Perceptions of harm to health from cigarettes, blunts, and marijuana among young adult African American men.

OBJECTIVES: To assess perceptions and knowledge of health effects of smoking tobacco, blunts, and marijuana among adult African American (AA) men aged 19-30 in five Black Belt counties of rural Alabama. METHODS: Cross-sectional study using interviewer-administered oral surveys. RESULTS: Four hundred and fifteen participants completed surveys. Cigarettes were the most common initial and current product used (40%) and there were more current than initial users of marijuana and blunts. Significantly more cigarette users (80%) felt that smoking cigarettes was harmful to health compared with marijuana (33%) and blunt (53%) users (p < .001). Many marijuana smokers (71%) and blunt smokers (48%) believed smoking their product was safer than cigarettes for reasons including more natural and less addictive. CONCLUSIONS: When compared with cigarettes, knowledge of the health-related effects of smoking marijuana-containing products among young African American men is poor. Intervention strategies focusing on the adverse health effects of smoking marijuana are needed.

Spiritual health locus of control and health behaviors in African Americans.

OBJECTIVE: To examine relationships between spiritual health locus of control beliefs and various health behaviors. METHODS: A cross-sectional survey of a national sample of African Americans assessed spiritual beliefs, fruit and vegetable consumption, physical activity, and alcohol consumption. RESULTS: Active spiritual beliefs were positively associated with fruit consumption and negatively associated with alcohol consumption. Passive spiritual beliefs were associated with lower vegetable and increased alcohol consumption. Among male participants, passive spiritual beliefs were associated with higher alcohol consumption. CONCLUSIONS: Findings suggest that dimensions of spiritual health locus of control beliefs have complex and varying relationships with health behaviors.

Polychlorinated biphenyl (PCB) exposure and diabetes: results from the Anniston Community Health Survey.

BACKGROUND: Polychlorinated biphenyls (PCBs) manufactured in Anniston, Alabama, from 1929 to 1971 caused significant environmental contamination. The Anniston population remains one of the most highly exposed in the world. OBJECTIVES: Reports of increased diabetes in PCB-exposed populations led us to examine possible associations in Anniston residents. METHODS: Volunteers (n = 774) from a cross-sectional study of randomly selected households and adults who completed the Anniston Community Health Survey also underwent measurements of height, weight, fasting glucose, lipid, and PCB congener levels and verification of medications. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the relationships between PCBs and diabetes, adjusting for diabetes risk factors. Participants with prediabetes were excluded from the logistic regression analyses. RESULTS: Participants were 47% African American, 70% female, with a mean age of 54.8 years. The prevalence of diabetes was 27% in the study population, corresponding to an estimated prevalence of 16% for Anniston overall; the PCB body burden of 35 major congeners ranged from 0.11 to 170.42 ppb, wet weight. The adjusted OR comparing the prevalence of diabetes in the fifth versus first quintile of serum PCB was 2.78 (95% CI: 1.00, 7.73), with similar associations estimated for second through fourth quintiles. In participants < 55 years of age, the adjusted OR for diabetes for the highest versus lowest quintile was 4.78 (95% CI: 1.11, 20.6), whereas in those ≥ 55 years of age, we observed no significant associations with PCBs. Elevated diabetes prevalence was observed with a 1 SD increase in log PCB levels in women (OR = 1.52; 95% CI: 1.01, 2.28); a decreased prevalence was observed in men (OR = 0.68; 95% CI: 0.33, 1.41). CONCLUSIONS: We observed significant associations between elevated PCB levels and diabetes mostly due to associations in women and in individuals < 55 years of age.

Patterns of blunt use among rural young adult African-American men.

BACKGROUND: Blunts are hollowed-out cigars or leaf tobacco filled with marijuana. Use of blunts has increased since the 1990s and, in 2005, 3.5% of all American youth were estimated to have used blunts in the past month. Blunt smokers may have greater odds of cannabis and tobacco dependency and are at risk of smoking-related diseases. Previous studies have suggested that blunt use is more common among blacks, older teens, and men. However, data pertaining to blunt use in non-adolescent African-American populations are scarce. PURPOSE: To assess patterns of blunt use among young adult African-American men aged 19-30 years residing in five rural Black Belt counties in Alabama and to compare these data with those from tobacco cigarette smokers within the same study population. METHODS: Verbal, face-to-face interviewer-administered survey of 415 participants collected and analyzed between December 2008 and February 2011. RESULTS: 159 respondents (38.3%) smoked cigarettes and 45 smoked blunts (10.8%). Of blunt smokers, 33 also smoked cigarettes (73.3%). Use of blunts was prevalent among unemployed, single men, and occupational blunt use was uncommon. Factors important in the initiation, maintenance, and cessation of product use were similar for blunt and cigarette smokers, especially product use and acceptance by friends. Legal concerns were an important factor facilitating blunt cessation. CONCLUSIONS: Blunt use is relatively common among male African Americans aged 19-30 years and is frequently associated with concomitant cigarette use. Tobacco control efforts in this male African-American population should also address blunt usage.

Tobacco use among rural African American young adult males.

