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Background: There is growing evidence that cigarette smoking has become a stigmatized behaviour, at least in western countries, and there is ongoing debate among experts about whether or not such stigma should be an instrument of anti-tobacco policy., Methods: We investigated French non-smokers attitudes toward cigarette smokers, using data from a telephone survey carried out in 2010 among a representative random sample of non-smokers aged 15-75 (N=3091). We carried out a cluster analysis to build contrasted attitudinal profiles and we also computed a score of stigmatization., Results: We found evidence for the existence of stigma associated with cigarette smoking in France: a majority of French non-smokers would not date a smoker, nor hire one to take care of their children. The cluster analysis identified four contrasting profiles, corresponding to different levels of stigmatization, including one cluster whose respondents demonstrated strong levels of moral condemnation and social rejection of smokers. Older people, those with a lower educational level and those reporting financial difficulties were more prone to stigmatize smokers, while those who reported that somebody smoked in their home were less likely to do so. Those who had never smoked and those who abstained from alcohol were more prone to stigmatize smokers. Obese people were also more likely to do so (in bivariate analysis only)., Conclusion: The process of tobacco stigmatization seems well-advanced in France, despite a cultural context that may be less permeable to this process. Further research is needed as our results raise some questions regarding its efficiency as a policy tool. First, people who are familiar with smokers are less prone to stigmatize them. More generally, simultaneously stigmatizing several categories of people may provide each of these same categories with stereotyped 'others' onto whom they can deflect their stigma., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Background: Tobacco control policies have succeeded in reducing tobacco use, but the negative correlation between smoking prevalence and socioeconomic status (SES) has increased. This study focused on the relationships between time preferences, SES, and smoking behaviour, attitudes and risk awareness., Methods: A cross-sectional telephone survey was conducted in France in 2008 on a representative national sample of people aged 18-75 (N = 2000, including 621 smokers) years. Two scales measuring planning horizon and impulsivity and various indicators of SES were introduced into the logistic regressions performed on smoking status and smokers' attitudes to anti-smoking campaigns, quitting attempts, attempts to quit or smoke less, fear of smoking-related cancer and risk perception., Results: Indicators of lower SES and smoking status were correlated with present time orientation and impulsivity. On modelling smoking status, time orientation and lower SES were found to be significant predictors. Among smokers, lower SES and present time orientation were predictive of smoking-related outcomes: little personal concern with anti-tobacco campaigns, not reporting recent behavioural changes, not expressing personal fear of smoking-related cancer and low risk awareness. When time-related preferences were introduced into the analysis, the effects of several lower SES indicators (especially a low educational level) became non-significant., Conclusion: The relationship between SES and smoking behaviour, attitudes and beliefs may be partly mediated by time preferences. Time preference is strongly correlated with smoking status, risk perceptions and attitudes towards anti-smoking campaigns. Tobacco control policies should include messages targeting present time-oriented smokers and/or interventions designed to enhance more future-oriented attitudes among smokers.

