0.000 * H1.2 Dage 25 (Older than 24 yo) 491 86.14 215 91.49 0.044 1.122 0.608 2.073 0.713 H1.4 Dminors 1=18yo 0r <; 0=>18yo 422 74.04 147 62.55 0.002 0.908 0.622 1.323 0.614 H1.6 rs67 Employed 429 75.53 202 85.96 0.001 0.745 0.460 1.205 0.229 H1.7 Dincome (>$25,000) 277 53.27 149 65.93 0.001 0.738 0.519 1.050 0.091 H1.9 Survey's language LangSurveySp 403 70.70 133 56.60 0.000 1.582 1.123 2.229 0.009 * H1.12 Orientation 4 Friends Dorient4f 357 62.63 127 54.04 0.027 1.106 0.788 1.552 0.559
Comparison by socioeconomic status variables between current and former smokers
Appendix K 2 describes the socioeconomic status variables of former and current
smokers.
When former smokers were compared to current smokers, statistically significant
differences were found for age, marital status, and friends from the same cultural
background. Former smokers tended to be older than current smokers; 97.7% of former
smokers were older than 24 years, compared to 83.8% of current smokers, p<.001; and
when looking at marital status, 79.7% of former smokers were married or living in a
marriage-like relationship compared to 60% of current smokers, p=.001. Finally, a larger
percentage (61%) of current smokers had more friends from the same ethnic background
77
compared to 47.7% of former smokers, p=.048; however, when the comparison was
controlled by age and gender only marital status was statistically significant. Former
smokers are more likely to be married or living in a marriage-like relationship
(OR=2.879, 95% CI=1.518, 5.460). Table 15 shows the statistical significant
socioeconomic differences between former and current smokers.
Table 15 Statistically Significant Differences Between Former and Current Smokers Given Socioeconomic Status
Univariate Multivariate Controlling by age and gender FS CS 95% CI
Variable No % No % P (FET) OR Lower Upper P H1.2 Dage 25 (Older than 24 yo) 125 97.66 88 83.81 0.000 3.256 0.834 12.720 0.089 H1.3 Marital Status dq12 M (married) 102 79.69 63 60.00 0.001 2.879 1.518 5.460 0.001 * H1.7 Dincome (>$25,000) 86 70.49 62 60.78 0.156 1.819 0.996 3.323 0.052 H1.12 Orientation 4 Friends Dorient4f 61 47.66 64 60.95 0.048 0.701 0.403 1.218 0.207
Comparison by socioeconomic status variables between former smokers in the
maintenance SOC, current smokers willing to quit, in the preparation SOC, and current
smokers not willing to quit, in the pre-contemplation SOC
Appendix K 3 describes the socioeconomic status variables of former smokers, in
the maintenance SOC, current smokers willing to quit, in the preparation SOC, and
current smokers not willing to quit, in the pre-contemplation SOC.
When smokers in the maintenance, preparation, and pre-contemplation SOC were
compared, statistically significant differences were found by age and marital status as
follows: former smokers tended to be older than current smokers; 97.7% of smokers in
the maintenance SOC were older than 24 years compared to 86.5% of smokers in the
preparation SOC and 77.4% of those in the pre-contemplation SOC, p<.001; and when
looking at marital status, 79.7% of smokers in the maintenance SOC were married or
78
living in a marriage-like relationship compared to 56.8% of smokers in the preparation
SOC and 67.7% of those in the pre-contemplation SOC, p = .002.
Contrary to what was expected, it was found that a lower percentage of smokers
in the preparation SOC was married or living in a marriage-like relationship than those in
the pre-contemplation SOC. Table 16 shows the statistically significant differences
between smokers in the maintenance, preparation, and pre-contemplation SOC.
Table 16 Statistically Significant Differences Between Smokers in the
Maintenance, Preparation, and Pre-Contemplation SOC Given Socioeconomic Status
Maintenance SOC Preparation SOC
Pre-contemplation SOC
Variable No % No % No % P FET H1.2 Dage 25 (Older than 24 yo) 125 97.66 64 86.49 24 77.42 0.000 * H1.3 Marital Status dq12 M (married) 102 79.69 42 56.76 21 67.74 0.002 *
Comparison by socioeconomic status variables between smokers in the preparation and
pre-contemplation SOC
There were no statistically significant differences between smokers in the
preparation and pre-contemplation SOC. Appendix K 4 shows the socioeconomic status
variables of smokers in the preparation and pre-contemplation SOC.
Comparison by socioeconomic status variables between smokers in the pre-
contemplation, contemplation, and preparation SOC
Appendix K 5 describes the socioeconomic characteristics of smokers in the pre-
contemplation, contemplation, and preparation SOC.
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Only age was statistically significantly different between smokers in the pre-
contemplation, contemplation, and preparation SOC. A large percentage of smokers in
the preparation SOC were older than 24 years (91.4%), compared to 83.3% of smokers in
the pre-contemplation and 70% of those in the contemplation SOC, p=.032, as is shown
in Table 17.
Table 17 Statistically Significant Differences Between Smokers in the Preparation, Contemplation, and Pre-Contemplation SOC Given Socioeconomic Status
Univariate Pre-contemplation SOC Contemplation SOC Preparation SOC
Variable No % No % No % P FET H1.2 Dage 25 (Older than 24 yo) 15 83.33 21 70.00 53 91.38 0.032 *
Comparison by socioeconomic status variables given perceived likelihood of success if
wanted to quit smoking
Appendix K 6 describes the socioeconomic characteristics of smokers who
perceive themselves to be likely and unlikely respectively to succeed if they wanted to
quit smoking.
The only statistically significant difference was found in friends from the same
cultural background. Smokers who answered that they were unlikely to succeed if they
wanted to quit smoking tend to have less friends from the same ethnic background
(52.9%), than those who answered they were likely to succeed (80.7%), (OR=.270, 95%
CI=.089, .0813), as is shown in Table 18.
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Table 18 Statistically Significant Differences by Likelihood to Succeed if
Wanted to Quit Smoking Given Socioeconomic Status Univariate
Multivariate Controlling by age and gender
Unlikely Likely 95% CI Variable No % No % P FET OR Lower Upper P
H1.11 Fluency 2 HC dfluency2hc 9 52.94 71 80.68 0.026 0.270 0.089 0.813 0.020 *
Comparison by socioeconomic status variables given believes about the likelihood of
success if decided to quit smoking
Appendix K 7 describes the socioeconomic characteristics of smokers who
perceive themselves to be likely and unlikely to succeed if they decided to quit smoking.
The only statistically significant difference was found in friends from the same
cultural background. Smokers who answered that they were unlikely to succeed if they
decided to quit smoking tend to have less friends from the same ethnic background
(50%), than those who answered they were likely to succeed (79%), (OR=.199, 95%
CI=.044, .903), as is shown in Table 19.
Table 19 Statistically Significant Differences by Likelihood to Succeed if
Decided to Quit Smoking Given Socioeconomic Status Univariate
Multivariate Controlling by age and gender
Unlikely Likely 95% CI Variable No % No % P FET OR Lower Upper P
H1.11 Fluency 2 HC dfluency2hc 5 50.00 75 78.95 0.055 0.199 0.044 0.903 0.036 *
Comparison by socioeconomic status variables given level of comfort asking for help
Appendix K 8 describes the socioeconomic characteristics of smokers who felt
comfortable and uncomfortable asking for help to quit smoking.
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The only statistically significant difference was found in the percentage of
respondents living with children under 18 years old. Smokers who answered that they
were uncomfortable asking for help to quit smoking are more likely to live with children
under 18 years old (82.9%), than those who answered they were comfortable (60%),
(OR=3.507, 95% CI=1.293, 9.510), as is shown in Table 20.
Table 20 Statistically Significant Differences by Level of Comfort Asking for
Help to Quit Smoking Given Socioeconomic Status Univariate
Multivariate Controlling by age and gender
Uncomfortable Comfortable 95% CI Variable No % No % P FET OR Lower Upper P
H1.4 Dminors 1=18yo 0r <; 0=>18yo 34 82.93 36 60.00 0.016 3.507 1.293 9.510 0.014 *
Comparison by socioeconomic status variables given level of agreement about the belief
that the only way to stop smoking is through will power
Appendix K 9 describes the socioeconomic characteristics of smokers who agree
and disagree about the belief that the only way to stop smoking is through their own will
power.
The only statistically significant difference was found by employment. A larger
percentage of smokers who answered that they agreed the only way to stop smoking is
through their own will power are employed (90.6%) compared to 55.6% of those who
disagree, p=.013. However, when controlling for age and gender this difference tended to
disappear (OR=0.194, 95% CI=.037, 1.022), as is shown Table 21.
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Table 21 Statistically Significant Differences by Agreement About Only Way to Stop Smoking is Through Will Power Given
Socioeconomic Status Univariate Multivariate Controlling by age and gender
Disagree Agree 95% CI Variable No % No % P FET OR Lower Upper P
H1.6 rs67 Employed 5 55.56 87 90.62 0.013 0.194 0.037 1.022 0.053 *
Summary results for hypothesis one
The results for the first hypothesis, differences by socioeconomic status, show
that there are significant differences among Latino smokers classified in the maintenance,
preparation, contemplation, and pre-contemplation SOC, by age. Smokers in the
maintenance SOC tend to be older than smokers in the preparation and pre-contemplation
SOC; similarly, smokers in the preparation SOC tend to be older than smokers in the pre-
contemplation and than those in the contemplation SOC.
The data support the following subhypothesis:
H1.2: Latino smokers who are not willing to quit smoking are younger than
Latino former smokers, and Latino smokers who are willing to quit
smoking.
The following subhypotheses are not supported:
H1.1: Latino men who smoke are more likely to be willing to quit smoking than
Latino women who smoke.
83
H1.3: Latino smokers who are not willing to quit smoking are more likely to be
single than Latino former smokers and Latino smokers who are willing to
quit smoking.
H1.4: Latino smokers who are not willing to quit smoking are less likely to live
with minors of 18 years old than Latino former smokers and Latino
smokers who are willing to quit smoking.
H1.5: Latino smokers who are not willing to quit smoking have a lower level of
education than Latino former smokers and Latino smokers who are willing
to quit smoking.
H1.6: Latino smokers who are not willing to quit smoking are more likely to be
unemployed than Latino smokers who are willing to quit smoking.
H1.7: Latino smokers who are not willing to quit smoking are more likely to
have lower income than Latino former smokers and Latino smokers who
are willing to quit smoking.
H1.8: Latino smokers who are not willing to quit smoking are more likely to live
in rural areas than Latino smokers who are willing to quit smoking.
H1.9: Latino smokers who are not willing to quit smoking are more likely to
answer the survey in Spanish than Latino former smokers and Latino
smokers who are willing to quit smoking.
H1.10: Latino smokers who are not willing to quit smoking are more likely to
have fewer years living in the U.S. than Latino former smokers and Latino
smokers who are willing to quit smoking.
84
H1.11: Latino smokers who are not willing to quit smoking are more likely to be
home country oriented than Latino former smokers and Latino smokers
who are willing to quit smoking.
H1.12: Latino smokers who are not willing to quit smoking are more likely to
have more friends with the same cultural background than Latino former
smokers and Latino smokers who are willing to quit smoking.
Self-reported health status given smoking status and stages of change
Results of the comparison of the self-reported health status variables between
never smokers and smokers in the different SOC are presented in Appendices L 1 to 9.
Comparison by self-reported health status among never smokers and ever smokers
Appendix L 1 shows the self-reported health status variables of never and ever
smokers.
When never smokers were compared to ever smokers, there were statistically
significant differences by self reported injury or illness affecting daily routine during the
previous year, self reported major injury or illness during the past year, major change in
health of relative in the past year, and BMI. When the comparison was made controlling
for age and gender, the following were statistically significantly different: self reported
happiness, self reported major injury or illness during the past year, and major change in
health of relative in the past year.
85
A larger percentage of ever smokers (44.3%) self-reported an injury or illness
affecting their daily routines during the previous year compared to 36.5% of never
smokers, p = .047; similarly, 24.3% of ever smokers reported suffering a major injury or
illness during the previous year compared to 12.9% of never smokers, p <.001. 30.2% of
ever smokers reported a major change in health of a relative during the previous year
compared to 22.1% of never smokers, p =.019, and a larger percentage of never smokers
(30.3%) have a normal BMI than ever smokers (21.9%), p=.020. When controlling for
age and gender, never smokers are more likely than ever smokers to report happiness
(OR=1.794, 95% CI=1.033, 3.115), and less likely than ever smokers to report major
injury or illness during the previous year (OR=.512, 95% CI=.336, .779) and major
change in health of relative in the past year (OR=.609, 95% CI=.420, .884), as is shown
in Table 22.
Table 22 Statistically Significant Differences Between Never and Ever Smokers
Given Self-Reported Health Status
Univariate Multivariate Controlling by
age and gender Never Ever 95% CI
Variable No % No % P FET OR
Lower
Upper P
H2.3 Self Reported Happiness Rq3 519 91.86 205 88.36 0.137 1.794 1.033 3.115 0.038 * H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 208 36.49 104 44.26 0.047
0.778
0.557
1.086
0.139
H2.9 Self reported Major Injury or illness in the Past Year Rs33a 73 12.85 57 24.26 0.000
0.512
0.336
0.779
0.002 *
H2.11 Major Change in Health of Relative in the past Year Rs33c
126
22.11 71
30.21 0.019
0.609
0.420
0.884
0.009 *
H2.14 DBMI 158 30.33 49 21.86 0.020 1.130 0.758 1.683 0.549
Comparison by self-reported health status among former smokers and current smokers
Appendix L 2 shows the self-reported health status variables of former and
current smokers.
86
When former smokers were compared to current smokers, there were no
statistically significant differences; however, a larger percentage of current smokers
(28.4%) have a normal BMI compared to former smokers (16.7%), p=.051. This
difference is no statistically significant when the comparison is made controlling for
gender and age, as is shown in Table 23.
Table 23 Statistically Significant Differences Between Former and
Current Smokers Given Self-Reported Health Status Univariate
Multivariate Controlling by age and gender
FS CS 95% CI Variable No % No % P FET OR Lower Upper P
H2.14 DBMI 20 16.67 29 28.43 0.051 0.545 0.272 1.089 0.086
Comparison by self-reported health status among former smokers in the maintenance
SOC, current smokers willing to quit, in the preparation SOC, and current smokers not
willing to quit, in the pre-contemplation SOC
Appendix L 3 describes the self-reported health status variables of Latino smokers
in the maintenance, preparation, and pre-contemplation SOC. There were no statistically
significant differences.
Comparison by self-reported health status among smokers in the preparation and pre-
contemplation SOC
Appendix L 4 shows the self-reported health status variables of smokers in the
preparation and pre-contemplation SOC.
87
When smokers in the preparation SOC were compared to those in the pre-
contemplation SOC, there were statistically significant differences by self-reported major
change in health of relative in the past year. When the comparison was made controlling
for age and gender, there were statistically significant differences by self-reported
interesting things in daily life, self-reported major change in health of relative in the past
year, and self-reported major change in family reunions during the previous year.
Smokers in the preparation SOC (82.2%) were more likely to self-report
interesting things in daily life compared to those in the pre-contemplation SOC (64.5%),
(OR=2.645, 95% CI=1.000, 6.995). As was expected, smokers in the preparation SOC
were more likely to self-report a major change in health of relative during the previous
year (23%) than smokers in the pre-contemplation SOC (45.2%), p=.034, (OR=.314, 95%
CI=.123, .802); similarly, smokers in the preparation SOC were less likely to self report a
major change in family reunions during the previous year (14.9%) than smokers in the
pre-contemplation SOC (32.3%), p=.060, (OR=.349, 95% CI=.126, .0967), as is shown in
Table 24.
Table 24 Statistically Significant Differences between Smokers in the Preparation, and
Pre-Contemplation SOC Given Self-Reported Health Status
Univariate Multivariate Controlling by age and
gender Preparation Precontemplation 95% CI
Variable No % No % PFET OR Lower Upper P H2.2 Self Reported Interesting Things in Daily Life Rq2 60 82.19 20 64.52 0.074 2.645 1.000 6.996 0.05 * H2.11 Major Change in Health of Relative in the past Year Rs33c 17 22.97 14 45.16 0.034 0.314 0.123 0.802 0.015 * H2.12 Major Change Family Get-togethers in the Past Year Rs33d 11 14.86 10 32.26 0.060 0.349 0.126 0.967 0.043 *
88
Comparison by self-reported health status among smokers in the pre-contemplation,
contemplation, and preparation SOC
Appendix L 5 describes the socioeconomic characteristics of smokers in
the pre-contemplation, contemplation, and preparation SOC. There were no statistically
significant differences.
Comparison by self-reported health status given perceptions of the likelihood of success
if wanted to quit smoking
Appendix L 6 describes the self-reported health status variables of smokers who
believed they would be likely and unlikely to succeed if they wanted to quit smoking.
The only statistically significant difference was adequate exercise. Smokers who
answered that they were unlikely to succeed if they wanted to quit smoking were less
likely to exercise adequately (17.7%) than those who answered that they were unlikely to
succeed (43.2%), (OR=.242, 95% CI=.603, .929), as is shown in Table 25.
Table 25 Statistically Significant Differences by Likelihood to Succeed
if Wanted to Quit Given Self-Reported Health Status
Univariate Multivariate Controlling by age and gender
Unlikely Likely 95% CI Variable No % No % P FET OR Lower Upper P
H2.7 Adequate Exercise – cumex 3 17.65 38 43.18 0.049 0.242 0.603 0.929 0.039 *
89
Comparison by self-reported health status given believes about the likelihood of success
if decided to quit smoking
Appendix L 7 describes the self-reported health status variables of smokers who
believe they are likely and unlikely to succeed if they decided to quit smoking. There
were no statistically significant differences.
Comparison by self-reported health status variables given level of comfort asking for
help
Appendix L 8 describes the self-reported health status variables of smokers who
felt comfortable and uncomfortable asking for help to quit smoking. There were no
statistically significant differences; however, a larger percentage of smokers who felt
uncomfortable asking for help tend to engage in adequate exercise (51.2%), compared to
those who felt comfortable asking for help (31.7%), p=0.063. When controlling for age
and gender, a similar trend was found, (OR=2.299, 95% CI=.0976, 5.414), as is shown in
Table 26.
Table 26 Statistically Significant Differences by Level of Comfort About Asking
for Help to Quit Smoking Given Self-Reported Health Status
Univariate Multivariate Controlling by age
and gender Uncomfortable Comfortable 95% CI
Variable No % No % P FET OR Lower
Upper P
H2.7 Adequate Exercise – cumex 21 51.22 19 31.67 0 .063 2.299
0.976
5.414
0.057
90
Comparison by self-reported health status variables given level of agreement about the
believe that the only way to stop smoking is through will power
Appendix L 9 describes the self-reported health status characteristics of smokers
who agree and disagree about the belief that the only way to stop smoking is through
their own will power.
Statistically significant differences were found for self-reported healthy, self-
reported major injury or illness during the previous year, and BMI.
A larger percentage of smokers who answered that they agreed that they believe
the only way to stop smoking is through their own will power self-reported healthy status
(72.9%), compared to those who disagree (37.5%), p=.049. A larger percentage of
smokers who answered that they disagreed with the belief that the only way to stop
smoking is through their own will power self-reported suffering a major injury or illness
during the previous year (66.7%), compared to those who agree (20.8%), p=.007,
Similarly, a larger percentage of smokers who answered that they disagreed about the
belief that the only way to stop smoking is through their own will power have a normal
BMI (88.9%), compared to those who agree (22.6%), p<.001.
When controlling for age and gender, smokers who disagree about the belief that
only way to stop smoking is through will power are more likely to report mayor injury or
illness during the previous year than those who agree (OR=5.736, 95% CI=1.216,
27.051); and smokers who disagree with the belief that the only way to stop smoking is
through will power are more likely to have a normal BMI than those who agree
(OR=39.402, 95% CI=3.799, 408.623), as is shown in Table 27.
91
Table 27 Statistically Significant Differences by Agreement About Only Way to
Stop Smoking is Through Will Power Given Self-Reported Health Status Univariate
Multivariate Controlling by age and gender
Disagree Agree 95% CI Variable No % No % PFET OR Lower Upper P
H2.1 Self Reported Healthy Rq1 3 37.50 70 72.92 0.049 0.264 0.054 1.286 0.099 H2.9 Self reported Major Injury or illness in the Past Year Rs33a 6 66.67 20 20.83 0.007 5.736 1.216 27.051 0.027 * H2.14 DBMI 8 88.89 21 22.58 0.000 39.402 3.799 408.623 0.002 *
Summary results for hypothesis two
The results for the second hypothesis, differences by self-reported health status,
show that there are significant differences among smokers in the preparation and pre-
contemplation SOC. Smokers in the preparation SOC are less likely to report major
change in the health of relative during the previous year and major change in family
reunions, and are more likely to report interesting things in their daily life than those in
the pre-contemplation SOC.
The data support the following subhypotheses:
H2.2: Latino smokers who are not willing to quit smoking are less likely to self-
report interesting things in daily life during the previous month than
Latino former smokers and Latino smokers who are willing to quit
smoking.
H2.11: Latino smokers who are not willing to quit smoking are more likely to
self-report major change in health of a family member during the previous
year than Latino former smokers and Latino smokers who are willing to
quit smoking.
92
H2.12: Latino smokers who are not willing to quit smoking are more likely to
self-report major change in the number of family get-togethers during the
previous year than Latino former smokers and Latino smokers who are
willing to quit smoking.
The following subhypotheses are not supported:
H2.1: Latino smokers who are not willing to quit smoking are more likely to
self-report fair or poor physical health during the previous year than
Latino former smokers and Latino smokers who are willing to quit
smoking.
H2.3: Latino smokers who are not willing to quit smoking are less likely to
report that they are happy with their personal life during the previous
month than Latino former smokers and Latino smokers who are willing to
quit smoking.
H2.4: Latino smokers who are not willing to quit smoking are less likely to
report that they are healthy compare to other people their age than Latino
former smokers and Latino smokers who are willing to quit smoking.
H2.5: Latino smokers who are not willing to quit smoking are more likely to
report injury or illness affecting daily routine during the previous year
than Latino former smokers and Latino smokers who are willing to quit
smoking.
93
H2.6: Latino smokers who are not willing to quit smoking are less likely to self-
report physical activity during the previous week than Latino former
smokers and Latino smokers who are willing to quit smoking.
H2.7: Latino smokers who are not willing to quit smoking are less likely to self-
report adequate exercise during the previous week than Latino former
smokers and Latino smokers who are willing to quit smoking.
H2.8: Latino smokers who are not willing to quit smoking are more likely to
self-report stressful events during the previous month than Latino former
smokers and Latino smokers who are willing to quit smoking.
H2.9: Latino smokers who are not willing to quit smoking are more likely to
self-report a major personal injury or illness during the previous year than
Latino former smokers and Latino smokers who are willing to quit
smoking.
H2.10: Latino smokers who are not willing to quit smoking are more likely to
self-report change of residence during the previous year than Latino
former smokers and Latino smokers who are willing to quit smoking.
H2.13: Latino smokers who are not willing to quit smoking are less likely to self-
report adequate fruit and vegetable consumption during the previous week
than Latino former smokers and Latino smokers who are willing to quit
smoking.
94
H2.14: Latino smokers who are not willing to quit smoking have a lower BMI
than Latino former smokers and Latino smokers who are willing to quit
smoking.
Beliefs about smoking variables given smoking status and stages of change
Results of the comparison of beliefs about smoking variables between never
smokers and smokers in the different SOC are presented in Appendices M 1 to 9.
Comparison by beliefs about smoking variables among never smokers and ever smokers
Appendix M 1 shows beliefs about smoking variables of never and ever smokers.
When never smokers were compared to ever smokers, there were statistically
significant differences by beliefs that smoking facilitates friendship, provides pleasure,
relieves stress, can help to focus on activities, helps to lose weight, and there are no
positive aspects of smoking as follows:
A larger percentage of ever smokers (11.2%) believed that smoking facilitates
friendship, compared to never smokers (6%), p=.017. A larger percentage of ever
smokers (40%) believed that smoking provides pleasure, compared to never smokers
(18.3%), p<.001. A larger percentage of ever smokers (48.7%) believed that smoking
relieves stress, compared to never smokers (21.1%), p<.001. A larger percentage of ever
smokers (14.7%) believed that smoking can help focus on activities, compared to never
smokers (8.67%), p=.015. Similarly, a larger percentage of ever smokers (29.3%)
believed that smoking helps to lose weight, compared to never smokers (21.6%), p=.027.
95
A larger percentage of never smokers (59%) believed that there are no positive aspects of
smoking, compared to ever smokers (32.3%), p<.001.
When the comparison was controlled by age and gender, statistically significant
differences were found for beliefs that smoking provides pleasure, relieves stress, that
there are no positive aspects of smoking, and that smoking causes heart disease. Never
smokers are less likely to believe that smoking provides pleasure and that smoking
relieves stress than ever smokers, (OR=.364, 95% CI=.252, .526) and (OR=.278, 95%
CI=.194, .400), respectively. As expected, never smokers were more likely to believe that
there are no positive aspects of smoking (OR=2.600, 95% CI=1.848, 3.660) and that
smoking causes heart disease (OR=2.252, 95% CI=1.175, 4.314). Table 28 describes the
statistically significant differences between never and ever smokers regarding their
beliefs about smoking.
Table 28 Statistically Significant Differences Between
Never and Ever Smokers Given Beliefs About Smoking
Univariate Multivariate Controlling by age
and gender Never Ever 95% CI
Variable No % No % PFET OR Lower Upper P H3.1 Smoking Facilitates Friendship Rs34a 34 6.00 26 11.16 0.017 0.641 0.359 1.146 0.134 H3.2 Smoking Provides Pleasure Rs34b 102 18.25 94 40.00 0.000 0.364 0.252 0.526 0.000 * H3.3 Smoking Relieves Stress Rs34c 114 21.07 112 48.70 0.000 0.278 0.194 0.400 0.000 * H3.4 Smoking Can Help focus on activities Rs34d 48 8.63 34 14.66 0.015 0.800 0.477 1.341 0.397 H3.5 Smoking helps to Lose Weight Rs34e 119 21.64 67 29.26 0.027 0.830 0.567 1.214 0.336 H3.6 No Positive Aspects of Smoking Rsmokeben 336 58.95 76 32.34 0.000 2.600 1.848 3.660 0.000 * H3.8 Smoking Causes Heart Disease Rs76c 509 94.09 207 91.19 0.157 2.252 1.175 4.314 0.014 *
Comparison by beliefs about smoking variables among former and current smokers
Appendix M 2 shows beliefs about smoking variables of former and current
smokers.
96
When former smokers were compared to current smokers, there were statistically
significant differences by the beliefs that there are no positive aspects of smoking and
that about smoking there are more harms than benefits. When controlling for age and
gender, former smokers are more likely to believe that there are no positive aspects of
smoking (OR=1.839, 95% CI=1.018, 3.323), and consequently, that with regard to
smoking there are more harms than benefits (OR=6.472, 95% CI=2.044, 20.494), as is
shown in Table 29.
Table 29 Statistically Significant Differences Between
Former and Current Smokers Given Beliefs About Smoking
Univariate Multivariate Controlling by age and gender
FS CS 95% CI Variable No % No % P FET OR Lower Upper P
H3.6 No Positive Aspects of Smoking Rsmokeben 48 37.50 28 26.67 0.092 1.839 1.018 3.323 0.044 * H3.13 About smoking, there are more harms than benefits ds39 123 96.09 89 84.76 0.005 6.472 2.044 20.494 0.001 *
Comparison by beliefs about smoking variables among former smokers in the
maintenance SOC, current smokers willing to quit, in the preparation SOC, and current
smokers no willing to quit, in the pre-contemplation SOC
Appendix M 3 describes the beliefs about smoking variables of former smokers,
in the maintenance SOC, current smokers willing to quit, in the preparation SOC, and
current smokers not willing to quit, in the pre-contemplation SOC.
When smokers in the maintenance, preparation, and pre-contemplation SOC were
compared, statistically significant differences were found only for beliefs that about
smoking there are more harms than benefits. A larger percentage of smokers in the
maintenance SOC (96.1%) believed that smoking causes more harms than benefits
97
compared to those in the preparation SOC (83.8%) and in the pre-contemplation
SOC(87.1%), p = .007, as is shown in Table 30.
Table 30 Statistically Significant Differences Between Smokers in the Maintenance,Preparation, and Pre-Contemplation SOC Given Beliefs About Smoking
Maintenance SOC
Preparation SOC
Pre-contemplation SOC
Variable No % No % No % P FET H3.13 About smoking, there are more harms than benefits ds39 123 96.09 62 83.78 27 87.10 0.007 *
Comparison by beliefs about smoking variables among smokers in the preparation and
pre-contemplation SOC
Appendix M 4 shows beliefs about smoking variables of smokers in the
preparation and pre-contemplation SOC.
When smokers in the preparation SOC were compared to those in the pre-
contemplation SOC, there were statistically significant differences by beliefs that
smoking facilitates friendship and provides pleasure. When controlling for age and
gender, smokers in the preparation SOC were less likely to believe that smoking
facilitates friendship (OR=.216, 95% CI=.052, .891) and that smoking provides pleasure
(OR=.373, 95% CI=.150, .930), as is shown in Table 31.
Table 31 Statistically Significant Differences Between Smokers in the
Preparation and Pre-Contemplation SOC Given Beliefs About Smoking Univariate
Multivariate Controlling by age and gender
Preparation Precontemplation 95% CI Variable No % No % PFET OR Lower Upper P
H3.1 Smoking Facilitates Friendship Rs34a 4 5.41 6 19.35 0.061 0.216 0.052 0.891 0.034 * H3.2 Smoking Provides Pleasure Rs34b 27 36.49 17 54.84 0.089 0.373 0.150 0.930 0.034 *
98
Comparison by beliefs about smoking variables among smokers in the pre-contemplation,
contemplation, and preparation SOC
Appendix M 5 describes beliefs about smoking variables of smokers in the
pre-contemplation, contemplation, and preparation SOC. There were no statistically
significant differences between smokers in the pre-contemplation, contemplation, and
preparation SOC.
Comparison by beliefs about smoking variables given perceived likelihood of success if
wanted to quit smoking
Appendix M 6 describes beliefs about smoking of smokers who believe they are
likely and unlikely to succeed if they wanted to quit smoking. There were no statistically
significant differences.
Comparison by beliefs about smoking variables given perceived likelihood of success if
decided to quit smoking
Appendix M 7 describes beliefs about smoking of smokers who believe they are
likely and unlikely to succeed if they decided to quit smoking.
When controlling for age and gender, smokers who answered that they were
unlikely to succeed if they decided to quit smoking are less likely to believe that people
smoke because they want to (OR=.114, 95% CI=.018, .671), as is shown in Table 32.
99
Table 32 Statistically Significant Differences by Likelihood to Succeed if
Decided to Quit Smoking Given Beliefs About Smoking Univariate
Multivariate Controlling by age and gender
Unlikely Likely 95% CI Variable No % No % P FET OR Lower Upper P
H3.9 People Smoke because they want to rs35 6 60.00 74 77.89 0.244 0.114 0.018 0.671 0.016 *
Comparison by beliefs about smoking variables given level of comfort asking for help
Appendix M 8 describes the self-reported health status variables of smokers who
felt comfortable and uncomfortable asking for help to quit smoking. There were no
statistically significant differences.
Comparison by beliefs about smoking variables given level of agreement about the belief
that the only way to stop smoking is through will power
Appendix M 9 describes beliefs about smoking by smokers who agree and
disagree about the belief that the only way to stop smoking is through their own will
power.
The only statistically significant difference was for the belief that smoking results
in more harms than benefits. When controlling for age and gender, smokers who disagree
with the belief that the only way to stop smoking is through will power are less likely to
believe that smoking causes more harms than benefits (OR=.200, 95% CI=.040, .991)
than those who agree, as is shown in Table 33.
100
Table 33 Statistically Significant Differences by Agreement About Only Way to Stop
Smoking is Through Will Power Given Beliefs About Smoking Univariate
Multivariate Controlling by age and gender
Variable Disagree Agree 95% CI No % No % P FET OR Lower Upper P
H3.13 About smoking, there are more harms than benefits ds39 5 55.56 84 87.50 0.029 0.200 0.040 0.991 0.049 *
Summary results for hypothesis three
The results for the third hypothesis show that there are significant differences
among former smokers in the maintenance, preparation and pre-contemplation SOC for
the beliefs that smoking facilitates friendship and provides pleasure. Smokers in the
preparation SOC are less likely to believe that smoking facilitates friendship and that
smoking provides pleasure than those in the pre-contemplation SOC.
The data support the following subhypotheses:
H3.1: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking facilitates friendship than Latino former smokers and
Latino smokers who are willing to quit smoking.
H3.2: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking provides pleasure than Latino former smokers and
Latino smokers who are willing to quit smoking.
101
The following subhypotheses are not supported:
H3.3: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking relieves stress than Latino former smokers and
Latino smokers who are willing to quit smoking.
H3.4: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking helps to focus on activities than Latino former
smokers and Latino smokers who are willing to quit smoking.
H3.5: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking helps to lose weight than Latino former smokers and
Latino smokers who are willing to quit smoking.
H3.6: Latino smokers who are not willing to quit smoking are more likely to
believe that smoking has positive aspects than Latino former smokers and
Latino smokers who are willing to quit smoking.
H3.7: Latino smokers who are not willing to quit smoking are less
knowledgeable that smoking causes lung cancer than Latino former
smokers and Latino smokers who are willing to quit smoking.
H3.8: Latino smokers who are not willing to quit smoking are less
knowledgeable that smoking causes heart disease than Latino former
smokers and Latino smokers who are willing to quit smoking.
H3.9: Latino smokers who are not willing to quit smoking are more willing to
believe that people smoke because they want to than Latino former
smokers and Latino smokers who are willing to quit smoking.
102
H3.10: Latino smokers who are not willing to quit smoking are more likely to
believe that people smoke because it is a habit than Latino former smokers
and Latino smokers who are willing to quit smoking.
H3.11: Latino smokers who are not willing to quit smoking are less likely to
believe that people who smoke cannot control whether they smoke or not
than Latino former smokers and Latino smokers who are willing to quit
smoking.
H3.12: Latino smokers who are not willing to quit smoking are more likely to
believe that it is okay to smoke as long as you are healthy than Latino
former smokers and Latino smokers who are willing to quit smoking.
H3.13: Latino smokers who are not willing to quit smoking are less likely to
believe that smoking causes more harms than benefits than Latino former
smokers and Latino smokers who are willing to quit smoking.
Behaviors about second-hand smoke variables given smoking status and stages of
change
Results of the comparison of behaviors about SHS between never smokers and
smokers in the different SOC are presented in Appendices N 1 to 9.
Comparison by behaviors about SHS variables among never smokers and ever smokers
Appendix N 1 shows behaviors about SHS of never and ever smokers.
103
When never smokers were compared to ever smokers, there were statistically
significant differences by the following behaviors: comfortable with others smoking
around you, living in a house in which someone smokes, riding in a car in which
someone smokes, smoking is not allowed at home, prefer to work where smoking is not
allowed, been exposed to SHS during the previous week, and exposing children under 18
years old to SHS during the previous week.
Controlling for age and gender, never smokers are less likely than ever smokers to
be comfortable with others smoking around them (OR=.234, 95% CI=.155, .353), live in
a house in which someone smokes (OR=.352, 95% CI=.207, .598), ride in a car with
someone who smokes (OR=.382, 95% CI=.256, .572), be exposed to SHS during the
previous week (OR=.392, 95% CI=.277, .557), and to expose children under 18 years old
to SHS during the previous week (OR=.443, 95% CI=.311, .631). Never smokers are
more likely to live in a home in which smoking is not allowed than ever smokers
(OR=3.424, 95% CI=1.992, 5.885), as well as to prefer work where smoking is not
allowed (OR=3.035, 95% CI=2.014, 4.572), as is shown in table 34.
