Biostatistics Inc

Sarasota, FL, United States

Biostatistics Inc

Sarasota, FL, United States
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Giovino G.A.,State University of New York at Buffalo | Villanti A.C.,The Schroeder Institute for Tobacco Research and Policy Studies at Legacy | Mowery P.D.,Biostatistics Inc. | Sevilimedu V.,Biostatistics Inc. | And 3 more authors.
Tobacco Control | Year: 2015

Introduction: Mentholated cigarettes are at least as dangerous to an individual’s health as non-mentholated varieties. The addition of menthol to cigarettes reduces perceived harshness of smoke, which can facilitate initiation. Here, we examine correlates of menthol use, national trends in smoking menthol and non-menthol cigarettes, and brand preferences over time.Methods: We estimated menthol cigarette use during 2004–2010 using annual data on persons ≥12 years old from the National Surveys on Drug Use and Health. We adjusted self-reported menthol status for selected brands that were either exclusively menthol or nonmenthol, based on sales data. Data were weighted to provide national estimates.Results: Among cigarette smokers, menthol cigarette use was more common among 12–17 year olds (56.7%) and 18–25 year olds (45.0%) than among older persons (range 30.5% to 34.7%). In a multivariable analysis, menthol use was associated with being younger, female and of non-Caucasian race/ethnicity. Among all adolescents, the percentage who smoked non-menthol cigarettes decreased from 2004–2010, while menthol smoking rates remained constant; among all young adults, the percentage who smoked non-menthol cigarettes also declined, while menthol smoking rates increased. The use of Camel menthol and Marlboro menthol increased among adolescent and young adult smokers, particularly non-Hispanic Caucasians, during the study period.Conclusions: Young people are heavy consumers of mentholated cigarettes. Progress in reducing youth smoking has likely been attenuated by the sale and marketing of mentholated cigarettes, including emerging varieties of established youth brands. This study should inform the Food and Drug Administration regarding the potential public health impact of a menthol ban. © 2015, BMJ Publishing Group. All rights reserved.


Villanti A.C.,Schroeder Institute for Tobacco Research and Policy Studies at Legacy | Giovino G.A.,State University of New York at Buffalo | Barker D.C.,Consultants Inc. | Mowery P.D.,Biostatistics Inc. | And 2 more authors.
American Journal of Public Health | Year: 2012

This study examines patterns of menthol and nonmenthol cigarette use from 2003 to 2005 in a cohort of smokers, aged 16 to 24 years in the National Youth Smoking Cessation Survey. At follow-up, 15.0% of baseline menthol smokers had switched to nonmentholated cigarettes; by contrast, 6.9% of baseline nonmenthol smokers had switched to mentholated cigarettes. Differences in switching patterns were evident by gender, race/ethnicity, parental education, and smoking frequency. These data support previous evidence that young smokers start with mentholated cigarettes and progress to nonmentholated cigarettes.


Mowery P.,Biostatistics Inc. | Delnevo C.,Rutgers University | Byron M.J.,Schroeder Institute for Tobacco Research and Policy Studies | Thornton-Bullock A.,American Legacy Foundation
American Journal of Public Health | Year: 2011

Objectives. We examined patterns in cigar use among young adults, aged 18- 25 years, focusing on race/ethnicity and brand. Methods. We conducted a secondary data analysis of cross-sectional waves of the National Survey on Drug Use and Health, 2002-2008, using multivariate logistic regression to assess time trends in past 30 days cigar use, past 30 days use of a "top 5" cigar brand, cigar use intensity, and age at first cigar use. Results. Cigar use has increased among White non-Hispanic men aged 18 to 25 years, from 12.0% in 2002 to 12.7% in 2008. Common predictors of all outcomes included male gender and past 30 days use of cigarettes, marijuana, and blunts. Additional predictors of past 30 days cigar and "top 5" brand use included younger age, non-Hispanic Black or White race, lower income, and highest level of risk behavior. College enrollment predicted intensity of use and "top 5" brand use. Conclusions. Recent legislative initiatives have changed how cigars are marketed and may affect consumption. National surveys should include measures of cigar brand and little cigar and cigarillo use to improve cigar use estimates.