Objectives: (1) To build a typology of persistent smokers' reactions to increasing cigarette prices (persistent smokers were defined as smokers who did not quit because of such increases) and (2) to investigate which factors were correlated with their reactions (we considered three categories: no reaction, trying to quit or smoking less, reducing the cost of smoking)., Methods: We used a French national telephone survey (n=2000; 621 smokers) that included questions about smokers' reactions to increasing cigarette prices, as well as questions about their socio-demographic background, personal time perspective, smoking behavior and reasons for smoking. We used logistic regressions to identify which of these factors were linked to smokers' reactions., Results: In response to the increasing cigarette prices, 24% of persistent smokers did not change their smoking habits at all, 31% only reduced the cost of smoking (they neither reduced their consumption nor tried to quit) and 45% tried to give up smoking or reduced their consumption (they also frequently reduced the cost of smoking). Male and older smokers, the more educated ones and the wealthier ones more frequently reported no reaction at all, as did those who smoked to improve their concentration or keep their weight down. Younger and unemployed smokers more frequently opted for spending less on cigarettes, as did those who smoked to forget about their problems. Finally, present-oriented smokers were less prone to try to quit or to reduce their consumption., Conclusion: These findings show the need to increase the price of all tobacco products in cooperation with neighboring states. People's reasons for smoking and their personal time perspectives contribute to their reactions to price increases, and different preventive measures are required for each category of persistent smokers., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Aims: This paper aimed to assess whether the increase of social differentiation of smoking is observed in France., Design and Setting: Five cross-sectional telephone surveys conducted in France between 2000 and 2007., Participants: The surveys were conducted among national representative samples of French subjects aged 18-75 years (n=12 256, n=2906, n=27 499, n=2887, n=6007 in 2000, 2003, 2005, 2006 and 2007, respectively). We focused on three groups: executives, manual workers and the unemployed., Measurements: Time trends of smoking prevalence were assessed, and socio-economic factors (especially occupation and job status) associated with smoking were identified and compared in 2000 and 2005. We also computed respondents' equivalized household consumption (EHI) and their cigarette budget to assess the financial burden of smoking., Findings: Between 2000 and 2007, smoking prevalence decreased by 22% among executive managers and professionals and by 11% among manual workers, and did not decrease among the unemployed. Indicators of an underprivileged social situation were associated more markedly with smoking in 2005 than in 2000. In addition, the falling-off of smoking initiation occurred later and was less marked among manual workers than it was among executive managers and professionals. Finally, in 2005 15% of French smokers devoted at least 20% of their EHI to the purchase of cigarettes, versus only 5% in 2000, and smoking weighted increasingly heavily on the poorest smokers' budgets., Conclusions: While these results point out an increased social differentiation in tobacco use, they underline the need to design and implement other forms of action to encourage people to quit, in particular targeting individuals belonging to underprivileged groups., (© 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction.)

Background: Smoking prevalence is very high among people living with HIV/AIDS, and smoking is riskier for them than for HIV-seronegative people. Promoting smoking cessation among HIV-infected people is therefore an emerging public health priority. Raising cigarette prices is usually considered as one of the most effective ways to reduce smoking, but its effectiveness has never been studied among HIV-infected smokers., Methods: We studied the impact of cigarette price increases among HIV-infected smokers, with data extracted from the French cohort study APROCO-COPILOTE conducted between 1997 and 2007 among 1,146 patients. Data regarding respondents' smoking status was collected every 8 months over the first 5 years, and every 12 months thereafter., Results: We found striking differences across transmission groups regarding socio-demographic background and smoking prevalence. The Intravenous Drug Use (IDU) group was characterised by a lower socioeconomic status, a higher smoking prevalence and a smaller decrease in this prevalence over the period 1997-2007. The homosexual group had a higher socioeconomic status, an intermediate smoking prevalence in 1997, and the highest rate of smoking decrease. In the dynamic multivariate analysis, smoking remained correlated with indicators of socioeconomic disadvantage and with infection through IDU. Aging and cigarette price increase had a negative impact on smoking among the homosexual group, but not for the IDU group., Conclusion: Among seropositive people, just as for the general population, poor smokers are poor quitters. Public health authorities should consider interventions which are not smoking-specific, but which contribute to improve the living conditions of the most deprived HIV-infected smokers.

Background: The relationship between smoking and poverty is a public health issue in many countries, and several studies have shown a link between living in deprived neighbourhoods and smoking. In France the prevalence of smoking has decreased since the year 2000s. We examined whether reduced smoking rates differed by socio-economic status, anticipating reductions to be smaller amongst lower socio-economic groups. We also investigated whether poor housing conditions and/or living in a deprived neighbourhood were significantly associated with smoking., Methods: Data were collected by telephone surveys conducted between 2000 and 2007 with representative samples of the French population aged 18-75. The data from the last of these surveys (2007, N=6007) were also used to carry out a cluster analysis on various indicators relating to housing conditions and neighbourhood., Results: Between 2000 and 2007 the social differential in smoking rates increased sharply in France. Specific types of neighbourhood and poor housing conditions (described as cramped housing in a noisy and stressful environment or deprived neighbourhood), which were closely correlated with socio-economic status, were found to be significantly correlated with smoking, even after adjusting for potential key confounders and especially for individual markers of social disadvantage., Conclusion: Interventions which do not specifically target smoking but which contribute to improving poor smokers' living conditions, are necessary to promote smoking cessation.