Table 34 Statistically Significant Differences Between Never and Ever Smokers
Given Behaviors About Second-Hand Smoke
Univariate Multivariate Controlling by age
and gender Never Ever 95% CI
Variable No % No % P FET OR Lower Upper P H4.1 Comfortable with others smoking around you Rs62 57 10.02 82 35.34 0.000 0.234 0.155 0.353 0.000 * H4.2 House someone smokes Rs64 37 6.49 37 15.75 0.000 0.352 0.207 0.598 0.000 * H4.3 Car someone smokes Rs66 82 14.39 71 30.21 0.000 0.382 0.256 0.572 0.000 * H4.4 smoking not Allowed at home Rs65 538 94.55 194 82.55 0.000 3.424 1.992 5.885 0.000 * H4.7 Prefer works where smoking is not allowed Rs73 352 82.05 122 60.40 0.000 3.035 2.014 4.572 0.000 * H4.8 SHS (1=exposure to shs; 0=no shs) 259 45.44 161 68.51 0.000 0.392 0.277 0.557 0.000 * H4.9 MinorsSHS 188 32.98 105 44.68 0.002 0.443 0.311 0.631 0.000 *
104
Comparison by behaviors about second-hand smoke variables among former smokers
and current smokers
Appendix N 2 shows behaviors about SHS of former and current smokers.
When former smokers were compared to current smokers, there were statistically
significant differences for the following behaviors: comfortable with others smoking
around you, living in a house in which someone smokes, riding in a car in which
someone smokes, smoking is not allowed at home, prefer to work where smoking is not
allowed, been exposed to SHS during the previous week, and exposing children under 18
years old to SHS during the previous week.
Controlling for age and gender, former smokers are less likely than current
smokers to be comfortable with others smoking around them (OR=.113, 95% CI=.058,
.222), live in a house in which someone smokes (OR=.154, 95% CI=.063, .377), ride in a
car in which someone smokes (OR=.238, 95% CI=.125, .452), be exposed to SHS during
the previous week (OR=.293, 95% CI=.155, .556), and to expose children under 18 years
old to SHS during the previous week (OR=.568443, 95% CI=.324, .995).
Former smokers are more likely to live in a home in which smoking is not
allowed than current smokers (OR=5.837, 95% CI=2.524, 13.497), as well as to prefer
work where smoking is not allowed (OR=4.465, 95% CI=2.350, 8.484), as is shown in
table 35.
105
Table 35 Statistically Significant Differences Between Former and
Current Smokers Given Behaviors About Second-Hand Smoke Univariate
Multivariate Controlling by age and gender
FS CS 95% CI Variable No % No % P FET OR Lower Upper P
H4.1 Comfortable with others smoking around you Rs62 20 15.87 61 58.65 0.000 0.113 0.058 0.222 0.000 * H4.2 House someone smokes Rs64 9 7.03 27 25.71 0.000 0.154 0.063 0.377 0.000 * H4.3 Car someone smokes Rs66 19 14.84 51 48.57 0.000 0.238 0.125 0.452 0.000 * H4.4 smoking not Allowed at home Rs65 116 90.63 77 73.33 0.001 5.837 2.524 13.497 0.000 * H4.7 Prefer works where smoking is not allowed Rs73 84 77.78 38 41.30 0.000 4.465 2.350 8.484 0.000 * H4.8 SHS (1=exposure to shs; 0=no shs) 72 56.25 87 82.86 0.000 0.293 0.155 0.556 0.000 * H4.9 MinorsSHS 46 35.94 58 55.24 0.004 0.568 0.324 0.995 0.048 *
Comparison by behaviors about second-hand smoke variables among former smokers in
the maintenance SOC, current smokers willing to quit, in the preparation SOC, and
current smokers not willing to quit, in the pre-contemplation SOC
Appendix N 3 describes the beliefs about SHS variables of former smokers, in the
maintenance SOC, current smokers willing to quit, in the preparation SOC, and current
smokers no willing to quit, in the pre-contemplation SOC.
When smokers in the maintenance, preparation, and pre-contemplation SOC were
compared, there were found statistically significant differences for the following
behaviors: comfortable with others smoking around you, living in a house in which
someone smokes, riding in a car in which someone smokes, smoking is not allowed at
home, prefer to work where smoking is not allowed, been exposed to SHS during the
previous week, and exposing children under 18 years old to SHS during the previous
week.
A lower percentage of smokers in the maintenance SOC (15.9%) felt comfortable
with others smoking around them, compared to smokers in the preparation SOC (55.4%)
and those in the pre-contemplation SOC (66.7%), p<.001. A lower percentage of smokers
106
in the maintenance SOC (7%) lived in a house in which someone smoked compared to
smokers in the preparation SOC (24.3%) and those in the pre-contemplation SOC (29%),
p<.001. A lower percentage of smokers in the maintenance SOC (14.8%) felt comfortable
riding in a car in which someone smoked compared to smokers in the preparation SOC
(43.2%) and those in the pre-contemplation SOC (61.3%), p<.001. A lower percentage of
smokers in the maintenance SOC (56.3%) had been exposed to SHS, compared to
smokers in the preparation SOC (81.1%) and those in the pre-contemplation SOC
(87.1%), p<.001. A lower percentage of smokers in the maintenance SOC (35.9%) had
exposed their children under 18 years old to SHS, compared to smokers in the
preparation SOC (51.4%) and those in the pre-contemplation SOC (64.5%) p=.006.
A larger percentage of smokers in the maintenance SOC (90.6%) lived in a home
in which smoking is not allowed, compared to smokers in the preparation SOC (71.6%)
and those in the pre-contemplation SOC (77.4%), p=.001. Similarly, a larger percentage
of smokers in the maintenance SOC (77.8%) preferred to work where smoking is not
allowed compared to smokers in the preparation SOC (43.75%) and those in the pre-
contemplation SOC (35.7%), p<.001, as is shown in Table 36.
Table 36
Statistically Significant Differences Between Smokers in the Maintenance, Preparation, and Pre-Contemplation SOC Given Behaviors About
Second-Hand Smoke Maintenance SOC
Preparation SOC
Pre-contemplation SOC
Variable No % No % No % P FET H4.1 Comfortable with others smoking around you Rs62 20 15.87 41 55.41 20 66.67 0.000 * H4.2 House someone smokes Rs64 9 7.03 18 24.32 9 29.03 0.000 * H4.3 Car someone smokes Rs66 19 14.84 32 43.24 19 61.29 0.000 * H4.4 smoking not Allowed at home Rs65 116 90.62 53 71.62 24 77.42 0.001 * H4.7 Prefer works where smoking is not allowed Rs73 84 77.78 28 43.75 10 35.71 0.000 * H4.8 SHS (1=exposure to shs; 0=no shs) 72 56.25 60 81.08 27 87.10 0.000 * H4.9 MinorsSHS 46 35.94 38 51.35 20 64.52 0.006 *
107
Comparison by behaviors about second-hand smoke variables among smokers in the
preparation and pre-contemplation SOC
Appendix N 4 shows beliefs about SHS variables of smokers in the
preparation and pre-contemplation SOC.
When smokers in the preparation SOC were compared to those in the pre-
contemplation SOC, there were no statistically significant differences.
Comparison by behaviors about second-hand smoke variables among smokers in the pre-
contemplation, contemplation, and preparation SOC
Appendix N 5 describes beliefs about SHS variables of smokers in the pre-
contemplation, contemplation, and preparation SOC.
Statistically significant differences were found for riding in a car in which
someone smoked and been exposed to SHS during the previous week. A lower
percentage of smokers in the preparation SOC (37.9%) rode in a car in which someone
smoked during the previous week, compared to smokers in the pre-contemplation SOC
(44.4%) and those in the contemplation SOC (73.3%), p=.007. Also, a lower percentage
of smokers in the preparation SOC (77.6%) had been exposed to SHS during the previous
week compared to smokers in the pre-contemplation SOC (77.8%) and those in the
contemplation SOC (96.7%), p=.048, as is shown in Table 37.
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Table 37 Statistically Significant Differences Between Smokers in the Preparation, Contemplation, and Pre-Contemplation SOC
Given Behaviors About Second-Hand Smoke Pre-contemplation SOC
Contemplation SOC
Preparation SOC
Variable No % No % No % P FET H4.3 Car someone smokes Rs66 8 44.44 22 73.33 22 37.93 0.007 * H4.8 SHS (1=exposure to shs; 0=no shs) 14 77.78 29 96.67 45 77.59 0.048 *
Comparison by behaviors about second-hand smoke variables given believes about the
likelihood of success if wanted to quit smoking
Appendix N 6 describes beliefs about SHS of smokers who are likely and unlikely
to succeed if they wanted to quit smoking.
Controlling for age and gender, the only statistically significant difference was
living in a house in which someone smoked. Smokers who believed they are unlikely to
succeed if they wanted to quit smoking are more likely to live in a house in which
someone smokes (OR=3.699. 95% CI=1.187, 11.529), as is shown in Table 38.
Table 38 Statistically Significant Differences by Likelihood to Succeed if Wanted to
Quit Smoking Given Behaviors About Second-Hand Smoke Univariate
Multivariate Controlling by age and gender
Unlikely Likely 95% CI Variable No % No % P FET OR Lower Upper P
H4.2 House someone smokes Rs64 8 47.06 19 21.59 0.037 3.699 1.187 11.529 0.024 *
Comparison by behaviors about second-hand smoke variables given believes about the
likelihood of success if decided to quit smoking
Appendix N 7 describes beliefs about SHS of smokers who perceived themselves
to be likely and unlikely to succeed if they decided to quit smoking.
109
The only statistically significant variable was children exposed to SHS during the
previous week; a larger percentage of smokers who perceived themselves to be unlikely
to succeed if they decided to quit smoking exposed their children younger than 18 years
old to SHS (90%) compared to those who perceived themselves likely to succeed
(51.6%), p=.022; however, when the comparison was controlled by age and gender, there
were no statistically significant differences, as is shown in Table 39.
Table 39 Statistically Significant Differences by Likelihood to Succeed if Decided to
Quit Smoking Given Behaviors About Second-Hand Smoke Univariate Multivariate Controlling by age and gender
Unlikely Likely 95% CI Variable No % No % P FET OR Lower Upper P
H4.9 MinorsSHS 9 90.00 49 51.58 0.022 6.841 0.803 58.29 0.079
Comparison by behaviors about second-hand smoke variables given level of comfort
asking for help
Appendix N 8 describes the behavior about SHS variables of smokers who felt
comfortable an uncomfortable asking for help to quit smoking. There were no statistically
significant differences.
Comparison by behaviors about second-hand smoke variables given level of agreement
about the belief that the only way to stop smoking is through will power
Appendix N 9 describes beliefs about SHS variables of smokers who agree and
disagree about the belief that the only way to stop smoking is through their own will
power. There were no statistically significant differences.
110
Summary results for hypothesis four
The results for the fourth hypothesis show that there are significant differences
between former smokers in the maintenance SOC, smokers in the preparation SOC, and
smokers in the pre-contemplation SOC by the following behaviors about SHS:
comfortable with other smoking around you, living in a house in which someone smokes,
riding in a car in which someone smoked, living in a home in which smoking is not
allowed, prefer to work where smoking is not allowed, exposure to SHS, and exposure of
their children younger than 18 years old to SHS during the previous week.
Former smokers in the maintenance SOC tend to be less comfortable with others
smoking around them, do not live in a house in which someone smokes, do not ride in a
car in which someone smokes, be less exposed to SHS, and to less frequently expose
their children under 18 years to SHS during the previous week than smokers in the
preparation and pre-contemplation SOC respectively. Also, they tend to live in a home in
which smoking is not allowed and prefer to work where smoking is not allowed, relative
to smokers in the preparation and pre-contemplation SOC.
Similarly, smokers in the preparation SOC tend to not ride in a car in which
someone smokes and to be less exposed to SHS during the previous week than smokers
in the contemplation SOC and those in the pre-contemplation SOC.
111
The data support the following subhypotheses:
H4.1: Latino smokers who are not willing to quit smoking are more likely to
feel comfortable when others smoke around them than Latino former
smokers and Latino smokers who are willing to quit smoking.
H4.2: Latino smokers who are not willing to quit smoking are more likely to live
in a house where someone smokes than Latino former smokers and Latino
smokers who are willing to quit smoking.
H4.3: Latino smokers who are not willing to quit smoking are more likely to ride
in a car with a smoker than Latino former smokers and Latino smokers
who are willing to quit smoking.
H4.4: Latino smokers who are not willing to quit smoking are more likely to live
in a household where smoking is allowed than Latino former smokers and
Latino smokers who are willing to quit smoking.
H4.7: Latino smokers who are not willing to quit smoking are more likely to
prefer to work in a workplace where smoking is allowed than Latino
former smokers and Latino smokers who are willing to quit smoking.
H4.8: Latino smokers who are not willing to quit smoking are more likely to be
exposed to SHS than Latino former smokers and Latino smokers who are
willing to quit smoking.
H4.9: Latino smokers who are not willing to quit smoking are more likely to live
with a minor exposed to SHS than Latino former smokers and Latino
smokers who are willing to quit smoking.
112
The following subhypotheses are not supported:
H4.5: Latino smokers who are not willing to quit smoking are more likely to
work where someone smokes in their work area than Latino former
smokers and Latino smokers who are willing to quit smoking.
H4.6: Latino smokers who are not willing to quit smoking are more likely to
work where smoking is allowed in common areas than Latino former
smokers and Latino smokers who are willing to quit smoking.
Behaviors about smoking and beliefs about stopping smoking variables given
smoking status and stages of change
Results of the comparison of behaviors about smoking and beliefs about stopping
smoking between never smokers and smokers in the different SOC are presented in
Appendices O 1 to 9.
Comparison by behaviors about smoking and beliefs about stopping smoking variables
among never smokers and ever smokers
Appendix O 1 shows behaviors about smoking and beliefs about stopping
smoking of never and ever smokers.
There were no statistically significant differences between never and ever
smokers by the variable choice or addiction, the only variable answered by never
smokers.
113
Comparison by behaviors about smoking and beliefs about stopping smoking variables
among former smokers and current smokers
Appendix O 2 shows behaviors about smoking and beliefs about stopping
smoking of former and current smokers.
When former smokers were compared to current smokers, there were statistically
significant differences by the following behaviors: smoking the first cigarette after been
18 years old and smoking cigarettes regularly after been18 years old. Controlling for age
and gender, former smokers are less likely to have smoked their first cigarette after their
18th birthday (OR=.349, 95% CI=.017, .718), and to have smoked cigarettes regularly
(OR=.419, 95% CI=.235, .745) after their 18th birthday than current smokers, as is
shown in Table 40.
Table 40 Statistically Significant Differences Between Former and Current Smokers
Given Behaviors About Smoking and Beliefs About Stopping Smoking
Univariate Multivariate Controlling by age
and gender FS CS 95% CI
Variable No % No % P FET OR Lower Upper P H5.11 Smoked first cigarette after 18 yo Ds50T18yo 19 14.84 28 26.92 0.032 0.349 0.170 0.718 0.004 * 5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 63 49.22 66 62.86 0.047 0.419 0.235 0.745 0.003 *
Comparison by behaviors about smoking and beliefs about stopping smoking variables
among smokers in the maintenance, preparation, and pre-contemplation SOC
Appendix O 3 describes the behaviors about smoking and beliefs about stopping
smoking variables of smokers in the maintenance, preparation, and pre-contemplation
SOC.
114
When smokers in the maintenance, preparation, and pre-contemplation SOC were
compared, there were found statistically significant differences by the age at which they
smoked their first cigarette. A lower percentage of smokers in the maintenance SOC
(14.8%) smoked their first cigarette after their 18th birthday, compared to smokers in the
preparation SOC (30.1%) and those in the pre-contemplation SOC (19.4%), p=.037, as is
shown in Table 41.
Table 41 Statistically Significant Differences Between Smokers in the
Maintenance, Preparation, and Pre-Contemplation SOC Given Behaviors About Smoking and Beliefs About Stopping Smoking
Maintenance SOC
Preparation SOC
Pre-contemplation SOC
Variable No % No % No % P FET H5.11 Smoked first cigarette after 18 yo Ds50T18yo 19 14.84 22 30.14 6 19.35 0.037 *
Comparison by behaviors about smoking and beliefs about stopping smoking variables
among smokers in the preparation and pre-contemplation SOC
Appendix O 4 shows behaviors about smoking and beliefs about stopping
smoking variables of smokers in the preparation and pre-contemplation SOC.
When smokers in the preparation SOC were compared to those in the pre-
contemplation SOC, the following beliefs about stopping smoking were statistically
significantly different: very likely to succeed if want to stop smoking and very likely to
succeed if decide to stop smoking. When controlling for age and gender, smokers in the
preparation SOC are more likely to believe that they would be very likely to succeed if
they want to stop smoking than those in the pre-contemplation SOC, (OR=5.441, 95%
CI=2.058, 14.384). Similarly, smokers in the preparation SOC are more likely to believe
115
that they would be very likely to succeed if they decide to stop smoking than those in the
pre-contemplation SOC, (OR=3.574, 95% CI=1.424, 8.969). It also appears that a larger
percentage of smokers in the preparation SOC (58.1%), compared to those in the pre-
contemplation SOC (36.7%), does not enjoy smoking p=.057, as is shown in Table 42.
Table 42 Statistically Significant Differences Between Smokers in the Preparation,
and Pre-Contemplation SOC Given Behaviors About Smoking and Beliefs About Stopping Smoking
Univariate Multivariate Controlling by
age and gender
Preparation SOC
Pre-contemplation SOC 95% CI
Variable No % No % P FET OR Lower Upper P H5.6 Does not enjoy smoking rS56 43 58.11 11 36.67 0.054 2.409 0.975 5.954 0.057 H5.7 Very likely to succeed if want to stop smoking rs58 46 62.16 8 25.81 0.001 5.441 2.058 14.384 0.001 * H5.8 Very likely to succeed if decide to stop smoking rs59 52 70.27 12 38.71 0.004 3.574 1.424 8.969 0.007 *
Comparison by behaviors about smoking and beliefs about stopping smoking variables
among smokers in the pre-contemplation, contemplation, and preparation SOC
Appendix O 5 describes behaviors about smoking and beliefs about stopping
smoking variables of smokers in the pre-contemplation, contemplation, and preparation
SOC.
Statistically significant differences were found by smoker does not enjoy smoking
and smoking cigarettes regularly after their 18th birthday. A larger percentage of smokers
in the preparation SOC (65.5%) does not enjoy smoking, compared to smokers in the
contemplation SOC (36.64%) and those in the pre-contemplation SOC (29.4%), p=.005.
Also, a larger percentage of smokers in the preparation SOC (72.41%) smoked cigarettes
116
regularly after their 18th birthday compared to smokers in the pre-contemplation SOC
(61.1%) and those in the contemplation SOC (43.3%), p=.030; as is shown in Table 43.
Table 43 Statistically Significant Differences Between Smokers in the
Preparation, Contemplation, and Pre-Contemplation SOC Given Behaviors About Smoking and Beliefs About Stopping Smoking
Pre-contemplation SOC
Contemplation SOC
Preparation SOC
Variable No % No % No % P FET H5.6 Does not enjoy smoking rS56 5 29.41 11 36.67 38 65.52 0.005 * H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 11 61.11 13 43.33 42 72.41 0.030 *
Comparison by behaviors about smoking and beliefs about stopping smoking variables
given believes about the likelihood of success if wanted to quit smoking
Appendix O 6 describes behaviors about smoking and beliefs about stopping
smoking of smokers who are likely and unlikely to succeed if they wanted to quit
smoking.
There were no statistically significant differences.
Comparison by behaviors about smoking and beliefs about stopping smoking variables
given perceived likelihood of success if decided to quit smoking
Appendix O 7 describes behaviors about smoking and beliefs about stopping
smoking variables of smokers who perceived themselves to be likely and unlikely to
succeed if they decided to quit smoking.
There were no statistically significant differences.
117
Comparison by behaviors about smoking and beliefs about stopping smoking variables
given level of comfort asking for help
Appendix O 8 describes behaviors about smoking and beliefs about stopping
smoking variables of smokers who felt comfortable an uncomfortable asking for help to
quit smoking.
There were no statistically significant differences
Comparison by behaviors about smoking and beliefs about stopping smoking variables
given level of agreement about the belief that the only way to stop smoking is through will
power
Appendix O 9 describes behaviors about smoking and beliefs about stopping
smoking variables of smokers who agree and disagree about the belief that the only way
to stop smoking is through their own will power.
The only statistically significant difference was by very comfortable asking for
help to stop smoking. As expected, controlling for age and gender, smokers who disagree
about the belief that the only way to stop smoking is through will power are more likely
to feel very comfortable asking for help to stop smoking than those who agreed
(OR=7.893, 95% CI=1.336, 46.641), as is shown in Table 44.
Table 44
Statistically Significant Differences by Agreement About Only Way to Stop Smoking is Through Will Power Given Behaviors About Smoking and Beliefs
About Stopping Smoking
Univariate Multivariate Controlling by age
and gender Disagree Agree 95% CI
Variable No % No % P FET OR Lower Upper P H5.9 Very comfortable asking for help to stop smoking rs60 7 77.78 35 38.04 0.032 7.893 1.336 46.641 0.023 *
118
Summary results for hypothesis five
The results for the fifth hypothesis show that there are significant differences
among former smokers in the maintenance SOC, smokers in the preparation SOC,
smokers in the contemplation SOC, and smokers in the pre-contemplation SOC by the
following behaviors about smoking and beliefs about stopping smoking variables:
smoked first cigarette after their 18th birthday, smoking cigarettes regularly after 18th
birthday, very likely to succeed if wanted to stop smoking, very likely to succeed if
decided to stop smoking, and does not enjoy smoking.
Formers smokers in the maintenance SOC tend to be less likely to smoke their
first cigarette after their 18th birthday than smokers in the pre-contemplation and
preparation SOC.
Smokers in the preparation SOC are more likely to believe they would be very
likely to succeed if they wanted and decided to stop smoking than smokers in the pre-
contemplation SOC.
Finally, smokers in the preparation SOC are less likely to enjoy smoking
compared to smokers in the contemplation and pre-contemplation SOC. Similarly,
smokers in the preparation SOC are more likely to start smoking cigarettes regularly after
their 18th birthday than smokers in the pre-contemplation and contemplation SOC.
119
The data support the following subhypotheses:
H5.6: Latino smokers who are not willing to quit smoking are more likely to
enjoy smoking than Latino smokers who are willing to quit smoking.
H5.7: Latino smokers who are not willing to quit smoking are less likely to think
they would succeed if they want to stop smoking than Latino smokers who
are willing to quit smoking.
H5.8: Latino smokers who are not willing to quit smoking are less likely to think
they would succeed if they decided to stop smoking than Latino smokers
who are willing to quit smoking.
H5.12: Latino smokers who are not willing to quit smoking are more likely to
report smoking cigarettes regularly at younger age than Latino smokers
who are willing to quit smoking.
The following subhypotheses are not supported:
H5.1: Latino smokers who are not willing to quit smoking are more likely to
perceive smoking as a habit than Latino smokers who are willing to quit
smoking.
H5.2: Latino smokers who are not willing to quit smoking are more likely to
smoke every day than Latino smokers who are willing to quit smoking.
H5.3: Latino smokers who are not willing to quit smoking are more likely to
smoke the first cigarette within 30 minutes after waking up than Latino
smokers who are willing to quit smoking.
120
H5.4: Latino smokers who are not willing to quit smoking are more likely to
report that they smoke more when facing stressful events than Latino
smokers who are willing to quit smoking.
H5.5: Latino smokers who are not willing to quit smoking are more likely to feel
comfortable smoking around others than Latino smokers who are willing
to quit smoking.
H5.9: Latino smokers who are not willing to quit smoking are less likely to feel
comfortable asking for help to stop smoking than Latino smokers who are
willing to quit smoking.
H5.10: Latino smokers who are not willing to quit smoking are more likely to
think the only way they would be able to stop smoking is through they
own will power than Latino smokers who are willing to quit smoking.
H5.11: Latino smokers who are not willing to quit smoking are more likely to
have smoked their first cigarette at younger age than Latino smokers who
are willing to quit smoking.
H5.13: Latino smokers who are not willing to quit smoking are more likely to
smoke a larger number of cigarettes daily than Latino smokers who are
willing to quit smoking.
H5.14: Latino smokers who are not willing to quit smoking are less likely to quit
smoking for a day or more one or more times during the last year than
Latino smokers who are willing to quit smoking.
121
CHAPTER SIX
DISCUSSION AND CONCLUSIONS
The final chapter includes five sections. The first section describes the relevant
findings from the study, which are discussed in the second section. The third section
describes the limitations of the study; the recommendations are shown in the fourth
section. Finally, the fifth section contains the conclusions and recommendations for
future research.
Key findings
Socioeconomic characteristics
The results of the study show that most of the respondents were first generation in
the U.S. (75.7%), younger than 40 years old (mean age 37.9 years), but older than 24
years (87.7%), were married or living in a marriage-like relationship (71.9%), lived with
children (70.7%), completed high school or some level of higher education (61.2%), and
were employed (83.8%). Similarly, the majority of respondents was home country
oriented (mean 3.52 in a scale 1 to 4) and was familiar with the U.S. culture (mean 2.33
in a scale 1 to 4).
The smoking prevalence was 13.3%, similar to the smoking prevalence among
Latinos living in Hennepin County, Minnesota (13.6%) (Hennepin County Human
Services and Public Health Department, 2008), and lower than the general population of
122
Minnesota at the time of the survey (18.3%) (CDC, 2007); however, men had a
statistically significant higher smoking prevalence (20.1%) compared to women (6.1%),
p=<.001. Although almost all of the respondents believed that smoking causes cancer
(99.1%) and heart disease (93.2%), almost half of them (48.8%) believed that there are
some positive aspects of smoking, including beliefs that smoking relieves stress (29.3%),
provides pleasure (24.7%), and helps to lose weight (23.9%). Only 18% of respondents
believed that smoking is an addiction; a small percentage (6.5%) believed that it is okay
to smoke as long as the person is healthy, and a similar percentage (7.3%) believed that
the dangers and benefits of smoking are equal. Very few respondents (1.4%) believed
that smoking has more benefits than not smoking.
Although the majority of the respondents (82.7%) felt uncomfortable when others
smoked around them, almost half of the smokers (47%) felt comfortable smoking around
others and more than half (52.2%) of the respondents were exposed to SHS during the
previous week, as well as a significant percentage of their children (36.4%), especially in
the car (19%), at work (16.4%), and at home (9.2%). The majority of Latino smokers
tried their first cigarette (79.5%), and almost half (44.9%) started smoking regularly,
before they were of legal age to smoke.
Smokers reported smoking on average 8 cigarettes per day, above the addiction
threshold of 5 cigarettes per day (Benowitz and Henningfield, 1994), and smoking on
average 9 days per month. The majority of smokers had tried to stop smoking for a day or
more (73%), on average 13.5 times, during the previous year. Regarding former smokers,
123
a large majority (87.5%) stopped smoking more than one year before the survey and
29.9% reported that smoking restrictions influenced their decision to stop smoking.
Although the majority of the respondents (75.1%) reported excellent, very good
or good physical health, 38.8% reported that an injury or illness affected their daily
routine during the previous year and 19% reported some degree of stress during the
previous month. These health problems prevented respondents from performing their
usual activities during two days during the previous month. Only 27.8% of the
respondents had a normal BMI. The mean BMI of the respondents was 28.2, probably as
consequence of the reported lack of adequate exercise (35% of respondents reported
exercising adequately during the previous week), and the low consumption of fruits (1.9
servings per day) and vegetables (1.7 servings per day).
Relevant comparisons given socioeconomic status
When never smokers were compared to ever smokers, controlling for age and
gender, there was a likelihood of never smokers to be women (OR=4.859, 95%
CI=3.413, 6.918), and to respond to the survey in Spanish (OR=1.582, 95% CI=1.123,
2.229). Regarding former and current smokers, only marital status was statistically
significant. Former smokers were more likely to be married or living in a marriage-like
relationship (OR=2.879, 95% CI=1.518, 5.460). Maintenance, preparation, and pre-
contemplation SOC data showed that age and marital status were statistically
significantly different; 97.7% of smokers in the maintenance SOC were older than 24
years compared to 86.5% of smokers in the preparation SOC and 77.4% of those in the
124
pre-contemplation SOC, p<.001. When looking at marital status, 79.7% of smokers in the
maintenance SOC were married or living in a marriage-like relationship, compared to
56.8% of smokers in the preparation SOC and 67.7% of those in the pre-contemplation
SOC, p = .002; however, contrary to what was expected, a lower percentage of smokers
in the preparation SOC was married or living in a marriage-like relationship than those in
the pre-contemplation SOC.
When smokers in the preparation, contemplation, and pre-contemplation SOC
were compared, age was the only statistically significant difference. A larger percentage
of smokers in the preparation SOC was older than 24 years (91.4%), compared to 83.3%
of smokers in the pre-contemplation and 70% of those in the contemplation SOC, p=.032;
however, contrary to expectations, smokers in the contemplation were younger than those
in the pre-contemplation SOC.
When smokers were compared by their beliefs about quitting smoking,
controlling for age and gender, those who believed they were unlikely to succeed if they
wanted (OR=.270, 95% CI=.089, .0813) or decided (OR=.199, 95% CI=.044, .903) to
quit smoking were less likely to have friends from the same ethnic background than those
who believed they were likely to succeed.
When the comparison was made given the level of comfort asking for help,
controlling for age and gender, the only statistically significant difference was that
smokers who responded that they were uncomfortable asking for help to quit smoking are
more likely to live with children under 18 years old than those who answered they were
comfortable (OR=3.507, 95% CI=1.293, 9.510).
125
Relevant comparisons given self-reported health status
When controlling for age and gender, never smokers were more likely to report
happiness (OR=1.794, 95% CI=1.033, 3.115), less likely to report major injury or illness
during the previous year (OR=.512, 95% CI=.336, .779), and less likely to report a major
change in health of relative in the past year (OR=.609, 95% CI=.420, .884) than never
smokers.
Smokers in the preparation SOC were less likely to report major change in the
health of relative during the previous year (OR=.314, 95% CI=.123, .802) and major
change in family reunions (OR=.349, 95% CI=.126, .0967) than those in the pre-
contemplation SOC, and were more likely to report interesting things in their daily life
(OR=2.645, 95% CI=1.000, 6.995) than those in the pre-contemplation SOC.
When smokers were compared according to their beliefs about quitting smoking,
controlling for age and gender, those who answered they believed they were unlikely to
succeed if they wanted to quit smoking were less likely to exercise adequately than those
who believed they were likely to succeed (OR=.242, 95% CI=.603, .929).
Smokers who disagree about the belief that the only way to stop smoking is
through will power were more likely to report mayor injury or illness during the previous
year (OR=5.736, 95% CI=1.216, 27.051) and to have a normal BMI (OR=39.402, 95%
CI=3.799, 408.623) than those who agree.
126
Relevant comparisons given beliefs about smoking
Controlling for age and gender, never smokers were less likely to believe that
smoking provides pleasure (OR=.364, 95% CI=.252, .526) and that smoking relieves
stress (OR=.278, 95% CI=.194, .400) than ever smokers. Never smokers were more
likely to believe that there are no positive aspects of smoking (OR=2.600, 95% CI=1.848,
3.660) and that smoking causes heart disease (OR=2.252, 95% CI=1.175, 4.314) than
ever smokers. Former smokers were more likely to believe that there are no positive
aspects of smoking (OR=1.839, 95% CI=1.018, 3.323) and, consequently, that smoking
causes more harms than benefits (OR=6.472, 95% CI=2.044, 20.494) than current
smokers.
When smokers in the maintenance, preparation, and pre-contemplation SOC were
compared, a larger percentage of smokers in the maintenance SOC (96.1%) believed that
smoking caused more harms than benefits compared to smokers in the preparation SOC
(83.8%) and those in the pre-contemplation SOC (87.1%), p = .007. It was unexpected
that smokers in the preparation SOC had the lower percentage; however, this difference
was no statistically significant when smokers in the preparation SOC were compared to
those in the pre-contemplation SOC. Smokers in the preparation SOC, controlling for age
and gender, were less likely to believe that smoking facilitates friendship (OR=.216, 95%
CI=.052, .891) and that smoking provides pleasure (OR=.373, 95% CI=.150, .930) than
those in the pre-contemplation SOC.
When smokers were compared by their beliefs about quitting smoking,
controlling for age and gender, smokers who believed that they were unlikely to succeed
127
if they decided to quit smoking are less likely to believe that people smoke because they
want to (OR=.114, 95% CI=.018, .671). It was also found that smokers who disagree
with the belief that the only way to stop smoking is through will power were less likely to
believe that smoking causes more harms than benefits (OR=.200, 95% CI=.040, .991)
than those who agree.
Relevant comparisons given behaviors about second-hand smoke
Controlling for age and gender, never smokers were less likely than ever smokers
to be comfortable with others smoking around them (OR=.234, 95% CI=.155, .353), live
in a house in which someone smokes (OR=.352, 95% CI=.207, .598), ride in a car with
someone who smokes (OR=.382, 95% CI=.256, .572), be exposed to SHS during the
previous week (OR=.392, 95% CI=.277, .557), and to expose children under 18 years old
to SHS during the previous week (OR=.443, 95% CI=.311, .631). It also was found that
never smokers were more likely to live in a home in which smoking is not allowed
(OR=3.424, 95% CI=1.992, 5.885) and to prefer work where smoking is not allowed
(OR=3.035, 95% CI=2.014, 4.572) than ever smokers.
Similarly, former smokers were less likely than current smokers to be comfortable
with others smoking around them (OR=.113, 95% CI=.058, .222), live in a house in
which someone smokes (OR=.154, 95% CI=.063, .377), ride in a car in which someone
smokes (OR=.238, 95% CI=.125, .452), be exposed to SHS during the previous week
(OR=.293, 95% CI=.155, .556), and to expose children under 18 years old to SHS during
the previous week (OR=.568443, 95% CI=.324, .995). Former smokers were more likely
128
to live in a home in which smoking is not allowed than ever smokers (OR=5.837, 95%
CI=2.524, 13.497), as well as to prefer work where smoking is not allowed (OR=4.465,
95% CI=2.350, 8.484) than current smokers.
Smokers in the maintenance SOC tended to be less comfortable with others
smoking around them (15.9%), do not live in a house in which someone smokes (7%), do
not ride in a car in which someone smokes (14.8%), be less exposed to SHS (56.3%) and
to expose their children under 18 years less to SHS (35.9%) during the previous week
than smokers in the preparation and pre-contemplation SOC. Consequently, smokers in
the maintenance SOC tended to live in a home in which smoking is not allowed (90.6%)
and prefer to work where smoking is not allowed (77.8%), relative to smokers in the
preparation and pre-contemplation SOC.
Similarly, smokers in the preparation SOC tended not to ride in a car in which
someone smokes (37.9%) and to be exposed less to SHS during the previous week
(77.6%) than smokers in the contemplation and pre-contemplation SOC.
When smokers were compared according to their beliefs about quitting smoking,
controlling for age and gender, the only statistically significant difference was that
smokers who see themselves as unlikely to succeed if they wanted to quit smoking were
more likely to live in a house in which someone smokes (OR=3.699. 95% CI=1.187,
11.529).
129
Relevant comparisons given behaviors about smoking and beliefs about stopping smoking
Controlling for age and gender, former smokers were less likely than current
smokers to have smoked their first cigarette after their 18th birthday (OR=.349, 95%
CI=.017, .718), and to have smoked cigarettes regularly after their 18th birthday
(OR=.419, 95% CI=.235, .745). Smokers in the preparation SOC were more likely to
believe they would be very likely to succeed if they wanted (OR=5.441, 95% CI=2.058,
14.384) and decided to stop smoking (OR=3.574, 95% CI=1.424, 8.969), than smokers in
the pre-contemplation SOC.
