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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

No national data have been used to compare self-reported and biochemically assessed cigarette smoking status among adolescents. We investigated discrepancies between self-reported smoking and measurement of serum cotinine concentration among adolescents aged 12-17 years in a representative sample (n=2,107) of the U.S. population. Smoking prevalence was 12.9% among teens who reported in a private interview whether they smoked during the previous 5 days (95% CI=10.9%-14.9%) and 12.5% (95% CI=10.3%-14.7%) according to serum cotinine concentration greater than 11.40 ng/ml (the cutpoint). Among teens who reported being a nonsmoker (i.e., that they did not smoke during the previous 5 days), 2.7% (95% CI=1.6%-3.8%) had a serum cotinine concentration of greater than 11.40 ng/ml. Discrepancies among self-reported nonsmokers were less likely among Mexican Americans than among Whites. Among self-reported smokers, 21.1% (95% CI=13.7%-28.5%) had a serum cotinine concentration of 11.40 ng/ml or less. This discrepancy is explained primarily by the high proportion (37.0%) of teen smokers who reported smoking, on average, less than 1 cigarette per day. We believe that social stigma or fear that their parents would find out about their survey responses may be the main explanation for the 2.7% discrepancy among self-reported nonsmokers, and that smoking patterns (including the extent of nicotine dosing) and a lack of measurement of recency of cigarette smoking are the main explanations for the 21.1% discrepancy among self-reported smokers. Efforts to improve the validity of self-reported cigarette smoking will benefit tobacco-related surveillance, evaluation, and research activities for adolescents.
Nicotine Tob Res 2004 Feb
PMID:Self-reported cigarette smoking vs. serum cotinine among U.S. adolescents. 1498 84

Despite the reality that smoking remains the most important preventable cause of death and disability, most clinicians underperform in helping smokers quit. Of the 46 million current smokers in the United States, 70% say they would like to quit, but only a small fraction are able to do so on their own because nicotine is so highly addictive. One third to one half of all smokers die prematurely. Reasons clinicians avoid helping smokers quit include time constraints, lack of expertise, lack of financial incentives, respect for a smoker's privacy, fear that a negative message might lose customers, pessimism because most smokers are unable to quit, stigma, and clinicians being smokers. The gold standard for cessation treatment is the 5 As (ask, advise, assess, assist, and arrange). Yet, only a minority of physicians know about these, and fewer put them to use. Acceptable shortcuts are asking, advising, and referring to a telephone "quit line" or an internal referral system. Successful treatment combines counseling with pharmacotherapy (nicotine replacement therapy with or without psychotropic medication such as bupropion). Nicotine replacement therapy comes in long-acting (patch) or short-acting (gum, lozenge, nasal spray, or inhaler) forms. Ways to counter clinicians' pessimism about cessation include the knowledge that most smokers require multiple quit attempts before they succeed, that rigorous studies show long-term quit rates of 14% to 20%, with 1 report as high as 35%, that cessation rates for users of telephone quit lines and integrated health care systems are comparable with those of individual clinicians, and that no other clinical intervention can offer such a large potential benefit.
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PMID:What to do with a patient who smokes. 1628 52