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Paul E. Terry	1165	Editorial For Whom the Bell Tolls: A Special Journal Issue on Smoking Control and an Interview with Dr. Harry Lando This special issue of the American Journal of Health Promotion is dedicated to the science of smoking control. From what’s working via Quit-Lines for adults to using NRT with kids and from an examination of e-cigarettes to the application of the socio-ecological framework, this issue reflects remarkable creativity, a commitment to continuous improvement and some edifying success stories in tackling tobacco addiction. This commentary features an interview with Dr. Harry Lando who is Distinguished International Professor in the Division of Epidemiology and Community Health in the School of Public Health of the University of Minnesota.
the Science of lifestyle change
Interventions
Jessica H. Williams Kathryn DeLaughter Julie E. Volkman Rajani S. Sadasivam Midge N. Ray Gregg H. Gilbert Thomas K. Houston	1170	Tobacco Control Exploring Online Asynchronous Counseling with Tobacco Treatment Specialists in The QUIT-PRIMO and National Dental PBRN HI-QUIT studies: Who uses it and what do they say? The purpose of this research is to describe the content of messages sent by smokers through asynchronous counseling within a Web-based smoking cessation intervention. Setting: National community-based setting of patients who had been engaged by the medical or dental practices at which they attended or via Google advertisements. Participants were Adults older than 19 years who were current smokers and interested in quitting. Participants throughout the United States referred to a Web-based cessation intervention by their medical or dental provider or by clicking on a Google advertisement. We conducted a qualitative review of 742 asynchronous counseling messages sent by 270 Web site users. Messages were reviewed, analyzed, and organized into qualitative themes by the investigative team. Result of the research was that the asynchronous counseling feature of the intervention was used most frequently by smokers who were white (87%), female (67%), aged 45 to 54 (32%), and who had at least some college-level education (70%). Qualitative analysis yielded 7 basic themes—Talk about the Process of Quitting, Barriers to Quitting, Reasons to Quit, Quit History, Support and Strategies for Quitting, Quitting with Medication, and Quit Progress. The most common theme was Support and Strategies for Quitting with 255 references among all messages. Conclusion of the research is that we found rich communication across the spectrum of the quit process, from persons preparing to quit to those who had successfully quit. Asynchronous smoking cessation counseling provides a promising means of social support for smokers during the quit process.
Research Methods
Deanna P. Jannat-Khah LeConté J. Dill Simone A. Reynolds Michael A. Joseph	1178	Qualitative Research Stress, Socializing and Other Motivations for Smoking Among the Lesbian, Gay, Bisexual, Transgender and Queer Community in New York City A grounded theory approach with blended methods was used with a New York City LGBTQ population to answer the following questions: (1) What is tobacco’s current image in the LGBTQ community and (2) What impact, if any, do interpersonal relationships have on current tobacco use? Interviews were conducted with leaders from organizations serving the LGBTQ community. Twenty-three organizations were contacted, eleven people responded and eight interviews were conducted. Interviews were coded in the order in which they occurred followed by a reassessment and each code inspected for relevance and frequency. Eighteen themes with 110 unique excerpts were identified. Three key themes identified: (1) smoking as an accessory to building one’s image, (2) smoking as a social medium and (3) smoking as a coping mechanism for stress. The authors concluded that smoking cessation interventions among the LGBTQ community should equip smokers with healthy coping mechanisms that address stressors. The purposive sample and small number of participants limits generalizability.
Mark M. Macauda James F. Thrasher Jessie E. Saul Paula Celestino K. Michael Cummings Scott M. Strayer	1187	Qualitative Research A Good Idea may not be Good Enough: Stakeholder Buy-in to QuitConnect, a National Smokers’ Registry Smoking quitline service providers (n=14), quitline funders (n=9) and national quitline partners (n=8) participated in focus groups covering the perceived benefits and barriers to creating a national smoker’s registry called QuitConnect. The focus groups were recorded, transcribed and coded for relevant major themes. Results showed stakeholders were positive about QuitConnect’s potential to improve cessation science by providing a central portal linking smokers to researchers. Stakeholders were also cautious about recruiting clients into a registry without specifically understanding the added value to their clients. The authors concluded that even if there is broad support amongst stakeholders for a new intervention it is important to understand the dynamics underlying stakeholder concerns and how a new intervention fits within existing programs and interests. Stakeholders had concerns over duplication of existing services which may have impacted perceived value to potential partners.