A larger percentage of smokers in the preparation SOC did not enjoy smoking
(65.5%) compared to smokers in the contemplation (29.4%) and pre-contemplation SOC
(29.4%), p=.005. Smokers in the preparation SOC were more likely to start smoking
cigarettes regularly after their 18th birthday (72.4%) than smokers in the pre-
contemplation (61.1%) and contemplation SOC (43.3%), p=.030.
When smokers were compared according to their beliefs about quitting smoking,
controlling for age and gender, the only statistically significant difference was by very
comfortable asking for help to stop smoking. As expected, smokers who disagree with
the belief that the only way to stop smoking is through will power were more likely to
feel very comfortable asking for help to stop smoking than those who agreed (OR=7.893,
95% CI=1.336, 46.641).
130
Discussion
Smoking prevalence
The smoking prevalence among Latinos living in Minnesota found in this study
(13.3%) was similar to the prevalence found the same year (2006) among Latinos living
in Hennepin County, Minnesota (13.6%), (Hennepin County Human Services and Public
Health Department, 2008); and tended to be lower than the prevalence among the U.S.
Latino population in the same year (15.2%), (CDC, 2007), and lower than the smoking
prevalence among the adults in Minnesota (18%) (ClearWay Minnesota, Blue Cross and
Blue Shield of Minnesota, and Minnesota Department of Health, 2008). Among Latino
men living in Minnesota, the smoking prevalence was similar to the prevalence among
Latino men in the U.S. (20%); however, the smoking prevalence for Latino women living
in Minnesota (6.1%) was lower than the smoking prevalence of U.S. Latino women
(10.1%) (CDC, 2007). Due to differences in the methodological approaches, several
results could be slightly different than those reported by The Tobacco use in Minnesota:
A quantitative survey of members of Minnesota’s Latino communities (Blue Cross and
Blue Shield of Minnesota, ClearWay Minnesota, Comunidades Latinas Unidas en
Servicio, 2008).
Smoking and socioeconomic variables
Age, married or living in a marriage-like relationship, friends from the same
ethnic background, and language of the survey were the statistically different
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socioeconomic and acculturation variables found in this study. These findings are
consistent with previous studies as follows:
Age
This study shows that Latino smokers in the maintenance SOC were older than
smokers in the preparation and pre-contemplation SOC, and that smokers in the
preparation SOC tend to be older than those in the contemplation and pre-contemplation
SOC. Previous studies found that smokers tend to quit when they are older because of
their greater amount of concern with health and friendship (Bossé & Rose, 1973). Due to
the sequential nature of the SOC model, it is expected that smokers’ age increases as they
advance through the SOC.
Marital status
This study found that former smokers were more likely to be married or living in
a marriage-like relationship than current smokers. This is consistent with previous studies
that found that the likelihood of smoking is significantly greater for singles (Umberson &
Liu, 2006) and that older, married, and heavy smokers are more likely to quit smoking
(Loon, Tijhuis, Surtees, & Ormel, 2005).
Acculturation
Although diverse authors consider language and years of residence in the U.S. as
proxies to level of acculturation (Bock, Niaura, Neighbors, Carmona-Barros, & Azam,
2005; Crespo, Smit, Carter-Pokras, & Anderson, 2001; and Maher, Boysun, Rohde,
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Stark, Pizacani, et al. 2005), the DREGAN project also utilized a multidimensional
approach of community to measure the level of acculturation of respondents, modeling
two major constructs and five latent variables to reflect cultural fluency and cultural
orientation (Constantine, Rockwood, Schillo, Castellanos, Foldes, & Saul, 2009). This
study included the variables fluency with home country culture (dfluency2HC) and
friends from the same ethnic background (friendsdorint4f) from the latent variables, in
addition to language of the survey and years living in the U.S., from the DREGAN
project data set (Rockwood, Virnig, Constantine, Miazga, & Turner, 2007). No
statistically significant differences were found between smokers in the maintenance, pre-
contemplation, contemplation, and preparation SOC given language of the survey, years
living in the U.S., fluency with home country culture, and friends from the same ethnic
background, this could be explained by the strong home-country orientation of the
respondents as most of them were first generation immigrants.
It was found that smokers who believed that they were unlikely to succeed if they
wanted or decided to quit smoking were less likely to have friends from the same ethnic
background than those who answered they were likely to succeed. This suggests that
more acculturated Latino smokers are less likely to believe they would succeed if they
want or decide to quit smoking. Several studies show that friendship predicted transition
into current cigarette use (Urberg, Degirmencioglu, & Pilgrim, 1997) and that
acculturation increases the risk of smoking among Latino adolescents and could lead to
an increased risk of experimentation with smoking (Unger, Cruz, Rohrbach, Ribisl, et al.,
2000).
133
Regarding language of the survey, this study found inconsistent results. For
example, respondents who answered the survey in Spanish were more likely to be never
smokers; however, there were no statistically significant differences between current and
former smokers, or between smokers in the different SOC. Some authors report that
acculturation has different effects on smoking behavior by gender (Perez-Stable,
Ramirez, Villareal, Talavera, et al., 2001). Marin (1989) found that smoking prevalence
was higher among less acculturated Latino men and higher among more acculturated
Latino women.
Smoking addiction
This study shows that Latino smokers smoked on average 8 cigarettes per day,
above the addiction threshold of 5 cigarettes per day (Benowitz and Henningfield, 1994);
however, they smoked on average 9 days per month, and had tried to stop smoking on
average 13.5 times during the previous year. This situation would call for the
implementation of smoking cessation programs that address smoking in social situations
and activities, as well educate them about how to modify their environment in order to
successfully quitting smoking (Reitzel, Costello, Mazas, Vidrine, et al, 2009).
The study also found that former smokers were less likely to have smoked their first
cigarette after their 18th birthday than current smokers, and also that former smokers and
smokers in the preparation SOC were less likely to smoke cigarettes regularly after their
18th birthday than current smokers and smokers in the pre-contemplation and
contemplation SOC respectively. The report of the Surgeon General: Preventing tobacco
134
use among young people describes how most smokers start smoking before their 18th
birthday, and that consequently most adolescent smokers became addicted to nicotine
(Elders, Perry, Eriksen, & Giovino, 1994), a situation that could make quitting smoking
more difficult. Breslau and Peterson (1996) found that a deferral to the initiation of
smoking might contribute to the reduction of smoking-related mortality and morbidity by
increasing the potential for quitting smoking.
Exposure to SHS behavior
Although never and former smokers are less likely to be exposed and exposed
their children to SHS, the present study found that a significant percentage of Latino
smokers and non smokers were exposed and exposed their children to SHS, particularly
in the car, at work, and at home. Similarly, data from the 1994 National Health Interview
Survey and Year 2000 Objectives supplement showed that 35% of children under 18
years old were exposed to SHS at homes where residents or visitors smoke on a regular
basis (Schuster, Franke, & Pham, 2002).
This is a very important cause of concern because the large number of
publications about the harms of SHS exposure, including that SHS exposure of children,
and particularly of single mothers, is associated with increased level of cotidine and
polycyclic aromatic hydrocarbon-albumin (PAH), a recognized carcinogen, in their
peripheral blood (Crawford, Mayer, Santella, Cooper, Ottman, et al., 1994). In addition,
various authors have found that exposure to SHS increases the risk for respiratory
infections in children (Kum, Meloy, & Herrod, 2006), and the numerous publications
135
about morbidity and mortality associated with smoking and exposure to SHS (U. S.
Department of Health, Education, and Welfare. Public Health Service, 1964; Department
of Health and Human Services, 1988; U. S. Department of Health and Human Services,
2006; CDC, 2005; & OEHHA, 2005).
The present study found that never and former smokers were less likely to be
comfortable with others smoking around them than ever and current smokers
respectively. Similarly, it was found that never smokers and former smokers were less
likely to live in a house in which someone smokes than ever and current smokers;
however, there were no statistically significant differences among smokers in the pre-
contemplation, contemplation, and preparation SOC. As some authors recommend,
tobacco control interventions should promote group as well as individual smoking
cessation efforts and encourage smoke-free home initiatives. (DiClemente, Delahanty, &
Fiedler, 2010).
Never and former smokers were also more likely to live in a home in which
smoking is not allowed and to prefer to work where smoking is not allowed than ever and
current smokers. Smokers who believed they were unlikely to succeed if they wanted to
quit smoking were more likely to live in a house in which someone smokes. Also, it was
found that never smokers and smokers in the maintenance and preparation SOC were less
likely to ride in a car with someone who smokes than ever, current, and smokers in the
contemplation and pre-contemplation SOC respectively. Previous studies found that the
presence of nonsmoking adults and children was associated with smoking restrictions in
the homes of inner-city smokers (Okah, Choi, Okuyemi, & Ahluwalia, 2002) and that
136
smoking bans were less likely among Mexican-Americans who live with smokers
(Martinez-Donate, Hovell, Hofstetter, González-Pérez, et al, 2007).
In general, the study found that never and former smokers were less likely to be
exposed to SHS during the previous week than ever and current smokers, as well as
smokers in the preparation and pre-contemplation SOC tended to be less exposed to SHS
during the previous week than smokers in the contemplation SOC. Similarly, never and
former smokers were less likely to expose their children under 18 years old to SHS
during the previous week than ever and current smokers. In addition, this study shows
that Latino smokers who felt uncomfortable asking for help to quit smoking were more
likely to live with children under 18 years old than those who answered they were
comfortable.
Smoking beliefs and behaviors
The study found that about half of the respondents believed that there are some
positive aspects of smoking, including the beliefs that smoking relieves stress, helps for
lose weight, and provides pleasure. Also, a small percentage believed that it is okay to
smoke as long as the person is healthy and a similar percentage believed that the dangers
and benefits of smoking are equal. These results help us to understand some of the
reasons for Latino to smoke, which it is necessary to plan adequate smoking cessation
interventions (Leventhal & Avis, 1976)
As expected, it was found that never and former smokers were more likely to
believe that there are no positive aspects of smoking than ever and current smokers; it
137
was also found that never smokers and smokers in the preparation SOC were less likely
to believe that smoking provides pleasure than ever smokers and those in the pre-
contemplation SOC. Similarly, smokers in the preparation SOC were less likely to
believe that smoking facilitates friendship than those in the pre-contemplation SOC; and
smokers who answered that they were unlikely to succeed if they decided to quit smoking
were less likely to believe that people smoke because they want to.
Never smokers were more likely to believe that smoking causes heart disease than
ever smokers, and never smokers were less likely to believe that smoking relieves stress
than ever smokers. Former smokers were more likely to believe that there are more harms
than benefits to smoking than current smokers. However, smokers who disagree about the
belief that the only way to stop smoking is through will power were less likely to believe
that smoking causes more harms than benefits. Ivings and Khardaji (2007) found that
most smokers report beliefs in the benefits of smoking, which should be modified to
encourage smoking cessation. Some authors recommend that smoking cessation
interventions should emphasize and help smokers to acknowledge that smoking causes
serious diseases (Chapman, Wong, & Smith, 1993).
The only behavior that was found statistically significantly different was enjoying
smoking. A larger percentage of smokers in the preparation SOC did not enjoy smoking
compared to smokers in the contemplation and pre-contemplation SOC.
These beliefs and behaviors about smoking contrast with the large percentage of
respondents who believed that smoking causes lung cancer and heart disease. This is an
example of cognitive dissonance as showed by Halpern (1994) that should be included in
138
smoking cessation efforts and interventions to educate the Latino population about the
short-and long-term health consequences of smoking and exposure to SHS, especially for
their children.
Smoking and stressful events
A strong relationship between stressful events and smoking was found in this
study. Never smokers were more likely to report happiness than ever smokers, and less
likely to report stressful events than current smokers. Never smokers and smokers in the
preparation SOC were less likely to report stressful events than ever smokers and
smokers in the pre-contemplation SOC respectively; never smokers and smokers in the
preparation SOC were less likely to report major change in health of relative during the
previous year than ever smokers and smokers in the pre-contemplation SOC. Similarly,
smokers in the preparation SOC are less likely to report a major change in family
reunions than smokers in the pre-contemplation SOC, and smokers in the preparation
SOC were more likely to report interesting things in their daily life than those in the pre-
contemplation SOC. Similarly, some authors have reported that smokers have a higher
level of stress (Parrot, 1999) and that smoking could help to relax and reduce stress
(Kassel, Stroud, & Paronis, 2003). Another study found that a successful long-term
cessation program should individualize the approach and identify interesting and or
pleasurable motivations to replace smoking (Moghaddam, & Ferguson, 2007).
Never smokers were less likely to report major injury or illness than ever
smokers; in contrast, smokers who disagree about the belief that the only way to stop
139
smoking is through will power were more likely to report major injury or illness during
the previous year. Similar results were reported by Mody and Smith (2003 and 2006),
who found that current smokers were more likely to report poor general health status than
non smokers and former smokers. Lee and Markides (1991) found that younger Mexican-
American men who smoke more than 10 cigarettes per day were more likely to report
greater activity limitation due to poor health, and that non-smoking middle-age men and
women generally reported better health than lighter smokers.
Expectations about quitting and confidence to succeed
As was found in a previous study (DiClemente, C., Delahanty, J., & Fiedler, R.
2010), the expectations about quitting smoking and the confidence about succeeding were
statistically significantly higher among smokers in the preparation SOC than those in the
pre-contemplation SOC. The study also found that smokers who disagree about the belief
that the only way to stop smoking is through will power were more likely to feel very
comfortable asking for help to stop smoking than those who agreed. Some authors found
that the intention to quit and the personal rating of the likelihood of success could be
predictors of smoking cessation. (Twigg, Moon, Szatkowski, & Iggulden, 2009).
The present study found that smokers who answered that they were unlikely to
succeed if they wanted or decided to quit smoking were less likely to exercise adequately
than those who answered they were likely to succeed. As some researches described, it is
possible that a negative body image could reduce the intention to quit smoking (King,
Matacin, White, Marcus, 2005). It was also reported that former smokers significantly
140
increased physical activity after quitting (Perkins, Rohay, Meilahn, Wing, Matthews, &
Kuller, 1993).
Quitting smoking and smoking restrictions
The majority of former smokers stopped smoking more than one year before the
survey and 30% reported that smoking restrictions influenced their decision to stop
smoking. These data support the importance of legislation to ban smoking in public
places and the adoption of prohibition of smoking at home and work to encourage
smokers to quit, as has been published by Shields (2007).
Limitations
The present study has some limitations. The most important is that as secondary
data analysis it has the same limitations as the original survey, which was not designed to
address the stages of change of Latino smokers living in Minnesota.
As in previous studies, recall bias and social desirability could have some effects
in the data (Gilpin & Pierce, 1994); however, self-reported smoking status has been
found to be valid in general population studies (Vartiainen, Seppala, Lillsunde, & Puska,
2002).
The present analysis suffers from a lack of statistical power resulting from the low
sample size for some of the groups included in the analysis.
141
Recommendations
The results of the present study demonstrate the need for tobacco control
interventions to educate the Latino population about the harms of smoking and SHS
exposure, especially for their children. Educational interventions should be implemented
to eliminate exposure to SHS, taking into account the cognitive dissonance that affects
smokers and non-smokers exposed to SHS. Tobacco control interventions and smoking
cessation programs should be culturally and linguistically appropriate as it is
recommended by the U.S. Department of Health and Human Services (1998) and the
CDC (1999, 2007).
Smoking cessation intervention should encourage young Latino smokers to quit,
especially those who do not report interesting things in their daily life and report stressful
events in their family. Such interventions should educate them about the long term
consequences of smoking and exposure to SHS such as the increased risk of
cardiovascular disease and cancer for their children.
The results show that smokers in the pre-contemplation SOC have more friends
from their same ethnic and cultural background. For this reason it is necessary to address
the impact of friendship on smoking behaviors, especially among recent immigrants.
Smoking cessation programs should engage smokers and their friends who smoke to quit
smoking. Some authors suggest that tobacco control initiatives may be more effective if
they promote group and individual smoking cessation efforts and promote smoke-free
home initiatives (DiClemente, Delahanty, & Fiedler, 2010).
142
Intervention efforts should also be directed to educating less acculturated Latino
smokers, especially those living with children about how individual and group smoking
cessation programs and nicotine replacement therapies could increase their chance to
succeed quitting smoking.
Smoking cessation programs should develop messages to eliminate SHS exposure
among Latino children at home and in the car.
Smoking bans at home, in cars, and at work places should be implemented to
protect non-smokers from exposure to SHS, encourage smokers to quit, and to prevent
children from trying their first cigarette.
Smoking cessation programs should emphasize healthy nutrition, particularly
increasing the consumption of fruits and vegetables, and adequate exercise, to prevent
smokers who quit from gaining weight. This would help to reduce the percentage of
relapsing smokers.
Stress and happiness should be addressed in smoking cessation interventions.
Latino smokers should be educated about relaxation techniques and mental health
programs to reduce their level of stress. In addition, smoking cessation programs should
address interesting and/or pleasurable incentives to replace smoking.
Expectations about quitting smoking should be addressed. Positive expectations
must be reinforced and negative expectations need to be changed in order to increase the
possibilities for success.
143
Understanding the motivational and volitional processes to quit smoking could
increase the effectiveness of smoking cessation programs, although research to better
understand the stages of change among Latino smokers is needed.
Although all health care providers should advise and educate their patients about
smoking cessation and elimination of SHS exposure, pharmacists are in a privileged
position to implement this practice (Tyc, Hovell, & Winickoff, 2008). In addition, as
some authors recommend for practitioners (Zimmerman, Olsen, & Bosworthan, 2000),
smoking cessation brief counseling sessions should be incorporated as a routine practice
among pharmacists.
A comprehensive literature review (Dent, Harris, & Noonan, 2007), demonstrated
that pharmacists are effective in providing smoking cessation interventions because they
are the most accessible health care professional and are in an ideal position to deliver
tobacco cessation services on-site, where nicotine replacement drugs are dispensed. In
addition, pharmacists should receive training in smoking cessation interventions and
should be motivated and reimbursed to provide these services.
Cipolle, Strand, and Morley (2004), included history of tobacco dependence
assessment in their comprehensive Pharmaceutical Care Practice: The Clinician Guide.
They recognize smoking as one of the common causes of drug therapy problems that
must be documented in the current medication record of the patient, and recommend
smoking cessation interventions as part of the preventive pharmacotherapy that positively
impact one of the most important common problems treated in primary care.
144
Conclusions
The results show that Latino smokers living in Minnesota share some of the
characteristics described by previous studies, including: A high level of exposure to SHS,
the trend to quit smoking when they are older, tendency to smoke and unwillingness to
quit when they are exposed to stressful events, the beliefs that smoking facilitates
friendship and provides pleasure, enjoyment of smoking and negative expectations for
successfully quitting smoking. These hypotheses should be tested in prospective
intervention studies using the SOC algorithm, taking into account the smoking prevalence
differences between women and men and the cause of smoking. As Prochaska and
DiClemente recognized in 1986, “The days of searching for simple solutions to complex
problems should be behind us. The complexities of changing addictive behaviors require
multivariate rather than univariate solutions” (Prochaska, DiClemente, 1986).
As the most accessible health care practitioner, pharmacists are in a privileged
position to provide smoking cessation interventions and to promote the elimination of
SHS exposure, especially to Latino recent immigrants who do not know how to navigate
the complex health care systems in the U.S. By learning the unique characteristics of
Latino smokers, pharmacists will be able to address their needs and increase the
possibilities for successful outcomes.
145
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APPENDICES
160
Appendix A
U.S Smoking Status By Selected Demographic Variables 1965 - 2006 Smoking Status Total Population
1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current 42.4 37.4 37.1 34.1 33.2 32.1 30.1 28.8 25.5 25 24.7 24.7 23.5 22.8 22.5 21.6 20.9 20.8 Former 13.6 18.5 19.5 20.8 21.3 21.8 24.2 22.8 24.6 24.6 23.3 22.8 23.1 22.2 22.6 21.8 21.4 21 Never 44 44.2 43.4 45 45.5 46.1 45.8 48.4 49.9 50.5 52 52.4 53.5 55 54.9 56.6 57.7 58.2
Sex Male 1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current 51.9 44.1 43.1 38.1 37.6 35.1 32.6 31.2 28.4 27.7 27 27.6 25.7 25.2 25.2 24.1 23.4 23.9 Former 19.8 26.3 27.7 28.3 28.1 28.3 30.9 28.9 30.3 29.9 27.5 27 27.3 26.4 26.4 25.2 24.8 24.5 Never 28.3 29.6 29.2 33.6 34.4 36.6 36.5 39.9 41.3 42.4 45.5 45.4 47 48.5 48.4 50.7 51.7 51.6 Female 1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current 33.9 31.5 32.1 30.7 29.3 29.5 27.9 26.5 22.8 22.5 22.6 22.1 21.5 20.7 20 19.2 18.5 18 Former 8 11.6 12.7 14.2 15.1 15.9 18.1 17.4 19.5 19.7 19.5 19 19.2 18.3 19.1 18.7 18.3 17.8 Never 58.1 56.9 55.2 55.2 55.5 54.6 54 56 57.7 57.8 57.9 58.9 59.3 61.1 60.9 62.1 63.2 64.2
Race§ White (Non-Hispanic)
1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current 42.1 37 36.4 33.9 32.9 31.8 29.6 28.5 25.6 24.9 24.8 24.8 23.7 23.4 22.9 21.8 22.2 21.9 Former 14.2 19.4 20.5 21.9 22.2 22.8 25.5 24.2 25.9 26.2 24.9 24.6 24.9 24.1 24.3 23.3 24.7 24.6 Never 43.8 43.6 43.1 44.3 44.9 45.3 44.9 47.3 48.5 48.9 50.3 50.7 51.5 52.5 52.8 54.9 53.1 53.5
Black (Non-Hispanic) Current 45.8 41.4 44 37.7 36.9 35.9 34.9 32.9 26.2 26.1 25.7 26.8 24.3 22.3 22.5 21.8 20.5 23 Former 8.4 10.7 10.8 13.3 13.8 14.2 15.9 14.8 16.7 15.7 14.4 13.6 15.4 14.5 15.5 14.3 12.9 12.6 Never 45.8 47.8 45.3 49 49.4 49.9 49.2 52.3 57.1 58.2 59.9 59.6 60.3 63.2 62 64 66.7 64.5 Hispanic 1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current N/A N/A N/A 31.6 30 25.3 25.9 23.6 23 20.4 18.3 20.4 18.1 16.7 16.7 16.4 15 15.2 Former N/A N/A N/A 15.6 15.1 15.7 17.2 16.1 17 16.2 16.5 14.9 14.7 14.3 15 12.9 13.2 12.7 Never N/A N/A N/A 52.9 54.9 59 56.9 60.4 60 63.4 65.2 64.7 67.2 69.1 68.4 70.8 71.7 72.1
Non-Hispanic Current N/A N/A N/A 34.3 33.4 32.6 30.3 29.2 25.7 25.4 25.4 25.2 24.1 23.6 23.2 22.3 21.7 N/A Former N/A N/A N/A 21.1 21.6 22.2 24.6 23.4 25.3 25.2 24.1 23.7 24 23.1 23.5 23.1 22.6 N/A Never N/A N/A N/A 44.6 45 45.3 45.1 47.5 49 49.4 50.6 51.1 51.9 53.3 53.2 54.6 55.7 N/A
Asian/Pacific Islander Current N/A N/A N/A 24.2 24.1 20.7 21.8 14.3 16.4 18.2 16.6 16.5 15 12.4 13.3 11.8 11.3 10.4 Former N/A N/A N/A 14 15.4 14.6 12.6 10.7 14.4 15.6 13.8 14.6 11.7 9.6 11.8 13.9 12.1 11.1 Never N/A N/A N/A 61.8 60.5 64.7 65.7 75 69.2 66.3 69.6 68.9 73.3 78 74.9 74.3 76.6 78.4
American Indian/Alaska Native Current N/A N/A N/A 45.2 60.1 39.6 32.6 37.4 38.4 38.7 36.3 32.1 41.2 32.7 40.8 39.7 33.4 32.4 Former N/A N/A N/A 22.7 20.9 22.6 20.8 23.9 20.7 20.9 19.6 21.1 17 20.5 20.6 14.3 21.2 25.6 Never N/A N/A N/A 32.1 19.1 37.8 46.6 38.8 40.9 40.4 44.2 46.8 41.8 46.8 38.7 46 45.4 42
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Appendix A
U.S Smoking Status By Selected Demographic Variables 1965 – 2006 (Continuation)
Age (years) 18-24 1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current 45.5 38 37.8 34.4 33.3 34.2 29.3 27.1 24.5 25.8 24.8 28.7 27.9 26.9 28.5 23.9 23.6 23.9 Former 6.9 9.2 9.5 9.2 10.5 9.3 10.1 8 9.5 7.2 8.6 7.3 7.6 7.8 7.5 7.1 7 5.9 Never 47.6 52.8 52.7 56.4 56.2 56.5 60.6 64.9 66 67 66.6 64 64.5 65.4 64 69 69.4 70.2 25-44 1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current 51.2 44.6 44.5 39.3 37.8 36.3 34.8 33.2 29.7 29.2 28.6 28.6 27.3 25.9 25.7 25.6 23.8 23.5 Former 13.6 18.8 18.4 19.5 19.8 19 21.4 19.6 20 18.6 17.5 15.9 15.4 14.5 15 14.2 13.4 13.7 Never 35.3 36.6 37.1 41.2 42.5 44.7 43.8 47.2 50.3 52.2 53.8 55.5 57.3 59.7 59.3 60.2 62.8 62.8 45-64 1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current 41.6 38.6 37.7 36.7 35.6 33.3 31.6 30.9 27 26 25.5 24.4 23.3 23.8 22.7 22 22.4 21.8 Former 16.1 21.7 24.8 26.1 26.6 28.8 31.2 29.9 32.9 33.9 30.9 31.2 31 29.4 29.4 28 27.9 26.9 Never 42.3 39.7 37.5 37.3 37.9 37.9 37.3 39.3 40.1 40.1 43.5 44.3 45.7 46.9 47.9 50 49.8 51.3 >=65 1965 1970 1974 1978 1980 1983 1985 1987 1990 1993 1995 1997 1999 2001 2002 2003 2004* 2006 Current 17.9 16.1 17.3 16.3 17.2 16.7 16 15.2 12.8 11.8 13 12 10.6 10.2 9.3 9.1 8.8 10.2 Former 15 21.3 23.3 28.1 27.9 30.7 34 34.1 36.6 38.4 37.7 38.6 40.6 39.3 40.5 40 39.3 37.9 Never 67.2 62.6 59.4 55.6 54.9 52.6 50 50.7 50.6 49.8 49.3 49.4 48.8 50.6 50.3 50.9 51.9 52
Footnotes
* Persons > = 18 years of age. † Current smokers reported smoking > = 100 cigarettes and currently smoked. Former smokers reported smoking > = 100 cigarettes and did not currently smoke. Never smokers reported that they had smoked < 100 cigarettes. § Questions assessing race/ethnicity changed in 1997 and Asian/Pacific Islanders from 1997 through 2004 are limited to persons who reported their race as Chinese, Filipino, or Asian Indians.
Data on education are presented for persons > = 25 years of age.
N/A Data not available. Source: National Health Interview Surveys: 1965, 1970, 1974, 1978, 1980, 1983, 1985, 1987, 1990, 1993, 1995, 1997, 1999, 2001-2006. Note: For any year, 95% confidence intervals do not exceed ±1.2% for the total population, ±1.8% for men, ±1.4% for women, ±3.9% for whites, ±4.7% for blacks, ±4.7% for Hispanics, ±7.8% for Asian/Pacific Islanders, ±14.8% for American Indian/Alaska Natives, ±2.7% for persons ages 18-24 years, ±1.8% for person ages 25-44 years, ±2.5% for persons ages 45-64 years, ±2.1% for persons ages >= 65 years, ±3.3% for < 8 years of education, ±2.8% for 9-11 years of education, ±1.9% for 12 years of education, ±3.1% for 13-15 years of education, ±2.9% for >= 16 years of educations, ±1.0% for persons at or above the poverty level, ±2.7% for persons below the poverty level, and ±3.5% for persons with unknown poverty level.
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Appendix B
DREGAN Phone Bilingual Survey DREGAN PHONE STUDY INTRO SCRIPT: Hello. My name is _____ and I’m calling from the University of Minnesota, School of Public Health. I am calling because we are conducting a study about health and health behaviors throughout the state of Minnesota. You may have received a letter about this study in the last week or two.
Hola. Mi nombre es y le estoy llamando desde la Escuela de Salud Pública de la Universidad de Minnesota. En estos momentos estamos llevando a cabo un estudio sobre salud y hábitos de salud a través de todo el estado de Minnesota. Es probable que haya recibido por correo una carta relacionada a este estudio hace una o dos semanas atrás.
Your household was selected at random from households throughout the state. The results from the study will help various organizations in the state to understand important issues related to health and community.
Su hogar ha sido seleccionado al azar entre todos los hogares del estado. Los resultados de este estudio ayudarán a varias organizaciones del estado a entender asuntos importantes relacionados con la salud y la comunidad.
We’re talking to people 18 years of age and older. The person we talk to within each household is the person who will have the next birthday. Would that be you or would that be someone else? (WE INTERVIEW WHOEVER HAS THE NEXT BIRTHDAY TO MAKE THE CHOICE TOTALLY RANDOM.)
1 RESPONDENT (CONSENT AND BEGIN INTERVIEW) 2 SOMEONE ELSE ---------May I speak to that person?
PERSON AVAILABLE ----------(EXPLAIN STUDY, CONSENT RESPONDENT AND INTERVIEW) PERSON NOT AVAILABLE ----------- When would be a good time to call back? Estamos hablando con personas que tengan 18 años o más. La persona con la cual hablamos en cada hogar es aquella que tenga el cumpleaños más próximo. ¿Esa persona sería usted o alguien más?
(ENTREVISTAMOS A AQUELLAS PERSONAS CON EL CUMPLEAÑOS MÁS PRÓXIMO PARA QUE LA SELECCIÓN SEA TOTALMENTE AL AZAR)
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1. ENTREVISTADO: (SOLICITE CONSENTIMIENTO Y COMIENCE LA
ENTREVISTA) 2. OTRA PERSONA: ¿Podría hablar con esa persona?
PERSONA DISPONIBLE: (EXPLIQUE, CONSIENTA Y COMIENCE ENTREVISTA)
PERSONA NO DISPONIBLE: ¿Cuándo sería un buen momento para encontrar a esta persona? CONSENT: CONSENTIMIENTO: This study takes between 5-6 minutes. Your participation is voluntary. In any reports we write about this study, we will not reveal information that would allow anyone to identify who took part. There aren’t any direct benefits to you, but the information will help us understand more about the health of people in Minnesota. Este estudio toma entre 5 a 6 minutos. Su participación es totalmente voluntaria. Cualquier informe que preparemos en relación a este estudio no incluirá ningún tipo de información que permita identificar a las personas que participaron. No hay beneficios directos; sin embargo, esta información nos ayudará entender un poco más acerca de la salud de la gente en Minnesota. Before we start, let me tell you that everything you say will be kept confidential. Your name or phone number will not be linked to your answers. Your answers will be combined with those of other people in Minnesota and only researchers doing the study will have access to the interview data.
Antes de comenzar, permítame informarle que todo lo que usted diga es totalmente confidencial. Su nombre y número de teléfono no estarán asociados con sus respuestas. Sus respuestas serán combinadas con las de las otras personas que participen en el estudio y solamente los investigadores tendrán acceso a los datos obtenidos.
The researcher in charge of this study is Dr. Todd Rockwood and you may have his phone number if you wish (612/624-7437). He would be able to answer any questions you have, or if you have questions now, I can answer them for you. If you would like to contact someone at the Research Subjects’ Advocates line, I can give you that number too (612/625-1650). El investigador a cargo de este estudio lo es el Dr. Todd Rockwood. Si usted desea le puedo dar su número de teléfono (612/624-7437). Él podrá contestar cualquier duda o pregunta que usted tenga acerca del estudio. De igual manera, si usted tiene alguna pregunta o duda en este momento yo podría contestarla o si usted desea contactar a la
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Línea de Defensores para Sujetos de Investigación, también le puedo dar ese número de teléfono (612/625-1650).
LIFESTYLE ITEMS GENDER (OBSERVE, ASK IF UNKNOWN)
1 MALE 2 FEMALE
GÉNERO (OBSERVE, PREGUNTE SI DESCONOCE)
1 MASCULINO 2 FEMENINO
1 During the past 12 months, would you say your physical health was…
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor 1 Durante los últimos 12 meses, ¿diría usted que su salud física ha sido: (MN)
Excelente
Muy Buena
Buena
Regular
Mala 2 Has your daily life been full of things that were interesting to you during the past month?
1 Most of the time 2 Some of the time 3 A little of the time 4 None of the time
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2 Durante el pasado mes, ¿ha estado su vida diaria llena de cosas interesantes para
usted?
Gran parte del tiempo Parte del tiempo Un poco del tiempo o Ninguna parte del tiempo
3 How happy or pleased have you been with your personal life during the past month?
1 Very Happy 2 Somewhat Happy 3 Somewhat Unhappy 4 Very Unhappy
3 Durante el último mes, ¿Qué tan feliz o complacido(a) ha estado usted con su
vida personal?
Muy Feliz Algo Feliz Algo Infeliz Muy Infeliz
4 Now thinking about your race or ethnicity, which of the following do you
consider yourself to be? [MAY SELECT MORE THAN ONE]
1 Asian (GO TO Q4a)
2 Hispanic or Latino (GO TO Q5) [INCLUDES MESTIZO, CHICANO, MORENO(A), TRIGUENO(A), ETC.]
3 American Indian or Alaskan Native (GO TO Q5) 4 Black or African American (GO TO Q5) 5 White (GO TO Q5) 6 Native Hawaiian or Other Pacific Islander (GO TO Q5) 7 Some other race (GO TO Q5)
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4 Pensando en su raza o etnia, ¿de qué raza o etnia se considera usted? (Similar to HA)
[PUEDE SELECCIONAR MÁS DE UNA]
Asiático(a) (GO TO Q4a)
Hispano(a) o Latino(a) (GO TO Q5) [INCLUYE MESTIZO(A), CHICANO(A), MORENO(A), TRIGUEÑO(A), ETC]
Indio(a) Americano(a) o Nativo(a) de Alaska (GO TO Q5)
Negro(a) o Afro-americano(a) (GO TO Q5)
Blanco(a) (GO TO Q5)
Isleño(a) nativo(a) de Hawaii o de otra isla del Pacífico. (GO TO
Q5)
Alguna otra raza (GO TO Q5)
4a. [ASIAN]. Which of the following do you consider yourself to be? [MAY SELECT MORE THAN ONE]
1 Hmong 2 Vietnamese 3 Cambodian 4 Laotian 5 Chinese 6 Korean 7 Japanese 8 Other Asian Nation (SPECIFY): __________________________
IF MORE THAN ONE SELECTED FOR Q4a, ASK Q4b
4a. [ASIÁTICO]. ¿Cuál de las siguientes mejor lo describe a usted? (HA) [PUEDE SELECCIONAR MÁS DE UNA]
Hmong Vietnamita Laosiano(a) Camboyano(a) Chino(a) Coreano(a) Japonés(a) Otro Asiático (ESPECIFIQUE): __________________________
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4b Which of these <FILL>, do you identify with most closely?
1 Hmong 2 Vietnamese 3 Cambodian 4 Laotian 5 Latino/Hispanic
4b ¿Con cuál de las siguientes <FILL>, usted mejor se identifica?