Objective: To study the relationships between working conditions, job dissatisfaction and smoking behaviors among clerks and manual workers., Methods: We used data from the French Health Barometer, a cross-sectional telephone survey conducted among a national random sample (N = 4825). Regarding working conditions, the questionnaire dealt with reported job satisfaction, psychological demands and mental workload, physical demands, latitude decision and work schedule., Results: Manual workers and clerks who reported strong dissatisfaction toward unhealthy working conditions also reported more frequently current smoking, tobacco dependence, potential alcohol dependence and perceived stress. After adjusting for socio-demographic confounders, perceived working conditions and job dissatisfaction remained correlated with smoking and tobacco dependence., Conclusions: Poor working conditions may heavily contribute to health inequalities, as they are likely to fuel both stress and unhealthy behaviors, which combine to increase morbidity and mortality.

In France, between 2000 and 2008, concurrently to the increase in cigarette price, we observed an increasing social differentiation of cigarette smoking: smoking prevalence decreased among executive managers and professional occupations, it remained stable among manual workers, and it increased among the unemployed. Poor smokers were heavier smokers, they were more frequently tobacco-dependent, and they were more prone to smoke automatically or to reduce "negative feelings". In-depth interviews provided a more comprehensive insight into poor smokers' motivations: they were aware of their addiction, but they also talked about the pleasure they get from smoking, and they highlighted the essential needs satisfied by smoking: stress relief, cheap leisure, compensation for loneliness, break-up or redundancy... Acknowledging the functional aspects of smoking experienced by poor smokers helps to understand why increasing the cigarette price is unlikely to deter many poor smokers from smoking.

Background: The aim of this study was to examine smoking motivation and motivation to quit, and determinants of these motivations among HIV-infected cigarette smokers., Methods: We conducted a 1-day cross-sectional survey on cigarette smoking in a representative sample of HIV-infected outpatients of French hospitals. A cluster analysis was used to characterize respondents' smoking motivation. A logistic regression was performed to study the factors associated with motivation to quit, including the clusters describing smoking motives., Results: We found four clusters of smoking motivation. These included intellectual/emotional support (22% of respondents), automatic/stress relief (22%; characterized by heavy smoking and strong dependency); weight control (29%; characterized by frequent symptoms of fat accumulation because of antiretroviral therapy) and pleasure/conviviality (27%; corresponding to 'lighter' smokers). In the logistic regression model, among other significant covariates (cigarette consumption level, tobacco dependence and perceived risk of developing a smoking-related disease), the automatic/stress relief cluster was negatively correlated to the motivation to quit (odds ratio 0.39), whereas the weight control cluster was strongly associated to this motivation (odds ratio 2.87)., Conclusions: The diversity of HIV-infected smokers' profiles suggests that different types of anti-tobacco measures should be implemented in this population, such as information campaigns on specific risks incurred by HIV-infected smokers, non-specific and comprehensive measures for those for whom smoking is combined with other difficulties, and alternative therapeutic solutions for those who smoke to deal with lipodystrophy.

Background: To assess the prevalence of and factors associated with tobacco smoking and dependence in HIV patients., Methods: In a one-day cross-sectional national survey of a representative sample of 82 French units specialized in HIV-infected patient care, 727 consecutive outpatients were asked to complete a self-administered questionnaire, assessing smoking habits, dependence, cessation motivation, other substance abuse, sociocultural characteristics, life with HIV and its treatment. Smoking prevalence and dependence were assessed and compared with a representative sample of the general French population., Results: The questionnaire was completed by 593 (82%) patients: 12% were active or ex-intravenous drug users, 37% were homosexual men, and 43% were active smokers (compared with 31% in the French population) of whom 56% were classified as moderately or highly dependent. Fourteen percent of smokers were highly motivated and free of other substance abuse and of depressive symptoms. Smoking was independently associated with male sex (odds ratio [OR] = 2.38; 95% confidence interval [CI] 0.99-1.11), lower body mass index (OR 1.08; 95% Cl 1.14-1.03), smoking environment (OR 4.75; 95% Cl 3.02-7.49), excessive alcohol consumption (OR 2.50; 95% CI 1.20-5.23), illicit drug use (OR 2.43; 95% CI 1.41-4.19), HIV status disclosure to family (OR 1.81; 95% CI 1.16-2.85) and experience of rejection due to disclosure (OR 1.90; 95% CI 1.14-3.17). Disclosure and drug substitute usage were associated with high tobacco dependence., Conclusions: Very few HIV smokers seem to be good candidates for a standard tobacco cessation program. Tobacco reduction or cessation strategies should be adapted to this population.