Frances C. Sherratt Michael W. Marcus Jude Robinson John K. Field	1196	Quantitative Research Utilizing Lung Cancer Risk Prediction Models to Promote Smoking Cessation: Two Randomized Controlled Trials This study used a two single-blinded randomized controlled trial to examine whether delivery of lung cancer risk projections (calculated using the Liverpool Lung Project [LLP] risk model) predicted follow-up smoking status. Participants were current smokers (N = 297) and baseline recent former smokers (N = 216) recruited from the Stop Smoking Services in Liverpool (UK). The authors used bivariate analyses to identify differences between randomization groups and logistic regression models to investigate the intervention effect on the outcome variables. The results showed that lung cancer risk projections were not found to predict follow-up smoking status in the trial of baseline current smokers; however, they predicted follow-up smoking status in the trial of baseline recent former smokers (OR 1.91, 95% CI 1.03-3.55). Based on these results, the authors concluded that lung cancer risk projections may help maintain abstinence among individuals who have quit smoking, although the results did not provide evidence to suggest that lung cancer risk projections motivate current smokers to quit.This study used a two single-blinded randomized controlled trial to examine whether delivery of lung cancer risk projections (calculated using the Liverpool Lung Project [LLP] risk model) predicted follow-up smoking status. Participants were current smokers (N = 297) and baseline recent former smokers (N = 216) recruited from the Stop Smoking Services in Liverpool (UK). The authors used bivariate analyses to identify differences between randomization groups and logistic regression models to investigate the intervention effect on the outcome variables. The results showed that lung cancer risk projections were not found to predict follow-up smoking status in the trial of baseline current smokers; however, they predicted follow-up smoking status in the trial of baseline recent former smokers (OR 1.91, 95% CI 1.03-3.55). Based on these results, the authors concluded that lung cancer risk projections may help maintain abstinence among individuals who have quit smoking, although the results did not provide evidence to suggest that lung cancer risk projections motivate current smokers to quit.
Sam Cole Casey Suter Chelsea Nash Joseph Pollard	1206	Quantitative Research Impact of a Temporary NRT Enhancement in a State Quitline and Web-based Program An intent-to-treat as treated approach was used to examine quit outcomes for tobacco users (n=4,022) participating the Idaho Tobacco Quitline or Idaho’s web-based program. Participants also received nicotine replacement therapy (NRT) at various times. Measures included baseline program data including demographics, frequency of tobacco use, service level including telephone calls or web-based program, frequency of NRT delivery, and quit rates. Logistic regression was used to analyze data. Results showed participants who were sent 8 weeks of NRT were more likely to quit than those sent only 4 weeks of NRT. Callers who selected the multiple-call program and received all 8 weeks of NRT were more likely to be tobacco abstinent for 30 days or longer compared to all other service levels. The authors concluded that increasing NRT and multiple calls are associated with higher quit rates. Since participants self-selected into their program of choice generalizability of results is difficult.
Kathleen M. Lenk Darin J. Erickson Jean L. Forster	1214	Quantitative Research Trajectories of Cigarette Smoking from Teens to Young Adulthood: 2000 to 2013 This paper identifies trajectories of smoking behaviors of a cohort of youth followed through young adulthood from 2000 to 2013 in the Minnesota Adolescent Community Cohort study. Subjects were a cohort of youth surveyed for 14 years beginning at ages 12-16 (n=4241 at baseline; 59% recruitment rate). The variable of interest was number of days smoked in past 30 days in addition to time varying and time invariant covariates. Growth mixture modeling was used to group individuals into trajectories over time, with five distinct trajectories: Non-Smokers (59.5%), Early Onset Regular Smokers (14.2%), Occasional Smokers (11.5%), Late Onset Regular Smokers (9.4%), and Quitters (5.3%). Adjusted models showed that early- and late-onset regular smokers (compared to non-smokers) had lower odds of attending or graduating from a four-year college (p<.05). Participants in all smoking classes compared to non-smokers had greater odds of having more close friends who smoked (p<.05).
