A longitudinal study of adolescent transition from virgin to nonvirgin status.

PURPOSE: To identify demographic and psychosocial predictors for early sexual initiation (ESI) among middle school midwestern suburban and rural youth. METHODS: A total of 884 middle school students completed a pretest and a 1-year follow-up questionnaire. At Time 1, 52 students reported already having initiated sexual behavior; the remaining 832 students were included in our analyses. The sample was 58.5% female and 92.8% white, with a mean age of 12.84 years. At Time 2, 105 students (12.6%) had changed their coital status from virgin to nonvirgin. A stepwise logistic regression was conducted to explore the relationship between the demographic and psychosocial variables measured at Time 1 (including grade, academic performance, mother's education, family structure, religiosity, self-esteem [school, home, and peer], perceived sexual norms, abstinence self-efficacy, peer pressure, etc.) and reported sexual behavior at Time 2. The analyses were conducted separately by gender. RESULTS: For both genders, academic achievement was positively related and peer self-esteem was negatively related to ESI. In addition, self-efficacy and frequency of prayer were negatively related to ESI for boys, and peer pressure, age, and traditional family structure were negatively related to ESI for girls. CONCLUSIONS: Risk and protective factors for ESI should be examined separately by gender. Use of a facet-specific measure of self-esteem revealed very different relationships among the peer, home, and school aspects of self-esteem and transition to nonvirgin status; therefore, researchers are encouraged to use area-specific rather than global measures of self-esteem.

A randomized, controlled trial to assess the efficacy and safety of a transdermal delivery system of nicotine/mecamylamine in cigarette smokers.

AIMS: To determine the efficacy and safety of nicotine transdermal therapy co-administered with the nicotine antagonist, mecamylamine, compared to a nicotine transdermal patch alone (21 mg nicotine + 6 mg mecamylamine, 21 mg nicotine + 3 mg mecamylamine, and 21 mg nicotine + 0 mg mecamylamine). DESIGN: Multi-center (n = 4), double-blind, randomized, parallel group, repeat-dose study. SETTING: Clinical laboratory. PARTICIPANTS: A total of 540 subjects were enrolled into the study-135 from each of four sites; 180 patients in each of three treatment arms. INTERVENTION: Treatment was administered for the first 6 weeks of the 8-week study. Patients were instructed to continue smoking for the first 2 weeks of treatment. MEASUREMENTS: The primary efficacy parameter was 4-week continuous abstinence after the quit date, confirmed with an expired carbon monoxide of < 10 parts per million. FINDINGS: Analysis of the 4-week continuous abstinence for the intent-to-treat population showed overall rates of 29% (nicotine + 6 mg mecamylamine), 29% (nicotine + 3 mg mecamylamine) and 23% (nicotine only) using the slip definition which allows smoking in the first 2 weeks after the quit date. Statistical analyses revealed no significant treatment differences. Analyses using the strict definition (no smoking after the quit date) yielded similar non-significant group differences (29%, 27%, 26%). CONCLUSION: If adding mecamylamine to nicotine replacement therapy (NRT) improves the chances of success at stopping smoking, the results of this study suggest that the effect is very small.

Sensitivity and specificity of a reagent-impregnated test strip in identifying smokeless tobacco users.

This study was designed to determine the sensitivity and specificity of a reagent-impregnated test strip in identifying habitual snuff users and tobacco chewers. Urine specimens were obtained from smokeless tobacco users and controls and blind tested on-site using a reagent-impregnated test strip. Samples also were sent to our university hospital lab for cotinine and nicotine analysis by gas chromatography (GC). The test strip results were compared with GC results and self-reported use of snuff and chewing tobacco. A total of 61 subjects enrolled in the study: 26 snuff users, 25 tobacco chewers, and 10 nonconsumers of nicotine. Using GC assessment of nicotine and cotinine (>or=200 ng/ml) as the standard, we found the sensitivity of the test strip to be 96% (25/26) for snuff users and 96% (24/25) for tobacco chewers. When compared with self-report, the sensitivity of the test strip was 92.3% (24/26) for snuff users and 84% (21/25) for tobacco chewers. The specificity for nonusers of nicotine was 100% (10/10) for both the self-report and GC conditions. These results suggest that a reagent-impregnated test strip is a rapid, valid, and user-friendly means of differentiating smokeless tobacco users from nonconsumers of tobacco. The intensity of the pink color on the test strip is proportional to the amount of nicotine or its metabolites present in urine and therefore offers a semiquantitative measure of nicotine consumption.

Publication ethics: an examination of authorship practices.

OBJECTIVE: To review health behavior research policies and practices related to authorship credit and responsibilities and to develop an authorship policy for the American Journal of Health Behavior. METHODS: Research on authorship criteria and byline placement was reviewed and the American Journal of Health Behavior Ethics Working Group made recommendations to the editor regarding an authorship policy. RESULTS: A new authorship policy was adopted by the editor. CONCLUSIONS: The new policy clarifies the position of the journal regarding authorship issues.

Developmental history of the Glover-Nilsson smoking behavioral questionnaire.

OBJECTIVE: To develop a simple, easily administered pencil-and-paper questionnaire to determine the degree to which behavioral patterns play a role in smoking dependence. METHODS: A modified Delphi technique was used to identify initial questions and to eliminate obvious duplications. Phase 2 utilized multiple statistical methods (principal components analysis, cluster analysis, stepwise multiple linear regression, cross tables, Mantel-Haenzel c2-test, and a Gamma test) to evaluate and reduce the number of questions from 18. RESULTS: These analyses yielded an 11-item questionnaire that can potentially assess behavioral dependence. CONCLUSION: It is hoped that the GN-SBQ will assist physicians, health care providers, and tobacco interventionists in identifying aspects of smoking addiction that are behavioral in nature. The need for future research is discussed.