Background: Past studies on smokers' risk perception have produced mixed results. We endorsed a new approach to assess smokers' perceptions of risk by asking them to estimate threshold values for the cancer risk associated with daily consumption of tobacco and number of smoking years. We expected that many smokers would endorse a "risk denial" attitude, with threshold estimates higher than their own smoking consumption and duration., Methodology: A French national telephone survey (n = 3820; 979 current smokers) included several questions about smoking behaviours and related beliefs., Results: Among current smokers, 44% considered that smoking can cause cancer only for a daily consumption higher than their own consumption, and an additional 20% considered that the cancer risk becomes high only for a smoking duration higher than their own. Most smokers also agreed with other "risk denial" statements ("smoking is not more dangerous than air pollution," "some people smoke their whole life but never get sick"). Those who considered they smoked too few cigarettes to be at risk were less likely to report personal fear of smoking related cancer., Conclusion: Risk denial is quite widespread among smokers and does not simply reflect a lack of information about health risks related to tobacco. Fully informing smokers about their risks may necessitate changing the way they process information to produce beliefs and limiting their capacity to generate self exempting beliefs.

Aims: To study the relationship between sporting activity and alcohol, cigarette and cannabis use among adolescents and young adults, by focusing on elite student athletes (ESAs)., Design, Setting, Subjects: Cross-sectional survey (Spring 2002), in a sample of 460 ESAs (ages 16-24 years) recruited at 40 public centres gathering the young sporting elite from 30 different sports in South-Eastern France, comparison with samples of the general population of adolescents in South-Eastern France., Measures: Respondents were asked confidentially by a self-administered questionnaire about their use of licit and illicit drugs, their sporting activity and other aspects of their life-style., Findings: Prevalences of cigarette, alcohol and cannabis use were markedly lower for ESAs than for other adolescents (generally twice or three times as low). Among ESAs, when compared with the practice of an individual sport, the practice of a team sport was correlated positively with alcohol use (OR = 2.7 for girls, OR = 1.8 for boys), and the practice of a sliding sport was correlated positively with cannabis use (for girls: OR = 2.3) and with alcohol use (for boys: 4.3). Girls who entered competition at international level were more prone to smoke cigarettes and cannabis (OR = 6.1 and 2.4, respectively)., Conclusions: As a whole, practising sports as an elite student-athlete can be considered as correlated negatively with cigarette, alcohol and cannabis use. Nevertheless, this relationship depends on the kind of sport practised as well as the level of competition, and further research is needed to understand specific elite athletes' motives for use.

Aims: This study aimed at increasing understanding of the relationship between sporting activities and alcohol, cigarette and cannabis use among adolescents, by examining gender, age and the context of sporting practice., Design, Setting, Subjects: The study was a national school survey (n=10807; ages 14-19 years) conducted in France in 1999., Measures: Respondents were asked confidentially by self-administered questionnaire (pen and paper) about their use of licit and illicit drugs and life-style (including sporting activities outside school: hours per week, registration in a club, type of sport)., Findings: The U-shaped curve between the intensity of physical activities and licit and illicit drug use appeared not to be systematic. It depended mainly on the product and the level of use. It only remained significant for boys and heavy smoking once gender and age effect were taken into account., Conclusion: The results stress the need to control for age and gender when the survey participants are teenagers. The relationship between drug use and sporting activity also depends on the type of sport.

The article presents an analysis of anti-smoking advertisements from Eastern Europe, the United States, and Australia over a twenty year period, with a focus on the presentation of smoking as disgusting. Topics include the creation of disgust for cigarettes, the use of disgust in the anti-tobacco campaign, and the attempt to define disgust in order to use it in the campaign.

Aims: We present the results of a cross-sectional survey that investigates young smokers’ reactions to an increase in cigarette prices in France, and the factors associated with these reactions. Methods: This survey was carried out in 2005–2006, in South-Eastern France, among first-year university students (response rate: 71%, N = 1723). Findings: Among the 427 current daily smokers, 32% did not react to the increase, 33% reduced the cost of smoking (they purchased cigarettes in foreign countries or smuggled cigarettes, turned to a cheaper brand or to hand-rolled cigarettes) and 35% reduced their consumption or tried to quit. Daily smokers with low-educated parents were less likely to react to the price increase, as well as those with psychological distress. Students with financial difficulties were more prone to diminish the cost of smoking, while students who suffered from being apart from family were less likely to reduce their consumption. Conclusions: Further research is needed to better understand the diversity and heterogeneity of young smokers’ reaction to cigarette price increase, in relation to their socio-economic background and their motivations for smoking. [ABSTRACT FROM AUTHOR]

