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Background and Objective: Prognostic indices have been developed to predict various outcomes, including mortality. These indices and hazard ratios may be difficult for patients to understand. We investigated the association between smoking, respiratory symptoms and lung function with remaining life expectancy (LE) in older adults., Methods: Data were from the 2004/05 English Longitudinal Study of Ageing (ELSA) (n = 8930), participants aged ≥50-years, with mortality data until 2012. Respiratory symptoms included were chronic phlegm and shortness of breath (SOB). The association between smoking, respiratory symptoms and FEV 1 /FVC, and remaining LE was estimated using a parametric survival function and adjusted for covariates including age at baseline and sex., Results: The extent to which symptoms and FEV 1 /FVC predicted differences in remaining LE varied by smoking. Compared to asymptomatic never smokers with normal lung function (the reference group), in never smokers, only those with SOB had a significant reduction in remaining LE. In former and current smokers, those with respiratory symptoms had significantly lower remaining LE compared to the reference group if they had FEV 1 /FVC <0.70 compared to those with FEV 1 /FVC ≥0.70. Males aged 50-years, current smokers with SOB and FEV 1 /FVC <0.70, had a remaining LE of 19.2 (95%CI: 16.5-22.2) years, a decrease of 8.1 (5.3-10.8) years, compared to the reference group., Conclusion: Smoking, respiratory symptoms and FEV 1 /FVC are strongly associated with remaining LE in older people. The use of remaining LE to communicate mortality risk to patients needs further investigation., (© 2024 Asian Pacific Society of Respirology.)

Background and Objective: Respiratory symptoms are recognizable to patients and may be markers of chronic disease and mortality risk. This risk may be easier to conceptualize if presented as remaining life expectancy (LE) rather than hazard ratios. We aimed to predict the remaining LE of older people with respiratory symptoms using data from the Australian Longitudinal Study of Ageing (ALSA)., Methods: The ALSA is a prospective longitudinal cohort of older Australians (n = 2087) with 22 years of follow-up. The symptoms analysed were cough, shortness of breath (SOB) and wheeze. The implied impact on LE was estimated using a parametric survival function., Results: SOB predicted shorter LE irrespective of smoking status. Cough predicted shorter LE in former smokers and wheeze predicted shorter LE in current smokers. The estimated remaining LE of a 70-year-old male never smoker with no symptoms was 16.6 (95% CI: 14.8-17.7) years. The years of life lost for a 70-year-old male current smoker with cough, SOB and wheeze compared to a never smoker with no symptoms was 4.93 (95% CI: 2.87-7.36) years with only 2.99 (95% CI: 1.35-4.97) years being attributed to their current smoking and the remainder to their respiratory symptoms., Conclusion: Respiratory symptoms predict mortality in older people. Cough in former smokers, wheeze in current smokers and all those with SOB require further investigations and disease-specific management., (© 2019 Asian Pacific Society of Respirology.)

Objective: To assess the relation between demographic factors and film smoking stereotypes in adolescents and the potential influence of smoker stereotypes on smoking susceptibility., Design: A cross sectional questionnaire survey of school students (n = 3041) aged 12-13 and 16-17 years who were asked to describe the personal characteristics of female and male smokers in films., Setting: 15 primary or intermediate schools and 10 secondary schools in Auckland, New Zealand., Results: Appraisals of smokers in film were strongly influenced by age and sex with younger adolescents and males more likely to see female smokers as sexy, intelligent and healthy whereas older students and females more often appraised female smokers as stressed bored and depressed. Overall, image stereotypes (sexy, stylish) were more likely to be significantly associated with smoking susceptibility than emotional sensitivity stereotypes (stressed, depressed etc)., Conclusions: Adolescents differ significantly in their appraisal of smokers in films; however, image based stereotypes, rather than emotional sensitivity stereotypes, are significantly associated with smoking susceptibility.

Aim: To compare the relationships of age level, gender, smoking status and ethnicity with Form Two and Form Six students' beliefs about smoking and their familial smoking behaviour., Methods: A stratified sample of 3041 Form Two and Form Six students from schools in the Auckland region was surveyed. Smoking prevalence, frequency, parental smoking and smoking inside the home were assessed using a 60-item questionnaire., Results: Analyses revealed several important differences across and within the Form Two and Form Six data relating to ever smoking, daily smoking and expectations of smoking in the future. Specifically, Form Six students were more likely to be ever smokers, daily smokers and have higher expectations of smoking in the future (p <0.001). Asian students reported a consistently lower propensity to smoke and hold expectations of smoking in the future compared with other ethnic groups. Students from higher-decile-rank schools were more likely to be ever smokers, daily smokers and have positive smoking expectations for the future; (p <0.001, p <0.01, p <0.001). Significant differences in familial smoking acceptability were observed across all measures., Conclusions: The critical age differences were: (1) higher rates of ever smoking; (2) higher rates of daily smoking; and (3) higher levels of smoking expectations in Form Six compared with Form Two. Evidence from this study suggests that by Form Two a proportion of adolescents have already experimented with tobacco and some are daily smokers. Future research should continue to monitor the beliefs and behaviour of young adolescents and older teenagers who are at critical stages for the initiation and establishment of smoking behaviour. In addition, New Zealand's tobacco-control agenda should continue to support adult-focused programmes that reduce the acceptability and visibility of smoking.

Smoking amongst adolescents in New Zealand continues to be a problem, with more than a one-third increase in smoking prevalence between 1992 and 1997. Favourable portrayals of smoking in the media have been cited as potential motivators of the initiation of smoking among adolescents. To date, however, its role in influencing smoking perceptions and behaviours has not received systematic analysis. A qualitative study was conducted to explore how adolescents interpret and decode smoking imagery in movies. Data was collected through focus groups. Same-gender groups of 12- and 13-year-old students were interviewed at their schools. Participants discussed their recollections of and responses to portrayals of smoking in recently viewed films, as well as their perceptions of smoking in general. Students perceived that smoking in film is both highly prevalent and recognisable, and they regarded on-screen-smoking imagery as an accurate reflection of reality. Adolescents in this study were predominantly nonchalant towards the inclusion of smoking images in film, and they perceived an unrealistically high prevalence of smoking amongst peers and adults. Their noncholant response is linked with the perception that smoking is normal and prevalent and with the broad understanding of the constructed nature of media imagery. Smoking imagery in film may play a critical role in reinforcing cultural interpretations of tobacco use, such as its role as a means of stress relief, development of self-image and as a marker of adult independence.