Kate Sustersic Gawlik Bernadette Mazurek  Melnyk Alai Tan	1221	Quantitative Research An Epidemiological Study of Population Health Reveals Social Smoking as a Major Cardiovascular Risk Factor Data from a cross-sectional survey of adults (Nn = 39, 555) was were analyzed with the purpose of presenting nationally representative data on the prevalence of social smoking and the relationship to cardiovascular risk factors and population health. Measures included age, gender, ethnicity/race, smoking status, body mass index (BMI), perceived stress, blood pressure, and total cholesterol level. Descriptive statistics were used to describe sample characteristics, and adjusted estimates were derived from multiple regression models. Results showed that 10% of the sample were social smokers, male, aged between 21- and 40, and Hispanic. The social smokers had significantly higher risks of having hypertension (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.80-2.41) and elevated cholesterol (OR: 1.53, 95% CI: 1.33-1.75) than non-smokers. Further, there was no significant difference between social smokers and current smokers for hypertension or elevated cholesterol. The authors concluded that social smokers have similar cardiovascular health risks and consequences to those of current, every day smokers. Since this is a cross-sectional study, generalizability is limited.
Olivier Drouin Robert C. McMillen Jonathan D. Klein Jonathan P. Winickoff	1228	Quantitative Research E-Cigarette Advice to Patients From Physicians and Dentists in the United States In this study, the authors analyzed nationally representative cross-sectional survey (Internet and random digit dialing) in the United States to report on adults’ recall of discussion by physicians and dentists about e-cigarettes. Results indicated that among the 3030 adults who completed the survey, 523 (17.2%) had ever used e-cigarettes. Of those who had seen their doctor, dentist, or child’s doctor in the last year, 7.3%, 1.7%, and 10.1%, respectively, reported discussing potential harms of e-cigarettes. Conversely, 5.8%, 1.7%, and 9.3% of participants who had seen their doctor, dentist, or child’s doctor in the last year reported that the clinician discussed the potential benefits of e-cigarettes. Each clinician type was as likely to discuss harms as benefits. Rates of advice were similar between doctors and child’s doctors but lower for dentists. Rates were comparable when the analysis was limited to current e-cigarette users, participants with children, or those who reported using both e-cigarettes and combusted tobacco. Based on these results, the authors concluded that few physicians and dentists discuss either the harms or benefits of e-cigarettes with their patients. These findings suggest an opportunity to educate, train, and provide resources for physicians and dentists about e-cigarettes and their use.
Emily Frith Paul Loprinzi	1234	Quantitative Research Exercise Facilitates Smoking Cessation Indirectly via Intention to Quit Smoking: Prospective Cohort Study Among A National Sample of Young Smokers The purpose of this study was to evaluate the potential for physical activity to build intentions for smoking cessation among a national sample of young adult smokers. It is unknown whether exercise can facilitate smoking cessation among smokers via changes in smoking-specific intentions to quit, though there is an inverse association between exercise and smoking. This study builds on research demonstrating that exercise may be an effective treatment strategy to facilitate smoking cessation. Changing exercise patterns can help to facilitate change in other health behaviors, and among smokers, exercise is associated with smoking-specific self-efficacy.
Melody Noland Mary Rayens Amanda T. Wiggins Luz Huntington-Moskos Emily A. Rayens Tiffany Howard Ellen J. Hahn	1239	Quantitative Research Current Use of E-Cigarettes and Conventional Cigarettes Among US High School Students in Urban and Rural Locations: 2014 National Youth Tobacco Survey In this study, the authors analyzed data on a nationally- representative sample of U.S. high school students (N = 11, 053) who completed the 2014 National Youth Tobacco Survey (which was obtained using a stratified, three3-stage cluster sampling design) to determine if whether adolescent tobacco use was higher in rural than in urban areas. Slightly more than half of the participants were urban (54%). The authors used a weighted logistic regression to assess the relationships of urban–/rural location with current e-cigarette use and dual use, adjusting for demographic factors, perceived risk, and social norms. Their results indicated that there were clear differences in patterns of adolescent e-cigarette and cigarette use in rural versus urban areas. Social norms and perceptions may play a role in understanding these differences. Based on these results, the authors concluded that urban youth current cigarette smokers were nearly twice as likely as rural cigarette smokers to also use e-cigarettes, and that the reasons for urban-–rural differences need to be taken into account when designing prevention programs and policy changes.