Individuals with certain personal, family and job characteristics are at elevated risk of poor mental health. Yet, the respective role of obesity, smoking, alcohol abuse, low education, income, living and family conditions, and socio-occupational category in fatigue/insomnia (FI), nervousness (N) and frequent drug use for those disorders (DFI and DN) among men and women and in gender disparities are not well known. We studied gender differences in FI, N, DFI, DN, and in their correlated, and whether the gender differences were mediated by individual and lifestyle factors among 3,450 active subjects aged 18–64, randomly selected from North-eastern France. Subjects completed a post-mailed questionnaire. Data were analyzed via adjusted odds ratio (ORa) computed with the logistic regression model. Women were more affected than men for FI (21.3 vs. 13.1%, OR adjusted for age ORa 1.80, 95% CI 1.50–2.16), DFI (11.6 vs. 7.1%, ORa 1.74, 1.38–2.21), N (14.7 vs. 9.9%, ORa 1.58, 1.28–1.94), and for DN (12.1 vs. 5.7%, ORa 2.29, 1.79–2.94). These differences were not mediated by the individual characteristics studied. Multivariate analysis showed that the risk patterns varied between the two sexes. Smoking was related to N in men as well as in women; alcohol abuse to DFI in men only; lack of family support to all outcome variables in men and women; low educational level to DFI in men only; low income to FI, N and DN in men and to FI and DN in women; being unmarried to DN in men; being divorced/separated to N and DN in women; being a manual worker to FI and being a farmer to DFI in men; and being a manual worker to DN and being an employee to FI in women (1.50 ≤ ORa ≤ 2.95). Women suffered more from fatigue/insomnia and nervousness and used more drug for those disorders than men. Socio-demographic and lifestyle factors played significant roles among men and women but they did not explain the gender disparities. [ABSTRACT FROM AUTHOR]

This paper aims to illustrate the relevance of Howard S. Becker's sociological model of deviance for a better understanding of contemporary adult smoking. From this perspective, one crucial aspect of smoking is smokers' ability to develop and entertain convincing rationalizations that help them to deny smoking hazards and challenge anti-tobacco messages. Several hypotheses are derived from this model and most of them are successfully tested with quantitative data from a cross-sectional survey conducted in the Paris Ile-de-France Region. As expected, most smokers agreed that smoking damages health and considered being well-informed about smoking hazards, even those who denied these hazards for themselves. Moreover, smokers' rationalizations were closely correlated to cigarette consumption and duration since smoking initiation. Paradoxically, risk denial was also stronger among smokers who have some characteristics usually considered as protective factors against smoking (especially future-orientation and importance attached to one's health). More generally, our sociological perspective leads to consider smokers' risk denial as the result of acquired cognitive skills instead of the consequences of lack of information or psychological bias. We believe it provides a promising avenue for further research. [ABSTRACT FROM AUTHOR]

This study examines attitudes to smoking among adolescents. Data for the study is derived from a large quantitative French cross-sectional survey of school students. Attitudes toward smoking were found to be associated with regularity and quantity of consumption, and the type of school attended. These associations are explained according to Becker's concept of a 'moral career', for attitudes differ among occasional, regular and heavy smokers. The association with school type indicates advanced formal schooling enables students to offer sophisticated rationalisations for smoking, combining an acknowledgement of health-related risks of smoking, emphasis on personal benefits derived from smoking, and claims that smoking is a private matter. [ABSTRACT FROM AUTHOR]

In France as in other developed countries, cigarette smoking has been acknowledged as the most preventable cause of death and disability. Tobacco control has become a priority for the French government, which decided a 20% rise of the cigarette price at the end of 2003 and plans further rise in 2004. This study adopted a life-course perspective with retrospective data extracted from a national telephone survey for assessing the impact of pricing policy and some other predictors on smoking behaviours in France during the period 1965–1999. Our findings suggest that during a period marked by cultural trends favouring more frequent and earlier initiation of cigarette smoking, pricing policy has been a poor deterrent to youth smoking. Such findings highlight the necessity to implement simultaneously other preventive strategies, including restrictions on tobacco advertising, youth access and smoking in public places, as well as mass media campaigns and school-based educational interventions. [Copyright &y& Elsevier]