Schauer G.L.,Centers for Disease Control and Prevention | Malarcher A.M.,Centers for Disease Control and Prevention | Mowery P.,Biostatistics Inc
Nicotine and Tobacco Research | Year: 2016

Introduction: To understand changes occurring in nondaily smoking, we assessed differences in demographics and trends in nondaily smoking, by smoking frequency and amount. Methods: Participants were 13 966 adult nondaily cigarette smokers (NDS) age 18 years and older responding to the 2000-2012 US National Health Interview Survey, an annual, nationally-representative, cross-sectional, household interview survey. We created a nine-level smoking frequency- amount variable using tertile cut points from the number of days smoked in the past 30 (1-7, 8-14, 15-29 days) and number of cigarettes smoked per day (cpd; 1-2, 3-5, ≥6). We computed weighted frequencies by low-, moderate-, high-frequency use, by low-, moderate-, high-cpd amount, and by demographics. We estimated temporal trends using weighted least squares regression, and the association between groups and past-year quit attempts using logistic regression. Results: Overall prevalence of nondaily smoking among adults remained stable between 2000 to 2012 (P = .62). The most prevalent nondaily smoking frequency-amount groups were: smoking 15-29 days (in the past 30), 3-5 cpd (20.2%); 1-7 days, 1-2 cpd (19.7%); 15-29 days, 1-2 cpd (14.9%); and 15-29 days, ≥6 cpd (12.1%). From 2000 to 2012, low-cpd NDS (1-2 cpd) across moderate (8-14 days) and high (15-29 days) frequency groups increased (P < .01), while moderate frequency-moderate cpd (8-14 days, 3-5 cpd; P < .05) and high frequency-high cpd (15-29 days, ≥6 cpd; P < .01) NDS declined. Adjusting for demographics and year, the lowest frequency-amount groups had the lowest odds of past-year quit attempts. Conclusion: Changes occurred in NDS frequency and amount from 2000 to 2012, suggesting that more granular classifications may be important for monitoring NDS patterns. Implications: From 2000 to 2012, low-cpd NDS (1-2 cpd) across moderate- (8-14 days) and high-frequency (15-29 days) groups increased in the United States, while moderate frequency-moderate cpd (8-14 days, 3-5 cpd) and high frequency-high cpd (15-29 days, ≥6 cpd) NDS declined. Demographic differences were found across NDS frequency-amount groups. Adjusting for demographics and year, the lowest frequency-amount groups had the lowest odds of past-year quit attempts. These data can be used to further understand evolving patterns of NDS behavior, and to provide possible targeted groups-both by demographics and smoking frequency/amount-for future research and intervention. © Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2015.


Zhang L.,Centers for Disease Control and Prevention | Vickerman K.,Alere Inc | Malarcher A.,Centers for Disease Control and Prevention | Mowery P.,Biostatistics Inc.
Nicotine and Tobacco Research | Year: 2014

Introduction: From March 19 through June 10, 2012, the Centers for Disease Control and Prevention launched the first federally funded National Tobacco Education Campaign: Tips From Former Smokers (Tips). This study examined the campaign's impact on quitline callers' intermediate cessation outcomes. Methods: We used quitline data from 23 states to examine changes in enrollment, service utilization, quit attempts, and selfreported quitting for 7 days or longer during Tips versus a similar time period in 2011. We used multivariate models to examine the relationship between Tips exposure (measured as gross rating points [GRPs]) and cessation outcomes during the campaign in 2012. We also assessed whether the Tips campaign's impact differed by state tobacco control funding. Results: Compared with similar weeks in 2011, the number of quitline callers and callers who received counseling and/or nicotine replacement therapies increased by 88.6% (48,738 in 2011 vs. 91,911 during Tips) and 70.8% (40,546 in 2011 vs. 69,254 during Tips), respectively. Greater numbers of callers reported having made 24-hr quit attempts or quitting for 7 days or longer during the campaign. Higher Tips campaign GRPs were positively associated with quit attempts and with quitting for 7 days or longer among persons from states with higher tobacco control funding. In states with lower funding, the highest GRP group (2,000+ GRPs) had lower levels of cessation compared with the middle GRP group (1,200-1,999 GRPs). Conclusions: An evidence-based national tobacco education campaign with adequate reach and frequency can lead to substantial increases in quitline use and, to a lesser degree, intermediate cessation outcomes.