1 Hmong 2 Vietnamita 3 Camboyano 4 Laosiano 5 Latino/Hispano
SCREENING ITEMS
5 What country were you born in? _________________________ COUNTRY
IF US GO TO Q8 5 ¿En qué país nació usted? (MN) _________________________ PAÍS IF US GO TO Q8 6 What country were you living in prior to coming to the U.S.? _________________________ COUNTRY 6 ¿En qué país vivía antes de llegar a los Estados Unidos? _________________________ PAÍS
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7 What year did you come to the U.S. to live? Interviewer Alternatives: When did you come to the U.S. How long ago did you come to U.S. ________ (Year) GO TO NEW QUESTION CHECKPOINT 7 ¿En qué año llegó a vivir a los Estados Unidos? Alternativas para el Entrevistador: ¿Cuándo vino a vivir a los Estados Unidos?
(HA) ¿Hace cuánto tiempo llegó a vivir a los Estados
Unidos? ________ (Año) GO TO Q11 8 Were both of your parents born in the United States?
1 Yes GO TO 11 2 No 7 DK GO TO 11 9 REF GO TO 11
8 ¿Nacieron sus dos padres en los Estados Unidos? (MN)
1 Sí GO TO 11 2 No 7 No sabe GO TO 11 9 REF GO TO 11
9 In what country was your mother born?
________ COUNTRY IF US, GO TO Q10
7 DK 9 REF
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9 ¿En qué país nació su madre? (MN) ________ PAÍS IF US, GO TO Q10
NO SABE REHUSÓ
9a What year did she come to the US?
________ YEAR
7 DK 9 REF
9a. ¿En qué año llegó ella a los Estados Unidos?
________ AÑO NO SABE REHUSÓ
10 In what country was your father born? ________ COUNTRY IF US, GO TO NEW QUESTION
CHECKPOINT 7 DK 9 REF
10 ¿En qué país nació su padre? (MN) ________ PAÍS IF US, GO TO NEW QUESTION CHECKPOINT
NO SABE REHUSÓ
10a What year did he come to the US?
________ YEAR
7 DK 9 REF
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GO TO NEW QUESTION CHECKPOINT
10a. ¿En qué año llegó él a los Estados Unidos?
________ AÑO NO SABE REHUSÓ
GO TO NEW QUESTION CHECKPOINT 11 Were any of your grandparents born outside of the US?
1 Yes GO TO 11a
2 No 7 DK GO TO NQ CHECKPOINT 9 REF
11. ¿Alguno de sus abuelos nació fuera de los Estados Unidos?
1 Sí GO TO 11a
2 No 7 DK GO TO NQ CHECKPOINT 9 REF
11a Where were they born? How about your mother’s mother? What country was she born in?
____________ COUNTRY 11b And your mother’s father?
____________ COUNTRY
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11c And where was your father’s mother born? ____________ COUNTRY 11d And your father’s father?
____________ COUNTRY
11a. ¿Dónde nacieron?
Qué tal su abuela materna, ¿en qué país nació? (LA MAMÁ DE SU
MAMÁ) ________ PAÍS 11b. ¿Y su abuelo materno? (EL PAPÁ DE SU MAMÁ) ________ PAÍS
11c. ¿Dónde nació su abuela paterna? (LA MAMÁ DE SU PAPÁ)
________ PAÍS
11d. ¿Y su abuelo paterno? (EL PAPÁ DE SU PAPÁ)
________ PAÍS
NEW QUESTION CHECKPOINT
IF Q4 is not LATINO and Q4a is not HMONG, VIETNAMESE, CAMBODIAN, or LAOTIAN, ask new questions. Otherwise, GO TO Q12 Si Q4 no es LATINO y Q4 no es HMONG, VIETNAMITA, CAMBOYANO o LAOSIANO pregunte las nuevas preguntas. De otro modo, GO TO Q12
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NQ1 Would either of your parents consider themselves to be one of the following?
A Hmong 1 YES 2 NO 7 DK 9 REF B Vietnamese 1 YES 2 NO 7 DK 9 REF C Cambodian 1 YES 2 NO 7 DK 9 REF D Laotian 1 YES 2 NO 7 DK 9 REF E Latino/Hispanic 1 YES 2 NO 7 DK 9 REF
IF ONE YES GO TO Q12 (marital status) IF MORE THAN ONE YES GO TO NQ2 IF ALL NO GO TO NQ3
NQ1 ¿Cualquiera de sus padres se considera a sí mismo alguno de los siguientes?
A Hmong 1 SÍ 2 NO 7 DK 9 REF B Vietnamita 1 SÍ 2 NO 7 DK 9 REF C Camboyano 1 SÍ 2 NO 7 DK 9 REF D Laosiano 1 SÍ 2 NO 7 DK 9 REF E Latino/Hispano 1 SÍ 2 NO 7 DK 9 REF
IF ONE YES GO TO Q12 (marital status) IF MORE THAN ONE YES GO TO NQ2 IF ALL NO GO TO NQ3
NQ2 Which of these, <FILL> and <FILL> and <FILL> do you identify with most closely? (CHOOSE ONLY ONE)
1 Hmong 2 Vietnamese 3 Cambodian 4 Laotian 5 Latino/Hispanic
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NQ2 ¿Con cuál de las siguientes, <FILL> y <FILL>, mejor se identifica usted?
(ESCOJA SÓLO UNA OPCIÓN)
1 Hmong 2 Vietnamita 3 Camboyano 4 Laosiano 5 Latino/Hispano
NQ3 Would any of your grandparents have considered themselves to be one of the following?
A Hmong 1 YES 2 NO 7 DK 9 REF B Vietnamese 1 YES 2 NO 7 DK 9 REF C Cambodian 1 YES 2 NO 7 DK 9 REF D Laotian 1 YES 2 NO 7 DK 9 REF E Latino/Hispanic 1 YES 2 NO 7 DK 9 REF
IF ONE YES GO TO Q12 (marital status) IF MORE THAN ONE YES GO TO NQ4 IF ALL NO GO TO Q12
NQ3 ¿Cualquiera de sus abuelos se consideraría alguno de los siguientes?
A Hmong 1 SÍ 2 NO 7 DK 9 REF B Vietnamita 1 SÍ 2 NO 7 DK 9 REF C Camboyano 1 SÍ 2 NO 7 DK 9 REF D Laosiano 1 SÍ 2 NO 7 DK 9 REF E Latino/Hispano 1 SÍ 2 NO 7 DK 9 REF
IF ONE YES GO TO Q12 (marital status)
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IF MORE THAN ONE YES GO TO NQ4 IF ALL NO GO TO Q12
NQ4 Which of these, <FILL> and <FILL> and <FILL> do you identify with most
closely? (CHOOSE ONLY ONE)
1 Hmong 2 Vietnamese 3 Cambodian 4 Laotian 5 Latino/Hispanic
NQ4 ¿Con cuál de las siguientes, <FILL> y <FILL>, mejor se identifica usted?
(ESCOJA SÓLO UNA OPCIÓN)
1 Hmong 2 Vietnamita 3 Camboyano 4 Laosiano 5 Latino/Hispano
12 Are you currently
1 Married GO TO Q13
2 Living in a Marriage Like
Relationship
3 Separated
GO TO Q14 4 Divorced 5 Widowed, or have you6 Never been married
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12. ¿Actualmente, está usted (MN)
1 Casado (a) GO TO Q13
2 Viviendo con su pareja como si
estuviese casado(a)
3 Separado(a)
GO TO Q14 4 Divorciado(a) 5 Viudo(a) o 6 Nunca se ha casado
13 Does your spouse/partner consider themselves to be of Latino/Hispanic,
Vietnamese, Cambodian, Laotian, or Hmong origin? code responses:
1 Hmong 2 Vietnamese 3 Cambodian 4 Laotian 5 Other Asian 6 Latino/Hispanic 7 None of the above
13. ¿Su esposo(a)/pareja se considera a si mismo de origen Latino/Hispano,
Vietnamita, Camboyano, Laosiano o Hmong?
code responses:
Vietnamita
Camboyano(a)
Laosiano(a)
Hmong
Otro GrupoAsiático
Latino(a)/Hispano(a)
Ninguno de los anteriores
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IF R doesn’t screen in any other way, and Q13 has more than 1 answer, ask Q13b
13b Which of these <FILL>, do you identify with most closely
1 Hmong 2 Vietnamese 3 Cambodian 4 Laotian
IF R doesn’t screen in any other way, and Q13 has more than 1 answer, ask
Q13b 13b ¿Con cuál de las siguientes, <FILL> y <FILL>, mejor se identifica
usted?
1 Hmong 2 Vietnamita 3 Camboyano 4 Laosiano
IF SELF-IDENTIFY AS ‘NON-QUALIFYING’ RACE/ETHNICITY: While you don’t self-identify as a <FILL ETHNICITY>, the research we are conducting is focused on people who are of <FILL ETHNICITY> heritage, and we want to include you in the study.
A. DECISION RULE FOR INCLUSION INTO STUDY – LATINO:
If Self-Identify is not Latino (Q4 ne2)
THEN R DOES NOT MEET SCREEN
If Parent Identify is not Latino (NQ1E is NO) If Grandparent identify is not Latino (NQ3E is NO)
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IF MARRIED TO SEASIAN: Since your spouse is <FILL ETHNICITY>, we want to include you in the study.
B. DECISION RULE FOR INCLUSION INTO STUDY – SEAsian:
If Self-Identify is not SEAsian (Q4 ne 1-4)
THEN R DOES NOT MEET SCREEN
If Parent Identify is not SEAsian (NQ1A-D are all NO) If Grandparent identify is not SEAsian (NQ3A-D are all NO) If Spouse is not SEAsian (Q13 ne 1-4)
TERMINATION STATEMENT IF SCREEN NOT MET: Okay. That is my last question. Thank you so much for taking part in our study. Esta ha sido mi última pregunta. Muchas gracias por tomar parte de nuestro estudio.
FLUENCY 14 How well do you understand each of the following: 14. Qué tan bien entiende usted cada uno de los siguientes: a How about U.S. Holidays such as Thanksgiving and 4th of July?
1 Very Well 2 Somewhat Well 3 Not Very Well 4 Not At All
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a Celebraciones de los Estados Unidos tales como el Día de Acción de Gracias o el 4 de Julio.
Muy Bien
Algo Bien
No Muy Bien
Para Nada Bien
b And how about the Minnesota Nice Celebration?
1 Very Well 2 Somewhat Well 3 Not Very Well 4 Not At All
b Y qué tan bien entiende usted la celebración del “Minnesota Nice”? (“MINNESOTA AGRADABLE”)
Muy Bien
Algo Bien
No Muy Bien
Para Nada Bien 15 If you attended a wedding or funeral based on <FILL> traditions, how well would
you understand what is going on? NOTE: if US born Latino use “Latino traditions” instead of “traditions from <FILL>
1 Very Well 2 Somewhat Well 3 Not Very Well 4 Not At All
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15. Si usted asistiera a una boda o funeral basado en tradiciones <FILL PAÍS>, ¿Qué tan bien entendería lo que está pasando?
NOTE: if US born Latino use “Latino traditions” instead of “traditions from <FILLCOUNTRY>
Muy Bien
Algo Bien
No Muy Bien
Para Nada Bien 16 Do you agree or disagree with the following statement? 16 ¿Está usted de acuerdo o en desacuerdo con lo siguiente?
a I understand <FILL> ways very well.
1 Agree GO TO a1 2 Disagree GO TO a2
a Entiendo muy bien las tradiciones de <FILL PAÍS>.
De
Acuerdo
GO TO a1
En
Desacuerdo
GO TO a2 a1 Do you strongly agree or somewhat agree?
1 STRONGLY AGREE 2 SOMEWHAT AGREE
a1 ¿Diría usted que está muy de acuerdo o algo de acuerdo?
MUY DE ACUERDO
ALGO DE ACUERDO
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a2 Do you strongly disagree or somewhat disagree?
1 STRONGLY DISAGREE 2 SOMEWHAT DISAGREE
a2 ¿Diría usted que está algo en desacuerdo o bastante en desacuerdo?
ALGO EN DESACUERDO
MUY EN DESACUERDO
ORIENTATION 17 How important is it to you that <FILL> ways are practiced in your home?
1 Not at All Important 2 A Little Important 3 Somewhat Important 4 Very Important
IMMIGRANTS (IF Q5 IS NOT US) 17 ¿Qué tan importante es para usted que las costumbres de <FILL PAÍS> sean
practicadas en su hogar? (Options from MN)
No es importante
Un poco importante
Algo más importante o
Muy importante IMMIGRANTS (IF Q5 IS NOT US) 18a How many of your neighbors are from the same ethnic background as you?
Would you say none, a few, some, a lot or almost all of them?
1 NONE 2 A FEW 3 SOME 4 A LOT 5 ALMOST ALL
181
18a ¿Cuántos de sus vecinos son del mismo grupo étnico que usted? ¿Diría usted que ninguno, unos pocos, algunos, muchos o casi todos? (Options from MN)
NINGUNO
UNOS POCOS
ALGUNOS
MUCHOS
CASI TODOS 18b How many of your close friends are from the same ethnic background as you?
Would you say none, a few, some, a lot or almost all of them?
1 NONE 2 VERY FEW 3 SOME 4 A LOT 5 ALMOST ALL
18b ¿Cuántos de sus amigos cercanos son del mismo grupo étnico que usted? ¿Diría
usted que ninguno, unos pocos, algunos, muchos o casi todos?
NINGUNO
MUY POCOS
ALGUNOS
MUCHOS
CASI TODOS 19 Do you think you are similar or different to <a-b>: 19 ¿Cree usted que es parecido(a) o diferente a <a-b>:
a People who live in <FILL> (country)
1 Similar GO TO a1 2 Different GO TO a2
a La gente que vive en <FILL> (país)
Parecido(a) GO TO a1
Diferente GO TO a2
182
a1 How similar are you? Are you a little similar, somewhat similar, or very similar?
1 A LITTLE SIMILAR 2 SOMEWHAT SIMILAR 3 VERY SIMILAR
a1 ¿Qué tan parecido(a) es usted? ¿Es usted un poco parecido(a), algo
parecido(a) o muy parecido(a)?
POCO PARECIDO(A)
ALGO PARECIDO(A)
MUY PARECIDO(A)
a2 How different are you? Are you a little different, somewhat different, or very different?
1 A LITTLE DIFFERENT 2 SOMEWHAT DIFFERENT 3 VERY DIFFERENT
a2 ¿Qué tan diferente es usted? ¿Es usted un poco diferente, algo diferente o
muy diferente?
UN POCO DIFERENTE
ALGO DIFERENTE
MUY DIFERENTE b Typical White Minnesotan
1 Similar GO TO b1 2 Different GO TO b2
b El típico habitante blanco de Minnesota
Parecido(a) GO TO b1
Diferente GO TO b2
183
b1 How similar are you? Are you a little similar, somewhat similar, or very similar?
1 A LITTLE SIMILAR 2 SOMEWHAT SIMILAR 3 VERY SIMILAR
b1 ¿Qué tan parecido(a) es usted? ¿Es usted un poco parecido(a), algo
parecido(a) o muy parecido(a)?
UN POCO PARECIDO(A)
ALGO PARECIDO(A)
MUY PARECIDO(A)
b2 How different are you? Are you a little different, somewhat different, or very different?
1 A LITTLE DIFFERENT 2 SOMEWHAT DIFFERENT 3 VERY DIFFERENT
b2 ¿Qué tan diferente es usted? ¿Es usted un poco diferente, algo diferente o
muy diferente?
UN POCO DIFERENTE
ALGO DIFERENTE
MUY DIFERENTE 20 Which of the following would you say best describes you:
1 <FILL> 2 <FILL> American 3 An American
20 ¿Cuál de las siguientes diría usted que mejor le describe?
<FILL>
<FILL> Americano
Un Americano
184
RANDOMLY SELECTED PHONE ONLY SAMPLE. ALL OTHERS GO TO Q26 Ask Q21-25 AND DEMOGRAPHICS. DO NOT SCHEDULE FOR FACE-TO-FACE INTERVIEW. 21 Have you ever smoked a cigarette, even 1 or 2 puffs?
1 Yes 2 No 21a Not even one or two puffs? 1 Yes CONTINUE 2 No GO TO Q 26
7 DK CONTINUE
9 REF RANDOMLY SELECTED PHONE ONLY SAMPLE. Ask Q47-51 AND DEMOGRAPHICS. DO NOT SCHEDULE FOR FACE-TO-FACE INTERVIEW. 21. Q40 (OPCIÓN 1): ¿Alguna vez ha fumado un cigarillo, bien sea una probadita? (ALGUNA VEZ EN LA
VIDA) (OPCIÓN 2): ¿Alguna vez ha fumado un cigarillo, bien sea una o dos pitadas? (CDC-GYTS) (ALGUNA VEZ EN LA
VIDA)
1 Sí 2 No 21a ¿Ni siquiera una pitada (una probadita)? 1 Sí CONTINUE 2 No GO TO Q 26
7 DK CONTINUE
9 REF 22 Do you consider yourself a smoker?
1 Yes 2 No 7 DK 9 REF
185
22 ¿Se considera usted un(a) fumador(a)?
1 Sí 2 No 7 DK 9 REF
23 Have you smoked at least 100 cigarettes in your entire life?
1 Yes 2 No GO TO Q 26
7 DK CONTINUE
9 REF 23 ¿Ha fumado al menos 100 cigarrillos en toda su vida? (MN)
1 Sí 2 No GO TO Q 26
7 DK CONTINUE
9 REF 24 Have you smoked a cigarette, even a puff in the last 6 months?
1 Yes 2 No GO TO Q 26
7 DK CONTINUE
9 REF 24 ¿En los últimos 6 meses ha fumado un cigarillo, aunque sea una probadita? (una
pitada)? 1 Sí 2 No GO TO Q 26
7 DK CONTINUE
9 REF
186
25 Do you now smoke cigarettes every day, some days, or not at all?
1 Everyday 2 Some Days 3 Not At All
25 Fuma usted actualmente cigarillos todos los días, algunos días o ningún día?
(MN)
Todos los días
Algunos días
Ningún día Finally, I have a few questions about you which will help our staff interpret the results. Finalmente, tengo algunas preguntas acerca de usted que ayudarán nuestro personal a interpretar los resultados. 26 What is your age? _______ YEARS 26 ¿Cuántos años tiene usted? _______ EDAD
IF REFUSED 27 What age group are you in?
1 Less than 20 2 20 – 29 3 30 – 39 4 40 – 49 5 50 – 59 6 60 – 69 7 70 or over
IF REFUSED
187
27. ¿Si le menciono algunas categorías de edades, diría que su grupo de edad es:
Menos de 20 20 a 29 30 a 39 40 a 49 50 a 59 60 a 69 70 o más
28 What is the highest grade or level of school you have completed? (DO NOT
READ CHOICES)
1 NO FORMAL EDUCATION 2 COMPLETED ELEMENTARY SCHOOL (GRADES 1-6) 3 COMPLETED JUNIOR HIGH SCHOOL (GRADES 7-9) 4 HIGH SCHOOL GRADUATE OR GED 5 TECHNICAL, VOCATIONAL TRAINING, OR BUSINESS SCHOOL 6 SOME COLLEGE (INCLUDES TECH SCHOOL/AA DEGREES) 7 COLLEGE GRADUATE (BA/BS DEGREE) 8 POST GRADUATE/PROFESSIONAL SCHOOL 9 OTHER, SPECIFY: ____________________________________________
97 DK 99 REF IF NOT IN PHONE ONLY STRATA
GO TO SCHEDULE
188
28 ¿Hasta qué grado o nivel escolar completó? (NO LEA LAS OPCIONES) (MN)
Ninguna educación formal (HA)
Completó la escuela primaria/elemental (Grados 1 – 6) (DS)
Completó la escuela secundaria (Grados 7 – 9) (DS)
Se graduó de la Escuela secundaria o GED (11 A 12 AÑOS DE
ESCUELA/COLEGIO) (MN)
Adiestramiento Técnico o Vocacional o Escuela de Comercio
Algo de Universidad (Incluye escuela técnica/Grado Asociado)
(MN)
Título Universitario (BA/BS)
Título de Pos-grado
Otro, Especifíque:
______________________________________________
No Sabe
Rehusó IF NOT IN PHONE ONLY STRATA GO TO SCHEDULE
PHONE GROUP ONLY Q29 In studies like this, households are often grouped according to income. What was
the total income for your household over the past year, including salaries or other earnings, interest, retirement and so on, for all household members combined?
, DOLLARS
7 DK 9 REF
Q29 En estudios de este tipo, las unidades familiares frecuentemente se agrupan según
sus ingresos. ¿Cuánto sumó el ingreso total de todas las personas de su unidad familiar durante el año pasado, incluyendo salarios y otros ingresos, intereses, jubilación, etc.? (MN)
, DÓLARES
NO SABE REHUSÓ
189
IF R REFUSES OR CANNOT ESTIMATE INCOME: Q30 How about if I give you some categories? Would you say it was more or less than
$25,000 a year?
1 LESS
2 MORE
7 DK 9 REF
IF R REFUSES OR CANNOT ESTIMATE INCOME: Q30 ¿Qué le parece si le menciono algunas categorías? ¿Podría decir que los ingresos
totales de su familia eran mayors o menores de $25,000 por año? (MN)
MENOR
Q30a 1 Less than $5,000 2 $5,001 to $10,000 3 $10,001 to $15,000 4 $15,001 to $20,000 5 $20,001 to $25,000
Q30b 1 $25,001 to $30,000 2 $30,001 to $35,000 3 $35,001 to $40,000 4 $40,001 to $75,000 5 Over $75,000
Q30a 1 Menos de$5,000 2 $5,001 a $10,000 3 $10,001 a $15,000 4 $15,001 a $20,000 5 $20,001 a $25,000
190
MAYOR
NO SABE REHUSÓ
TERMINATION STATEMENT FOR RANDOMLY SELECTED ‘SMOKING” PHONE ONLY GROUP: Okay. That was my last question. I really appreciate your help with our study. TERMINATION STATEMENTFOR RANDOMLY SELECTED ‘SMOKING’ PHONE
ONLY GROUP:
Bueno, esta ha sido mi última pregunta. Muchísimas gracias por su participación y su ayuda.
Q30b 1 $25,001 a $30,000 2 $30,001 a $35,000 3 $35,001 a $40,000 4 $40,001 a $75,000 5 Más de $75,000
191
Appendix C DREGAN Face to Face Bilingual Survey
Q1 Compared to other people your age, do you consider your health to be excellent,
very good, good, fair, or poor?
Excellent
Very Good
Good
Fair
Poor Q1 En comparación con otras personas de su edad, ¿considera que su salud es
excelente, muy buena, buena, regular o mala?
Excelente
Muy buena
Buena
Regular
Mala Q2 During the past 12 months has injury or illness caused you to cut down on the
things you usually do?
Not at all
A little bit or
A lot Q2 Durante los últimos 12 meses, ¿se ha visto limitado(a) en las cosas que
normalmente hace por alguna lesión o enfermedad? Diría Ud. que…
Nada
Un poco; o
Muy
ID # _____________
192
Q3 Do you think that a typical white Minnesotan would think that you are Latino, Asian or Southeast Asian, White, African American, American Indian, or from some other racial ethnic background?
Latino/Hispanic
Asian
Southeast Asian
White
African American
American Indian
Other (SPECIFY): _______________________________________________
Q3 ¿Cree usted que un típico habitante blanco de Minnesota pensaría que usted es latino/a, Hispano(a), asiático/a, o, asiático/a del sudeste, blanco/a, afro-americano/a, indio/a americano/a o de algún otro grupo racial o étnico?
Latino/a/Hispano/a
Asiático/a
Asiático del sudeste/a
Blanco/a
Afro americano/a
Indio/a americano/a
Otro (Por favor ESPECIFIQUE):
_______________________________________________
FLUENCY Q4 What was the first language you learned to speak? (IF R LEARNED TWO LANGUAGES AT ONCE, CODE BOTH) A. _______________________________ B. _______________________________
193
Q4 ¿Cuál fue el primer idioma que aprendió a hablar? (IF R LEARNED TWO LANGUAGES AT ONCE, CODE BOTH) A. _______________________________ B. _______________________________ Q5 And what other languages do you know? ______________________________
______________________________
Q5 ¿qué otros idiomas habla u? ______________________________
______________________________
Q6 (ASK OF SECOND LANGUAGE ONLY)
NOT AT
ALL
NOT VERY WELL
SOMEWHAT WELL
VERY WELL
a How comfortable are you communicating in <FILL>
PRIORITY LIST ENGLISH NATIVE LANGUAGE (KHMER, ETC.) LATINO: PORTUGUESE VIET: FRENCH
194
Q6 (Solamente PREGUNTE ACERCA DEL SEGUNDO IDIOMA)
NADA NO MUY
BIEN ALGO BIEN
MUY BIEN
a ¿Qué tan cómodo(a) se siente comunicándose en <FILL>?
PRIORITY LIST ENGLISH NATIVE LANGUAGE (KHMER, ETC.) LATINO: PORTUGUESE VIET: FRENCH Q7 How well do you understand each of the following:
Q7a U.S. sport events such as the Super Bowl or Stanley Cup playoffs?
Very Well
Somewhat Well
Not Very Well
Not At All
DON’T FOLLOW SPORTS Q7 Qué tan bien entiende usted lo siguiente:
Q7a ¿Eventos deportivos de los EE.UU. como el Súper Tazón (SUPER BOWL) o la copa Stanley?
Muy bien
Bien
No muy bien
Nada
NO SIGO DEPORTES
195
Q7b How well do you understand the legend of Paul Bunyan and Babe the Blue Ox?
Very Well
Somewhat Well
Not Very Well
Not At All
Q7b ¿Qué tan bien entiende la leyenda de Paul Bunyan y Bebé, el buey azul?
Muy bien
Algo bien
No muy bien
Para nada bien
Q7c And how well do you understand the Boston Tea Party?
Very Well
Somewhat Well
Not Very Well
Not At All
Q7c Y ¿Qué tan bien entiende la (MOTÍN DEL TÉ DE BOSTON)?
Muy bien
Algo bien
No muy bien
Para nada bien
196
Q8 If you attended a wedding or funeral based on <FILL> traditions, how well would you understand what is going on?
NOTE: if US born Latino use “Latino traditions” instead of “traditions from <FILL>
Very Well
Somewhat Well
Not Very Well
Not At All Q8 Si usted asistiera a una boda o a un funeral basado en tradiciones < FILL >, ¿Qué
tan bien entendería lo que está pasando? NOTE: if US born Latino use “Latino traditions” instead of “traditions from <FILL>
Muy bien
Bien
No muy bien
Nada Q9 Do you agree or disagree with each of the following: Q9a I understand <FILL> traditions very well
Agree
Disagree
Q9a1 Do you strongly agree or somewhat agree? 9 STRONGLY AGREE 9 SOMEWHAT AGREE
Q9a2 Do you strongly disagree or somewhat disagree? 9 STRONGLY DISAGREE 9 SOMEWHAT DISAGREE
197
Q9 ¿Está usted de acuerdo o en desacuerdo con cada una de las siguientes afirmaciones?
Q9a Entiendo muy bien las tradiciones <FILL>
De
acuerdo
En
desacuerdo
Q9b I understand American ways very well
Agree
Disagree
Q9b1 Do you strongly agree or somewhat agree? 9 STRONGLY AGREE 9 SOMEWHAT AGREE
Q9b2 Do you strongly disagree or somewhat disagree? 9 STRONGLY DISAGREE 9 SOMEWHAT DISAGREE
Q9a1 ¿Está usted muy de acuerdo o algo de acuerdo? 9 MUY DE ACUERDO
9 ALGO DE ACUERDO
Q9a2 ¿Está usted muy en desacuerdo o algo en desacuerdo? 9 MUY EN DESACUERDO 9 ALGO EN DESACUERDO
198
9b Entiendo muy bien las costumbres americanas
De
acuerdo
En
desacuerdo
ORIENTATION
Q10 How important is it to you that <FILL> ways are practiced in your home?
Not at All Important
A Little Important
Somewhat Important
Very Important
Q10 ¿Qué tan importante es para usted que las costumbres <FILL> sean seguidas en su casa? (MN Needs)
No es importante
Poco importante
Importante
Muy importante CHECKPOINT
1 U.S. BORN GO TO Q15
2 IMMIGRANT
Q9b1 ¿Está usted muy de acuerdo o algo de acuerdo? 9 MUY DE ACUERDO 9 ALGO DE ACUERDO
Q9b2 ¿Está usted muy en desacuerdo o algo en desacuerdo? 9 MUY EN DESACUERDO 9 ALGO EN DESACUERDO
199
Since moving to the U.S., how much has changed for each of the following: Q11 How about the language you speak at home, has there been no change at all, a
little change, some change or a lot of change?
NO CHANGE AT ALL
VERY LITTLE CHANGE
SOME CHANGE
A LOT OF CHANGE Desde que llegó a los EE.UU., qué tanto ha cambiado en cada uno de los siguientes
aspectos: Q11 El idioma que usted habla en casa, ¿no ha cambiado, ha cambiado muy poco, ha
cambiado algo o ha cambiado mucho? (DESDE QUE LLEGÓ A LOS EE.UU.)
NO HA CAMBIADO
MUY POCO
ALGO
MUCHO
Q12 And how about the sports or sporting teams you follow, no change, a little, some or a lot of change?
NO CHANGE AT ALL
VERY LITTLE CHANGE
SOME CHANGE
A LOT OF CHANGE
DON’T FOLLOW SPORTS
Q12 Y que tal los deportes o equipos deportivos que sigue de cerca, ¿no ha cambiado, ha cambiado muy poco, ha cambiado algo o ha cambiado mucho? (DESDE QUE LLEGÓ A LOS EE.UU.)
NO HA CAMBIADO
MUY POCO
ALGO
MUCHO
NO SIGO DEPORTES
200
Q13 How about the food you eat. Would you say there has been no change, a little, some or a lot of change?
NO CHANGE AT ALL
VERY LITTLE CHANGE
SOME CHANGE
A LOT OF CHANGE
Q13 Y que tal la comida que usted come. ¿No ha cambiado, ha cambiado muy poco, ha cambiado algo o ha cambiado mucho? (DESDE QUE LLEGÓ A LOS EE.UU.)
NO HA CAMBIADO
MUY POCO
ALGO DE
MUCHO
Q14 And how about the music you listen to. Has there been no change, a little, some
or a lot of change?
NO CHANGE AT ALL
VERY LITTLE CHANGE
SOME CHANGE
A LOT OF CHANGE Q14 Y que tal la música que usted escucha. ¿No ha cambiado, ha cambiado muy poco,
ha cambiado algo o ha cambiado mucho? (DESDE QUE LLEGÓ A LOS EE.UU.)
NO HA CAMBIADO
MUY POCO
ALGO DE
MUCHO
201
Q15 Thinking about a typical white Minnesotan, are you similar or different to them for each of the following:
Q15a The music you listen to
Similar
Different Q15 Pensando en un típico habitante blanco de Minnesota, ¿es usted parecido/a o
diferente en cada uno de los siguientes aspectos? Q15a La música que usted escucha
Parecido/a
Diferente
Q15a1 How similar are you? Are you a little similar, somewhat similar, or very similar?
9 A LITTLE SIMILAR 9 SOMEWHAT SIMILAR 9 VERY SIMILAR
Q15a2 How different are you? Are you a little different, somewhat different, or very different?
9 A LITTLE DIFFERENT 9 SOMEWHAT DIFFERENT 9 VERY DIFFERENT
Q15a1 ¿Qué tan parecido/a es usted? ¿es usted poco parecido/a, algo parecido/a o muy parecido/a?
9 POCO PARECIDO/A 9 ALGO PARECIDO/A 9 MUY PARECIDO/A
Q15a2 ¿Qué tan diferente es usted? ¿es usted poco diferente, algo diferente, o muy diferente?
9 POCO DIFERENTE 9 ALGO DIFERENTE 9 MUY DIFERENTE
202
Q15b The food you eat
Similar
Different
Q15b La comida que usted come
Parecido/a
Diferente
Q15b1 How similar are you? Are you a little similar, somewhat similar, or very similar?
9 A LITTLE SIMILAR 9 SOMEWHAT SIMILAR 9 VERY SIMILAR
Q15b2 How different are you? Are you a little different, somewhat different, or very different?
9 A LITTLE DIFFERENT 9 SOMEWHAT DIFFERENT 9 VERY DIFFERENT
Q15b1 ¿Qué tan parecido/a es usted? ¿es usted poco parecido/a, algo parecido/a o muy parecido/a?
9 POCO PARECIDO/A 9 ALGO PARECIDO/A 9 MUY PARECIDO/A
Q15b2 ¿Qué tan diferente es usted? ¿es usted poco diferente, algo diferente, o muy diferente?
9 POCO DIFERENTE 9 ALGO DIFERENTE 9 MUY DIFERENTE
203
Q15c Expressions you use when you speak (slang)
Similar
Different Q15c Expresiones que usted utiliza al hablar (como por ejemplo jerga)
Parecido/a
Diferente
Q15c1 How similar are you? Are you a little similar, somewhat similar, or very similar?
9 A LITTLE SIMILAR 9 SOMEWHAT SIMILAR 9 VERY SIMILAR
Q15c2 How different are you? Are you a little different, somewhat different, or very different?
9 A LITTLE DIFFERENT 9 SOMEWHAT DIFFERENT
9 VERY DIFFERENT
Q15c1 ¿Qué tan parecido/a es usted? ¿es usted poco parecido/a, algo parecido/a o muy parecido/a?
9 POCO PARECIDO/A 9 ALGO PARECIDO/A 9 MUY PARECIDO/A
Q15c2 ¿Qué tan diferente es usted? ¿es usted poco diferente, algo diferente, o muy diferente?
9 POCO DIFERENTE 9 ALGO DIFERENTE 9 MUY DIFERENTE
204
Q15d The sport or sporting teams you follow
Similar
Different
Q15d Deportes o equipos deportivos que usted sigue de cerca
Parecido/a
Diferente
Q15d1 How similar are you? Are you a little similar, somewhat similar, or very similar?
9 A LITTLE SIMILAR 9 SOMEWHAT SIMILAR 9 VERY SIMILAR
Q15d2 How different are you? Are you a little different, somewhat different, or very different?
9 A LITTLE DIFFERENT 9 SOMEWHAT DIFFERENT 9 VERY DIFFERENT
Q15d1 ¿ Qué tan parecido/a es usted? ¿es usted poco parecido/a, algo parecido/a o muy parecido/a?
9 POCO PARECIDO/A 9 ALGO PARECIDO/A 9 MUY PARECIDO/A
Q15d2 ¿Qué tan diferente es usted? ¿es usted poco diferente, algo diferente, o muy diferente?
9 POCO DIFERENTE 9 ALGO DIFERENTE 9 MUY DIFERENTE
205
Q16 Thinking overall, how similar or different are you to a Typical White Minnesotan
Similar
Different Q16 En lo general, ¿qué tan parecido/a o diferente es usted a un típico habitante blanco
de Minnesota?
Parecido/a
Diferente
Q16a How similar are you? Are you a little similar, somewhat similar, or very similar?
9 A LITTLE SIMILAR 9 SOMEWHAT SIMILAR 9 VERY SIMILAR
Q16b How different are you? Are you a little different, somewhat different, or very different?
9 A LITTLE DIFFERENT 9 SOMEWHAT DIFFERENT
9 VERY DIFFERENT
Q16a1 ¿Qué tan parecido/a es usted? ¿es usted poco parecido/a, algo parecido/a o muy parecido/a?
9 POCO PARECIDO/A 9 ALGO PARECIDO/A 9 MUY PARECIDO/A
Q16a2 ¿Qué tan diferente es usted? ¿es usted poco diferente, algo diferente, o muy diferente?
9 POCO DIFERENTE 9 ALGO DIFERENTE 9 MUY DIFERENTE
206
Q17 How many of your casual friends or acquaintances are from the same ethnic background as you? Would you say none, a few, some, a lot or almost all of them?
NONE
A FEW
SOME
A LOT
ALMOST ALL Q17 ¿Cuántos de sus amigos casuales o conocidos son de su grupo étnico? ¿diría que
ninguno, muy pocos, algunos, muchos, o casi todos?
