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OBJECTIVES. This study was undertaken to explore smoking patterns and attitudes that influence smoking cessation and relapse among African Americans. METHODS. Baseline data from eight Community Intervention Trial for Smoking Cessation (COMMIT) sites were analyzed. RESULTS. Compared with Whites, African Americans who smoke less than 25 cigarettes per day were 1.6 times more likely to smoke within 10 minutes of awakening (a behavioral indicator of nicotine dependence), adjusting for education, age, and gender (OR = 1.2 for heavier smokers). African Americans reported a stronger desire to quit smoking and reported serious quit attempts in the past year. African Americans favored tobacco restrictions (they were 1.8 times more likely than Whites to view smoking as a serious community problem, 1.7 times more likely to favor restrictions on cigarette vending machines, and 2.1 times more likely to prohibit smoking in their car). African Americans were lighter/moderate, menthol smokers. CONCLUSIONS. African Americans find smoking socially unacceptable and are strongly motivated to quit, but their "wake-up" smoking may indicate high nicotine dependence, making abstinence difficult even for lighter smokers.

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In most bifurcations with a significant stenosis in both branches, a provisional strategy of stenting the main branch only is effective, with the need to implant a second stent on the side branch occurring in approximately one third of cases. The implantation of 2 stents does not appear to be associated with a higher incidence of adverse events at 6 months.

Tobacco, alcohol, and drug use are problems for American-Indian people. We reviewed these problems and the explanations for them and described a bicultural competence skills approach for preventing substance abuse with American-Indian adolescents. Data from a study of that approach suggest its efficacy with American-Indian youth. At posttest and a 6-month follow-up, AmericanIndian subjects who received preventive intervention based on bicultural competence skills concepts improved more than did American-Indian subjects in a no-intervention control condition on measures of substance-use knowledge, attitudes, and interactive skills, and on self-reported rates of tobacco, alcohol, and drug use. Our findings have implications for future substance-abuse prevention research with American-Indian people.Earlier, in this journal, LaFromboise and Rowe (1983) noted the value of skills training to increase bicultural competence among American-Indian people. According to LaFromboise and Rowe, bicultural competence is the capacity of "making one's desires or preferences known in an Indian or in a non-Indian setting" (p. 592). Bicultural competence skills seem appropriate for use in helping American-Indian young people combat substance abuse and its related problems. More than other Americans, Indian and Alaska-Native children and adults suffer from such substance-related problems as school failure, antisocial behavior, unemployment, criminal arrest, and increased morbidity and mortality (

Most adolescent smoking prevention studies employ designs in which classrooms, schools, school districts, or sometimes whole communities are assigned to treatment conditions while observations are made on individual students. The critical design feature in such community trials is the nesting of intact social groups within treatment conditions. This combination requires that the treatment effect be assessed against the between-group variance; unfortunately, that variance is usually larger than for randomly constituted groups and its precision is usually less than that for the within-group variance. These factors often combine to reduce power so that it is almost impossible to detect important treatment effects in an otherwise well designed and properly executed study. To address these problems, investigators need good estimates of the intraclass correlation for the variables of interest, which together with the number of observations per unit determine the magnitude of the extra variation in the nested design. The purpose of this paper is to describe the methods and results from a study designed to generate estimates of intraclass correlation for common outcomes in adolescent smoking prevention studies and to discuss the use of these estimates in the planning of new studies.

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