Nelson D.E.,U.S. National Cancer Institute | Pederson L.L.,McKing Consulting Corporation | Mowery P.,Biostatistics Inc. | Bailey S.,Centers for Disease Control and Prevention | And 4 more authors.
Tobacco Control | Year: 2015

Purpose: The news media plays an important role in agenda setting and framing of stories about tobacco control. The purpose of this study was to examine newspaper, newswire and television coverage of tobacco issues in the USA over a 7-year period.Methods: Analyses of 2004–2010 news media surveillance system data from the US Centers for Disease Control and Prevention’s Office on Smoking and Health, based on content analysis and quantitative methods. Information on extent of news coverage, and types of tobacco-related themes, were examined from articles in 10 newspapers and 2 major newswires, as well as transcripts from 6 national television networks.Results: The overall extent of newspaper, newswire and television stories about tobacco, and level of coverage by specific media outlets, varied over time, especially for newspapers. Nevertheless, there was an average of 3 newspaper stories, 4 newswire stories, and 1 television tobacco-related story each day. Television stories were more likely to contain cessation/addiction or health effects/statistics themes and less likely to contain secondhand smoke or policy/regulation themes than newspaper/newswire stories. There was more variation in the choice of tobacco theme among individual newspapers/newswires than television media outlets.Conclusions: News coverage of tobacco in the USA was relatively constant from 2004 to 2010. Audiences were more likely to be exposed to different tobacco themes in newspapers/newswires than on television. Tracking information about tobacco news stories can be used by advocates, programs and others for planning and evaluation, and by researchers for hypothesis generation. © 2015, BMJ Publishing Group. All rights reserved.


Caraballo R.S.,Centers for Disease Control and Prevention | Holiday D.B.,Rti International | Stellman S.D.,Columbia University | Mowery P.D.,Biostatistics Inc. | And 6 more authors.
Cancer Epidemiology Biomarkers and Prevention | Year: 2011

Background: The Food and Drug Administration (FDA) is examining options for regulating menthol content in cigarettes. There are many pharmacologic properties of menthol that may facilitate exposure to tobacco smoke, and it has been suggested that the preference for menthol cigarettes in black smokers accounts for their higher cotinine levels. Objective: To assess cigarettes smoked per day-adjusted cotinine levels in relation to smoking a menthol or nonmenthol cigarette brand among non-Hispanic black and white U.S. adult smokers under natural smoking conditions. Method: Serum cotinine concentrations were measured in 1,943 smokers participating in the 2001 to 2006 National Health and Nutrition Examination Surveys (NHANES). The effect of smoking a menthol brand on cigarettes smoked per day-adjusted serum cotinine levels in these two populations was modeled by adjusting for sex, age, number of smokers living in the home, body weight, time since last smoked, and FTC (Federal Trade Commission)-measured nicotine levels. The 8- or 12-digit Universal Product Code (UPC) on the cigarette label was used to determine the cigarette brand and whether it was menthol. Results: Smoking a menthol cigarette brand versus smoking a nonmenthol cigarette brand was not associated (P ≥ 0.05) with mean serum cotinine concentration in either black or white smokers. Conclusions: The higher levels of cotinine observed in black smokers compared with white smokers are not explained by their higher preference for menthol cigarette brands. Impact: Further studies like ours are needed to improve our ability to understand health consequences of future changes in tobacco product design. ©2011 AACR.


