State-specific trends in smoke-free workplace policy coverage: the current population survey tobacco use supplement, 1993 to 1999.

We examined trends in smoke-free workplace policies among all indoor workers in the United States using the National Cancer Institute's Tobacco Use Supplement to the Census Bureau's Current Population Survey (total n = 270,063). Smoke-free was defined as smoking not permitted in public or common areas or in work areas of a worksite. Nationally, we found that nearly 70% of the US workforce worked under a smoke-free policy in 1999. At the state level, a greater than 30-percentage-point differential existed in the proportion of workers with such policies. Although significant progress has been made to reduce worker exposure to environmental tobacco smoke on the job, we predict further progress may be difficult unless comprehensive regulations to protect all workers are implemented at the national, state, or local level.

An analysis of breast cancer coverage in selected women's magazines, 1987-1995.

PURPOSE: Women's magazines are a significant source of health information for many women, but there is some concern that the media may misrepresent a woman's risk of breast cancer. This review analyzes breast cancer articles in selected women's magazines to determine if the information presented is accurate and balanced. SEARCH METHODS: For the years 1987 to 1995, the quantity and content of breast cancer articles were examined in four popular women's magazines and three magazines with a large African-American audience. Fifty-nine lead factual breast cancer articles were analyzed for the information presented on prevention measures, risk factors, incidence/mortality statistics, and lifetime risk. The age at diagnosis for women featured in these articles was also determined. SUMMARY OF IMPORTANT FINDINGS: Breast cancer was the topic of 34.9% of the 585 cancer articles published in these seven magazines. Mammography screening guidelines were recommended in 68% of articles that discussed prevention; 66% presented the American Cancer Society guidelines. Risk factors for breast cancer were reported as age greater than 50 in 41% and family history in 78% of the articles that discussed risk factors. Twenty articles used the lifetime risk statistic of developing breast cancer; six explained what this statistic means. The average age of diagnosis for women featured in the articles was 40.5. MAJOR CONCLUSIONS: The proportion of breast cancer articles to all cancer articles in these magazines (34.9%) was similar to breast cancer incidence (32.2%) but was higher than its contribution to either female cancer mortality (17.2%) or overall female mortality (4.0%). Magazines that targeted the African-American audience had fewer breast cancer articles than the other four magazines. Risk factors for breast cancer were not discussed in proportion to their impact on risk. The popular lifetime risk statistic was not explained in the majority of cases where it was presented. The average age of diagnosis for the women featured in these articles was far below the median age of diagnosis of 65. Thus, magazine reports may be contributing to women's misunderstanding of their true breast cancer risk.

Workplace smoking policies in the United States: results from a national survey of more than 100,000 workers.

OBJECTIVE: To determine the prevalence of smoking policies in indoor work environments as reported by a nationally representative sample of workers in the United States. DESIGN: Cross-sectional survey of households within the United States. SETTING: All 50 state and the District of Columbia, 1992-93. PARTICIPANTS: Currently employed indoor workers 15 years of age and older who responded to the National Cancer Institute's Tobacco Use Supplement to the Current Population Survey (n = 100,561). MAIN OUTCOME MEASURES: The prevalence and restrictiveness of workplace smoking policies as reported by workers currently employed in indoor workplaces in the United States. RESULTS: Most of the indoor workers surveyed (81.6%) reported that their place of work had an official policy that addressed smoking in the workplace; 46.0% reported that their workplace policy did not permit smoking in either the public/common areas--for example, restrooms and cafeterias--or the work areas of the workplace. The reporting of these "smoke-free" policies varied significantly by gender, age, race/ethnicity, smoking status, and occupation of the worker. CONCLUSIONS: Although nearly half of all indoor workers in this survey reported that they had a smoke-free policy in their workplace, significant numbers of workers, especially those in blue-collar and service occupations, reported smoke-free rates well below the national average. If implemented, the US Occupational Safety and Health Administration's proposed regulation to require worksites to be smoke-free has the potential to increase significantly the percentage of American workers covered by these policies and to eliminate most of the disparity currently found across occupational groups.

Cancer coverage and tobacco advertising in African-American women's popular magazines.

