Secondhand Smoke Exposure 7 Years After an Indoor Smoke-Free Law.

PURPOSE: To examine locations of secondhand smoke (SHS) exposure among nonsmokers, 7 years after a statewide smoke-free policy. DESIGN: Data collected via statewide, random digit dial telephone survey. Response rates were 64.7% for landline and 73.5% for cell phone. SETTING: Minnesota, 2014. PARTICIPANTS: Representative sample of 7887 nonsmoking adults. MEASURES: Self-reported locations of SHS exposure and opinions on smoke-free restrictions. ANALYSIS: Descriptive statistics and logistic regression. RESULTS: A total of 35.5% of nonsmokers reported SHS exposure in the past 7 days. The greatest proportion of exposure occurred in community settings (31.7%) followed by cars (6.9%) and in the home (3.2%). Young adults were more likely to be exposed in a home or car than older adults. Nonsmokers living with a smoker were 39.6 (20.6-75.8) times more likely to be exposed to SHS in their home and 5.3 (4.1-6.8) times more likely to be exposed in a car, compared to those who did not live with a smoker. CONCLUSION: SHS exposure continues after comprehensive smoke-free policies restricted it from public places. Disparities in exposure rates exist for those who live with a smoker, are young, and have low incomes. Findings suggest the need for additional policies that will have the greatest public health benefit.

Tobacco Use among Minnesota Adults, 2014.

OBJECTIVES: The changing landscape of tobacco including the introduction of new products such as smokeless tobaccos and electronic delivery devices has highlighted the need for continued surveillance of tobacco use. METHODS: Minnesota has conducted an in-depth surveillance of adult tobacco use since 1999. For the fifth in the series, conducted in 2014, 9304 telephone interviews were completed. RESULTS: The 2014 prevalence of cigarette smoking (14.4%) continues a downward trend that remains lower than the national smoking prevalence (17.3%). Among all Minnesota adults, use prevalence of other tobacco products was as follows: e-cigarettes 5.9%, all smokeless tobaccos 3.6%, cigars 3.0%, water pipe 1.4%, and regular pipe 0.7%. Among individuals who have never smoked cigarettes, smokeless tobacco was the most common product used (2.0%), nearly twice the prevalence of e-cigarette use (1.2%). Former smokers were equally likely to use smokeless tobacco (4.9%) or e-cigarettes (4.8%). Among smokers, 27.3% reported current use of e-cigarettes. CONCLUSION: In the past 15 years, cigarette smoking prevalence in Minnesota has dropped by an average of 0.51 percentage points annually, and prevalence could drop to less than 5% by 2034.

Intermediate CGG repeat length at the FMR1 locus is not associated with hormonal indicators of ovarian age.

OBJECTIVE: Premutation and intermediate CGG repeat length at the fragile X mental retardation 1 (FMR1) locus have been associated with premature ovarian failure. We tested whether intermediate length is associated with indicators of ovarian age in a sample of fertile women. Our primary measures of ovarian age were antimüllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels. METHODS: The cross-sectional sample comprised 258 women with karyotyped spontaneous abortions (140 trisomic spontaneous abortions and 118 chromosomally normal spontaneous abortions or spontaneous abortions with anomalies other than trisomy) and 325 women with recent live births (LBs). We analyzed data from the total sample and data from LBs only. We defined CGG repeat length by the length (both continuous and categorical) on the longer allele. RESULTS: CGG repeat length was not significantly associated with either hormone measure. A repeat length of 35 to 54 CGG, versus the modal category of 30 CGG, was associated with an approximately 7% increase in median AMH level and a 3% increase in median FSH level. Results were unaltered when analyses were limited to LBs. Analyses of hormone levels using cutpoints to define older ovarian age showed no associations with repeat length. Among 10 women with repeat lengths of 35 to 54 CGG analyzed for AGG sequences, the uninterrupted CGG length was not significantly longer among women with hormonal indicators of "old" versus "young" ovarian age. CONCLUSIONS: Our data do not support an association between intermediate CGG repeat length and levels of AMH or FSH among fertile women.

Smoker identity among occasional smokers: findings from Minnesota.

OBJECTIVES: To investigate characteristics of occasional smokers who deny being smokers (ie, deniers). METHODS: Data were from 3 rounds of the Minnesota Adult Tobacco Survey (MATS 2003, 2007, and 2010), a statewide, cross-sectional, and random-digit-dial telephone survey. RESULTS: Nearly half of occasional smokers did not view themselves as smokers. Characteristics that were predictive of being a denier included less perceived harm from secondhand smoke, fewer days smoked, and fewer cigarettes smoked per day. CONCLUSIONS: Denial of being a smoker is primarily characterized by very light smoking. Future communication efforts should be tailored for this group.