Jennifer C. Duke Matthew C. Farrelly Tesfa N. Alexander Anna J. MacMonegle Xiaoquan Zhao Jane A. Allen Janine C. Delahanty Pamela Rao James Nonnemaker	1248	Quantitative Research Effect of a National Tobacco Public Education Campaign on Youth’s Risk Perceptions and Beliefs about Smoking This article assesses the relationship between youth’s exposure to the Food and Drug Administration’s national tobacco public education campaign, The Real Cost, and changes in campaign-targeted beliefs. A longitudinal design with baseline survey and 2 postcampaign follow-up surveys is used in 75 US media markets (N = 1680). Participants had to complete all 3 surveys and had experimented with or were susceptible to future cigarette smoking. Exposure was measured by self-reported frequency of ad exposure and media market level target rating points. Agreement with 30 self-reported tobacco-related beliefs were assessed in 3 categories: (1) beliefs specifically targeted by campaign messages (campaign-targeted belief); (2) beliefs not targeted by the campaign (nontargeted beliefs); and (3) beliefs corresponding to other media campaigns on air concurrent with The Real Cost (ambiguous beliefs). Agreement with campaign-targeted beliefs increased from baseline to first and second follow-ups, with a mean relative increase of 10.4% and 11.5%, respectively. Nontargeted beliefs did not change substantially. Both measures of campaign exposure were positively associated with increased odds of agreeing with 5 of 8 campaign-targeted beliefs. Exposure was not significantly associated with 12 of 14 nontargeted tobacco-related beliefs.
Kim A. Hayes Christine Jackson Denise M. Dickinson Audra L. Miller	1257	Quantitative Research Providing Antismoking Socialization to Children After Quitting Smoking: Does It Help Parents Stay Quit? A 2-group randomized control design was used to determine whether parents (N = 577) who had quit smoking and received a program promoting antismoking socialization of children would be more likely than untreated controls to be abstinent when assessed at 2 and 3 years postbaseline measure. Of the 577 participants, 358 completed the year 2 follow-up interview and 304 competed the year 3 follow-up interview. Measures included quit status at baseline, sociodemographic covariates, abstinence at follow-up. The χ2 tests and t tests were used to analyze data. Results showed 23.1% and 17.5% of treatment and control participants were abstinent at 2 years and 20.3% and 14.4% were abstinent after 3 years, respectively. The authors concluded that engaging parents who recently quit smoking as agents of antismoking socialization of children has the potential to reduce the long-term odds of relapse. Since self-reported abstinence was not validated using a biochemical method, generalizability is limited.
Nathan Mann James Nonnemaker LeTonya Chapman Asma Shaikh Jesse Thompson Harlan Juster	1264	Quantitative Research Comparing the New York State Smokers’ Quitline Reach, Services Offered, and Quit Outcomes to 44 Other State Quitlines, 2010 to 2015 This is a descriptive study that summarized the reach, services offered, and cessation outcomes of the New York Quitline and compare it with other state quitlines using data from 45 US states that provided complete data to the Centers for Disease Control and Prevention’s National Quitline Data Warehouse for 24 quarters over 6 years (2010-Q1 through 2015-Q4). The telephone quitlines offered tobacco use cessation services, including counseling, self-help materials, and nicotine replacement therapy to smokers at no cost to them. The results showed that New York’s average annual quitline reach from 2010 through 2015 was 3.0% per year, compared with 1.1% per year for the other 44 states examined. Based on these results, the authors concluded that although the New York Quitline was open fewer hours per week and offered fewer counseling sessions and a smaller amount of free nicotine replacement therapy than most of the other 44 state quitlines, the New York Quitline had similar quit rates to most of those state quitlines.