NINGUNO
MUY POCOS
ALGUNOS
MUCHOS
CASI TODOS Q18 Which of the following would you say best describes you:
<FILL>
<FILL> American
An American IF R IS NOT SEAsian AND SPOUSE IS SEAsian ASK “YOUR SPOUSE” Q18 ¿Cuál de las siguientes palabras lo describiría mejor?:
<FILL>
<FILL> Americano/a
Americano/a IF R IS NOT SEAsian AND SPOUSE IS SEAsian ASK “YOUR SPOUSE”
207
Q19 How strongly do you identify with your/your spouse’s <FILL 1> background?
Not at All
A Little
Somewhat
A Lot IF R IS NOT SEAsian AND SPOUSE IS SEAsian ASK “YOUR SPOUSE” Q19 ¿Qué tanto se identifica usted con sus raices <FILL1>/las raices <FILL 1> de su
esposo/a?
Nada
Poco
Algo
Mucho IF R IS NOT SEAsian AND SPOUSE IS SEAsian ASK “YOUR SPOUSE” Q20 How important do you feel it is to keep in touch with or learn about your/your
spouse’s <FILL 1> ethnic or cultural background?
Not at All
A Little
Somewhat
A Lot Q20 ¿Qué tan importante es para usted mantenerse en contacto o aprender sobre sus
raices étnicas o culturales o las de su esposo/a?
Nada
Poco
Algo
Muy
208
Q21 Now thinking about the conversations that you have at home with other family members, friends or guests, are more of those conversations in <FILL> than English, more in English than <FILL> or are they about the same?
More <FILL> than English
More English than <FILL>
About the same Q21 Pensando en las conversaciones que usted tiene en casa con otros miembros de su
familia, amigos o visitas, ¿son estas conversaciones más en <FILL> que inglés, más en inglés que en <FILL> o más o menos igual en ambos idiomas?
Más <FILL> que inglés
Más inglés que <FILL>
Más o menos iguales en ambos idiomas Q22 How important are each of the following to keeping ones identity as a <FILL 1>: Q22a Speak <LANGUAGE FILL>
Very Important
Somewhat Important
Not Very Important
Not at All Important Q22 ¿Qué tan importante para usted es mantener su identidad como <FILL 1> en cada
uno de los siguientes aspectos? Q22a Hablar < LANGUAGE FILL >. Es…
Muy importante
Algo importante
No muy importante
No es importante
209
Q22b Raise children as a <FILL>
Very Important
Somewhat Important
Not Very Important
Not at All Important
Q22b Criar los niños como <FILL> Es…
Muy importante
Algo importante
No muy importante
No es importante
Q22c Take on as few American ways as possible
Very Important
Somewhat Important
Not Very Important
Not at All Important
Q22c Adoptar el menor número posible de costumbres estadounidenses. Es…
Muy importante
Algo importante
No muy importante
No es importante
Q22d Be born in <FILL>
Very Important
Somewhat Important
Not Very Important
Not at All Important
210
Q22d Haber nacido en <FILL> Es…
Muy importante
Algo importante
No muy importante
No es importante
Q22e View themselves as a <FILL> first and an American second
Very Important
Somewhat Important
Not Very Important
Not at All Important
Q22e Verse primero como <FILL> y segundo como americano(a). Es…
Muy importante
Algo importante
No muy importante
No es importante
Q22f Spend time mainly with others who are from the same ethnic background
Very Important
Somewhat Important
Not Very Important
Not at All Important
Q22f Pasar la mayor parte del tiempo con personas que tienen las mismas raices étnicas. Es…
Muy importante
Algo importante
No muy importante
No es importante
211
Q22g Marry someone who shares the same cultural background
Very Important
Somewhat Important
Not Very Important
Not at All Important
Q22g Casarse con alguien que tenga las mismas raices culturales. Es…
Muy Importante
Algo Importante
No Muy Importante
No es Importante
Q22h Follow events in <FILL – COUNTRY>
Very Important
Somewhat Important
Not Very Important
Not at All Important
Q22h Seguir los eventos en <FILL – PAÍS> Es…
Muy Importante
Algo Importante
No Muy Importante
No es Importante Q22i Caring for children in traditional <FILL> ways
Very Important
Somewhat Important
Not Very Important
Not at All Important
212
Q22i El criar a los niños de la manera tradicional <FILL>. Es...
Muy Importante
Algo Importante
No Muy Importante
No es Importante Q2 My next questions are about physical activities that you did in the past 7 days,
including activities that you did at work, as part of your house and yard work, to get from place to place, or in your spare time for recreation, exercise or sports.
During the past 7 days, have you done any physical activity, that is any activity that caused you to breathe at least a little harder than normal?
Yes
GO TO Q24
No
GO TO Q28, Next page Q23 Las siguientes preguntas son sobre aquellas actividades físicas que usted llevó a
cabo durante los últimos 7 días. Estas incluyen actividades que hizo en su trabajo, como parte de las tareas de su hogar, o jardín, aquellas que hizo para ir de un lugar a otro o en su tiempo libre por motivos recreacionales, de ejercicio o deportivos.
¿Durante los pasados 7 días, ha hecho alguna actividad física? Es decir, cualquier
actividad que le haya hecho respirar al menos un poco más fuerte que lo común.
SÍ
GO TO Q24
NO
GO TO Q28, Próxima página Q24 The next few questions are about moderate activity you may have done in the past
7 days. Moderate physical activities are those activities that make you breathe just a little harder than normal. Examples are carrying light loads, bicycling at a regular pace or walking.
213
During the past 7 days, on how many days did you do moderate physical activities for more than 10 minutes at a time?
# DAYS PER WEEK
Q24 Las siguientes preguntas son acerca de aquellas actividades físicas moderadas que
pudo haber hecho durante los pasados 7 días. Actividades físicas moderadas son aquellas en las que usted tiene que respirar un poco más fuerte que lo normal. Por ejemplo, llevar cargas livianas, andar en bicicleta o caminar.
En los pasados 7 días, durante cuántos días llevó a cabo actividades físicas
moderadas por más de 10 minutos en cada ocasión? _______ # DÍAS POR SEMANA
Q25 On the most recent day that you did moderate physical activity, how long did you do this for? How many minutes or hours?
MINUTES/HOURS Q25 El último día que realizó alguna actividad física moderada, ¿Durante cuánto
tiempo la realizó? ¿Cuántos minutos u horas? _______ MINUTOS/HORAS Q26 Now think about vigorous physical activities you may have done in the past 7
days. These are activities such as heavy lifting, digging or fast running that cause you to breathe much harder than normal.
During the past 7 days, on how many days did you do vigorous physical activities
for more than 10 minutes at a time?
# DAYS PER WEEK Q26 Ahora, piense en actividades físicas vigorosas que usted haya hecho en los
últimos 7 días. Estas son actividades que lo hacen respirar mucho más fuerte que
lo normal; tales como levantar cosas pesadas, excavar o correr.
214
En los pasados 7 días, ¿durante cuántos días llevó a cabo actividades físicas vigorosas por más de 10 minutos en cada occasión?
# DÍAS POR SEMANA
Q27 On the most recent day that you did vigorous physical activity, how long did you
do this for? MINUTES/HOURS
Q27 El día más reciente en el cual llevó a cabo alguna actividad física vigorosa, ¿Por
cuánto tiempo? MINUTOS/HORAS Q28 The next question concerns the foods you usually eat. Thinking back over the
past 7 days, how many servings of fruit did you usually eat in a day? A serving would be half a cup of fruit or fruit juice or a medium piece of fruit.
SERVINGS PER DAY INTERVIEW INSTRUCTION: A cup is about a handful Q28 Las siguientes preguntas son acerca de los alimentos que usualmente come.
Pensando en los últimos 7 días, ¿cuántas porciones de fruta, por lo general, comió en un día? Una porción sería media taza de fruta o de jugo de fruta o un pedazo mediano de fruta.
SERVINGS PER DAY INTERVIEW INSTRUCTION: Una taza es un puñado. Q29 Over the past 7 days, how many servings of vegetables did you usually eat in a
day? A serving would be half a cup of cooked vegetables or one cup of raw vegetables.
SERVINGS PER DAY INTERVIEW INSTRUCTION: A cup is about a handful
215
Q29 Pensando en los últimos 7 días, ¿cuántas porciones de vegetales, por lo general, comió en un día? Una porción sería media taza de vegetales cocidos o una taza de vegetales crudos.
PORCIONES POR DÍA INTERVIEW INSTRUCTION: Una taza es un puñado
Q30 During the past 30 days, for about how many days did stress, poor physical health, or depression keep you from doing your usual activities?
(IF NEEDED: USUAL ACTIVITIES SUCH AS TAKING CARE OF YOURSELF, WORK OR RECREATION?)
ENTER NUMBER OF DAYS (1 - 30) Q30 Durante los pasados 30 días, ¿Durante cuántos días el estrés, la mala salud física,
o la depresión le impidieron llevar a cabo sus actividades usuales? (DE SER NECESARIO: ACTIVIDADES USUALES TALES COMO EL CUIDAR DE SÍ MISMO(A) TRABAJAR O ACTIVIDADES RECREACIONALES)
ENTRE EL NÚMERO DE DÍAS (1 – 30) Q31 Now thinking about your physical health, which includes physical illness and
injury, for how many days during the past 30 days was your physical health not good?
ENTER NUMBER OF DAYS (1 - 30) Q31 Pensando en el aspecto físico, el cual incluye cualquier enfermedad física o
lesiones. ¿Durante cuántos días, en los últimos 30 días, no se encontró bien de salud? (~DS)
ENTRE EL NÚMERO DE DÍAS (1 – 30) Q32 Have you been anxious, worried, or upset during the past month?
Extremely
Quite A Bit
Some
A Little
Not At All
216
Q32 Durante el mes pasado, ¿ha estado ansioso(a), preocupado(a) o molesto(a)?
Muchísimo
Bastante
Algo
Muy poco
Nada Q33 For each of the following events or situations please indicate if they have
occurred in your life in the last year. YES NO
Death of a spouse or close family member
Change in where you live
Major change in health or behavior of a family member
Major change in the number of family get-togethers
Q33 Para cada uno de los siguientes eventos o situaciones, por favor indique si le ha
ocurrido en su vida durante el pasado año. SÍ NO
Muerte de esposo/a o familiar cercano
Cambios en el lugar que vive
Cambio significativo en la salud o conducta de un miembro de la familia
Cambio significativo en el número de reuniones familiares.
SMOKING My next questions are about smoking. Q34a Do you think smoking can help a person make friends?
Yes
No
217
Las siguientes preguntas son acerca del fumar. Q34a ¿Cree usted que fumar puede ayudarle a una persona a hacer amigos?
SÍ
NO Q34b Do you think it provides pleasure?
Yes
No Q34b ¿Cree que causa placer?
SÍ
NO Q34c Does it relieve stress and anxiety?
Yes
No Q34c ¿Alivia el estrés y la ansiedad?
SÍ
NO Q34d Do you think smoking can help a person focus on activities such as work, chores
or other tasks?
Yes
No Q34d ¿Cree que el fumar puede ayudarle a una persona a concentrarse en el trabajo,
tareas domésticas, o en otras actividades?
SÍ
NO
Q34e And do you think it helps to lose weight?
Yes
No Q34e ¿Y cree que ayuda a perder peso?
SÍ
NO
218
For each of the next statements, please tell me if you strongly agree, somewhat agree, somewhat disagree or strongly disagree. Q35 People who smoke do so because they want to.
STRONGLY AGREE
SOMEWHAT AGREE
SOMEWHAT DISAGREE
STRONGLY DISAGREE Para cada una de las siguientes afirmaciones, por favor dígame si está acuerdo, algo de
acuerdo, algo en desacuerdo o en desacuerdo.
Q35 La gente que fuma lo hace porque quiere. Está...
DE ACUERDO
ALGO DE ACUERDO
ALGO EN DESACUERDO
DESACUERDO Q36 People who smoke do so because it is a habit.
Strongly Agree
Somewhat Agree
Somewhat Disagree
Strongly Disagree Q36 La gente que fuma lo hace porque es un hábito. Está...
de acuerdo
Algo de acuerdo
Algo en desacuerdo
en desacuerdo
219
Q37 People who smoke cannot control whether they smoke or not.
Strongly Agree
Somewhat Agree
Somewhat Disagree
Strongly Disagree Q37 La gente que fuma no puede controlar si fuma o no. Está...
de acuerdo
Algo de acuerdo
Algo en desacuerdo
en desacuerdo Q38 As long as you are healthy, it is ok to smoke.
Strongly Agree
Somewhat Agree
Somewhat Disagree
Strongly Disagree Q38 Mientras se esté saludable, está bien fumar. Está...
de acuerdo
Algo de acuerdo
Algo en desacuerdo
en desacuerdo Q39 Which of the following best describes your beliefs about smoking:
There are more benefits than harms
There are more harms than benefits
The harms and benefits are about equal Q39 ¿Cuál de las siguientes frases describe mejor lo que usted opina sobre fumar?
Hay más beneficios que daños.
Hay más daños que beneficios
No hay diferencia.
220
TOBACCO BEHAVIOR QUESTIONS
Q40 Have you ever smoked a cigarette, even 1 or 2 puffs? Yes
No Q40a Not even one or two puffs?
Yes CONTINUE
No GO TO Q62 Q40 (OPCIÓN 1): ¿Alguna vez ha fumado un cigarillo, bien sea una
probadita/fumadita? (ALGUNA VEZ EN LA VIDA) (OPCIÓN 2): ¿Alguna vez ha fumado un cigarillo, bien sea una o dos
probaditas/fumaditas? (CDC-GYTS) (ALGUNA VEZ EN LA VIDA)
Sí
No Q40a ¿Ni siquiera una (una
probadita/fumadita)?
Sí CONTINÚE
No GO TO Q62 Q41 Do you consider yourself a smoker?
Yes
No Q41 ¿Se considera usted un/a fumador/a?
Sí
No Q42 Have you smoked at least 100 cigarettes in your entire life?
Yes
No GO TO Q62 Q42 ¿Ha fumado al menos 100 cigarrillos en toda su vida? (MN)
Sí
No GO TO Q62
221
Q43 Have you smoked a cigarette, even a puff in the last 6 months? Yes
No GO TO Q48 (BLUE SECTION) Q43 ¿En los últimos 6 meses ha fumado un cigarillo aunque sea una probadita? (una
fumadita)?
Sí
No GO TO Q48 (SECCIÓN AZUL) Q44 Do you now smoke cigarettes every day, some days, or not at all?
Everyday
Some Days
Not At All
Q45 On average, about how many cigarettes a day do you smoke?
CIGARETTES GO TO Q50
Q46 During the past 30 days, on how many days did you smoke cigarettes?
# OF DAYS Q47 On average, on days when you smoked during
the past 30 days, how many cigarettes did you smoke a day?
CIGARETTES 9 LESS THAN ONE A DAY 9 DON’T KNOW 9 REFUSED GO TO Q50
GO TO Q48 (BLUE SECTION)
222
Q44 Fuma usted actualmente cigarillos todos los días, algunos días o no fuma? (MN)
Todos los
días
Algunos
días
Ningún día
Q45 ¿Cuántos cigarrillos, en promedio, fuma diariamente? (MN)
CIGARRILLOS GO TO Q50
GO TO Q48 (SECCIÓN AZUL)
Q46 Durante los últimos 30 días, ¿cuántos fueron los días en los que fumó cigarrillos/cigarros? (MN)
# DE DÍAS Q47 En los días que fumó durante los últimos 30
días, ¿cuántos cigarillos/cigarros, en promedio, fumó al día? (MN)
CIGARRILLOS 9 MENOS DE UN CIGARRILLO AL DÍA 9 NO SABE
9 REHUSÓ
223
FORMER SMOKERS
Q48 About how long has it been since you last smoked cigarettes regularly?
“REGULARLY” IS WHATEVER “REGULARLY” MEANS TO THE RESPONDENT
NEVER SMOKED REGULARLY
WITHIN THE PAST MONTH (1 MONTH OR LESS)
WITHIN THE PAST 3 MONTHS (> 1 MONTH BUT LESS THAN 3
MONTHS AGO)
WITHIN THE PAST 6 MONTHS (> 3 MONTHS BUT LESS THAN 6
MONTHS AGO)
WITHIN THE PAST YEAR (> 6 MONTHS BUT LESS THAN 1 YEAR
AGO)
WITHIN THE PAST 5 YEARS (> 1 YEAR BUT LESS THAN 5 YEARS
AGO)
WITHIN THE PAST 10 YEARS (> 5 YEARS BUT LESS THAN 10 YEARS
AGO)
10 OR MORE YEARS AGO Q48 ¿Desde hace cuánto tiempo dejó de fumar cigarrillos/cigarros regularmente?
“REGULARLY” IS WHATEVER “REGULARLY” MEANS TO THE RESPONDENT
NUNCA FUMÉ REGULARMENTE
DURANTE DEL MES PASADO (1 MES O MENOS)
DURANTE LOS ÚLTIMOS 3 MESES (> 1 MES PERO MENOS DE 3
MESES ATRÁS)
DURANTE LOS ÚLTIMOS 6 MESES (> 3 MESES, PERO MENOS DE 6
MESES ATRÁS)
DURANTE EL AÑO PASADO (> 6 MESES, PERO MENOS DE 1 AÑO
ATRÁS)
DURANTE LOS ‘ULTIMOS 5 AÑOS (> 1 AÑO, PERO MENOS DE 5
AÑOS ATRÁS)
DURANTE LOS ÚLTIMOS 10 AÑOS (> 5 AÑOS, PERO MENOS DE 10
AÑOS ATRÁS)
HACE 10 O MÁS AÑOS
224
Q49 How much did smoking restrictions at home, work or anywhere else affect your decision to quit smoking?
None
A Little
Some
A Lot Q49 ¿Qué tanto le afectaron en su decisión de dejar de fuma, las restricciones de fumar
ya sea en casa, el trabajo, o cualquier otro lugar?
Nada
Muy poco
Algo
Mucho Q50 How old were you the first time you smoked a cigarette? AGE
Q50 ¿Cuántos años tenía la primera vez que fumó un cigarillo? EDAD Q51 How old were you when you first started to smoke cigarettes regularly? AGE NEVER SMOKED REGULARLY Q51 ¿Cuántos años tenía cuando comenzó a fumar cigarillos regularmente? EDAD NUNCA FUMÓ REGULARMENTE
225
Q52 On the days that you smoke, how soon after you wake up do you have your first cigarette?
Within 5 minutes
6 – 30 minutes
31 – 60 minutes
More than 60 minutes Q52 En los días que fuma, ¿Qué tan pronto fuma su primer cigarrillo después de
levantarse?
Dentro de los primeros 5 minutos
De 6 – 30 minutos
De 31 – 60 minutos
Más de 60 minutos Q53 When you are facing stressful events or situations, do you smoke…
A lot more
A little more
The same amount
A little less
A lot less
Q53 Cuando se enfrenta a eventos o situaciones estresantes, usted fuma...
Mucho más
Un Poco más
La misma cantidad
Un poco menos
Mucho menos
226
Q54 How comfortable are you smoking around other <FILL>?
Very comfortable
Somewhat comfortable
Somewhat uncomfortable
Very uncomfortable Q54 ¿Qué tan cómodo/a se siente al fumar cerca de otros <FILL>?
Muy cómodo/a
Algo cómodo/a
Algo incómodo/a
Muy incómodo/a Q55 How many times in the past 12 months did you quit smoking for a day or more? TIMES Q55 ¿ Durante los últimos 12 meses cuántas veces dejó de fumar por un día o más? VECES Q56 Which of the following statements best describes how you feel?
I really enjoy smoking
I enjoy smoking
I don’t like smoking
I really don’t like smoking Q56 ¿Cuál de las siguientes afirmaciones mejor describe lo que usted siente?
Disfruto mucho fumar
Disfruto fumar
No me gusta mucho fumar
Realmente no me gusta fumar
227
Q57 Which of the following best describes how you feel?
I don’t think about stopping smoking
I don’t want to stop smoking
I would like to stop smoking, but don’t want to go through the process
I want to stop smoking
I WOULD LIKE TO STOP FOR SOME OTHER REASON
<INTERVIEWER: IF VOLUNTEERED “DO NOT WANT TO STOP FOR SOME OTHER REASON” CODE BUT DO NOT OFFER AS RESPONSE>
Q57 ¿Cuál de las siguientes afirmaciones describe mejor lo que usted siente?
No pienso en dejar de fumar
No quiero dejar de fumar
Me gustaría dejar de fumar, pero no quiero pasar por el proceso
Quiero dejar de fumar
QUISIERA DEJAR DE FUMAR POR ALGUNA OTRA RAZÓN
<INTERVIEWER: IF VOLUNTEERED “DO NOT WANT TO STOP FOR SOME OTHER REASON” CODE BUT DO NOT OFFER AS RESPONSE>
Q58 If you wanted to stop smoking, how likely do you think you would be to succeed?
Very likely
Somewhat likely
Somewhat unlikely
Very unlikely Q58 Si usted quisiera dejar de fumar, ¿Qué tan probable es que tuviera éxito?
Muy probable
Algo probable
Algo improbable
Muy improbable
228
Q59 If you decided to stop smoking, how likely do you think you would be to succeed?
Very likely
Somewhat likely
Somewhat unlikely
Very unlikely Q59 Si usted decidiera dejar de fumar, ¿Qué tan probable es que tuviera éxito?
Muy probable
Algo probable
Algo improbable
Muy improbable Q60 How comfortable would you be asking for help to stop smoking?
Very comfortable
Somewhat comfortable
Somewhat uncomfortable
Very uncomfortable Q60 ¿Qué tan cómodo/a se sentiría usted al pedir ayuda para dejar de fumar?
Muy cómodo/a
Algo cómodo/a
Algo incómodo/a
Muy incómodo/a Q61 For this next statement, please tell me if you strongly agree, somewhat agree,
somewhat disagree or strongly disagree: The only way I would be able to stop smoking is through my own will power.
STRONGLY AGREE
SOMEWHAT AGREE
SOMEWHAT DISAGREE
STRONGLY DISAGREE
229
Q61 Por favor dígame si Ud. está de acuerdo, algo de acuerdo, algo en desacuerdo o en desacuerdo con las siguientes afirmaciones: Sólo dejaría de fumar sin ayuda. DE ACUERDO ALGO DE ACUERDO
ALGO EN DESACUERDO EN DESACUERDO
Q62 How comfortable are you when other <FILL> smoke around you?
Very comfortable
Somewhat comfortable
Somewhat uncomfortable
Very uncomfortable Q62 ¿Qué tan cómodo/a se siente cuando otros <FILL> fuman cerca de usted?
cómodo/a
Algo cómodo/a
Algo incómodo/a
incómodo/a
Q63 Now I would like to ask you about other forms of tobacco. In the last 6 months, have you used <FILL a – h>
YES NO
a. Pipe
b. Water pipe (ASK OF SEAsians ONLY)
c. Cigar
d. Cigarillo (small cigars Spanish)
e. Chewing Tobacco (with nuts for Hmong) or snuff
f. Bidis
g. Kreteks or Clove Cigarettes
h. Any other (What would that be?)
230
Q63 Ahora, me gustaría preguntarle acerca de otras formas de tabaco. En los últimos 6 meses, ha usado <FILL a – h>
SÍ NO a. Una pipa
B. UNA PIPA DE AGUA (SÓLO A SEASIANS )
c. (PURO/HABANO)
d. Purito (PURO PEQUEÑO)
e. Tabaco para mascar (CON NUECES PARA PERSONAS HMONG) o Rapé
f. Bidis
g. Kreteks o cigarrillos de clavo de olor
h. Algún otro tipo de tabaco (¿Cuál?)
Q64 During the past 7 days has anyone smoked anywhere inside your home?
Yes
No Q64 Durante los últimos 7 días, ¿ alguien ha fumado dentro de su casa?
Sí
No
231
Q65 Which statement best describes the rules about smoking inside your home. (Inside does not include places such as decks, garages, or porches.)
Smoking is not allowed anywhere in the house
Smoking is allowed some places in the house
People can smoke anywhere
Or is there some other rule
Q65 ¿Cuál de los siguientes afirmaciones describe mejor las reglas existentes en su hogar en cuanto a fumar dentro de su casa? (Dentro de su casa no incluye áreas tales como balcones, garajes y pórticos)
Fumar no está permitido en ningún lugar de la casa.
Está permitido fumar en ciertas áreas dentro de
la casa.
La gente puede fumar donde desee
Existe alguna otra regla
Q65a What is that? 9 People can smoke in certain places 9 Certain people can smoke 9 People can smoke on some occasions 9 Other (SPECIFY): _________________
Q65a ¿Cuál?
9 La gente puede fumar en ciertas áreas de la casa
9 Ciertas personas pueden fumar
9 La gente puede fumar en ciertas ocasiones
9 Otra (ESPECIFIQUE): ______________
232
Q66 In the past 7 days, have you been in a car with someone else who was smoking?
Yes
No Q66 En los últimos 7 días, ¿ha estado en un carro con alguien que estuviera fumando?
Sí
No Q67 Are you currently employed for wages or are you self employed?
Employed for wages (Work for someone else)
Self-Employed
Don’t Work for
Wages
SKIP TO Q75 Q67 Actualmente, ¿está empleado con pagos o trabaja por cuenta propia?
Empleado por pagos (Trabaja para alguien más)
Trabaja por cuenta propia
No trabaja por pagos SKIP TO Q75 Q68 How many different jobs do you have?
ONE JOB
TWO JOBS
THREE OR MORE JOBS
Q68a Are you indoors or outdoors most of the time? 9 INDOORS GO TO Q69 9 OUTDOORS GO TO Q73
233
Q68 ¿Cuántos empleos tiene usted?
UN
TRABAJO
DOS TRABAJOS
TRES O MÁS
TRABAJOS
Q68b Now I want to ask you some questions about smoking at the place you work the most or your primary job. While working at your main job, are you indoors or outdoors most of the time?
9 INDOORS 9 OUTDOORS GO TO Q73
Q68a ¿Pasa la mayor parte del tiempo en áreas interiores o exteriores?
9 INTERIORES GO TO Q69 9 EXTERIORES GO TO Q73
Q68b Ahora me gustaría hacerle algunas preguntas sobre el fumar en su sitio principal de trabajo. ¿Pasa la mayor parte del tiempo en áreas interiores o exteriores?
9 INTERIORES 9 EXTERIORES GO TO Q73
234
Q69 What best describes where your primary or main job is? ( READ IF NECESSARY) YES NO A. A CLASSROOM
B. A HOSPITAL
C. AN OFFICE OR OFFICE BUILDING
D. YOUR HOME
E. A PLANT OR FACTORY
F. A RETAIL OR CONVENIENCE STORE OR WAREHOUSE
G. A RESTAURANT
DOES IS SERVE ALCOHOL?
H. BAR OR TAVERN
I. HOTEL OR MOTEL
J. VEHICLE
K. SOME OTHER PLACE
235
Q69 ¿Cuál de los siguientes lugares decribe mejor su sitio principal de trabajo?
(LEA DE SER NECESARIO) SÍ NO A. UN SALÓN DE CLASES
B. UN HOSPITAL
C. UNA OFICINA EN UN COMPLEJO DE OFICINAS
D. SU CASA
E. UNA PLANTA O FÁBRICA
F. UNA TIENDA O UN ALMACÉN
G. UN RESTAURANTE
¿SIRVEN BEBIDAS ALCOHÓLICAS?
H. UNA BARRA O TAVERNA
I. UN HOTEL O MOTEL
J. UN VEHÍCULO
K. ALGÚN OTRO LUGAR:
Q70 In the past 7 days, has anyone smoked in your work area?
Yes
No Q70 En los últimos 7 días, ¿ alguien fumó en su área de trabajo?
Sí
No
236
Q71 Thinking of your primary or main job, which of the following best describes the official smoking policy for indoor public or common areas, such as lobbies, rest rooms, and lunchrooms?
Smoking is not allowed in any common areas
SKIP TO Q73, YELLOW PAGE
Smoking is allowed
in common areas Q71 Pensando en su sitio principal de trabajo, ¿cuál de las siguientes frases describe
mejor la política oficial sobre el fumar en áreas interiores, públicas o comunes, como los vestíbulos, baños y comedores?
Fumar no está permitido en ninguna área común
SKIP TO Q73, YELLOW PAGE
Fumar está permitido en
áreas comunes
Q72 Is it allowed in….. All common areas Some common areas
WORKPLACE HAS NO INDOOR AREAS (DO NOT READ/DOES NOT APPLY)
Q72 Está permitido en… Todas las áreas comunes Algunas áreas comunes
EL LUGAR DE TRABAJO NO TIENE ÁREAS INTERIORES (NO LEA/NO APLICA)
237
Q73 Do you prefer to work where smoking is allowed, not allowed or does it make no difference?
Allowed
Not Allowed
No Difference
Q73 ¿Prefiere usted trabajar en lugares donde se permite fumar, donde no se permite
fumar o le es indiferente?
PERMITIDO
NO PERMITIDO
LE ES INDIFERENTE
CHECKPOINT
1 R HAS ONE JOB GO TO Q75
2 R HAS MORE THAN ONE JOB CHECKPOINT
1 R HAS ONE JOB GO TO Q75
2 R HAS MORE THAN ONE JOB
Q74 In the past 7 days, has anyone smoked in your work area at your other job?
9 YES 9 NO
Q74 En su otro lugar de trabajo, ¿ alguien ha fumado en los últimos 7 días?
9 SÍ 9 NO
238
Q75 In the past 7 days, has anyone smoked near you at any other place besides your home, workplace or in a car?
Yes
No Q75 En los últimos 7 días, ¿ alguien ha fumado cerca de usted en algún otro sitio que
no sea su casa, trabajo o en el carro?
Si
No Q76 Do you think smoking causes: YES NO Lung Cancer
Poor Vision
Heart Disease
Arthritis
Q76 Piensa usted que el fumar causa:
SÍ NO Cáncer del pulmón
Mala visión
Enfermedades del corazón
Artritis
239
REFUGEE (SE Asian ONLY) Q77 Were you or your parents in a refugee camp before entering the U.S.?
Yes GO TO Q77a No GO TO Q78
Q77 ¿Estuvieron sus padres o usted en un campamento para refugiados antes de entrar
a los Estados Unidos? Sí GO TO Q77a No GO TO Q78
Q77a Who was that?
Me Parents Both
Q77b How long were you in the refugee camp? YEARS
GO TO Q78
Q77c How long were they in the refugee camp? YEARS
GO TO Q78
Q77b How long were you in the refugee camp? YEARS Q77c And how long were they in the refugee camp? YEARS GO TO Q78
240
Q77a ¿Quién estuvo?
Yo Padres Ambos
DEMOGRAPHIC Q78 Including yourself, how many people live in your house? # OF PEOPLE Q78 Incluyéndole a usted, ¿cuántas personas viven en su casa? (Similar MN) # DE PERSONAS Q79 How many are over 18 years of age? # OVER 18
Q77b ¿Durante cuánto tiempo estuvo en el campamento para refugiados?
YEARS
Q77c ¿Durante cuánto tiempo estuvieron ellos en el
campamento para refugiados? YEARS
Q77b ¿Durante cuánto tiempo estuvo en el campamento para refugiados?
YEARS Q77c ¿Durante cuánto tiempo estuvieron ellos en el
campamento para refugiados? YEARS GO TO Q78
241
Q79 ¿Cuántas de estas personas son mayores de 18 años? # MAYORES DE 18 Now I would like to ask a few questions about the people who are over 18 years old who live in the household Ahora, me gustaría hacerle algunas preguntas sobre las personas mayores de 18 años que viven en su hogar.
Q80 Starting with yourself, how old are you? Q80 Comenzando con usted, ¿qué edad tiene? (HA)
And are you male or female? (OBSERVE, ASK IF NEEDED) ¿Y es usted hombre o mujer? (PREGUNTE SÓLO DE SER NECESARIO)
(MN) And what is the age of the next person? ¿Qué edad tiene la siguiente persona? (HA) Is that person male or female? ¿Es esta persona hombre o mujer? (HA) Does that person smoke cigarettes? ¿Esta persona fuma cigarillos? Does that person use any other form of tobacco? ¿Esta persona utiliza alguna otra forma de tabaco? And what is the age of the next person etc. etc.
242
¿Qué edad tiene la siguiente persona? etc. etc. (HA) Person Age Sex Smoke Other Tobacco
RESPONDENT 1
M / F
2
M / F Y / N Y / N
3
M / F Y / N Y / N
4
M / F Y / N Y / N
5
M / F Y / N Y / N
6
M / F Y / N Y / N
7
M / F Y / N Y / N
8
M / F Y / N Y / N
9
M / F Y / N Y / N
Persona Edad Sexo Fuma Otro Tabaco
ENTREVISTADO 1 M /
F
2 M /
F S / N S / N
3 M /
F S / N S / N
4 M /
F S / N S / N
5 M /
F S / N S / N
6 M /
F S / N S / N
7 M /
F S / N S / N
8 M /
F S / N S / N
9 M /
F S / N S / N
243
Q81 What is your religion or religious orientation? ____________________________________ Q81 ¿Cuál es su religion u orientación religiosa? ____________________________________ Q82 What County do you live in? ____________________________________ Q82 ¿En qué condado vive usted? (MN) ____________________________________ Q83 In studies like this, households are often grouped according to income. What was
the total income for your household over the past year, including salaries or other earnings, interest, retirement and so on, for all household members combined?
, DOLLARS
DON’T KNOW REFUSED
IF R REFUSES OR CANNOT ESTIMATE INCOME: Q83 En estudios de este tipo, las unidades familiares frecuentemente se agrupan según
sus ingresos. ¿Cuánto sumó el ingreso total de todas las personas de su unidad familiar durante el año pasado, incluyendo salarios y otros ingresos, intereses, jubilación, etc.? (MN)
, DÓLARES
NO SABE REHUSÓ
IF R REFUSES OR CANNOT ESTIMATE INCOME:
244
Q84 How about if I give you some categories? Would you say it was more or less than $25,000 a year?
