Evaluation Plan for the Community Intervention Trial for Smoking Cessation (COMMIT).

The National Cancer Institute is sponsoring the Community Intervention Trial for Smoking Cessation (COMMIT), a multi-center research project designed to test the value of a community-based effort to promote smoking cessation. The trial involves eleven matched pairs of communities with random assignment of one community per pair to the intervention or to the comparison condition. This article reviews the rationale and methodology of the COMMIT evaluation plan which is organized into four components: 1) outcome assessment, monitoring changes in community smoking patterns; 2) impact assessment, measuring the effect of the COMMIT intervention on mediating factors thought to be important in facilitating changes in community smoking behavior (e.

Predictors of quitting smoking: the NHANES I followup experience.

There are no published prospective studies on the predictors of spontaneously quitting cigarette smoking in a nationally-representative U.S. population.

Passive smoking on commercial airline flights.

In-flight exposure to nicotine, urinary cotinine levels, and symptom self-reports were assessed in a study of nine subjects (five passengers and four attendants) on four routine commercial flights each of approximately four hours' duration. Urine samples were collected for 72 hours following each flight. Exposures to nicotine measured during the flights using personal exposure monitors were found to be variable, with some nonsmoking areas attaining levels comparable to those in smoking sections.

Smokeless tobacco: association with increased cancer risk.

Smokeless tobacco (chewing tobacco and snuff) contains known carcinogens shown to increase the risk for oral cancer. The effect of snuff has been more fully documented than other forms of smokeless tobacco, although the carcinogenic potential of all such products is acknowledged. Risk increases with increasing length of exposure, with risks greatest for anatomic sites where the product has been held in contact the longest time.

Change in public perspective on cholesterol and heart disease. Results from two national surveys.

The National Heart, Lung and Blood Institute, Bethesda, Md, and the Food and Drug Administration, Washington, DC, sponsored two national probability telephone surveys (N = 4000) of adults to assess attitudes and knowledge about heart disease risk from high blood cholesterol levels and the public's efforts to lower blood cholesterol levels. The first survey was conducted in 1983, before release of the results from the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease; the second survey was conducted in 1986. The percentage of adults who believed that reducing high blood cholesterol levels would have a large effect on heart disease increased from 64% in 1983 to 72% in 1986, so that the importance attached to reducing high blood cholesterol levels approached that attributed to reducing smoking and high blood pressure.

Change in physician perspective on cholesterol and heart disease. Results from two national surveys.

The National Heart, Lung, and Blood Institute sponsored national telephone surveys of practicing physicians in 1983 (N = 1610) and 1986 (N = 1277) to assess attitudes and practices regarding elevated serum cholesterol levels. The 1983 survey was conducted just before the release of the results of the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease. In 1986, 64% of physicians thought that reducing high blood cholesterol levels would have a large effect on heart disease, up considerably from 39% in 1983.

What are the odds that smoking will kill you?

We calculated the long-term risks of death from smoking for individuals of various ages and smoking status in terms of the excess mortality contributed by smoking, over and above the baseline mortality from the same diseases caused by factors other than smoking using standard life table procedures. Since mortality data for specific smoking categories were available only from prospective studies in the late 1950s, we scaled these to the 1982 mortality levels. We assumed, for lung cancer, that the death rates for nonsmokers have not changed and, for other smoking-related diseases, that the risks of death for smokers relative to those for nonsmokers have not changed since the 1950s.

Associations between smoking and body weight in the US population: analysis of NHANES II.

Recent recommendations for increases in desirable body weights are based upon studies which did not consider the potential confounding effect of cigarette consumption on body weight. We investigated the relation between tobacco use and several anthropometric measurements in 12,103 men and women 19-74 years of age in the United States examined between 1976 and 1980 during the Second National Health and Nutrition Examination Survey (NHANES II). Cigarette smokers weighed less (mean +/- standard error = 69.

Participation in a clinical trial: the patients' point of view.

Little systematic information is available concerning the advantages and disadvantages of participation in a clinical trial from the patients' point of view. Surveys were undertaken among participants in the Beta-Blocker Heart Attack Trial (BHAT) and the Aspirin Myocardial Infarction Study (AMIS) to obtain data on these perceptions. In AMIS, an open-ended personal interview format was employed.

Assessment of double-blindness at the conclusion of the beta-Blocker Heart Attack Trial.

At the conclusion of a double-blinded, randomized clinical trial of propranolol hydrochloride, but before unblinding, the patients and clinic personnel were asked to guess the treatment group assignment of each patient. While 79.9% of the patients receiving propranolol correctly identified their treatment group assignment, 57.

Issues in medication adherence assessment in clinical trials of the National Heart, Lung, and Blood Institute.

The mission of the National Heart, Lung, and Blood Institute is to sponsor research in the prevention, diagnosis, and treatment of heart, lung, and blood diseases. As a part of its activities toward this end, the Institute plans and conducts clinical trials that test the safety and efficacy of a broad range of preventive and treatment regimens. Many of these trials involve thousands of patients and require the cooperation of many research clinics under a common protocol, often for many years.

Health risks associated with residence near a primary copper smelter: a preliminary report.

Mortality for three groups of ICD codes covering acute, chronic, and malignant respiratory diseases were studied for adult white women in communities near or adjacent to primary copper smelting facilities in the United States between 1968 and 1975, a period when women had not as yet entered the industrial work force. A previous comprehensive survey, sponsored by the EPA, of all U.S.