Mass circulating magazines offer an opportunity to inform large segments of the population about preventive health behaviors relevant for cancer control. We collected information about the number and type of cancer articles from January 1987 through December 1994 in Jet, Ebony and Essence magazines. These magazines each have a principal readership of African-American women and a paid circulation of 1,000,000 or more annually. Cancer articles were counted if the content was gender neutral or specifically targeted for women. There were 84 articles on cancer including 6 on lung cancer and 3 on other tobacco-related cancers. Nine additional references to lung cancer were mentioned under the general cancer category, but lung cancer was not the primary focus of the articles. There were 24 articles on breast cancer and 9 on cervical cancer over the 8 year period. Most of the articles (> 70%) were short fillers of less than one page in length. A prevention focus was included in 42.2%, 75.0%, and 71.0% of the cancer articles in Jet, Ebony, and Essence respectively. Of the 649 health articles, 116 were on cardiovascular disease. In contrast, there were 1,477 tobacco advertisements over the 8 years. The number of cancer articles was not significantly associated with the number of tobacco advertisements. Because tobacco-related cancers are entirely preventable and contribute to the significant cancer burden, the lack of coverage of tobacco-related cancers is a missed opportunity for health promotion among African-American females.

Lack of colon cancer coverage in seven women's magazines.

Women's magazines are an important source of health information. To evaluate the relevancy of articles in these publications to known disease risks, seven women's magazines were reviewed to assess their coverage of colon cancer, the third leading cause of cancer mortality in U.S. women. Specifically, the amount of coverage devoted to colon cancer as well as the presentation of issues in the prevention, risks, treatment, diagnosis and genetics of colon cancer were recorded. Twenty articles were published on colon cancer in these magazines during the years 1987-1995. Compared to five other cancers that also affect women, colon cancer was the focus of the fewest articles in the seven magazines analyzed.

Cancer coverage in women's magazines: what information are women receiving?

BACKGROUND: Women use magazines as sources of health-related information, including information about cancer. Given this reliance on magazines for cancer-related information, it may interest cancer educators to know which cancers are reported on in women's magazines and what types of information are being presented. METHODS: Four widely circulated monthly women's magazines were analyzed for their coverage of cancers during the years 1987-1995. The types of cancers discussed and the frequencies of coverage were noted for each issue of every magazine. Additionally, the content of every cancer-related article was assessed for issues in cancer prevention (primary and secondary), risks, treatment, and genetics. RESULTS: All four magazines in this study reported on breast cancer more often than any other cancer. Lung and colon cancers received very little coverage. The percentages of articles devoted to the six most-discussed cancers (breast, cervical, colon, lung, ovarian, and skin) did not reflect either the mortality rates or the incidence rates of these cancers. CONCLUSIONS: The discussions of cancers in these four women's magazines focused mostly on breast and skin cancers and neglected two very important cancers--lung and colon. If women are indeed receiving much of their cancer information from such media coverage, these findings should alert cancer educators to the possible need to work with these media to help in the dissemination of additional information about cancers to women.

Public health approaches to tobacco use prevention and cessation in the U.S.

Tobacco has a long history of use in the U.S., and its serious health effects have been well-documented during the past half century, U.S. efforts to control tobacco use and tobacco-related morbidity and mortality have been reasonably successful over the past 25 years, during which time there has been a 34 percent reduction in adult smoking. Nevertheless, tobacco use remains a significant public health problem in the U.S., with more than 430,000 tobacco-related deaths per year and over one-fourth of the population continuing to smoke. Many organizations are involved in tobacco use control activities, the most broadly focused of which is the National Cancer Institute (NCI). As an example of the type of program needed to address the problem of tobacco use on a national scale, the NCI's public health research plan and activities are described and its emphasis on a data-based decision matrix in its approach to tobacco and cancer control research and applications of research is discussed. Finally, future approaches to tobacco use control in the U.S. are suggested.

Hepatitis B virus C gene promoter is under negative regulation.

The regulation of the core promoter of Hepatitis B virus (HBV) was investigated using the chloramphenicol acetyltransferase (CAT) reporter system. Deletional analysis of sequences 5' to the HBV core promoter indicated the presence of a negative regulatory element (NRE) located within a 282-bp BamHI-HincII DNA fragment. The NRE was functional in hepatic as well as nonhepatic cells. Results of in vivo competition experiments suggest a role for cellular transacting repressor protein(s) in the functioning of the NRE. The HBV NRE, positioned 5' to the SV40 early promoter, inhibited the activity of the heterologous promoter in an orientation-independent, but position-dependent manner. These data indicate that the HBV NRE is a silencer element, which functions to downregulate the activity of the core promoter.