LESS
MORE
DON’T KNOW REFUSED
Q84 ¿Qué le parece si le menciono algunas categorías? ¿Podría decir que los ingresos
totales de su familia eran mayores o menores a$25,000 por año? (MN)
MENOR
MAYOR
NO SABE REHUSÓ
Q84a 1 Less than $5,000 2 $5,001 to $10,000 3 $10,001 to $15,000 4 $15,001 to $20,000 5 $20,001 to $25,000
Q84b 6 $25,001 to $30,000 7 $30,001 to $35,000 8 $35,001 to $40,000 9 $40,001 to $75,000 10 Over $75,000
Q84a 1 Menos de $5,000 2 $5,001 a $10,000 3 $10,001 a $15,000 4 $15,001 a $20,000 5 $20,001 a $25,000
Q84b 6 $25,001 a $30,000 7 $30,001 a $35,000 8 $35,001 a $40,000 9 $40,001 a $75,000 10 Más de $75,000
245
Appendix D Study Variables
246
Appendix D 1
Dependent Variables Dependent Variables Type Value Source Ever smokers Dichotomous Never smokers = 0; Ever smokers = 1 Created from DREGAN data set
Dfs Dichotomous former smokers = 0; Current smokers = 1 Created from DREGAN data set
Fwtq Trichotomous (fsmoker=1)=0 (Maintenance); (wtqsum= < 6)=1 (Preparation) ; (wtqsum>6)=2 (Precontemplation)
Created from DREGAN data set
Wtq Dichotomous (wtqsum= < 6)=1 (Preparation) ; (wtqsum>6)=2 (Precontemplation)
Created from DREGAN data set
s573G Trichotomous 1 and 2 = 0 (Precontemplation); 3 = 1 (Contemplation); 4 and 5 = 2 (Preparation)
Recoded from DREGAN data set
s582GT (WanttoQuit) Dichotomous 3 and 4 = 0; 1 and 2 = 1 Recoded from DREGAN data set
s592GT (DecidetoQuit) Dichotomous 3 and 4 = 0; 1 and 2 = 1 Recoded from DREGAN data set
s602GT (AskingforHelp) Dichotomous 3 and 4 = 0; 1 and 2 = 1 Recoded from DREGAN data set
rs61 (Willpower) Dichotomous 3 and 4 = 0; 1 and 2 = 1 Recoded from DREGAN data set
Appendix D 2 Hypothesis 1 Independent Variables
Independent Variables Type Value Source H1.1 Gender male Dichotomous 1= Male; 2=Female DREGAN data set
H1.2 Dage25 Dichotomous 1=>25 Years old Dummy variable
H1.3 Marital Status dq12 M Dichotomous 0=Not Married; 1=Married or marriage like DREGAN data set
H1.4 Dminors 1=18yo 0r <; 0=>18yo
Dichotomous Dminors<=18=1 Recoded from DREGAN data set
H1.5 dq28 Level of education Dichotomous 1=Completed High School or higher education DREGAN data set
H1.6 rs67 Employed Dichotomous rs67Employed=1 Recoded from DREGAN data set
H1.7 Dincome Dichotomous 1=More than $25,000 per household Dummy variable
H1.8 Place of residence Urban1 Dichotomous 1= Urban; 0=rural DREGAN data set
H1.9 Survey's language LangSurveySp
Dichotomous 0=English; 1=Spanish DREGAN data set
H1.10 Years living in the U.S. >5 YrUsa6
Dichotomous 0=Less than 6 years; 1=6 or more years living in the USA
DREGAN data set
H1.11 Fluency 2 HC dfluency2hc Dichotomous 0=USA oriented, Fluency2 0 to 2; 1=Home country oriented, Fluency2 2.1 to 4
DREGAN data set
H1.12 Orientation 4 Friends Dorient4f
Dichotomous 0=Friends little similar ethnicity, Orientation 4 0 to 2.5; 1=Friends very similar ethnicity, Orientation 2.6 to 5
DREGAN data set
247
Appendix D 3 Hypothesis 2 Independent Variables
Dependent Variables Type Value Source H2.1 Self Reported Healthy Rq1 Dichotomous 0=fair or poor health status;
1=excellent, very good, or good health status Dummy variable
H2.2 Self Reported Interesting Things in Daily Life Rq2
Dichotomous 0=A little or none of the time; 1=Most or some of the time
Dummy variable
H2.3 Self Reported Happiness Rq3 Dichotomous 0=Somewhat or very unhappy; 1=Somewhat or very happy
Dummy variable
H2.4Self Reported Healthy Compare to Other People Rs1
Dichotomous 0=fair or poor health status; 1=excellent, very good, or good health status
Dummy variable
H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2
Dichotomous 0=Not at all; 1=A little bit or a lot Dummy variable
H2.6 Physical Activity Past Week Rs23 Dichotomous 0=No; 1=Yes Dummy variable H2.7 Adequate Exercise – cumex Dichotomous 0=No; 1=Yes Dummy variable H2.8 Self Reported Stressful Events During the past month Rs32.
Dichotomous 0=No; 1=Yes Dummy variable
H2.9 Self reported Major Injury or illness in the Past Year Rs33a
Dichotomous 0=No; 1=Yes Dummy variable
H2.10 Change Residence in the Past Year Rs33b
Dichotomous 0=No; 1=Yes Dummy variable
H2.11 Major Change in Health of Relative in the past Year Rs33c
Dichotomous 0=No; 1=Yes Dummy variable
H2.12 Major Change Family Get-togethers in the Past Year Rs33d
Dichotomous 0=No; 1=Yes Dummy variable
H2.13 5 + fav dfav Dichotomous 0=Less than 4 servings of fruits and vegetables per day; 1=5 or more servings of fruits and vegetables per day
Dummy variable
H2.14 DBMI Dichotomous 0=Less than 18 or More than 24.9; 1=Normal (from 18 to 24.9)
Dummy variable
Appendix D 4
Hypothesis 3 Independent Variables Independent Variables Type Value Source H3.1 Smoking Facilitates Friendship Rs34a Dichotomous 0=No; 1=Yes Dummy variable H3.2 Smoking Provides Pleasure Rs34b Dichotomous 0=No; 1=Yes Dummy variable H3.3 Smoking Relieves Stress Rs34c Dichotomous 0=No; 1=Yes Dummy variable H3.4 Smoking Can Help focus on activities Rs34d Dichotomous 0=No; 1=Yes Dummy variable H3.5 Smoking helps to Lose Weight Rs34e Dichotomous 0=No; 1=Yes Dummy variable H3.6 No Positive Aspects of Smoking Rsmokeben Dichotomous 0=No; 1=Yes Dummy variable H3.7 Smoking Causes Lung Ca Rs76a Dichotomous 0=No; 1=Yes Dummy variable H3.8 Smoking Causes Heart Disease Rs76c Dichotomous 0=No; 1=Yes Dummy variable H3.9 People Smoke because they want to rs35 Dichotomous rs35 want=1 Dummy variable H3.10 People smoke because it is a habit rs36 Dichotomous rs36 habit = 1 Dummy variable H3.11 People who smoke cannot control they smoke or not rs37 Dichotomous rs37 no control = 1 Dummy variable H3.12 As long as you are healthy, it is OK to smoke rs38 Dichotomous rs38 healthy ok=1 Dummy variable H3.13 About smoking, there are more harms than benefits ds39 Dichotomous ds39 harms>ben=1 Dummy variable
Appendix D 5
Hypothesis 4 Independent Variables Independent Variables Type Value Source H4.1 Comfortable with others smoking around you Rs62 Dichotomous 0=No; 1=Yes Dummy variable H4.2 House someone smokes Rs64 Dichotomous 0=No; 1=Yes Dummy variable H4.3 Car someone smokes Rs66 Dichotomous 0=No; 1=Yes Dummy variable H4.4 smoking not Allowed at home Rs65 Dichotomous 0=No; 1=Yes Dummy variable H4.5 Someone smokes in work area Rs70 Dichotomous 0=No; 1=Yes Dummy variable H4.6 Smoking not permitted at work's common areas Rs71. Dichotomous 0=No; 1=Yes Dummy variable H4.7 Prefer works where smoking is not allowed Rs73 Dichotomous 0=No; 1=Yes Dummy variable H4.8 SHS (1=exposure to shs; 0=no shs) Dichotomous Exposed to SHS=1 Dummy variable H4.9 MinorsSHS Dichotomous Minors exposed to SHS=1 Dummy variable
248
Appendix D 6 Hypothesis 5 Independent Variables
Dependent Variables Type Value Source H5.1 Rchoadic Dichotomous Addiction=1 Choise=0 H5.2 Smoke cigarettes every day rs44 Dichotomous 0=No; 1=Yes Dummy variable H5.3 First cigarette smoked within 30 minutes after waking up rs52 Dichotomous 0=No; 1=Yes Dummy variable H5.4 Smoking more when facing stressful events rs53 Dichotomous 0=No; 1=Yes Dummy variable H5.5 Comfortable smoking around others rs54 Dichotomous 0=No; 1=Yes Dummy variable H5.6 Does not enjoy smoking rS56 Dichotomous 0=No; 1=Yes Dummy variable H5.7 Very likely to succeed if want to stop smoking rs58 Dichotomous 0=No; 1=Yes Dummy variable H5.8 Very likely to succeed if decide to stop smoking rs59 Dichotomous 0=No; 1=Yes Dummy variable H5.9 Very comfortable asking for help to stop smoking rs60 Dichotomous 0=No; 1=Yes Dummy variable H5.10 Ability to stop smoking through own will power rs61 Dichotomous 0=No; 1=Yes Dummy variable H5.11 Smoked first cigarette after 18 yo Ds50T18yo Dichotomous 0=No; 1=Yes Dummy variable H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo Dichotomous 0=No; 1=Yes Dummy variable H5.13 smokes= >5 cigarettes/day rs45 Dichotomous 0= smokes<5 cigarettes;
1= smokes= >5cigarettes/day
DREGAN data set
H5.14 Quitting smoking for a day or more in the past year Ds55 Dichotomous Ds55Quit=1 DREGAN data set
249
Appendix E Demographic Characteristics of the Sample
250
Appendix E 1 Demographic Characteristics of the Sample
Categorical Variables Categorical Variables N % Total Sample 805 100.00 Gender
Male 413 51.30 Female 392 48.70 Total 805 100.00
Marital Status of Respondents q12 Married 446 56.00 Marriage like 127 15.90 Separated 45 5.60 Divorced 51 6.40 Widowed 19 2.40 Never married 109 13.70 Total 797 100.00
Self-identify Ethnicity cq20 Latino / Hispanic 476 60.33 Latino / Hispanic-American 218 27.63 American 95 12.04 Total 789 100.00
Country of Origin Mexico 443 55.4 United States 194 24.3 Ecuador 29 3.6 El Salvador 27 3.4 Guatemala 23 2.9 Colombia 17 2.1 Puerto Rico 15 1.9 Peru 10 1.3 Honduras 8 1.0 Dominican Republic 5 .6 Argentina 4 .5 Cuba 4 .5 Nicaragua 4 .5 Spain 4 .5 Chile 3 .4 Costa Rica 3 .4 Venezuela 3 .4 Belize 1 .1 Cyprus 1 .1 Philippines 1 .1 Uruguay 1 .1 Total 800 100.0 Language of the survey
English 267 33.25 Spanish 536 66.75 Total 803 100.00
First Language Learned s4a English 113 14.00 Spanish 681 84.60 Other 11 1.40 Total 805 100.00
Living whit minors 18 years old or younger 0 236 29.30 1 569 70.70 Total 805 100.00
Type of Employment s67 For Wages 560 69.74 Self Employed 71 8.84 Do Not Work for Wages 172 21.42 Total 803 100.00
251
Appendix E 1 Demographic Characteristics of the Sample
Categorical Variables (Continuation) Categorical Variables N % Number of Current Jobs
1 527 83.80 2 89 14.10 3 13 2.10 Total 629 100.00
Primary Job Indoors 525 83.60 Outdoors 103 16.40 Total 628 100.00
Secondary Job Indoors 86 85.10 Outdoors 15 14.90 Total 101 100.00
Location of Primary Job Plant or Factory 148 28.20 Office or office building 91 17.40 Restaurant 83 15.80
Restaurant that serves alcohol 44 5.50* Some other place 57 10.90 Retail, convenient store, or warehouse 43 8.20 Home 40 7.60 Classroom 27 5.20 Hospital 20 3.80 Hotel or Motel 12 2.30 Vehicle 2 0.40 Bar or tavern 1 0.20 Total 568 100.00
* Included in Restaurants Level of Education
No formal education 18 2.30 Completed elementary school 150 18.80 Completed junior high school 141 17.70 High school graduate or GED 204 25.60 Technical, vocational training, or business school 53 6.60 Some college 107 13.40 College graduate BA/BS degree 84 10.50 Post graduate / professional school 40 5.00 Other 1 0.10 Total 798 100.00
Religion Catholic 547 68.20 Other Christian 189 23.57 Other Religion 9 1.12 None 53 6.61 Agnostic / Atheist 4 0.50 Total 802 100.00
County of Residence Hennepin 245 32.70 Ramsey 115 15.40 Rice 65 8.70 St. Louis 62 8.30 Olmsted 60 8.00 Polk 25 3.30 Steele 21 2.80 Clay 20 2.70 Anoka 19 2.50 Washington 18 2.40 Blue Earth 16 2.10 Other 83 11.10 Total 749 100.00
252
Appendix E 1 Demographic Characteristics of the Sample
Categorical Variables (Continuation) Categorical Variables N % Household Income Distribution
Less than $5,000 19 2.55 $5,001 to $10,000 55 7.37 $10,001 to $15,000 83 11.13 $15,001 to $20,000 76 10.19 $20,001 to $25,000 87 11.66 $25,001 to $30,000 84 11.26 $30,001 to $35,000 59 7.91 $35,001 to $40,000 50 6.70 $40,001 to $75,000 140 18.77 Over $75,000 93 12.47 Total 746 100.00
Appendix E 2 Demographic Characteristics of the Sample
Continuous Variables Continuous Variables N Mean Minimum Maximum SD
Age (q26) (s801) 805 37.91 18 91 12.58 Age of Entry to the US (q7) 594 23.82 0 63 9.87 Immigrant's Years Living in the US (q7) 594 12.66 0 90 10.33 Year Migrated to US 594 1,993 1,916 2,006 10.33 Years living in the US 594 12.66 0 90 10.33 Household Last Year Income (q29) 218 54,860.50 1,200 500,000 58,014.54 Number of People Living in Household (s78) 805 4.09 1 15 1.86 Number of Adults Living in Household (s79) 805 2.49 1 10 1.24
253
Appendix F Self-Reported Health Status, Physical Activity, and Stress
254
Appendix F 1 Self-Reported Health Status, Physical Activity, and Stress
Categorical Variables Categorical Variables N % Health S1 Self Reported Health Status Compared to Other People of Respondent's Age
Excellent 161 20.02 Very good 179 22.26 Good 264 32.84 Fair 178 22.14 Poor 22 2.74 Total 804 100.00
q1 Self Reported Physical Health Excellent 116 14.50 Very good 144 18.00 Good 274 34.25 Fair 218 27.25 Poor 48 6.00 Total 800 100.00
S2 Self Reported Injury or Illness Affecting Daily Routine During the Past 12 Months
Not at all 493 61.20 A little bit 252 31.30 A lot 60 7.50 Total 805 100.00
Physical Activity S23 Self Reported Physical Activity During the Past Seven Days
Yes 607 75.50 No 197 24.50 Total 804 100.00
TESTVIG Behavioral Risk Factor Surveillance System (BRFSS)~ Meets Definition of Adequate Moderate Exercise (At Least Five Times a Week for a Minimum of 30 Minutes per Time)
0 679 84.35 1 126 15.65 Total 805 100.00
TESTVIG Behavioral Risk Factor Surveillance System (BRFSS)~ Meets Definition of Adequate Vigorous Exercise (At Least Three Times a Week for a Minimum of 20 Minutes per Time)
0 585 72.70 1 220 27.30 Total 805 100.00
BRFSS Standard for Adequate Exercise (Moderate or Vigorous) in a Week
0 523 65.00 1 282 35.00 Total 805 100.00
BMI 18.5 – 24.9 207 27.8 <18.5 and = or >25 538 72.2 Total 745 100.00
Stress S32 Self Reported Stress During the Past Month
Extremely 64 7.95 Quite a bit 74 9.19 Some 226 28.07 A little 288 35.78 Not at all 153 19.01 Total 805 100.00
255
Appendix F 1 Self-Reported Health Status, Physical Activity, and Stress
Categorical Variables (Continuation) Categorical Variables N % S33a Self Reported Major Injury/Illness In the Past Year
Yes 130 16.20 No 673 83.80 Total 803 100.00
S33b Change Residence in the Past Year Yes 134 16.60 No 671 83.40 Total 805 100.00
S33c Major Change in Health/Behavior of a Family member in the Past Year
Yes 197 24.50 No 608 75.50 Total 805 100.00
S33d Major Change in the Number of Family Get-togethers in the Past Year
Yes 163 20.30 No 641 79.70 Total 804 100.00
RECODE: Number of Stressful Events in the Past Year 0 417 51.80 1 226 28.10 2 106 13.20 3 38 4.70 4 18 2.20 Total 805 100.00
Q2 Number of Interesting Things in Daily Life During the Past Month Most of the time 345 43.51 Some of the time 282 35.56 A little of the time 136 17.15 None of the time 30 3.78 Total 793 100.00
Q3 Self Reported Happiness with Personal Life During the Past Month Very happy 382 47.90 Somewhat happy 342 42.90 Somewhat unhappy 61 7.70 Very unhappy 12 1.50 Total 797 100.00
256
Appendix F 2 Summary of Health, Nutrition, Physical Activity and BMI
Continuous Variables Continuous Variables N Mean Minimum Maximum SD Health
s30=During the past 30 days, for about how many days did stress, poor physical health, or depression keep you from doing your usual activities? 799 2.42 0 30 6.24
s31=Now thinking about your physical health, which includes physical illness and injury, for how many days during the past 30 days was your physical health not good? 804 3.05 0 30 6.78 Physical Activity
Minutes Exercised During Most Recent Time - Moderate Exercise -S25 584 79.54 5 180 60.84
Days of Vigorous Exercise for at Least 10 Minutes the Past Seven Days (S26) 398 3.36 1 7 1.86 Minutes Exercised During Most Recent Time - Vigorous Exercise -S27 395 77.49 5 180 61.70 Nutrition
S28 Servings of Fruits Eaten Per Day over the Past Seven Days 804 1.92 0 14 1.49
S29 Servings of Vegetables Eaten Per Day over the Past Seven Days 782 1.65 0 10 1.21
Total Servings Fruits and Vegetables in last Day S28 804 3.53 0 20 2.23 BMI = Body Mass Index 745 28.17 16.1 61.2 5.22
S31c=Height Inches 750 64.79 55 78 3.97 S31b=Weight Pounds 800 166.27 90 341 34.08
257
Appendix G
Summary of Acculturation Categorical Variables Fluency N % Understanding of US Holidays q14a
Very well 578 72.30 Somewhat well 185 23.20 Not very well 28 3.50 Not at all 8 1.00 Total 799 100.00
Understanding of the "Minnesota Nice Celebration" q14b Very well 157 21.10 Somewhat well 141 19.00 Not very well 134 18.00 Not at all 311 41.90 Total 743 100.00
Understanding of Traditional Latino Weddings and Funerals Q15 Very well 530 66.00 Somewhat well 195 24.30 Not very well 55 6.80 Not at all 23 2.90 Total 803 100.00
Very Good Understanding of Latino Traditions q16 Strongly agree 489 61.20 Somewhat agree 246 30.80 Somewhat disagree 38 4.80 Strongly disagree 26 3.30 Total 799 100.10
S7a Understanding of US Sport Events Very well 202 25.10 Somewhat well 189 23.50 Not very well 184 22.90 Not at all 191 23.70 Do not follow sports 39 4.80 Total 805 100.00
S7b Understanding of US Legends Very well 119 14.90 Somewhat well 160 20.00 Not very well 117 14.60 Not at all 404 50.50 Total 800 100.00
S7c Understanding of the Boston Tea Party Very well 160 20.00 Somewhat well 168 21.00 Not very well 105 13.10 Not at all 368 45.90 Total 801 100.00
Very Good Understanding of American Ways -CS9B Strongly agree 335 42.10 Somewhat agree 251 31.60 Somewhat disagree 167 21.00 Strongly disagree 42 5.30 Total 795 100.00
Importance of Practicing Latino Ways at Home q17 Not at all 55 6.90 A little 113 14.10 Somewhat 204 25.50 Very 428 53.50 Total 800 100.00
258
Appendix G Summary of Acculturation Categorical Variables
Orientation N % Neighbors from the Same Ethnic Background - q18a
None 303 38.60 A few 219 27.90 Some 151 19.20 A lot 54 6.90 Almost all 58 7.40 Total 785 100.00
Close Friends from the Same Ethnic Background -Q18b N % None 86 10.80 A few 211 26.50 Some 184 23.10 A lot 135 16.90 Almost all 181 22.70 Total 797 100.00
S17 Casual Friends or Acquaintances from the Same Ethnic Background None 70 8.70 A few 210 26.10 Some 194 24.10 A lot 147 18.30 Almost all 183 22.80 Total 804 100.00
Self Reported Similarity to People Who Live in Country of Origin or Latin America –CQ19A Very similar 197 24.69 Somewhat similar 188 23.56 A little similar 85 10.65 A little different 86 10.78 Somewhat different 125 15.66 Very different 117 14.66 Total 798 100.00
CQ19B Self Reported Similarity to Typical White Minnesotan Very similar 89 11.40 Somewhat similar 120 15.40 A little similar 63 8.10 A little different 101 13.00 Somewhat different 162 20.80 Very different 244 31.30 Total 779 100.00
S19a Strong Identification with Latino Background Not at all 10 1.20 A little 83 10.30 Somewhat 198 24.70 A lot 512 63.80 Total 803 100.00
S20a Importance of Keeping in Touch With/Learning About Ethnic/Cultural Background Not at all 17 2.10 A little 73 9.10 Somewhat 214 26.60 A lot 501 62.20 Total 805 100.00
S21 Language of Conversations at Home More Spanish than English 436 54.20 More English than Spanish 157 19.50 About the same 212 26.30 Total 805 100.00
s22a Importance of Speaking Spanish to Keep Latino Identity Very important 517 64.38 Somewhat important 219 27.27 Not very important 52 6.48 Not at all important 15 1.87 Total 803 100.00
259
Appendix G Summary of Acculturation Categorical Variables
Orientation N % S22b Importance of Raising Children as Latinos to keep Latino Identity
Very important 474 59.00 Somewhat important 246 30.60 Not very important 59 7.30 Not at all important 25 3.10 Total 804 100.00
S22c Importance of Incorporating As Few American Ways As Possible to Keep Latino Identity Very important 231 29.20 Somewhat important 317 40.00 Not very important 142 17.90 Not at all important 102 12.90 Total 792 100.00
s22d Importance of Being Born in a Latino Country to Latino Identity Very important 405 50.80 Somewhat important 186 23.30 Not very important 107 13.40 Not at all important 100 12.50 Total 798 100.00
s22e Importance of Viewing Self Identity First As Latino, Second As an American to Keep Latino Identity Very important 396 49.60 Somewhat important 216 27.10 Not very important 92 11.50 Not at all important 94 11.80 Total 798 100.00
S22f Importance of Spending Time Primarily with Others of Same Ethnic Background To Keep Latino Identity
Very important 281 35.04 Somewhat important 302 37.66 Not very important 140 17.46 Not at all important 79 9.85 Total 802 100.00
S22g Importance of Marrying Someone of Same Cultural Background to Keep Latino Identity Very important 281 35.00 Somewhat important 194 24.20 Not very important 165 20.60 Not at all important 162 20.20 Total 802 100.00
s22h Importance of Following Events in Latin America to Keep Latino Identity Very important 296 36.86 Somewhat important 292 36.36 Not very important 125 15.57 Not at all important 90 11.21 Total 803 100.00
s22i Importance of Caring for Children in Traditional Latino Ways to Keep Latino Identity Very important 369 46.00 Somewhat important 293 36.50 Not very important 97 12.10 Not at all important 43 5.40 Total 802 100.00
S11 Change in the Language Spoken at Home since Moving to US No change at all 233 38.10 Very little change 155 25.40 Some change 135 22.10 A lot of change 88 14.40 Total 611 100.00
s12 Change in Sports Team Allegiance Since Moving to US A lot of change 240 39.30 Some change 124 20.30 Very little change 96 15.70 No change at all 88 14.40 Do not follow sports 63 10.30 Total 611 100.00
260
Appendix G Summary of Acculturation Categorical Variables
Orientation N % S13 Change in Food Eaten at Home since Moving to US
No change at all 139 22.70 Very little change 165 27.00 Some change 163 26.70 A lot of change 144 23.60 Total 611 100.00
S14 Change in Music Listened to since Moving to US No change at all 228 37.30 Very little change 130 21.30 Some change 151 24.70 A lot of change 102 16.70 Total 611 100.00
Similarity of Music Listened to Compared to a Typical White Minnesotan CS15A Very similar 109 13.64 Somewhat similar 90 11.26 A little similar 52 6.51 A little different 106 13.27 Somewhat different 169 21.15 Very different 273 34.17 Total 799 100.00
Similarity of Food Eaten Compared to a Typical White Minnesotan -CS15B Very similar 93 11.60 Somewhat similar 97 12.10 A little similar 62 7.70 A little different 112 13.90 Somewhat different 137 17.10 Very different 302 37.60 Total 803 100.00
Similarity of Verbal Expressions Used Compared to a Typical White Minnesotan CS15C Very similar 92 11.57 Somewhat similar 111 13.96 A little similar 56 7.04 A little different 107 13.46 Somewhat different 167 21.01 Very different 262 32.96 Total 795 100.00
Similarity of Sports Team Allegiance Compared to a Typical White Minnesotan CS15D Very similar 165 21.30 Somewhat similar 117 15.10 A little similar 77 9.90 A little different 100 12.90 Somewhat different 111 14.30 Very different 205 26.50 Total 775 100.00
s4a First Language Learned English 113 14.04 Spanish 681 84.60 Hmong 1 0.12 Filipino 1 0.12 Maya 2 0.25 Quechua 2 0.25 South American dialects 4 0.50 Other 1 0.12 Total 805 100.00
s4_b If Multiple First Languages - First Language Learned English 19 50.00 Spanish 17 44.74 Quechua 1 2.63 South American dialects 1 2.63 Total 38 100.00
261
Appendix G Summary of Acculturation Categorical Variables
Orientation N % s5_a Other Languages
English 534 66.50 Spanish 83 10.34 French 3 0.37 Portuguese 2 0.25 German 1 0.12 Italian 1 0.12 Chinese 1 0.12 Filipino 1 0.12 Catalan 1 0.12 Quechua 1 0.12 Other 3 0.37 No other language 172 21.42 Total 803 100.00
S5_B Other Languages English 10 10.90 American sign language 4 4.30 Spanish 2 2.20 French 25 27.20 Portuguese 5 5.40 German 6 6.50 Italian 8 8.70 Greek 1 1.10 Chinese 1 1.10 Other 3 3.30 No other 27 29.30 Total 92 100.00
Phenotype Self Reported Ethnicity Q20
Latino/Hispanic 440 74.07 Latino/Hispanic-American 131 22.05 American 23 3.87 Total 594 100.00
Self Reported Ethnicity Best Describes Respondents -Q20b Latino 36 18.50 Chicano 35 17.90 Hispanic 52 26.70 American 72 36.90 Total 195 100.00
Phenotype s3 Self Reported Perceived Ethnicity from the Perspective of a Typical White Minnesotan
Latino/Hispanic 660 86.60 Asian 6 0.80 Southeast Asian 1 0.10 White 77 10.10 African American 2 0.30 American Indian 16 2.10 Total 762 100.00
262
Appendix H Smoking Beliefs
Variables N % S34a Smoking Facilitate Friendship Yes 60 7.50 No 740 92.50 Total 800 100.00 s34b Smoking Provides Pleasure Yes 196 24.69 No 598 75.31 Total 794 100.00 s34c Smoking Relieves Stress/Anxiety Yes 226 29.31 No 545 70.69 Total 771 100.00 s34d Smoking Can Help a Person Focus Yes 82 10.41 No 706 89.59 Total 788 100.00 ps34e Smoking Helps to Lose Weight Yes 186 23.88 No 593 76.12 Total 779 100.00 RECODE: Number of Positive Aspects of Smoking (MAX=5) s34a-e 0 412 51.18 1 178 22.11 2 120 14.91 3 59 7.33 4 25 3.11 5 11 1.37 Total 805 100.00 S76 a Belief that Smoking Causes Lung Cancer Yes 794 99.13 No 7 0.87 Total 801 100.00 s76 c Belief that Smoking Causes Heart Disease Yes 716 93.23 No 52 6.77 Total 768 100.00 s35 People Smoke Because they Want to Strongly agree 435 54.17 Somewhat agree 182 22.67 Somewhat disagree 75 9.34 Strongly disagree 111 13.82 Total 803 100.00 s36 People Smoke Because it Is a Habit Strongly agree 463 57.66 Somewhat agree 177 22.04 Somewhat disagree 65 8.09 Strongly disagree 98 12.20 Total 803 100.00 s37 People Who Smoke Cannot Control whether They Smoke or not Strongly agree 250 31.33 Somewhat agree 201 25.19 Somewhat disagree 164 20.55 Strongly disagree 183 22.93 Total 798 100.00 S38 As Long As You Are Healthy, It Is OK to Smoke Strongly agree 21 2.62 Somewhat agree 31 3.86 Somewhat disagree 76 9.46 Strongly disagree 675 84.06 Total 803 100.00
263
Appendix H
Smoking Beliefs (Continuation) Variables N % s39 Beliefs About Smoking's Harms/Benefits There are more benefits than harms 11 1.37 There are more harms than benefits 735 91.3 The harms and benefits are about equal 59 7.33 Total 805 100
264
Appendix I Second-Hand Smoke Behaviors
Variables N % S62 Comfort Level When Other Latinos Smoke Around You
Very comfortable 72 8.99 Somewhat comfortable 67 8.36 Somewhat uncomfortable 161 20.10 Very uncomfortable 501 62.55 Total 801 100.00
s64 Smoking Inside Home During the Past 7 Days Yes 74 9.19 No 731 90.81 Total 805 100.00
s66 Been in a Car With Someone Who Was Smoking in the Past Seven Days Yes 153 19.01 No 652 80.99 Total 805 100.00
s65 Statement Best Describing Smoking Rules at Home Smoking is not allowed anywhere 732 91.04 Smoking is allowed some places 40 4.98 People can smoke anywhere 17 2.11 Other rule 15 1.87 Total 804 100.00
s70 Smoking in Work Area in the Past Seven Days Yes 86 16.38 No 439 83.62 Total 525 100.00
s71 Smoking Policy in Primary Job Facilities Smoking is not allowed in any common areas 441 84.48 Smoking is allowed in common areas 81 15.52 Total 522 100.00
s73 Work Place Preference Regarding Smoking Allowed 9 1.43 Not allowed 474 75.12 No difference 148 23.45 Total 631 100.00
Number of SHS Exposures In Past 7 Days (MAX=5.) 0 385 47.83 1 263 32.67 2 111 13.79 3 38 4.72 4 8 0.99 Total 805 100.00
Minors of 18 yo exposed to SHS Yes 293 36.40 No 512 63.60 Total 805 100.00
265
Appendix J
Smoking Behaviors Variables N % Choice Vs. Addiction Scale -Choice=2 Addiction=8 -s36-37
2 102 12.81 3 102 12.81 4 147 18.47 5 302 37.94 6 73 9.17 7 37 4.65 8 33 4.15 Total 796 100.00
rs44 Smoke cigarettes every day Yes 55 51.40 No 52 48.60 Total 107 100.00
S52 Minutes Between Waking and First Cigarette Within 5 minutes 6 5.70 6 - 30 minutes 12 11.30 31 - 60 minutes 16 15.10 More than 60 minutes 72 67.90 Total 106 100.00
s53 Amount of Smoking When Facing Stress A lot 16 14.95 A little more 37 34.58 The same amount 38 35.51 A little less 6 5.61 A lot less 10 9.35 Total 107 100.00
s54 Level of Comfort Smoking Around Other Latinos Very comfortable 20 19.23 Somewhat comfortable 29 27.88 Somewhat uncomfortable 31 29.81 Very uncomfortable 24 23.08 Total 104 100.00
s56 Feelings About Smoking I really enjoy smoking 7 6.60 I enjoy smoking 44 41.51 I don't like smoking 47 44.34 I really don't like smoking 8 7.55 Total 106 100.00
s57 Feelings About Quitting Smoking I don't think about stopping smoking 12 11.32 I don't want to stop smoking 6 5.66 I would like to stop smoking, but don't want to go through the process 30 28.30 I want to stop smoking 56 52.83 I would like to stop for some other reason 2 1.89 Total 106 100.00
S58 Belief About Ability to Stop Smoking if Wanted Very likely 54 51.43 Somewhat likely 34 32.38 Somewhat unlikely 9 8.57 Very unlikely 8 7.62 Total 105 100.00
s59 Belief About Ability to Stop Smoking if Decided Very likely 64 60.95 Somewhat likely 31 29.52 Somewhat unlikely 6 5.71 Very unlikely 4 3.81 Total 105 100.00