Amy Sanders Cendrine Robinson Shani C. Taylor Samantha D. Post Jeffrey Goldfarb Rui Shi Yvonne M. Hunt Erik M. Augustson	1273	Quantitative Research Using a Media Campaign to Increase Engagement with a Mobile-based Youth Smoking Cessation Program The current manuscript article sought to explore the impact of the National Cancer Institute’s (NCI) promotion of its youth smoking cessation program, Smokefree Teen (SFT). The campaign’s strategies seek to engage a teen audience with cessation resources using what is described as a cost-effective approach. The campaign occurred nationally, using traditional (TV and radio), online, and social media outreach. The authors’ targeted adolescent smokers (ages aged 14–17 years), and although the baseline population was 42 ,586 and , it increased to increased to 464, 357 over the course of the campaign. Outcome metrics included (1) visits to the SFT website from traditional and online ads, (2) cost to get an online ad clicked (cost-per-click), and (3) SmokefreeTXT program enrollments during the 8-week campaign period. The SFT campaign achieved an online ad click-through- rate of .33%, and overall, Wweb traffic to the teen.smokefree.gov site increased by 980%. The online cost-per-click for ads, including social media actions, was approximately $1, far less than for traditional ads. Additionally, the campaign increased the SmokefreeTXT program teen sign-ups by 1,334%. The authors’ conclude that the campaign increased engagement with evidence-informed cessation resources for teen smokers.
Ashley L. Merianos Tierney F. Mancuso Judith S. Gordon Kelsi J. Wood Katherine A.  Cimperman E. Melinda Mahabee-  Gittens	1280	Quantitative Research Dual- and Polytobacco/Nicotine Product Use Trends in a National Sample of High School Students A secondary analysis of 31 022 high school students completing the National Youth Tobacco Survey in 2013, 2014, and 2015 was undertaken to examine changes in patterns of ever and current dual- and polyproduct use over time and to examine the demographic and modifiable risk factors including tobacco smoke exposure (TSE). Measures included data from questions focused on tobacco/nicotine product use, tobacco smoke exposure, and e-cigarette vapor exposure. Multivariable logistic regression and multinomial logistic regression were used to analyze data. Results showed (1) high rates of home tobacco/nicotine use and high rates of TSE and e-cigarette vapor exposure, (2) increased rates in ever/current use of e-cigarettes and hookah, and (3) participants reporting TSE were 15.4 times (95% CI = 11.5-21.0) more likely to report current poly use. The authors concluded that from 2013 to 2015, the rates of e-cigarettes and hookah increased. Since this was a cross-sectional study, causal or longitudinal relationships could not be observed.
Literature Review
Jessica L. King Julie W. Merten Tzu-Jung Wong Jamie L. Pomeranz	1291	Applying a social ecological framework to factors related to nicotine replacement therapy for adolescent smoking cessation This literature review searched 2016 articles in PubMED, ProQuest, EBSCOhost, and ERIC to synthesize factors related to nicotine replacement therapy (NRT) use among adolescents seeking to quit smoking, using the social–ecological model as a guiding framework. Only original studies of cigarette smokers younger than 18 years that discussed NRT were included. The results indicated that 103 907 articles were identified during initial search. After narrowing to peer-reviewed articles in English and eliminating reviews and adult-only studies, 51 articles were reviewed. These 51 articles identified factors at each level of the social–ecological model: intrapersonal (20 articles), interpersonal (2 articles), organizational (7 articles), community (11 articles), and public policy (14 articles). Based on these findings, the authors concluded that their study provided insight into the applicability of NRT for adolescent smoking cessation. Additionally, their review highlights areas for additional research. Future adolescent NRT studies should assess factors at the interpersonal, organizational, and community levels, as well as the interactions between levels.
Sara Johnson	TAHP-1304	Editor s Desk: Social Connection: Though often overlooked, social connection is a critical component of our health, cognitive function, longevity, and our performance at work. This issue provides three diverse perspectives on the importance of and how to promote high-quality social connections in the workplace.
Julianne Holt-Lunstad	TAHP-1307	Fostering Social Connection in the Workplace: Dr. Julianne Holt-Lunstad operationalizes social connection, defines its multiple dimensions, underscores its importance to health and the workplace, and provides guidance that employers can use to foster it.
Mandy O'Neill	TAHP-1312	The FACCTs of (Work) Life: How Relationships (and Returns) Are Linked to the Emotional Culture of Companionate Love: Dr. Mandy O'Neill defines a culture of companionate love at work; explains the importance of intentionally managing the emotional culture of an organization; and offers tips for how to do so.
Marissa King	TAHP-1315	Working to Address the Loneliness Epidemic: Perspective Taking, Presence, and Self-Disclosure: Dr. Marissa King describes the impact of loneliness on an organization and shares three steps employers can take to promote high-quality connections at work.
Sara Johnson	TAHP-1317	Is Technology Making Us More Disconnected?: This closing commentary explores the potential role of technology in social connection.