Effects of portion size on chronic energy intake.

BACKGROUND: This study experimentally examined the effects of repeated exposure to different meal portion sizes on energy intake. METHODS: Nineteen employees of a county medical center were given free box lunches for two months, one month each of 1528 and 767 average kcal. Foods were identical in the two conditions, but differed in portion size. Meals averaged 44% calories from fat. Participants self-reported how much of each lunch was eaten. Unannounced 24-hour dietary recalls were also conducted by phone twice per week during each exposure period. RESULTS: Mean energy intake at the lunch meal was 332 kcal/day higher in large lunch than in small lunch periods (p < .001). Mean 24-hour energy intake was 278 kcal/day higher in large versus small lunch periods (p < .001). There was no evidence of compensation over time. Average weight change over the month of large and small lunches was 0.64 +/- 1.16 kg and 0.06 +/- 1.03 kg, respectively, about what would be expected with the observed differences in energy intake. CONCLUSION: This study suggests that chronic exposure to large portion size meals can result in sustained increases in energy intake and may contribute to body weight increases over time.

Empowering youth for tobacco control.

PURPOSE: To investigate common youth group activities and how they relate to young people's attitudes of empowerment around tobacco control. DESIGN: A mailed survey was administered to 940 Minnesota youth involved in locally organized tobacco prevention groups. By multivariate linear regression, participation in eight tobacco-related activities and selected personal characteristics were examined in relation to youths'perceived influence on youth smoking. RESULTS: Two activities--developing materials with antismoking messages and taking action to change school smoking policies--were associated with significantly higher perceived influence scores for the youth involved (p < .05). Youth in groups who had worked to raise awareness of how the tobacco industry targets teens also had significantly higher influence scores (p < .001). Associated personal factors included high involvement in extracurricular activities (p < .001), having never experimented with smoking (p < .01), leadership experience (p < .001), and being white (p < .01). DISCUSSION: Some youth group activities and strategies may be particularly effective at instilling attitudes of empowerment for tobacco control among youth.

Outcomes of a statewide anti-tobacco industry youth organizing movement.

PURPOSE: To outline the design and present select findings from an evaluation of a statewide anti-tobacco industry youth organizing movement. DESIGN: A telephone survey was administered to teenagers to assess associations between exposure to anti-industry youth organizing activities and tobacco-related attitudes and behaviors. A group-level comparison between areas high and low in youth organizing activities was planned. Methodological obstacles necessitated a subject-level analytic approach, with comparisons being made between youth at higher and lower levels of exposure. SETTING: Six rural areas (comprising 13 counties) and two urban regions of Minnesota were selected for survey. SUBJECTS: The study comprised 852 youth, aged 15 to 17 years old, randomly selected from county-specific sampling frames constructed from a marketing research database. MEASURES: Exposure index scores were developed for two types of activities designed to involve youth in the anti-industry program: branding (creating awareness of the movement in general) and messaging (informing about the movement's main messages). Attitudinal outcomes measured attitudes about the tobacco industry and the effectiveness of youth action. Behavioral outcomes included taking action to get involved in the organization, spreading an anti-industry message, and smoking susceptibility. RESULTS: Branding index scores were significantly correlated with taking action to get involved (p < or = .001) and spreading an anti-industry message (p < or = .001). Messaging index scores were significantly correlated with all five attitudinal constructs (all associations, p < or = .001), taking action to get involved (p < or = .001), and spreading an anti-industry message (p < or = . 01). The hypothesized association between messaging scores and susceptibility was not significant. CONCLUSION: A youth organizing effort, in combination with an intensive countermarketing media campaign, can be an effective strategy for involving youth in tobacco prevention and generating negative attitudes about the industry.

Self exposure to secondhand smoke among prenatal smokers, abstainers, and nonsmokers.

PURPOSE: Prenatal smoking cessation will not eliminate health risks if women continue to be exposed to passive smoking. This study compared the risks of secondhand smoke (SHS) exposure for low-income prenatal nonsmokers, abstainers, and smokers. METHODS: A questionnaire was administered to 225 pregnant women. Exposure to six sources of SHS was compared across smoking groups using chi-square and multivariate logistic regression. RESULTS: In adjusted analyses, patterns of SHS exposure were consistent. Abstainers were at lower risk of exposure than smokers for all sources except for having a partner who smoked. Abstainers were at higher risk of exposure than nonsmokers for most sources. For example, 11.7% of nonsmokers were exposed to < 4 hours of SHS daily compared with 33.3% of abstainers (adjusted odds ratio = .32, 95% confidence interval = .12-.88). Mean number of exposures for nonsmokers, abstainers, and smokers were 1.4, 2.7, and 4.2, respectively (p < .001). DISCUSSION: Interventions need to address the full range of health risks posed by cigarette smoke exposure during pregnancy.

The advice-giving role of female friends and relatives during pregnancy.

Disparities in prenatal smoking rates indicate the need for new smoking cessation intervention strategies tailored to low-income pregnant women. Information about natural patterns of advice-giving during pregnancy would facilitate this goal. This study examines the advice-giving role of close female friends and relatives ('confidantes') during pregnancy, and assesses the utility of including them in an intervention. A questionnaire was administered verbally to 225 low-income pregnant women to assess: (1) the prevalence and characteristics of confidantes, (2) the persuasiveness of confidante advice in general and with respect to smoking, specifically, and (3) the permissiveness of confidante smoking advice. Comparisons were made with doctors and partners. Most women (91.4%) identified a confidante, the majority of whom were their own mothers. Doctors were rated most persuasive in their general prenatal advice, followed by confidantes and partners (all differences, P < 0.05). A similar pattern was observed among prenatal smokers in relation to advice given about prenatal smoking. As compared to doctors, confidante advice was significantly more permissive of smoking during pregnancy. While women value their doctors' advice during pregnancy, close female friends and relatives also have an important and unique role. Educational efforts may be effective when directed at these advice-givers.