266
Appendix J Smoking Behaviors (Continuation)
Variable N % S60 Level of Comfort Asking for Help to Stop Smoking Very comfortable 42 41.58 Somewhat comfortable 18 17.82 Somewhat uncomfortable 27 26.73 Very uncomfortable 14 13.86 Total 101 100 S61 Will Power is the Only Way I Would Stop Smoking Strongly agree 81 77.14 Somewhat agree 15 14.29 Somewhat disagree 2 1.9 Strongly disagree 7 6.67 Total 105 100 ds50T18yo Tried the first cigarette after 18 yo Yes 48 20.51 No 186 79.49 Total 234 100 ds51R18yo Smoked regularly after 18 yo Yes 130 55.56 No 105 44.87 Total 234 100.43 rs45 Smokes 5 or more cigarettes daily Yes 35 63.64 No 20 36.36 Total 55 100 ds55quit Quitting smoking per a day or more during the last year Yes 74 73.27 No 27 26.73 Total 101 100
267
Appendix K Group Comparisons Given Socioeconomic Status
268
Appendix K 1
Never and Ever Smokers Given Socioeconomic Status Univariate
Multivariate Controlling by age and gender
Never Ever 95% CI Variable No % No % P FET OR Lower Upper P
H1.1 Gender Male 233 40.88 180 76.60 0.000 4.859 3.413 6.918 0.000 * H1.2 Dage 25 (Older than 24 yo) 491 86.14 215 91.49 0.044 1.122 0.608 2.073 0.713 H1.3 Marital Status dq12 M (married) 407 71.40 166 70.84 0.864 1.221 0.850 1.754 0.281 H1.4 Dminors 1=18yo 0r <; 0=>18yo 422 74.04 147 62.55 0.002 0.908 0.622 1.323 0.614 H1.5 dq28 Level of education (=>HS) 342 60.32 147 63.64 0.423 0.911 0.647 1.283 0.593 H1.6 rs67 Employed 429 75.53 202 85.96 0.001 0.745 0.460 1.205 0.229 H1.7 Dincome (>$25,000) 277 53.27 149 65.93 0.001 0.738 0.519 1.050 0.091 H1.8 Place of residence Urban1 366 64.21 148 62.98 0.747 0.979 0.693 1.384 0.906 H1.9 Survey's language LangSurveySp 403 70.70 133 56.60 0.000 1.582 1.123 2.229 0.009 * H1.10 Years living in the U.S. >5 YrUsa6 340 77.63 129 82.69 0.209 0.963 0.563 1.645 0.889 H1.11 Fluency 2 HC dfluency2hc 414 72.76 179 76.17 0.333 0.781 0.535 1.141 0.201 H1.12 Orientation 4 Friends Dorient4f 357 62.63 127 54.04 0.027 1.106 0.788 1.552 0.559
Appendix K 2 Former and Current Smokers Given Socioeconomic Status
Univariate Multivariate Controlling by age
and gender FS CS 95% CI
Variable No % No % P FET OR Lower Upper P H1.1 Gender Male 97 75.78 82 78.10 0.756 1.026 0.536 1.963 0.939 H1.2 Dage 25 (Older than 24 yo) 125 97.66 88 83.81 0.000 3.256 0.834 12.720 0.089 H1.3 Marital Status dq12 M (married) 102 79.69 63 60.00 0.001 2.879 1.518 5.460 0.001 * H1.4 Dminors 1=18yo 0r <; 0=>18yo 74 57.81 72 68.57 0.103 0.944 0.519 1.717 0.849 H1.5 dq28 Level of education (=>HS) 83 66.40 63 60.58 0.408 1.393 0.782 2.480 0.261 H1.6 rs67 Employed 108 84.38 92 87.62 0.572 1.482 0.610 3.600 0.385 H1.7 Dincome (>$25,000) 86 70.49 62 60.78 0.156 1.819 0.996 3.323 0.052 H1.8 Place of residence Urban1 79 61.72 67 63.81 0.786 1.347 0.742 2.447 0.327 H1.9 Survey's language LangSurveySp 71 55.47 61 58.10 0.693 0.967 0.558 1.677 0.906 H1.10 Years living in the U.S. >5 YrUsa6 69 85.19 59 79.73 0.403 0.866 0.339 2.214 0.764 H1.11 Fluency 2 HC dfluency2hc 97 75.78 80 76.19 1.000 0.982 0.519 1.861 0.956 H1.12 Orientation 4 Friends Dorient4f 61 47.66 64 60.95 0.048 0.701 0.403 1.218 0.207
Appendix K 3 Smokers in the Maintenance, Preparation,
and Pre-Contemplation SOC Given Socioeconomic Status Maintenance SOC Preparation SOC
Pre-contemplation SOC
Variable No % No % No % P FET H1.1 Gender Male 97 75.78 57 77.03 25 80.65 0.884 H1.2 Dage 25 (Older than 24 yo) 125 97.66 64 86.49 24 77.42 0.000 * H1.3 Marital Status dq12 M (married) 102 79.69 42 56.76 21 67.74 0.002 * H1.4 Dminors 1=18yo 0r <; 0=>18yo 74 57.81 48 64.86 24 77.42 0.119 H1.5 dq28 Level of education (=>HS) 83 66.40 41 56.16 22 70.97 0.246 H1.6 rs67 Employed 108 84.37 64 86.49 28 90.32 0.748 H1.7 Dincome (>$25,000) 86 70.49 43 59.72 19 63.33 0.292 H1.8 Place of residence Urban1 79 61.72 45 60.81 22 70.97 0.623 H1.9 Survey's language LangSurveySp 71 55.47 44 59.46 17 54.84 0.851 H1.10 Years living in the U.S. >5 YrUsa6 69 85.19 43 79.63 16 80.00 0.636 H1.11 Fluency 2 HC dfluency2hc 97 75.78 59 79.73 21 67.74 0.406 H1.12 Orientation 4 Friends Dorient4f 61 47.66 47 63.51 17 54.84 0.095
269
Appendix K 4
Smokers in the Preparation and Pre-Contemplation SOC Given Socioeconomic Status
Univariate
Multivariate Controlling by age
and gender Preparation
SOC Pre-contemplation
SOC 95% CI Variable No % No % P FET OR Lower Upper P H1.1 Gender Male 57 77.03 25 80.65 0.799 1.133 0.391 3.283 0.819 H1.2 Dage 25 (Older than 24 yo) 64 86.49 24 77.42 0.259 0.888 0.222 3.558 0.867 H1.3 Marital Status dq12 M (married) 42 56.76 21 67.74 0.383 0.565 0.222 1.439 0.231 H1.4 Dminors 1=18yo 0r <; 0=>18yo 48 64.86 24 77.42 0.253 0.608 0.223 1.654 0.330 H1.5 dq28 Level of education (=>HS) 41 56.16 22 70.97 0.191 0.539 0.215 1.352 0.188 H1.6 rs67 Employed 64 86.49 28 90.32 0.751 0.883 0.198 3.941 0.871 H1.7 Dincome (>$25,000) 43 59.72 19 63.33 0.295 0.949 0.382 2.360 0.911 H1.8 Place of residence Urban1 45 60.81 22 70.97 0.378 0.807 0.294 2.217 0.678 H1.9 Survey's language LangSurveySp 44 59.46 17 54.84 0.671 1.241 0.523 2.944 0.625 H1.10 Years living in the U.S. >5 YrUsa6 43 79.63 16 80.00 1.000 0.664 0.168 2.626 0.559 H1.11 Fluency 2 HC dfluency2hc 59 79.73 21 67.74 0.214 1.957 0.735 5.209 0.179 H1.12 Orientation 4 Friends Dorient4f 47 63.51 17 54.84 0.511 1.629 0.676 3.927 0.277
Appendix K 5 Smokers in the Preparation, Contemplation,
and Pre-Contemplation SOC Given Socioeconomic Status Pre-contemplation SOC
Contemplation SOC
Preparation SOC
Variable No % No % No % P FET H1.1 Gender Male 14 77.78 23 76.67 45 77.59 1.000 H1.2 Dage 25 (Older than 24 yo) 15 83.33 21 70.00 53 91.38 0.032 * H1.3 Marital Status dq12 M (married) 13 72.22 14 46.67 36 62.07 0.197 H1.4 Dminors 1=18yo 0r <; 0=>18yo 13 72.22 18 60.00 41 70.69 0.582 H1.5 dq28 Level of education (=>HS) 14 77.78 19 63.33 32 54.39 0.190 H1.6 rs67 Employed 15 83.33 27 90.00 51 87.93 0.846 H1.7 Dincome (>$25,000) 12 70.59 17 58.62 34 59.65 0.730 H1.8 Place of residence Urban1 10 55.56 23 76.67 35 60.34 0.220 H1.9 Survey's language LangSurveySp 10 55.56 15 50.00 36 62.07 0.551 H1.10 Years living in the U.S. >5 YrUsa6 11 91.67 17 73.91 31 79.49 0.581 H1.11 Fluency 2 HC dfluency2hc 16 88.89 19 63.33 46 79.31 0.117 H1.12 Orientation 4 Friends Dorient4f 8 44.44 21 70.00 36 62.07 0.206
270
Appendix K 6
Likelihood to succeed if Wanted to Quit Smoking Given Socioeconomic Status
Univariate Multivariate Controlling by age
and gender Unlikely Likely 95% CI
Variable No % No % P FET OR Lower Upper P H1.1 Gender Male 14 82.35 68 77.27 0.759 0.739 0.192 2.845 0.660 H1.2 Dage 25 (Older than 24 yo) 14 82.35 74 84.09 1.000 1.009 0.180 5.639 0.992 H1.3 Marital Status dq12 M (married) 10 58.82 53 60.23 1.000 0.895 0.302 2.652 0.841 H1.4 Dminors 1=18yo 0r <; 0=>18yo 13 76.47 59 67.05 0.573 1.645 0.476 5.680 0.432 H1.5 dq28 Level of education (=>HS) 10 58.82 53 60.23 1.000 0.919 0.317 2.663 0.877 H1.6 rs67 Employed 15 88.24 77 87.50 1.000 0.894 0.156 5.106 0.900 H1.7 Dincome (>$25,000) 12 70.59 50 58.82 0.425 1.626 0.518 5.103 0.405 H1.8 Place of residence Urban1 10 58.82 57 64.77 0.784 0.636 0.195 2.071 0.452 H1.9 Survey's language LangSurveySp 10 58.82 51 57.95 1.000 1.040 0.361 2.992 0.942 H1.10 Years living in the U.S. >5 YrUsa6 7 87.50 52 78.79 1.000 2.057 0.226 18.690 0.522 H1.11 Fluency 2 HC dfluency2hc 9 52.94 71 80.68 0.026 0.270 0.089 0.813 0.020 * H1.12 Orientation 4 Friends Dorient4f 8 47.06 56 63.64 0.278 0.495 0.172 1.430 0.194
Appendix K 7
Likelihood to Succeed if Decided to Quit Smoking Given Socioeconomic Status
Univariate Multivariate Controlling by age and
gender Unlikely Likely 95% CI
Variable No % No % P FET OR Lower Upper P H1.1 Gender Male 6 60.00 76 80.00 0.220 3.445 0.816 14.538 0.092 H1.2 Dage 25 (Older than 24 yo) 7 70.00 81 85.26 0.204 1.257 0.150 10.508 0.833 H1.3 Marital Status dq12 M (married) 6 60.00 57 60.00 1.000 1.651 0.381 7.162 0.503 H1.4 Dminors 1=18yo 0r <; 0=>18yo 10 100.00 62 65.26 0.029 NA H1.5 dq28 Level of education (=>HS) 7 70.00 56 58.95 0.736 1.411 0.326 6.115 0.645 H1.6 rs67 Employed 10 100.00 82 86.32 0.357 NA H1.7 Dincome (>$25,000) 6 60.00 56 60.87 1.000 0.985 0.245 3.961 0.983 H1.8 Place of residence Urban1 5 50.00 62 65.26 0.490 0.447 0.100 2.273 0.353 H1.9 Survey's language LangSurveySp 8 80.00 53 55.79 0.187 3.310 0.627 17.489 0.159 H1.10 Years living in the U.S. >5 YrUsa6 4 80.00 55 79.71 1.000 1.268 0.107 15.090 0.851 H1.11 Fluency 2 HC dfluency2hc 5 50.00 75 78.95 0.055 0.199 0.044 0.903 0.036 * H1.12 Orientation 4 Friends Dorient4f 6 60.00 58 61.05 1.000 0.882 0.219 3.558 0.860
Appendix K 8
Level of Comfort Asking for Help to Quit Smoking Given Socioeconomic Status
Univariate Multivariate Controlling by age
and gender Uncomfortable Comfortable 95% CI
Variable No % No % P FET OR Lower Upper P H1.1 Gender Male 33 80.49 46 76.67 0.807 0.806 0.302 2.148 0.666 H1.2 Dage 25 (Older than 24 yo) 33 80.49 52 86.67 0.420 0.603 0.159 2.279 0.455 H1.3 Marital Status dq12 M (married) 28 68.29 32 53.33 0.153 1.880 0.797 4.433 0.149 H1.4 Dminors 1=18yo 0r <; 0=>18yo 34 82.93 36 60.00 0.016 3.507 1.293 9.510 0.014 * H1.5 dq28 Level of education (=>HS) 25 60.98 36 61.02 1.000 0.990 0.434 2.258 0.981 H1.6 rs67 Employed 37 90.24 51 85.00 0.552 1.527 0.395 5.910 0.540 H1.7 Dincome (>$25,000) 26 63.41 33 56.90 0.540 1.263 0.549 2.905 0.583 H1.8 Place of residence Urban1 27 65.85 37 61.67 0.834 1.112 0.450 2.745 0.818 H1.9 Survey's language LangSurveySp 24 58.54 35 58.33 1.000 1.011 0.450 2.273 0.978 H1.10 Years living in the U.S. >5 YrUsa6 25 78.13 31 79.49 1.000 0.866 0.261 2.869 0.814 H1.11 Fluency 2 HC dfluency2hc 32 78.05 44 73.33 0.645 1.328 0.515 3.421 0.557 H1.12 Orientation 4 Friends Dorient4f 27 65.85 35 58.33 0.534 1.386 0.602 3.189 0.443
271
Appendix K 9 Agreement About the Only Way to Stop Smoking
is Through Will Power Given Socioeconomic Status Univariate
Multivariate Controlling by age and gender
Disagree Agree 95% CI
Variable No % No % P FET OR Lower Upper P H1.1 Gender Male 5 55.56 77 80.21 0.103 2.936 0.687 12.546 0.146 H1.2 Dage 25 (Older than 24 yo) 9 100.00 79 82.29 0.349 6.060E+07 0.000 - 0.999 H1.3 Marital Status dq12 M (married) 3 33.33 60 62.50 0.151 0.340 0.074 1.568 0.167 H1.4 Dminors 1=18yo 0r <; 0=>18yo 6 66.67 66 68.75 1.000 1.404 0.257 7.657 0.695 H1.5 dq28 Level of education (=>HS) 6 75.00 57 59.38 0.475 2.786 0.450 17.239 0.271 H1.6 rs67 Employed 5 55.56 87 90.62 0.013 0.194 0.037 1.022 0.053 * H1.7 Dincome (>$25,000) 3 37.50 59 62.77 0.257 0.547 0.108 2.764 0.466 H1.8 Place of residence Urban1 4 44.44 63 65.63 0.279 0.762 0.170 3.415 0.723 H1.9 Survey's language LangSurveySp 6 66.67 55 57.29 0.731 1.832 0.387 8.662 0.445 H1.10 Years living in the U.S. >5 YrUsa6 5 100.00 54 78.26 0.576 1.345E+08 0.000 - 0.998 H1.11 Fluency 2 HC dfluency2hc 8 88.89 72 75.00 0.683 3.181 0.315 32.160 0.327 H1.12 Orientation 4 Friends Dorient4f 7 77.78 57 59.38 0.477 0.292 0.048 1.763 0.180
272
Appendix L
Group Comparisons Given Self-Reported Health Status
273
Appendix L 1
Never and Ever Smokers Given Self-Reported Health Status Univariate Multivariate Controlling by age and gender
Never Ever 95% CI Variable No % No % P FET OR Lower Upper P
H2.1 Self Reported Healthy Rq1 377 66.49 157 67.38 0.869 0.970 0.683 1.380 0.868 H2.2 Self Reported Interesting Things in Daily Life Rq2 451 80.54 176 75.54 0.125 1.466 0.983 2.186 0.061 H2.3 Self Reported Happiness Rq3 519 91.86 205 88.36 0.137 1.794 1.033 3.115 0.038 * H2.4 Self Reported Healthy Compare to Other People Rs1 430 75.57 174 74.04 0.655 1.202 0.819 1.763 0.347 H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 208 36.49 104 44.26 0.047 0.778 0.557 1.086 0.139 H2.6 Physical Activity Past Week Rs23 421 73.99 186 79.15 0.126 0.937 0.630 1.396 0.751 H2.7 Adequate Exercise – cumex 191 33.51 91 38.72 0.168 1.050 0.774 1.481 0.783 H2.8 Self Reported Stressful Events During the past month Rs32. 456 80.00 196 83.40 0.279 0.677 0.439 1.044 0.078 H2.9 Self reported Major Injury or illness in the Past Year Rs33a 73 12.85 57 24.26 0.000 0.512 0.336 0.779 0.002 * H2.10 Change Residence in the Past Year Rs33b 97 17.02 37 15.74 0.755 1.070 0.685 1.671 0.768 H2.11 Major Change in Health of Relative in the past Year Rs33c 126 22.11 71 30.21 0.019 0.609 0.420 0.884 0.009 * H2.12 Major Change Family Get-togethers in the Past Year Rs33d 111 19.51 52 22.13 0.440 0.839 0.562 1.253 0.391 H2.13 5 + fav dfav 28 21.21 12 23.08 0.843 1.541 0.654 3.631 0.323 H2.14 DBMI 158 30.33 49 21.86 0.020 1.130 0.758 1.683 0.549
Appendix L 2 Former and Current Smokers Given Self-Reported Health Status
Univariate Multivariate Controlling by
age and gender FS CS 95% CI
Variable No % No % P FET OR Lower Upper P H2.1 Self Reported Healthy Rq1 83 65.35 73 70.19 0.481 0.932 0.518 1.679 0.815 H2.2 Self Reported Interesting Things in Daily Life Rq2 95 74.80 80 76.92 0.759 0.944 0.498 1.791 0.861 H2.3 Self Reported Happiness Rq3 113 88.98 90 87.38 0.837 1.149 0.490 2.694 0.749 H2.4 Self Reported Healthy Compare to Other People Rs1 92 71.88 80 76.19 0.549 0.981 0.521 1.849 0.954 H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 54 42.19 50 47.62 0.429 0.776 0.448 1.344 0.366 H2.6 Physical Activity Past Week Rs23 103 80.47 82 78.10 0.745 1.218 0.625 2.375 0.562 H2.7 Adequate Exercise – cumex 49 38.28 41 39.05 1.000 0.928 0.525 1.637 0.795 H2.8 Self Reported Stressful Events During the past month Rs32. 107 83.59 88 83.81 1.000 1.059 0.508 2.204 0.879 H2.9 Self reported Major Injury or illness in the Past Year Rs33a 30 23.44 26 24.76 0.878 0.844 0.444 1.602 0.603 H2.10 Change Residence in the Past Year Rs33b 19 14.84 18 17.14 0.719 0.964 0.460 2.021 0.923 H2.11 Major Change in Health of Relative in the past Year Rs33c 40 31.25 31 29.52 0.886 1.026 0.565 1.864 0.933 H2.12 Major Change Family Get-togethers in the Past Year Rs33d 31 24.22 21 20.00 0.528 1.195 0.618 2.311 0.597 H2.13 5 + fav dfav 7 24.14 5 23.81 1.000 0.945 0.232 3.849 0.937 H2.14 DBMI 20 16.67 29 28.43 0.051 0.545 0.272 1.089 0.086
274
Appendix L 3 Smokers in the Maintenance, Preparation, and
Pre-Contemplation SOC Given Self-Reported Health Status Maintenance SOC
Preparation SOC
Pre-contemplation SOC
Variable No % No % No % P FET H2.1 Self Reported Healthy Rq1 83 65.35 53 72.60 20 64.52 0.542 H2.2 Self Reported Interesting Things in Daily Life Rq2 95 74.80 60 82.19 20 64.52 0.151 H2.3 Self Reported Happiness Rq3 113 88.98 63 87.50 27 87.10 0.879 H2.4 Self Reported Healthy Compare to Other People Rs1 92 71.88 56 75.68 24 77.42 0.794 H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 54 42.19 33 44.59 17 54.84 0.437 H2.6 Physical Activity Past Week Rs23 103 80.47 55 74.32 27 87.10 0.337 H2.7 Adequate Exercise – cumex 49 38.28 28 37.84 13 41.94 0.946 H2.8 Self Reported Stressful Events During the past month Rs32. 107 83.59 64 86.49 24 77.42 0.491 H2.9 Self reported Major Injury or illness in the Past Year Rs33a 30 23.44 17 22.97 9 29.03 0.748 H2.10 Change Residence in the Past Year Rs33b 19 14.84 12 16.22 6 19.35 0.768 H2.11 Major Change in Health of Relative in the past Year Rs33c 40 31.25 17 22.97 14 45.16 0.084 H2.12 Major Change Family Get-togethers in the Past Year Rs33d 31 24.22 11 14.86 10 32.26 0.105 H2.13 5 + fav dfav 7 24.14 5 29.41 - - 0.600 H2.14 DBMI 20 16.67 18 25.35 11 35.48 0.061
Appendix L 4 Smokers in the Preparation and Pre-Contemplation SOC
Given Self-Reported Health Status Univariate
Multivariate Controlling by age and gender 95% CI
Preparation SOC
Pre-contemplation
SOC
Variable No % No % P FET OR Lower Upper P
H2.1 Self Reported Healthy Rq1 53 72.60 20 64.52 0.484 1.650 0.652 4.176 0.290 H2.2 Self Reported Interesting Things in Daily Life Rq2 60 82.19 20 64.52 0.074 2.645 1.000 6.996 0.050 * H2.3 Self Reported Happiness Rq3 63 87.50 27 87.10 1.000 1.053 0.288 3.848 0.938 H2.4 Self Reported Healthy Compare to Other People Rs1 56 75.68 24 77.42 1.000 1.042 0.374 2.908 0.937 H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 33 44.59 17 54.84 0.395 0.687 0.290 1.630 0.395 H2.6 Physical Activity Past Week Rs23 55 74.32 27 87.10 0.199 0.428 0.130 1.403 0.161 H2.7 Adequate Exercise – cumex 28 37.84 13 41.94 0.827 0.870 0.350 2.164 0.765 H2.8 Self Reported Stressful Events During the past month Rs32. 64 86.49 24 77.42 0.259 2.163 0.709 6.593 0.175 H2.9 Self reported Major Injury or illness in the Past Year Rs33a 17 22.97 9 29.03 0.621 0.642 0.239 1.722 0.378 H2.10 Change Residence in the Past Year Rs33b 12 16.22 6 19.35 0.778 0.765 0.249 2.346 0.639 H2.11 Major Change in Health of Relative in the past Year Rs33c 17 22.97 14 45.16 0.034 0.314 0.123 0.802 0.015 * H2.12 Major Change Family Get-togethers in the Past Year Rs33d 11 14.86 10 32.26 0.060 0.349 0.126 0.967 0.043 * H2.13 5 + fav dfav 5 29.41 0 0 0.532 NA H2.14 DBMI 18 25.35 11 35.48 0.343 0.625 0.244 1.600 0.327
275
Appendix L 5 Smokers in the Preparation, Contemplation, and Pre-Contemplation SOC
Given Self-Reported Health Status Pre-contemplation SOC
Contemplation SOC
Preparation SOC
Variable No % No % No % P FET H2.1 Self Reported Healthy Rq1 15 83.33 18 60.00 42 71.93 0.242 H2.2 Self Reported Interesting Things in Daily Life Rq2 13 72.22 20 66.67 48 84.21 0.152 H2.3 Self Reported Happiness Rq3 16 88.89 27 90.00 48 85.71 0.921 H2.4 Self Reported Healthy Compare to Other People Rs1 16 88.89 23 76.67 42 72.41 0.405 H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 8 44.44 14 46.67 28 48.28 0.965 H2.6 Physical Activity Past Week Rs23 16 88.89 20 66.67 46 79.31 0.197 H2.7 Adequate Exercise – cumex 7 38.89 10 33.33 24 41.38 0.737 H2.8 Self Reported Stressful Events During the past month Rs32. 14 77.78 24 80.00 51 87.93 0.395 H2.9 Self reported Major Injury or illness in the Past Year Rs33a 4 22.22 7 23.33 16 27.59 0.867 H2.10 Change Residence in the Past Year Rs33b 4 22.22 8 26.67 6 10.34 0.114 H2.11 Major Change in Health of Relative in the past Year Rs33c 6 33.33 10 33.33 15 25.86 0.676 H2.12 Major Change Family Get-togethers in the Past Year Rs33d 5 27.78 7 23.33 9 15.52 0.375 H2.13 5 + fav dfav - - 1 16.67 4 33.33 0.524 H2.14 DBMI 7 38.89 6 20.69 16 28.57 0.420
Appendix L 6 Likelihood to Succeed if Wanted to Quit Given Self-Reported Health Status
Univariate Multivariate Controlling by age and
gender Unlikely Likely 95% CI
Variable No % No % P FET OR Lower Upper P H2.1 Self Reported Healthy Rq1 12 70.59 61 70.11 1.000 1.009 0.320 3.176 0.998 H2.2 Self Reported Interesting Things in Daily Life Rq2 14 82.35 66 75.86 0.756 1.492 0.390 5.709 0.559 H2.3 Self Reported Happiness Rq3 13 76.47 77 89.53 0.221 0.346 0.090 1.335 0.123 H2.4 Self Reported Healthy Compare to Other People Rs1 12 70.59 68 77.27 0.545 0.670 0.207 2.165 0.503 H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 9
52.94 41
46.59 0.792 1.257 0.442 3.581 0.668
H2.6 Physical Activity Past Week Rs23 14 82.35 68 77.27 0.759 1.337 0.347 5.161 0.673 H2.7 Adequate Exercise – cumex 3 17.65 38 43.18 0.049 0.242 0.603 0.929 0.039 * H2.8 Self Reported Stressful Events During the past month Rs32. 13
76.47 75
85.23 0.470 0.559 0.156 2.004 0.372
H2.9 Self reported Major Injury or illness in the Past Year Rs33a 7
41.18 19
21.59 0.123 2.826 0.920 8.679 0.070
H2.10 Change Residence in the Past Year Rs33b 3 17.65 15 17.05 1.000 1.092 0.275 4.330 0.901 H2.11 Major Change in Health of Relative in the past Year Rs33c 5
29.41 26 29.55 1.000 1.033 0.327 3.263 0.955
H2.12 Major Change Family Get-togethers in the Past Year Rs33d 2
11.76 19
21.59 0.514 0.492 0.103 2.351 0.374
H2.13 5 + fav dfav 0 0 5 27.78 0.549 NA H2.14 DBMI 6 35.29 23 27.06 0.559 1.497 0.491 4.561 0.478
276
Appendix L 7 Likelihood to Succeed if Decided to Quit Given Self-Reported Health Status
Univariate Multivariate Controlling by age and gender
Unlikely Likely 95% CI
Variable No %
No %
P FET OR Lower Upper P
H2.1 Self Reported Healthy Rq1 8 80.00 65 69.15 0.719 1.367 0.258 7.243 0.713 H2.2 Self Reported Interesting Things in Daily Life Rq2 8 80.00 72 76.60 1.000 1.256 0.235 6.722 0.790 H2.3 Self Reported Happiness Rq3 7 70.00 83 89.25 0.112 0.313 0.064 1.541 0.153 H2.4 Self Reported Healthy Compare to Other People Rs1 7 70.00 73 76.84 0.699 0.571 0.127 2.575 0.466 H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 5 50.00 45 47.37 1.000 1.243 0.313 4.946 0.757 H2.6 Physical Activity Past Week Rs23 8 80.00 74 77.89 1.000 1.174 0.214 6.422 0.854 H2.7 Adequate Exercise – cumex 3 30.00 38 40.00 0.737 0.905 0.186 4.394 0.902 H2.8 Self Reported Stressful Events During the past month Rs32. 8 80.00 80 84.21 0.663 0.498 0.086 2.896 0.435 H2.9 Self reported Major Injury or illness in the Past Year Rs33a 3 30.00 23 24.21 0.706 1.302 0.289 5.874 0.731 H2.10 Change Residence in the Past Year Rs33b 1 10.00 17 17.89 1.000 0.398 0.044 3.631 0.414 H2.11 Major Change in Health of Relative in the past Year Rs33c 3 30.00 28 29.47 1.000 0.882 0.195 3.984 0.871 H2.12 Major Change Family Get-togethers in the Past Year Rs33d 1 10.00 20 21.05 0.683 0.411 0.048 3.542 0.418 H2.13 5 + fav dfav ND H2.14 DBMI 3 33.33 26 27.96 0.711 1.072 0.235 4.892 0.928
Appendix L 8 Level of Comfort Asking for Help to Quit
Given Self-Reported Health Status Univariate
Multivariate Controlling by age and gender
Uncomfortable Comfortable 95% CI
Variable No % No % P FET OR Lower Upper P
H2.1 Self Reported Healthy Rq1 29 70.73 40 67.80 0.828 1.131 0.472 2.710 0.783 H2.2 Self Reported Interesting Things in Daily Life Rq2 35 85.37 41 69.49 0.095 2.576 0.920 7.214 0.072 H2.3 Self Reported Happiness Rq3 34 82.93 52 89.66 0.375 0.524 0.158 1.732 0.289 H2.4 Self Reported Healthy Compare to Other People Rs1 32 78.05 44 73.33 0.645 1.250 0.483 3.231 0.645 H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 19 46.34 31 51.67 0.687 0.789 0.354 1.758 0.562 H2.6 Physical Activity Past Week Rs23 35 85.37 44 73.33 0.220 2.113 0.746 5.988 0.159 H2.7 Adequate Exercise – cumex 21 51.22 19 31.67 0.063 2.299 0.976 5.414 0.057 * H2.8 Self Reported Stressful Events During the past month Rs32. 38 92.68 48 80.00 0.094 3.258 0.852 12.457 0.084 H2.9 Self reported Major Injury or illness in the Past Year Rs33a 7 17.07 19 31.67 0.111
0.454
0.167
1.231
0.121
H2.10 Change Residence in the Past Year Rs33b 6 14.63 12 20.00 0.600 0.706 0.239 2.083 0.528 H2.11 Major Change in Health of Relative in the past Year Rs33c 11 26.83 20 33.33 0.518
0.755 0.312 1.826 0.532
H2.12 Major Change Family Get-togethers in the Past Year Rs33d 9 21.95 11 18.33 0.800 1.259 0.468 3.391 0.648 H2.13 5 + fav dfav 1 16.67 4 28.57 1.000 0.341 0.028 4.102 0.396 H2.14 DBMI 11 28.21 15 25.42 0.817 1.179 0.471 2.953 0.725
277
Appendix L 9 Agreement About the Only Way to Stop Smoking is Through Will Power
Given Self-Reported Health Status Univariate
Multivariate Controlling by age and gender
Disagree Agree 95% CI
Variable No %
No %
P FET OR
Lower Upper P
H2.1 Self Reported Healthy Rq1 3 37.50 70 72.92 0.049 0.264 0.054 1.286 0.099 H2.2 Self Reported Interesting Things in Daily Life Rq2 5 62.50 75 78.13 0.382 0.362 0.071 1.837 0.220 H2.3 Self Reported Happiness Rq3 5 62.50 85 89.47 0.061 0.182 0.032 1.037 0.055 * H2.4 Self Reported Healthy Compare to Other People Rs1 6 66.67 74 77.08 0.442
0.928
0.185
4.659
0.928
H2.5 Self Reported Injury or Illness affecting daily routine during the past 12 months Rs2 5 55.56 45 46.88 0.733
1.572
0.374
6.607
0.537
H2.6 Physical Activity Past Week Rs23 8 88.89 74 77.08 0.680 2.671 0.292 24.403 0.384 Moderate Exercise modex 8 88.89 72 75.00 0.683 3.408 0.383 30.314 0.271 Vigorous Exercise – vigex 5 55.56 56 58.33 1.000 1.364 0.308 6.043 0.683 H2.7 Adequate Exercise – cumex 3 33.33 38 39.58 1.000 1.068 0.223 5.120 0.934 H2.8 Self Reported Stressful Events During the past month Rs32. 8 88.89 80 83.33 1.000 1.674
0.186
15.024
0.646
H2.9 Self reported Major Injury or illness in the Past Year Rs33a 6 66.67 20 20.83 0.007
5.736
1.216
27.051
0.027 *
H2.10 Change Residence in the Past Year Rs33b 3 33.33 15 15.63 0.182 2.332 0.486 11.202 0.290 H2.11 Major Change in Health of Relative in the past Year Rs33c 5 55.56 26 27.08 0.120 2.707 0.631 11.612 0.180 H2.12 Major Change Family Get-togethers in the Past Year Rs33d 2 22.22 19 19.79 1.000
0.907
0.151
5.453
0.915
H2.13 5 + fav dfav 0
0.00 5 26.32 1.000 0.000 0.000 - 0.999 H2.14 DBMI 8 88.89 21 22.58 0.000 39.402 3.799 408.623 0.002 *
278
Appendix M Group Comparisons Given Beliefs About Smoking
279
Appendix M 1
Never and Ever Smokers Given Beliefs About Smoking Univariate
Multivariate Controlling by age and gender
Never Ever 95% CI
Variable No % No % P FET OR Lower Upper P
H3.1 Smoking Facilitates Friendship Rs34a 34 6.00 26 11.16 0.017 0.641 0.359 1.146 0.134 H3.2 Smoking Provides Pleasure Rs34b 102 18.25 94 40.00 0.000 0.364 0.252 0.526 0.000 * H3.3 Smoking Relieves Stress Rs34c 114 21.07 112 48.70 0.000 0.278 0.194 0.400 0.000 * H3.4 Smoking Can Help focus on activities Rs34d 48 8.63 34 14.66 0.015 0.800 0.477 1.341 0.397 H3.5 Smoking helps to Lose Weight Rs34e 119 21.64 67 29.26 0.027 0.830 0.567 1.214 0.336 H3.6 No Positive Aspects of Smoking Rsmokeben 336 58.95 76 32.34 0.000 2.600 1.848 3.660 0.000 * H3.7 Smoking Causes Lung Ca Rs76a 563 99.30 231 98.72 0.423 1.329 0.250 7.056 0.739 H3.8 Smoking Causes Heart Disease Rs76c 509 94.09 207 91.19 0.157 2.252 1.175 4.314 0.014 * H3.9 People Smoke because they want to rs35 445 78.35 172 73.19 0.119 0.974 0.661 1.433 0.892 H3.10 People smoke because it is a habit rs36 446 78.52 194 82.55 0.211 0.797 0.522 1.219 0.295 H3.11 People who smoke cannot control they smoke or not rs37 320 56.74 131 55.98 0.875 1.079 0.774 1.505 0.653 H3.12 As long as you are healthy, it is OK to smoke rs38 39 6.87 13 5.53 0.532 1.282 0.645 2.548 0.478 H3.13 About smoking, there are more harms than benefits ds39 522 91.58 213 90.64 0.681 1.236 0.688 2.217 0.478
Appendix M 2 Former and Current Smokers Given Beliefs About Smoking
Univariate Multivariate Controlling by age
and gender FS CS 95% CI
Variable No % No % P FET OR Lower
Upper P
H3.1 Smoking Facilitates Friendship Rs34a 16 12.50 10 9.52 0.533 1.230 0.505 2.996 0.649 H3.2 Smoking Provides Pleasure Rs34b 49 38.28 44 41.90 0.593 0.708 0.403 1.244 0.229 H3.3 Smoking Relieves Stress Rs34c 53 43.09 57 54.29 0.111 0.696 0.400 1.211 0.200 H3.4 Smoking Can Help focus on activities Rs34d 15 11.90 17 16.35 0.346 0.581 0.259 1.304 0.188 H3.5 Smoking helps to Lose Weight Rs34e 42 34.15 24 22.86 0.078 1.605 0.864 2.982 0.134 H3.6 No Positive Aspects of Smoking Rsmokeben 48 37.50 28 26.67 0.092 1.839 1.018 3.323 0.044 * H3.7 Smoking Causes Lung Ca Rs76a 127 99.22 102 98.08 0.589 5.086 0.441 58.593 0.191 H3.8 Smoking Causes Heart Disease Rs76c 116 93.55 90 89.11 0.335 1.668 0.609 4.567 0.320 H3.9 People Smoke because they want to rs35 92 71.88 80 76.19 0.549 0.969 0.515 1.822 0.921 H3.10 People smoke because it is a habit rs36 108 84.38 105 100.00 0.492 1.434 0.693 2.967 0.332 H3.11 People who smoke cannot control they smoke or not rs37 68 53.54 62 59.05 0.427 0.828 0.477 1.438 0.502 H3.12 As long as you are healthy, it is OK to smoke rs38 5 3.91 7 6.67 0.384 0.642 0.183 2.247 0.488 H3.13 About smoking, there are more harms than benefits ds39 123 96.09 89 84.76 0.005 6.472 2.044 20.494 0.001 *
280
Appendix M 3 Smokers in the Maintenance, Preparation,
and Pre-Contemplation SOC Given Beliefs About Smoking Maintenance SOC
Preparation SOC
Pre-contemplation SOC
Variable No %
No % No % P FET H3.1 Smoking Facilitates Friendship Rs34a 16 12.7 4 5.41 6 19.35 0.084 H3.2 Smoking Provides Pleasure Rs34b 41 32.28 27 36.49 17 54.84 0.199 H3.3 Smoking Relieves Stress Rs34c 53 43.09 43 58.11 14 45.16 0.113 H3.4 Smoking Can Help focus on activities Rs34d 15 11.9 11 15.07 6 19.35 0.495 H3.5 Smoking helps to Lose Weight Rs34e 42 34.15 16 21.62 8 25.81 0.162 H3.6 No Positive Aspects of Smoking Rsmokeben 48 37.5 21 28.38 7 22.58 0.185 H3.7 Smoking Causes Lung Ca Rs76a 127 99.22 71 97.26 31 100 0.545 H3.8 Smoking Causes Heart Disease Rs76c 116 93.55 64 91.43 26 83.87 0.213 H3.9 People Smoke because they want to rs35 92 71.87 58 78.38 22 70.97 0.551 H3.10 People smoke because it is a habit rs36 108 84.37 58 78.38 27 87.1 0.474 H3.11 People who smoke cannot control they smoke or not rs37 68 53.54 46 62.16 16 51.61 0.444 H3.12 As long as you are healthy, it is OK to smoke rs38 5 3.91 5 6.76 2 6.45 0.633 H3.13 About smoking, there are more harms than benefits ds39 123 96.09 62 83.78 27 87.1 0.007 *