PubMed | Centers for Disease Control and Prevention, Training and Biostatistics Inc.
Type: | Journal: Tobacco control | Year: 2016

Describe cigarette smoking abstinence among employer and health plan-sponsored quitline registrants who were not using Electronic Nicotine Delivery Systems (ENDS), were using ENDS to quit smoking or were using ENDS for other reasons at the time of quitline registration.We examined 6029 quitline callers aged 18years who smoked cigarettes at registration, and completed 1 counselling calls, baseline ENDS use questions and a 6-month follow-up survey (response rate: 52.4%). 30-day point prevalence smoking quit rates (PPQRs) were assessed at 6-month follow-up (ENDS-only users were considered quit). Data were weighted for non-response bias. Logistic regression analyses controlled for participant characteristics and programme engagement.At registration, 13.8% of respondents used ENDS (7.9% to quit smoking, 5.9% for other reasons). 30-day PPQRs were: 55.1% for callers using ENDS to quit, 43.1% for callers using ENDS for other reasons, and 50.8% for callers not using ENDS at registration. Callers using ENDS for other reasons were less likely to quit than other groups (adjusted ORs=0.65-0.77); quit rates did not significantly differ between non-ENDS users and those using ENDS to quit. Among callers using ENDS to quit at baseline, 40% used ENDS regularly at follow-up.ENDS users not using ENDS to quit smoking were less successful at quitting at 6-month follow-up compared with callers using ENDS to quit smoking and callers who did not use ENDS at programme registration. Incorporating reasons for ENDS use may be important for future studies examining the role of ENDS in tobacco cessation.


Vallone D.M.,Research and Evaluation | Duke J.C.,Research Triangle Institute | Mowery P.D.,Biostatistics Inc. | McCausland K.L.,Research and Evaluation | And 5 more authors.
American Journal of Preventive Medicine | Year: 2010

Background: Mass media campaigns can be an effective strategy to increase quitting activity among smokers, particularly when aired in the context of other anti-tobacco efforts. Design: A longitudinal study using data collected from smokers identified in a random-digit-dial survey of adults in Grand Rapids MI, prior to the campaign and approximately 6 months after the launch of the campaign. Setting/participants: Adult smokers who were interviewed in the fall of 2006 and agreed to participate in a follow-up interview approximately 6 months later (n=212). Intervention: A pilot mass media campaign, branded EX®, which used empathy to encourage smokers to "relearn" life without cigarettes, and focused on disassociating smoking from common activities that would otherwise function as smoking cues, such as driving or drinking coffee. The campaign averaged 100 targeted rating points per week on television. Main outcome measures: Primary outcome measures were five campaign-related cognitions and confidence in quitting. Secondary outcome measures were quitting behaviors. Results: This 2007 analysis suggests that the campaign generated a high level of awareness of EX, with 62% of the sample demonstrating confirmed awareness and 79% reporting aided awareness. Awareness of EX was associated with significant change in two of five campaign-related cognitions. Awareness was not associated with confidence in quitting or having made a quit attempt. Conclusions: These findings demonstrate that a branded, empathetic media campaign that offers smokers practical advice on how to approach quitting can change cognitions related to successful cessation over a relatively short time period. © 2010 American Journal of Preventive Medicine.


Mowery P.D.,Biostatistics Inc. | Babb S.,CDC Office on Smoking and Health | Hobart R.,ICF International | Tworek C.,West Virginia University | MacNeil A.,CDC Office on Smoking and Health
Journal of Environmental and Public Health | Year: 2012

Introduction. Preemption is a legislative or judicial arrangement in which a higher level of government precludes lower levels of government from exercising authority over a topic. In the area of smoke-free policy, preemption typically takes the form of a state law that prevents communities from adopting local smoking restrictions. Background. A broad consensus exists among tobacco control practitioners that preemption adversely impacts tobacco control efforts. This paper examines the effect of state provisions preempting local smoking restrictions in enclosed public places and workplaces. Methods. Multiple data sources were used to assess the impact of state preemptive laws on the proportion of indoor workers covered by smoke-free workplace policies and public support for smoke-free policies. We controlled for potential confounding variables. Results. State preemptive laws were associated with fewer local ordinances restricting smoking, a reduced level of worker protection from secondhand smoke, and reduced support for smoke-free policies among current smokers. Discussion. State preemptive laws have several effects that could impede progress in secondhand smoke protections and broader tobacco control efforts. Conclusion. Practitioners and advocates working on other public health issues should familiarize themselves with the benefits of local policy making and the potential impact of preemption. Copyright © 2012 Paul D. Mowery et al.

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