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. ~~~.~ Jt.~~u J~l~~.J~~.~~ AMER,ICA~ 1'ublic Health September 1989 ContentS, Volume 79, Numtler9 (continued) DIFFERENT' VIEWS ~ Ihappropriate Comparisons of inadence and Prevalence in Epidemiofogic Research ............. . ........... 1301 W Dana;Flanders and Thomas R: O:Srien ..................... Ma t ~ t M ~ ~ e e ........... 1303 F7a Fei~teln, Ch~ sn~ n, John Esd aile, FPglph I~ F+lotwrtr Michael J M AYvan aFarlarre, Cha and'Carolyn K Wells ! NOTES' FROM THE FIELD The AIDS Action Committee Safety Nbtp Program: Small Group Parties for Safer Sex EdOcation .. .......... 1305 Dorothy C. kWertz, Anne Ntade Srlvia, John Dreyer, Jeff Epperly,~ Gary Sandison, and Chris La C LETTERS TO THE' E'DITOR ~ ~A Note from the Tobacco Industry :............. 1'...............,............................. .. harite ........,... 1307 Response from Professor Sprafka......... ; ... .......,, 1307 .. Determinants of StoPAn9 Smoking: ' Italian ~lation i al Health Surwey . . . . . . . . . . ......... 1307 Laws Regulating Tattboing . .. . . , . . . . . . . . . . . , , 1308 Contrasting View on Rheumatoid!ARhritis ....... ............. ................................ ........... 1308 Comment on Changes in Alaohol-Retated Inpatient Care ..................................... ........... 1309 Response from Romelsjb and Diderichsen.................................................... .......... 1309 Biehaviorof Clients of Prostitutes ............................................................ .......... 1310 ASSOCIATION NEWS Call for Abstracts, APHA Late-Breaker Epidemiofogy Exchange Session ......................... .......... ,1294 Annual Meeting Registrati0n.............. ..................................................... .......... 1311 APHA Constitution and!By-Laws................................................................ ........ .......,, 1316 JOURNAL DEPA'RTMMENTS~ ....................,. Masthead.................................................................................. .......,.-. 1206' .......... Advertisers'Index ..... ..............................-...........,.......................... ........... 1'214' Membership Form:.................................................,..,......-.................. .._,...... 1322 Agency Membership Form .. „ ........................ ............. ... .. 1323 Job Opportunities ...........................................,................,.-........... .......... 1324 Prospective authors should consult "Information for Authors" which appeared!ih the April 1989 issue of'this Journal!and may, also be obtained from the Journal Editorial Office: Amerk:an!Journal'of Public Health, 1015 15th Street, NW, Washington, DC 20005. (202) 789-5600. The American Journal of Public Health, published monthly, is the official Journal of the American Public Health Association, 1015 Fifteenth Street, NW, Washington, DC 20005: (202) 789-5600 APHA,is a nongovernmental, professional society founded in 1872, representing all disciplines and specialties in public health. APHA OFFICERS Iris R. Shannon, PhD; RN, President Bailus Walker, Jr., PhD, MPH. Irnmediate Pasr President Myron Allukian, Jr., DDS,,MPH, President-Elect. Mabel H. Morris, RN: MA„ Vice President (USA) John M.,Last4 MD, MPH„Vice President(Canada) Cardyle Guerra de Macedo, MD, MPH„Vice President (Latin Atnerica) Caswell A. Evans, Jr.,DDS, MPH, Treasurer Molly, Joel Coye, MD„Chuir, Executiee Board George E. Hardy„Jr., MD. MiPHI Speaker. Governing,Council William H.,Mc6leath, MD, MPH, Executive Director EXEC. TVE BDARD Molly Joel'Coye, MD,MPH. (1991)ChairPerson Myron A'llUkian, Jn, DOS, MPH. President-Elect TediT: L, Chen,PhD; MI'H, (1990) Brian A. Dobrow. MPH, (1'99Z) Caswell A.,Erans, Jr., DDS, MPH, Treasurer Eugene:Feingold, PhD„(i99'1) Frank Goldsmith, DrPH, (1989) Margaret H. Jordan, RN. MPH, (1992) Allen N. Koplin, MD, MPH, (N990) Joyce C. L,ashof,,MD, (1990) JudithRae Mifler, MPH, (1989) Shirley Reed-Randolphc MSPH, (I199t). Helen Rodriguez-Trias, MD, (1989) ~ Iris R, Shannon, RN, PhD, President Frances M. Veverka, MPH, RS, (1992) Bailus Walker, Jr., PtsD lanumdiare /'asi MPIi , „ iV r A ~!. ~!~'t EX OFFICIO ~i~~+ William H. McBeath, h1D, MPH, E'zecurive Director M1 Richard A. Wisseit: MPHI~ CJiair,. Action Board VI. Cecil'G. Sheps, MD: MPH. Cltair, ProRra.n Drvelnpnrrnt Board ~ George E. Hardy, Jr., MD, MPH. Speaker, Governing, Council AJPH!September 1989, Vol. 79, No. 9 1203 0 to Preslrlcnr lipb