Appendix M 4 Smokers in the Preparation, and Pre-Contemplation SOC
Given Beliefs About Smoking Univariate
Multivariate Controlling by age and gender
Preparation SOC
Pre-contemplation
SOC 95% CI
Variable
No % No % P
FET OR
Lower
Upper P H3.1 Smoking Facilitates Friendship Rs34a 4 5.41 6 19.35 0.061 0.216 0.052 0.891 0.034 * H3.2 Smoking Provides Pleasure Rs34b 27 36.49 17 54.84 0.089 0.373 0.150 0.930 0.034 * H3.3 Smoking Relieves Stress Rs34c 43 58.11 14 45.16 0.284 1.771 0.730 4.296 0.206 H3.4 Smoking Can Help focus on activities Rs34d 11 15.07 6 19.35 0.575 0.716 0.233 2.200 0.560 H3.5 Smoking helps to Lose Weight Rs34e 16 21.62 8 25.81 0.621 0.806 0.298 2.181 0.671 H3.6 No Positive Aspects of Smoking Rsmokeben 21 28.38 7 22.58 0.633 1.514 0.551 4.161 0.421 H3.7 Smoking Causes Lung Ca Rs76a 71 97.26 31 100.00 1.000 NA H3.8 Smoking Causes Heart Disease Rs76c 64 91.43 26 83.87 0.305 1.972 0.530 7.329 0.311 H3.9 People Smoke because they want to rs35 58 78.38 22 70.97 0.456 2.220 0.768 6.419 0.141 H3.10 People smoke because it is a habit rs36 58 78.38 27 87.10 0.416 0.508 0.151 1.709 0.274 H3.11 People who smoke cannot control they smoke or not rs37 46 62.16 16 51.61 0.386 1.492 0.629 3.536 0.364 H3.12 As long as you are healthy, it is OK to smoke rs38 5 6.76 2 6.45 1.000 1.189 0.209 6.754 0.845 H3.13 About smoking, there are more harms than benefits ds39 62 83.78 27 87.10 0.773 0.927 0.261 3.287 0.907
281
Appendix M 5 Smokers in the Preparation, Contemplation,
and Pre-Contemplation SOC Given Beliefs About Smoking Pre-contemplation SOC
Contemplation SOC
Preparation SOC
Variable No % No % No % P FET H3.1 Smoking Facilitates Friendship Rs34a 3 16.67 1 3.33 6 10.34 0.254 H3.2 Smoking Provides Pleasure Rs34b 8 44.44 15 50.00 22 37.93 0.551 H3.3 Smoking Relieves Stress Rs34c 8 44.44 21 70.00 29 50.00 0.126 H3.4 Smoking Can Help focus on activities Rs34d 2 11.11 7 23.33 9 15.79 0.564 H3.5 Smoking helps to Lose Weight Rs34e 3 17.65 6 20.00 15 25.86 0.772 H3.6 No Positive Aspects of Smoking Rsmokeben 4 22.22 6 20.00 18 31.03 0.522 H3.7 Smoking Causes Lung Ca Rs76a 17 94.44 30 100.00 56 98.25 0.395 H3.8 Smoking Causes Heart Disease Rs76c 15 83.33 25 83.33 51 94.44 0.158 H3.9 People Smoke because they want to rs35 14 77.78 25 83.33 41 70.69 0.456 H3.10 People smoke because it is a habit rs36 16 88.89 24 80.00 45 77.59 0.711 H3.11 People who smoke cannot control they smoke or not rs37 11 61.11 14 46.67 38 65.52 0.254 H3.12 As long as you are healthy, it is OK to smoke rs38 2 11.11 3 10.00 3 5.17 0.542 H3.13 About smoking, there are more harms than benefits ds39 12 66.67 27 90.00 50 86.21 0.108
Appendix M 6 Likelihood to Succeed if Wanted to Quit Given Beliefs About Smoking
Univariate Multivariate Controlling
by age and gender
Unlikely Likely 95% CI
Variable No % No % P FET OR Lower Upper P
H3.1 Smoking Facilitates Friendship Rs34a 3 17.65 7 7.95 0.204 2.391 0.534 10.700 0.254 H3.2 Smoking Provides Pleasure Rs34b 9 2.94 35 39.77 0.422 1.859 0.635 5.410 0.258 H3.3 Smoking Relieves Stress Rs34c 10 58.82 47 53.41 0.793 1.320 0.450 3.871 0.613 H3.4 Smoking Can Help focus on activities Rs34d 4 23.53 13 14.77 0.472 1.747 0.491 6.110 0.389 H3.5 Smoking helps to Lose Weight Rs34e 6 35.29 18 20.45 0.211 2.112 0.687 6.493 0.192 H3.6 No Positive Aspects of Smoking Rsmokeben 4 23.53 24 27.27 1.000 0.784 0.230 .672 0.697 H3.7 Smoking Causes Lung Ca Rs76a 17 100.00 85 97.70 1.000 NA H3.8 Smoking Causes Heart Disease Rs76c 15 88.24 75 89.29 1.000 0.881 0.169 4.599 0.881 H3.9 People Smoke because they want to rs35 11 64.71 69 78.41 0.228 0.455 0.136 1.520 0.201 H3.10 People smoke because it is a habit rs36 14 82.35 71 80.68 1.000 1.133 0.291 4.406 0.857 H3.11 People who smoke cannot control they smoke or not rs37 7 41.18 55 62.50 0.114 0.423 0.146 1.221 0.112 H3.12 As long as you are healthy, it is OK to smoke rs38 1 5.88 6 6.82 1.000 0.786 0.087 7.107 0.830 H3.13 About smoking, there are more harms than benefits ds39 15 88.24 74 84.09 1.000 1.405 0.280 7.053 0.679
282
Appendix M 7 Likelihood to Succeed if Decided to Quit Given Beliefs About Smoking
Univariate Multivariate Controlling by
age and gender Unlikely Likely 95% CI
Variable No % No % P FET OR Lower Upper P
H3.1 Smoking Facilitates Friendship Rs34a 2 20.00 8 8.42 0.242 4.864 0.706 33.498 0.108 H3.2 Smoking Provides Pleasure Rs34b 6 60.00 38 40.00 0.314 2.247 0.539 9.375 0.267 H3.3 Smoking Relieves Stress Rs34c 6 60.00 51 53.68 0.751 0.900 0.210 3.859 0.888 H3.4 Smoking Can Help focus on activities Rs34d 3 30.00 14 14.89 0.208 2.337 0.465 11.731 0.303 H3.5 Smoking helps to Lose Weight Rs34e 4 40.00 20 21.05 0.231 2.421 0.572 10.246 0.230 H3.6 No Positive Aspects of Smoking Rsmokeben 2 20.00 26 27.37 1.000 0.738 0.138 3.928 0.720 H3.7 Smoking Causes Lung Ca Rs76a 10 100.00 92 97.87 1.000 NA H3.8 Smoking Causes Heart Disease Rs76c 8 88.89 82 89.13 1.000 1.426 0.143 14.248 0.763 H3.9 People Smoke because they want to rs35 6 60.00 74 77.89 0.244 0.114 0.018 0.671 0.016 * H3.10 People smoke because it is a habit rs36 8 80.00 77 81.05 1.000 0.725 0.130 4.045 0.714 H3.11 People who smoke cannot control they smoke or not rs37 7 70.00 55 57.89 0.521 1.815 0.418 7.876 0.426 H3.12 As long as you are healthy, it is OK to smoke rs38 1 10.00 6 6.32 0.515 2.202 0.207 23.478 0.513 H3.13 About smoking, there are more harms than benefits ds39 9 90.00 80 84.21 1.000 1.370 0.150 12.522 0.760
Appendix M 8 Level of Comfort Asking for Help to Quit Given Beliefs About Smoking
Univariate Multivariate Controlling by
age and gender Variable Uncomfortable Comfortable 95% CI
No % No %
P FET OR
Lower
Upper P
H3.1 Smoking Facilitates Friendship Rs34a 4 9.76 6 10.00 1.000 0.924 0.239 3.578 0.909 H3.2 Smoking Provides Pleasure Rs34b 20 48.78 23 38.33 0.314 1.654 0.722 3.789 0.234 H3.3 Smoking Relieves Stress Rs34c 24 58.54 30 50.00 0.313 1.644 0.720 3.756 0.238 H3.4 Smoking Can Help focus on activities Rs34d 6 14.63 10 16.95 1.000 0.846 0.280 2.551 0.766 H3.5 Smoking helps to Lose Weight Rs34e 8 19.51 14 23.33 0.807 0.799 0.300 2.125 0.653 H3.6 No Positive Aspects of Smoking Rsmokeben 11 26.83 17 28.33 1.000 0.895 0.364 2.202 0.810 H3.7 Smoking Causes Lung Ca Rs76a 40 97.56 58 98.31 1.000 0.620 0.035 11.143 0.746 H3.8 Smoking Causes Heart Disease Rs76c 33 84.62 54 93.10 0.194 0.376 0.096 1.481 0.162 H3.9 People Smoke because they want to rs35 32 78.05 45 75.00 0.814 1.185 0.435 3.229 0.740 H3.10 People smoke because it is a habit rs36 34 82.93 48 80.00 0.799 1.223 0.435 3.436 0.703 H3.11 People who smoke cannot control they smoke or not rs37 26 63.41 33 55.00 0.420 1.436 0.634 3.253 0.386 H3.12 As long as you are healthy, it is OK to smoke rs38 1 2.44 5 8.33 0.397 0.256 0.028 2.306 0.225 H3.13 About smoking, there are more harms than benefits ds39 35 85.37 51 85.00 1.000 0.987 0.309 3.148 0.982
283
Appendix M 9 Agreement About the Only Way to Stop Smoking is Through Will Power
Given Beliefs About Smoking Univariate
Multivariate Controlling by age and gender
Variable Disagree Agree 95% CI
No % No % P FET OR
Lower
Upper P
H3.1 Smoking Facilitates Friendship Rs34a 0 - 10 10.42 0.596 0.000 0.000 - 0.999 H3.2 Smoking Provides Pleasure Rs34b 3 33.33 41 42.71 0.731 0.438 0.092 2.082 0.299 H3.3 Smoking Relieves Stress Rs34c 4 44.44 53 55.21 0.729 0.507 0.113 2.270 0.375 H3.4 Smoking Can Help focus on activities Rs34d 1 11.11 16 16.84 1.000 0.758 0.084 6.876 0.806 H3.5 Smoking helps to Lose Weight Rs34e 2 22.22 22 22.92 1.000 1.078 0.196 5.926 0.931 H3.6 No Positive Aspects of Smoking Rsmokeben 4 44.44 24 25.00 0.243 3.519 0.773 16.010 0.104 H3.7 Smoking Causes Lung Ca Rs76a 9 100.00 93 97.89 1.000 2.65E+08 0.000 - 0.999 H3.8 Smoking Causes Heart Disease Rs76c 9 100.00 81 88.04 0.592 1.735 0.000 - 0.999 H3.9 People Smoke because they want to rs35 5 55.56 75 78.13 0.212 0.361 0.074 1.772 0.209 H3.10 People smoke because it is a habit rs36 6 66.67 79 82.29 0.368 0.429 0.088 2.103 0.297 H3.11 People who smoke cannot control they smoke or not rs37 6 66.67 56 58.33 0.734 1.489 0.325 6.820 0.608 H3.12 As long as you are healthy, it is OK to smoke rs38 1 11.11 6 6.25 0.476 3.776 0.338 42.222 0.281 H3.13 About smoking, there are more harms than benefits ds39 5 55.56 84 87.50 0.029 0.200 0.040 0.991 0.049 *
284
Appendix N Group Comparisons Given Behaviors About Second-Hand Smoke
285
Appendix N 1
Never and Ever Smokers Given Behaviors About Second-Hand Smoke Univariate
Multivariate Controlling by age and gender
Never Ever 95% CI
Variable No % No % P FET OR
Lower
Upper P
H4.1 Comfortable with others smoking around you Rs62 57 10.02 82 35.34 0.000 0.234 0.155 0.353 0.000 * H4.2 House someone smokes Rs64 37 6.49 37 15.75 0.000 0.352 0.207 0.598 0.000 * H4.3 Car someone smokes Rs66 82 14.39 71 30.21 0.000 0.382 0.256 0.572 0.000 * H4.4 smoking not Allowed at home Rs65 538 94.55 194 82.55 0.000 3.424 1.992 5.885 0.000 * H4.5 Someone smokes in work area Rs70 55 14.95 31 19.75 0.198 0.810 0.481 1.364 0.428 H4.6 Smoking not permitted at work's common areas Rs71 312 84.78 129 83.77 0.792 1.154 0.662 2.010 0.614 H4.7 Prefer works where smoking is not allowed Rs73 352 82.05 122 60.40 0.000 3.035 2.014 4.572 0.000 * H4.8 SHS (1=exposure to shs; 0=no shs) 259 45.44 161 68.51 0.000 0.392 0.277 0.557 0.000 * H4.9 MinorsSHS 188 32.98 105 44.68 0.002 0.443 0.311 0.631 0.000 *
Appendix N 2 Former and Current Smokers Given Behaviors About Second-Hand Smoke
Univariate Multivariate Controlling by age
and gender FS CS 95% CI
Variable No % No %
P FET OR
Lower
Upper P
H4.1 Comfortable with others smoking around you Rs62 20 15.87 61 58.65 0.000 0.113 0.058 0.222 0.000 * H4.2 House someone smokes Rs64 9 7.03 27 25.71 0.000 0.154 0.063 0.377 0.000 * H4.3 Car someone smokes Rs66 19 14.84 51 48.57 0.000 0.238 0.125 0.452 0.000 * H4.4 smoking not Allowed at home Rs65 116 90.63 77 73.33 0.001 5.837 2.524 13.497 0.000 * H4.5 Someone smokes in work area Rs70 13 14.77 18 26.87 0.071 0.484 0.211 1.113 0.088 H4.6 Smoking not permitted at work's common areas Rs71 72 82.76 55 84.62 0.827 0.776 0.315 1.909 0.580 H4.7 Prefer works where smoking is not allowed Rs73 84 77.78 38 41.3 0.000 4.465 2.35 8.484 0.000 * H4.8 SHS (1=exposure to shs; 0=no shs) 72 56.25 87 82.86 0.000 0.293 0.155 0.556 0.000 * H4.9 MinorsSHS 46 35.94 58 55.24 0.004 0.568 0.324 0.995 0.048 *
Appendix N 3 Smokers in the Maintenance, Preparation, and Pre-Contemplation
SOC Given Behaviors About Second-Hand Smoke Maintenance SOC
Preparation SOC
Pre-contemplation SOC
Variable No % No % No % P FET H4.1 Comfortable with others smoking around you Rs62 20 15.87 41 55.41 20 66.67 0.000 * H4.2 House someone smokes Rs64 9 7.03 18 24.32 9 29.03 0.000 * H4.3 Car someone smokes Rs66 19 14.84 32 43.24 19 61.29 0.000 * H4.4 smoking not Allowed at home Rs65 116 90.62 53 71.62 24 77.42 0.001 * H4.5 Someone smokes in work area Rs70 13 14.77 13 27.66 5 25.00 0.166 H4.6 Smoking not permitted at work's common areas Rs71 72 82.76 38 82.61 17 89.47 0.903 H4.7 Prefer works where smoking is not allowed Rs73 84 77.78 28 43.75 10 35.71 0.000 * H4.8 SHS (1=exposure to shs; 0=no shs) 72 56.25 60 81.08 27 87.10 0.000 * H4.9 MinorsSHS 46 35.94 38 51.35 20 64.52 0.006 *
286
Appendix N 4 Smokers in the Preparation and Pre-Contemplation SOC Given Behaviors
About Second-Hand Smoke
Univariate Multivariate Controlling by age and
gender Variable WTQ NWTQ 95% CI
No % No % P FET OR Lower Upper P H4.1 Comfortable with others smoking around you Rs62 41 55.41 20 66.67 0.380 0.519 0.205 1.313 0.166 H4.2 House someone smokes Rs64 18 24.32 9 29.03 0.631 0.595 0.218 1.620 0.309 H4.3 Car someone smokes Rs66 32 43.24 19 61.29 0.134 0.588 0.240 1.442 0.246 H4.4 smoking not Allowed at home Rs65 53 71.62 24 77.42 0.633 1.021 0.355 2.939 0.969 H4.5 Someone smokes in work area Rs70 13 27.66 5 25.00 1.000 1.190 0.356 3.981 0.778 H4.6 Smoking not permitted at work's common areas Rs71 38 82.61 17 89.47 0.710 0.549 0.103 2.917 0.482 H4.7 Prefer works where smoking is not allowed Rs73 28 43.75 10 35.71 0.500 1.296 0.510 3.298 0.586 H4.8 SHS (1=exposure to shs; 0=no shs) 60 81.08 27 87.10 0.576 0.624 0.185 2.099 0.446 H4.9 MinorsSHS 38 51.35 20 64.52 0.283 0.638 0.261 1.560 0.325
Appendix N 5 Smokers in the Preparation, Contemplation, and Pre-Contemplation SOC
Given Behaviors About Second-Hand Smoke Pre-contemplation SOC
Contemplation SOC Preparation SOC
Variable No % No % No % P FET H4.1 Comfortable with others smoking around you Rs62 13 72.22 17 58.62 32 55.17 0.485 H4.2 House someone smokes Rs64 6 33.33 7 23.33 15 25.86 0.723 H4.3 Car someone smokes Rs66 8 44.44 22 73.33 22 37.93 0.007 * H4.4 smoking not Allowed at home Rs65 12 66.67 22 73.33 43 74.14 0.797 H4.5 Someone smokes in work area Rs70 3 20.00 3 18.75 12 32.43 0.573 H4.6 Smoking not permitted at work's common areas Rs71 14 100.00 13 81.25 29 80.56 0.214 H4.7 Prefer works where smoking is not allowed Rs73 5 33.33 11 40.74 22 43.14 0.808 H4.8 SHS (1=exposure to shs; 0=no shs) 14 77.78 29 96.67 45 77.59 0.048 * H4.9 MinorsSHS 9 50.00 18 60.00 31 53.45 0.776
Appendix N 6 Likelihood to Succeed if Wanted to Quit Given Behaviors
About Second-Hand Smoke
Univariate Multivariate Controlling by age
and gender Unlikely Likely 95% CI
Variable No % No % P FET OR Lower Upper P H4.1 Comfortable with others smoking around you Rs62 12 75.00 49 55.68 0.177 2.544 0.745 8.688 0.136 H4.2 House someone smokes Rs64 8 47.06 19 21.59 0.037 3.699 1.187 11.529 0.024 * H4.3 Car someone smokes Rs66 9 52.94 42 47.73 0.793 1.193 0.402 3.540 0.751 H4.4 smoking not Allowed at home Rs65 11 64.71 66 75.00 0.382 0.532 0.158 1.730 0.288 H4.5 Someone smokes in work area Rs70 5 45.45 13 23.21 0.149 2.766 0.716 10.693 0.140 H4.6 Smoking not permitted at work's common areas Rs71 9 81.82 46 85.19 0.673 0.754 0.135 4.213 0.748 H4.7 Prefer works where smoking is not allowed Rs73 6 40.00 32 41.56 1.000 0.997 0.318 3.128 0.996 H4.8 SHS (1=exposure to shs; 0=no shs) 16 94.12 71 80.68 0.294 3.934 0.486 31.854 0.199 H4.9 MinorsSHS 12 70.59 46 52.27 0.192 0.282 0.723 7.196 0.159
287
Appendix N 7 Likelihood to Succeed if Decided to Quit Given
Behaviors About Second-Hand Smoke Univariate Multivariate Controlling by age and gender
Unlikely Likely 95% CI Variable No % No % P FET OR Lower Upper P
H4.1 Comfortable with others smoking around you Rs62 8 80.00 53 56.38 0.190 3.433 0.651 18.121 0.146 H4.2 House someone smokes Rs64 2 20.00 25 26.32 1.000 0.962 0.178 5.212 0.964 H4.3 Car someone smokes Rs66 5 50.00 46 48.42 1.000 0.641 0.152 2.701 0.545 H4.4 smoking not Allowed at home Rs65 9 90.00 68 71.58 0.283 2.791 0.303 25.667 0.365 H4.5 Someone smokes in work area Rs70 3 42.86 15 25.00 0.375 2.279 0.412 12.598 0.345 H4.6 Smoking not permitted at work's common areas Rs71 6 85.71 49 84.48 1.000 1.192 0.118 11.988 0.882 H4.7 Prefer works where smoking is not allowed Rs73 4 40.00 34 41.46 1.000 1.045 0.243 4.494 0.953 H4.8 SHS (1=exposure to shs; 0=no shs) 9 90.00 78 82.11 1.000 1.663 0.187 14.759 0.648 H4.9 MinorsSHS 9 90.00 49 51.58 0.022 6.841 0.803 58.29 0.079
Appendix N 8 Level of Comfort Asking for Help to Quit
Given Behaviors About Second-Hand Smoke Univariate
Multivariate Controlling by age and gender
Uncomfortable Comfortable 95% CI Variable No % No % P FET OR Lower Upper P H4.1 Comfortable with others smoking around you Rs62 23 56.10 36 61.02 0.682 0.846 0.371 1.932 0.692 H4.2 House someone smokes Rs64 7 17.07 18 30.00 0.164 0.478 0.173 1.322 0.155 H4.3 Car someone smokes Rs66 19 46.34 31 51.67 0.687 0.747 0.321 1.735 0.497 H4.4 smoking not Allowed at home Rs65 30 73.17 44 73.33 1.000 0.917 0.353 2.380 0.858 H4.5 Someone smokes in work area Rs70 8 30.77 9 24.32 0.579 1.387 0.447 4.311 0.571 H4.6 Smoking not permitted at work's common areas Rs71 21 84.00 31 83.78 1.000 0.985 0.245 3.959 0.983 H4.7 Prefer works where smoking is not allowed Rs73 12 32.43 24 47.06 0.193 0.534 0.220 1.299 0.167 H4.8 SHS (1=exposure to shs; 0=no shs) 34 82.93 49 81.67 1.000 1.109 0.389 3.158 0.847 H4.9 MinorsSHS 27 65.85 29 48.33 0.104 2.149 0.926 4.988 0.075
Appendix N 9 Agreement about the Only Way to Stop Smoking is Through Will Power
Given Behaviors About Second-Hand Smoke
Univariate Multivariate Controlling by age and
gender Disagree Agree 95% CI
Variable No % No % P FET OR Lower Upper P H4.1 Comfortable with others smoking around you Rs62 6 66.67 55 57.89 0.733 1.237 0.273 5.618 0.783 H4.2 House someone smokes Rs64 4 44.44 23 23.96 0.231 2.043 0.466 8.956 0.343 H4.3 Car someone smokes Rs66 2 22.22 49 51.04 0.162 0.401 0.073 2.197 0.292 H4.4 smoking not Allowed at home Rs65 4 44.44 73 76.04 0.055 0.368 0.084 1.600 0.182 H4.5 Someone smokes in work area Rs70 1 25.00 17 26.98 1.000 0.950 0.087 10.330 0.966 H4.6 Smoking not permitted at work's common areas Rs71. 3 75.00 52 85.25 0.496 0.413 0.034 5.070 0.489 H4.7 Prefer works where smoking is not allowed Rs73 1 20.00 37 42.53 0.400 0.261 0.024 2.903 0.275 H4.8 SHS (1=exposure to shs; 0=no shs) 7 77.78 80 83.33 0.650 0.528 0.090 3.087 0.479 H4.9 MinorsSHS 4 44.44 54 56.25 0.510 0.755 0.169 3.385 0.714
288
Appendix O Group Comparisons Given Behaviors About Smoking
and Beliefs About Stopping Smoking
289
Appendix O 1 Never and Ever Smokers Given Behaviors
About Smoking and Beliefs About Stopping Smoking Univariate Multivariate Controlling by age and gender
Never Ever 95% CI Variable No % No % P FET OR Lower Upper P
H5.1 rCHOADIC 93 16.55 50 21.37 0.128 0.884 0.581 1.344 0.563
Appendix O 2 Former and Current Smokers Given Behaviors
About Smoking and Beliefs About Stopping Smoking Univariate
Multivariate Controlling by age and gender
FS CS 95% CI Variable No % No % P FET OR Lower Upper P
H5.1 rCHOADIC 27 21.26 22 20.95 1.000 0.912 0.465 1.787 0.787 H5.11 Smoked first cigarette after 18 yo Ds50T18yo 19 14.84 28 26.92 0.032 0.349 0.170 0.718 0.004 * 5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 63 49.22 66 62.86 0.047 0.419 0.235 0.745 0.003 *
Appendix O 3 Smokers in the Maintenance, Preparation, and Pre-Contemplation SOC Given Behaviors About Smoking and Beliefs About Stopping Smoking
Maintenance SOC
Preparation SOC
Pre-contemplation SOC
Variable No % No % No % P FET H5.1 rCHOADIC 27 21.26 16 21.62 6 19.35 1.000 H5.11 Smoked first cigarette after 18 yo Ds50T18yo 19 14.84 22 30.14 6 19.35 0.037 * H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 63 49.22 49 66.22 17 54.84 0.064
290
Appendix O 4
Smokers in the Preparation and Pre-Contemplation SOC Given Behaviors About Smoking and Beliefs About Stopping Smoking
Univariate Multivariate Controlling by
age and gender
Preparation SOC
Pre-contemplation SOC 95% CI
Variable No % No % P FET OR Lower Upper P H5.1 rCHOADIC 16 21.62 6 19.35 1.000 0.805 0.254 2.549 0.713 H5.2 Smoke cigarettes every day rs44 38 51.35 16 51.61 1.000 0.958 0.407 2.254 0.922 H5.3 First cigarette smoked within 30 minutes after waking up rs52
12 16.44 6 19.35 0.779
0.829
0.274
2.510
0.740
H5.4 Smoking more when facing stressful events rs53
35 47.30 17 54.84 0.526
0.684
0.274 1.708
0.416
H5.5 Comfortable smoking around others rs54 30 41.67 18 60.00 0.127 0.490 0.197 1.217 0.125 H5.6 Does not enjoy smoking rS56 43 58.11 11 36.67 0.054 2.409 0.975 5.954 0.057 H5.7 Very likely to succeed if want to stop smoking rs58
46 62.16 8 25.81 0.001
5.441
2.058 14.384
0.001 *
H5.8 Very likely to succeed if decide to stop smoking rs59
52 70.27 12 38.71 0.004
3.574
1.424 8.969
0.007 *
H5.9 Very comfortable asking for help to stop smoking rs60
28 38.36 14 50.00 0.368
0.632
0.256 1.558
0.319
H5.10 Ability to stop smoking through own will power rs61
67 90.54 29 93.55 0.620
0.959
0.173 5.307
0.962
H5.11 Smoked first cigarette after 18 yo Ds50T18yo 22 30.14 6 19.35 0.336 1.690 0.598 4.777 0.322 H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo
49 66.22 17 54.84 0.279
1.406
0.579 3.412 0.452
H5.13 smokes= >5 cigarettes/day rs45 23 60.53 11 68.75 0.759 0.582 0.155 2.184 0.422 H5.14 Quitting smoking for a day or more in the past year Ds55
53 75.71 20 68.97 0.616
2.051
0.716 5.873
0.181
Appendix O 5 Smokers in the Preparation, Contemplation, and Pre-contemplation SOC
Given Behaviors About Smoking and Beliefs About Stopping Smoking Pre-contemplation SOC
Contemplation SOC
Preparation SOC
Variable No % No % No % P FET H5.1 rCHOADIC 4 22.22 4 13.33 15 25.86 0.408 H5.2 Smoke cigarettes every day rs44 8 44.44 19 63.33 28 48.28 0.335 H5.3 First cigarette smoked within 30 minutes after waking up rs52 3 16.67 7 23.33 8 14.04 0.529 H5.4 Smoking more when facing stressful events rs53 11 61.11 17 56.67 25 43.10 0.324 H5.5 Comfortable smoking around others rs54 11 64.71 16 55.17 22 38.60 0.109 H5.6 Does not enjoy smoking rS56 5 29.41 11 36.67 38 65.52 0.005 * H5.7 Very likely to succeed if want to stop smoking rs58 12 70.59 13 43.33 29 50.00 0.198 H5.8 Very likely to succeed if decide to stop smoking rs59 14 82.35 15 50.00 35 60.34 0.085 H5.9 Very comfortable asking for help to stop smoking rs60 10 71.43 11 36.67 21 36.84 0.061 H5.10 Ability to stop smoking through own will power rs61 16 94.12 29 96.67 51 87.93 0.452 H5.11 Smoked first cigarette after 18 yo Ds50T18yo 6 33.33 4 13.33 18 31.58 0.131 H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 11 61.11 13 43.33 42 72.41 0.030 * H5.13 smokes= >5 cigarettes/day rs45 6 75.00 9 47.37 20 71.43 0.175 H5.14 Quitting smoking for a day or more in the past year Ds55 9 56.25 24 80.00 40 74.07 0.205
291
Appendix O 6 Likelihood to Succeed if Wanted to Quit Given Behaviors
About Smoking and Beliefs About Stopping Smoking Univariate
Multivariate Controlling by age and gender
Unlikely Likely 95% CI
Variable No %
No % P FET OR
Lower
Upper P
H5.1 rCHOADIC 5 29.41 17
19.32 0.344
1.936
0.535
7.004
0.314
H5.2 Smoke cigarettes every day rs44 12 70.59 42
47.73 0.113
0.266
0.862
8.211
0.089
H5.3 First cigarette smoked within 30 minutes after waking up rs52 4
23.53 14
15.91 0.488
1.602
0.454
5.652
0.464
H5.4 Smoking more when facing stressful events rs53 10 58.82 42
47.73 0.438
1.765
0.589
5.295
0.310
H5.5 Comfortable smoking around others rs54 10
58.82 38
44.71 0.303
1.710
0.580
5.040
0.331
H5.6 Does not enjoy smoking rS56 6
35.29 48
55.17 0.185
0.436
0.147
1.292
0.134
H5.7 Very likely to succeed if want to stop smoking rs58 Excluded from analysis H5.8 Very likely to succeed if decide to stop smoking rs59 Excluded from analysis
H5.9 Very comfortable asking for help to stop smoking rs60 8 50.00 34
40.00 0.582
1.488
0.508
4.355
0.469
H5.10 Ability to stop smoking through own will power rs61 14 82.35 82
93.18 0.159
0.261
0.051
1.332
0.106
H5.11 Smoked first cigarette after 18 yo Ds50T18yo 2 11.76 26
29.89 0.147
0.319
0.068
1.506
0.149
H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 8
47.06 58
65.91 0.174
0.444
0.151
1.308
0.141
H5.13 smokes= >5 cigarettes/day rs45 9 75.00 25
59.52 0.500
2.226
0.496
9.992
0.296
H5.14 Quitting smoking for a day or more in the past year Ds55 12
70.59 61
74.39 0.766
0.755
0.227
2.513
0.647
292
Appendix O 7 Likelihood to Succeed if Decided to Quit Given Behaviors
About Smoking and Beliefs About Stopping Smoking
Univariate Multivariate Controlling by
age and gender Unlikely Likely 95% CI
Variable No %
No % P FET OR
Lower
Upper P
H5.1 rCHOADIC 3 30.00 19 20.00 0.434
5.978
0.983
36.365
0.052
H5.2 Smoke cigarettes every day rs44 6 60.00 48 50.53 0.742
1.494
0.377
5.920
0.568
H5.3 First cigarette smoked within 30 minutes after waking up rs52 2 20.00 16
17.02 0.683
1.285
0.236
6.991
0.772
H5.4 Smoking more when facing stressful events rs53 6 60.00 46 48.42 0.526
0.917
0.185 4.545 0.915
H5.5 Comfortable smoking around others rs54 5 50.00 43 46.74 1.000
1.200
0.282 5.103 0.805
H5.6 Does not enjoy smoking rS56 4 40.00 50 53.19 0.515
0.826
0.199 3.433 0.793
H5.7 Very likely to succeed if want to stop smoking rs58 Excluded from analysis H5.8 Very likely to succeed if decide to stop smoking rs59 Excluded from analysis H5.9 Very comfortable asking for help to stop smoking rs60 3 30.00 39
42.86 0.516
0.471
0.106 2.094 0.322
H5.10 Ability to stop smoking through own will power rs61 10 100.00 86 90.53 0.596 NA
H5.11 Smoked first cigarette after 18 yo Ds50T18yo 3 30.00 25 26.60 1.000
1.421
0.314 6.419 0.648
H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 7 70.00 59
62.11 0.741
2.278
0.499 10.397 0.288
H5.13 smokes= >5 cigarettes/day rs45 4 66.67 30 62.50 1.000
0.825
0.070 9.775 0.879
H5.14 Quitting smoking for a day or more in the past year Ds55 9 90.00 64
71.91 0.284
3.339
0.355 31.384 0.291
293
Appendix O 8
Level of Comfort Asking for Help to Quit Given Behaviors About Smoking and Beliefs About Stopping Smoking
Univariate Multivariate Controlling by age
and gender Uncomfortable Comfortable 95% CI
Variable No % No % P FET OR Lower
Upper P
H5.1 rCHOADIC 11 26.83 10 16.67 0.225
2.108
0.727
6.113
0.170
H5.2 Smoke cigarettes every day rs44 16 39.02 35 58.33 0.070
0.457
0.203 1.030 0.059
H5.3 First cigarette smoked within 30 minutes after waking up rs52 5 12.20 12
20.00 0.419
0.559
0.180 1.732 0.313
H5.4 Smoking more when facing stressful events rs53 20 48.78 31 51.67 0.841
0.934 0.402 2.173 0.875
H5.5 Comfortable smoking around others rs54 18 45.00 29 50.00 0.684
0.790 0.346 1.805 0.576
H5.6 Does not enjoy smoking rS56 22 53.66 31 51.67 1.000
1.079 0.484 2.404 0.853
H5.7 Very likely to succeed if want to stop smoking rs58 22 53.66 30
50.00 0.840
1.137 0.511 2.29 0.754
H5.8 Very likely to succeed if decide to stop smoking rs59 22 53.66 39
65.00 0.302
0.598 0.258 1.39 0.233
H5.9 Very comfortable asking for help to stop smoking rs60 Excluded from analysis H5.10 Ability to stop smoking through own will power rs61 40 97.56 52
86.67 0.079
6.130 0.71 52.916 0.099
H5.11 Smoked first cigarette after 18 yo Ds50T18yo 9 21.95 18 30.51 0.370
0.650 0.257 1.643 0.362
H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 25 60.98 40
66.67 0.673
0.775 0.331 1.815 0.557
H5.13 smokes= >5 cigarettes/day rs45 10 62.50 22 62.86 1.000
0.874 0.241 3.171 0.837
H5.14 Quitting smoking for a day or more in the past year Ds55 33 84.62 39
68.42 0.094
2.588 0.902 7.423 0.077
294
Appendix O 9 Agreement About the Only Way to Stop Smoking is Through Will Power
Given Behaviors About Smoking and Beliefs About Stop Smoking Univariate
Multivariate Controlling by age and gender
Disagree Agree 95% CI
Variable No %
No % P FET OR
Lower
Upper P
H5.1 rCHOADIC 3 33.33 19
19.79 0.392
1.801
0.326
9.952
0.500
H5.2 Smoke cigarettes every day rs44 7 77.78 47
48.96 0.162
4.144
0.745
23.061
0.105
H5.3 First cigarette smoked within 30 minutes after waking up rs52 3
33.33 15
15.79 0.186
2.898
0.599
14.028
0.186
H5.4 Smoking more when facing stressful events rs53 6 66.67 46
47.92 0.319
2.014 0.433 9.366 0.372
H5.5 Comfortable smoking around others rs54 2 22.22 46
49.46 0.167
0.314 0.056 1.763 0.188
H5.6 Does not enjoy smoking rS56 5 55.56 49
51.58 1.000
1.080 0.256 4.551 0.916
H5.7 Very likely to succeed if want to stop smoking rs58 4
44.44 50
52.08 0.737
0.755 0.18 3.175 0.702
H5.8 Very likely to succeed if decide to stop smoking rs59 7
77.78 57
59.38 0.477
2.033 0.364 11.355 0.419
H5.9 Very comfortable asking for help to stop smoking rs60 7
77.78 35
38.04 0.032
7.893 1.336 46.641 0.023 *
H5.10 Ability to stop smoking through own will power rs61 Excluded from analysis
H5.11 Smoked first cigarette after 18 yo Ds50T18yo 3 33.33 25
26.32 0.699
1.002 0.203 4.945 0.998
H5.12 Smoking cigarettes regularly after 18 yo Ds51R18yo 4
44.44 62
64.58 0.287
0.305 0.066 1.402 0.127
H5.13 smokes= >5 cigarettes/day rs45 6 85.71 28
59.57 0.239
4.009 0.374 42.982 0.251
H5.14 Quitting smoking for a day or more in the past year Ds55 5
62.50 68
74.73 0.429
0.779 0.161 3.771 0.756