OBJECTIVE: Tobacco-related disease is a primary source of mortality for African American men. Recent studies suggest that alternative tobacco products may have supplanted cigarettes as the most common products used by young African Americans. Effective cessation strategies require community-specific prevalence data. This project measures the prevalence of 9 tobacco products among young African American men in rural Alabama. STUDY DESIGN: Principles of community-based participatory research were used to design a verbally administered tobacco product survey to measure the prevalence and behavioral factors influencing use. SETTING: Black Belt counties of rural Alabama. SUBJECTS AND METHODS: African American men aged 19 to 30 years were recruited from the target counties. Participants were stratified by income and education level. Prevalence rates for 9 products were determined, and logistic regression analysis was performed. RESULTS: A total of 415 participants completed surveys. Cigarettes were the most common product ever (54%) and currently (39.9%) used. Participants who attended school for more than 12 years or attended religious services were less likely to use cigarettes. Marijuana and blunts were used next most commonly. Only 35 respondents (8.9%) currently used mini-cigars. Other products, bidis/kreteks, smokeless tobacco, and pipes were used uncommonly in this sample. CONCLUSIONS: Cigarettes remain the dominant tobacco product used by young African American men in rural Alabama. Cigarette prevalence far exceeds that measured statewide for African American men of the same age. Alternative products were not commonly used in this study population. Effective community-based intervention must target cigarette initiation and cessation in this vulnerable population.

Self-perceived lactose intolerance results in lower intakes of calcium and dairy foods and is associated with hypertension and diabetes in adults.

BACKGROUND: Self-perceived lactose intolerance may result in adverse dietary modifications; thus, more studies are needed to understand the prevalence of self-perceived lactose intolerance and how it relates to calcium intake and selected health conditions. OBJECTIVE: The objective was to examine the effects of self-perceived lactose intolerance as it relates to calcium intake and specific health problems that have been attributed to reduced intakes of calcium and dairy foods in a nationally representative multiethnic sample of adults. DESIGN: This was a cross-sectional study in a national sample of 3452 adults. The relation between self-perceived lactose intolerance, calcium intakes, and physician-diagnosed health conditions was analyzed by using linear regression analyses. RESULTS: Of the total sample, 12.3% of respondents perceived themselves to be lactose intolerant. The age-adjusted prevalence of self-perceived lactose intolerance was 7.8% for non-Hispanic whites, 20.1% for non-Hispanic blacks, and 8.8% for Hispanics. Respondents with self-perceived lactose intolerance had significantly lower (P < 0.05) average daily calcium intakes from dairy foods than did those without self-perceived lactose intolerance. A significantly higher (P < 0.05) percentage of respondents with self-perceived lactose intolerance than of respondents without self-perceived lactose intolerance reported having physician-diagnosed diabetes and hypertension. The odds of self-reported physician-diagnosed diabetes or hypertension decreased by factors of 0.70 and 0.60, respectively, for a 1000-mg increase in calcium intake from dairy foods per day. CONCLUSIONS: Self-perceived lactose-intolerant respondents had a significantly lower calcium intake from dairy foods and reported having a significantly higher rate of physician-diagnosed diabetes and hypertension.

Blood pressure in relation to concentrations of PCB congeners and chlorinated pesticides.

BACKGROUND: Residents of Anniston, Alabama, live near a Monsanto plant that manufactured polychlorinated biphenyls (PCBs) from 1929 to 1971 and are relatively heavily exposed. OBJECTIVES: The goal of this study was to determine the relationship, if any, between blood pressure and levels of total serum PCBs, several PCB groups with common actions or structure, 35 individual PCB congeners, and nine chlorinated pesticides. METHODS: Linear regression analysis was used to determine the relationships between blood pressure and serum levels of the various contaminants after adjustment for age, body mass index, sex, race, smoking, and exercise in 394 Anniston residents who were not taking antihypertensive medication. RESULTS: Other than age, total serum PCB concentration was the strongest determinant of blood pressure of the covariates studied. We found the strongest associations for those PCB congeners that had multiple ortho chlorines. We found the associations over the full range of blood pressure as well as in those subjects whose blood pressure was in the normal range. The chlorinated pesticides showed no consistent relationship to blood pressure. CONCLUSIONS: In this cross-sectional study, serum concentrations of PCBs, especially those congeners with multiple ortho chlorines, were strongly associated with both systolic and diastolic blood pressure.

Vaginal douches and other feminine hygiene products: women's practices and perceptions of product safety.

OBJECTIVE: Use of vaginal douche products has been linked with a variety of reproductive health problems; nonetheless, the practice of douching persists. The goals of this study were to 1) determine the use of vaginal douches and other feminine hygiene products, 2) ascertain how safe women think vaginal douche products are, and 3) evaluate women's readiness to stop douching. METHODS: A random-digit-dial computer-assisted telephone survey was conducted among US women between the ages of 18 and 44. RESULTS: Of the 2,602 women interviewed, 11.8% (n = 307) engaged in regular douching (White: 9.1%; African American: 27.7%; Hispanic: 15.0%). Women who douched, compared to women who did not douche, used other feminine hygiene products significantly more often (vaginal sprays [ p < .0001], wipes/towelettes [ p < 0.01], vaginal powder [ p < 0.0001] and bubble bath for feminine cleansing [ p < 0.001]). Women who douched also were more likely than nondouchers to agree with the statement, "Douche products are safe to use; otherwise they wouldn't be on the market" (70.3% vs. 33.4%, respectively; p < 0.0001). Nearly all women (90.0%) who douched had no intention to discontinue the practice. CONCLUSION: Compared with women who do not douche, women who douche use other feminine hygiene products at a much higher rate and also believe that douche products are safe. Women who douche will remain resistant to stopping the practice without innovative interventions. Given that most women start douching in adolescence, teens should be targeted for prevention efforts.