i ' I . ~ Letters ~ to the Editor Letters to the Editor are welcomed and wNl' be published;, if fwund suitable, as sp, ace p, er-mits. Submission of' a Letter to the Editor constitutes pennissiort for its publication in, the Journal. Letters should not duplicate similar material being, submitted or pub- lished elsewhere. Letters referring to a re- cent' Journal article should, be received rrithim three ntonths of'the article's publica- tion. The editors reserve the right to edit'and abridge letters; to publish replies;, and' to solicit responses from uuthors and others. Letters should be submitted in ditplicate, double-spaced (jncludinb references), and slould not e.rceed'4(XJ words. A Note from the Tobacco Industry While Sprafka, et af;' failed tolac- knowledge it, explicitly„their, Twin Cities data reconfirm a discordancy in rthe case against cigaretrces. Premature mottality from CHD and! stroke is higher among Blacks, as itlis nationally,2 butiper capita cigarette consumption (prevalence times quantity smoked per smoker) is lowen, as it also is nationally.3 REFERENCES IL Spralka MO;,Folsom AR„Bueke GL, Edlavitch SA: Prevalence of cardiovascular disease risk factors in blacks and whites:,The Minnesota heart survey. American J Public Health 1988; 78:12,15+16-1549: 2. Vital' Statistics., Mortality Reports. US Vital Statistics: Washington DC, 1900-1985. 3. US Dept Health k'duman Services: The Health Consequences of Smoking. Cancerand Chronic Lung Disease in the Workplace. A Report ofthe Surgeon General., DHHS (PHS) 85:50207. Rockville, MD: DIIHS, 1985,. Rebecca C. Gantt Research Specialist Jerson E. Lincoln Retired Vice Presid6nt Stratcgic Researeh Philip M orris Management Curp;,1 20 Park Avenue, . New York, NY 10017 . 0 1989 American Journal of Public Health Response from Professor Sprafka An example of multifactot-aal think- ing,from the tobacco industry. J, bfichael Sprq/Jcu;,AfPH, PJrD Assistant Prufessur, Division of C•j+idcmioldtgy, AJPH September 1'989, Vol. 79. No. 9 School of'Public Health, University of'Minnesota; was having one or more smokin re- Stadium Gate 27, 611 Beacon Street, SE, Minne- MN 55455 lis lated health diseasesor cpmplaint , foi- . apo , loWed' by knowledge of the heal con- 0 1989 American Journal.of Public Health sequences of smoking (38 reent)~ D erminanrt's of' Stopping Sm king: Italian National ealth Survey We ha applied an approach sim- ilar to that'o abat and Wynder' to the I'986=87 Ita `an National Health Sitrvey,Z condu ed by the Central bn+ stitute of Statisti , based ona sample of 30;096 males an 2,176ft:males aged 15 or over„ randorn seltected within strata of gepgraphical rea, size of the place of residence andi, o the household. in order to be represe ative of the general Italian population. Among 16,033 males ev smokers,. 3,717 were ex-smokers for at east one year, a quit rate of 23,2' perc t;, the comparable figure fpr, females w 1'1.9 percent (753V6,340). In : males, uit rates'" were directly andllinearly rela d to age, ranging from 1.3 pereentat ag 15}24 to 59.5 pereentiat ages 75 or over. In females„a clear trend, of'increasin' "quiti rates"'wit~h, agewasevident~o y above age 55. ! After standardization for age„ ""quit rates'"in both sexes were nectly related to edueatian Wfien a easurr. of social class based' onLtheubjt:cts" occupation was used, stoppi g smoking was directly associated wi higher so- ciallclass for females, but otfor males. In both sexes, cessation f smoking;was more common in No ecn (richer) ar- eas of the country, a positively asso- ciated with the pre lenee of smking- related chronic iseases: Smoking cessation rates tzre somewhat lower among separat or divorced individu- als; but abs ute numbers were too sma'lli to per it any meaningful infer- ence: QuiG tes were lower'among those smokin less than 25 cigarettes/day (20.9 ercent), than among heavier. smok s (27:8 percent): x-smokers gave a number of'rt:a- so for stopping smoking: the most, fr quent (49 percent of ex-smokers) Only 1 percent gave the cost smoking as a reason, and 12 ptsrc 't listed a variety of other reasons. These data refiee the limited knowledge of smoking<r ated risks and the low prices of'~ cig , ettes ~ in Italy.' The low cessation r tes as compared with other develop countries (partic- ularllyamongfem es),`'7 is discourag- ing. Further, t 1 s study confirms the results fnom a evious Italian National Health Sinrve :" Females, less educated individitals f both sexes, particularliyy from the ss developed areas of the country; re a major target for future interve tions against smoking,, a1- thoug it should be noted that in this stud no material differencce in "quit nat "' emerged among males when oe- e atimn, was used as an indicator of', cial class. REFERENCES 1. Kabat GC.,Wynder EL: Determinants of quit- ting, smoking. Am J, Public Health 1987; 77:1301-1305. 2. ISTAT (Iktituto Centrale di Statistica): Indagine sullecondizioni di salute,della populazione e sul corso ai, servizi sanitari. Novembre 1986'- rile 1987. Primi~risultati: Not¢iario ISTAT 19 ; 8:n. 17; 3. La cchia C, Garattini S: Attitudes to kgisla• tion restriction of smoking. hncet 1987: 11310. 4. La Vee ' C, Decarli A. Pagano R: Education and preval ce of'smoking in Italian men and women. Int ' Epidemiol 1986c 1'5:279. 51 OQ'icc of Po lation Censuses and Surveysc Cigarette smoki 1972'to I982. OPCS'I9tonitor July 5, 1983: 6. Remington PL, , rman MR. Gentry EML Marks JS, Hogelin L„'Ilrowbridge FL: Cur, renC smoking trends i the United States. The 19811-1983 behavioral 'sk factor surveys. JAMA 1985; 253:2975- 7. Pierce :JP, Aldrich RNl ratty S. Dwycr T, Hi11 D: Uptake and quitting oking trends in Australia 1974-1984. Prev M 1987; 16:252= 260. 8. Negri' E. Pagano R, La Vecchia : Determi- nants of stopping cigarette smoking iltaly: Rev Epidemiol Sante Publique (in press). Eva Ne ", ScD Carlo La Necch~MD Mario Negri' Institute for Pharmacotogicale- search; Via Eritrea, 62-20157 Milan, Italy 1307