Isanti County active living: measuring change in perception and behavior.

BACKGROUND: In 2003, Isanti County MN received an Active Living by Design grant from the Robert Wood Johnson Foundation to increase physical activity through environmental changes. PURPOSE: The goal of the Isanti County Active Living project was to provide leadership in promoting environments that offer choices for active living and increase the physical activity of community members. The project conducted two surveys to examine whether project activities had helped in shaping levels of physical activity and perceptions of the built environment. METHODS: The project conducted a mail survey with a random sample of Isanti County adult residents in February-March 2005 and repeated this survey in August-December 2008, using the same methodology for survey administration. RESULTS: There was a significant increase between 2005 and 2008 in the percentage of Isanti County adults who reported participating in moderate physical activity. In contrast, there was no change in the percentage of Minnesota adults as a whole who reported comparable amounts of moderate physical activity between 2005 and 2007. On measures of the physical environment, there was a significant increase between 2005 and 2008 in the percentage of residents who perceive that their neighborhood encourages physical activity. CONCLUSIONS: The Isanti County Active Living project likely contributed to the increase in moderate physical activity in Isanti County as well as to perceptions of a safe environment conducive to physical activity.

Concurrent use of cigarettes and smokeless tobacco in Minnesota.

Cigarette smokers are being encouraged to use smokeless tobacco (SLT) in locations where smoking is banned. We examined state-wide data from Minnesota to measure changes over time in the use of SLT and concurrent use of cigarettes and SLT. The Minnesota Adult Tobacco Survey was conducted four times between 1999 and 2010 and has provided state-wide estimates of cigarette smoking, SLT use and concurrent use of SLT by smokers. The prevalence of SLT was essentially unchanged through 2007, then increased significantly between 2007 and 2010 (3.1% versus 4.3%, P < 0.05). Similarly, the prevalence of cigarette smokers who reported using SLT was stable then increased between 2007 and 2010 (4.4% versus 9.6%, P < 0.05). The finding of higher SLT use by smokers could indicate that smokers in Minnesota are in an experimental phase of testing alternative products as they adjust to recent public policies restricting smoking in public places. The findings are suggestive that some Minnesota smokers are switching to concurrent use of cigarettes and SLT. Future surveillance reports will be necessary to confirm the results.

The prevalence of unrecognized tobacco use among young adults.

OBJECTIVE: To evaluate the prevalence of smoking among young adults and to describe their characteristics. METHODS: Data were examined from the Minnesota Adult Tobacco Survey, a telephone survey of 8821 residents with a sample of 1205 young adults. RESULTS: Prevalence was 39% using the adolescent definition and 32% using the adult definition. Nearly 1 in 5 young adult smokers may be considered a "previously unrecognized smoker" who would not have been identified as a cigarette user according to the standard adult definition. CONCLUSIONS: Future studies assessing prevalence should use both adolescent and adult measures.

Menopausal transition: predicting time to menopause for women 44 years or older from simple questions on menstrual variability.

OBJECTIVE: To assess whether menstrual variability predicts time to menopause. DESIGN: Analyses drew on 326 menstruating women, aged 44 to 56, who were followed until they reached menopause or the study ended. The women provided data on their menstrual characteristics at intake. We evaluated the utility of six definitions of menstrual variability for predicting time to ascertained menopause (final menstrual period + 12 months): (1) more than 90 days since the most recent menstrual period (n = 20); (2) 60 or more days of amenorrhea during the previous year (n = 71); (3) cycle lengths that varied by 19 or more days (n = 106); (4) cycle lengths too variable to report a usual length (n = 29); (5) cycles less regular than they had been at age 40 (n = 107); and (6) change in the duration or heaviness of menstrual flow compared with age 40 (n = 255). In addition, we evaluated hot flashes or night sweats during the previous week (n = 50) and age 50 or more years (n = 60) as predictors. RESULTS: Definitions 1 to 5 predicted time to menopause; definition 6 did not. Definition 1 had the highest positive predictive value for ascertained menopause within 2 years and within 4 years; definitions 2 and 4 had low to moderate positive predictive values for ascertained menopause within 2 years but good positive predictive values for ascertained menopause within 4 years. For ascertained menopause within 2 years, definition 2 showed the best balance of sensitivity (94%) and specificity (91%). CONCLUSION: Simple questions about menstrual variability elicit information that is informative about proximity to menopause.