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This report describes a longitudinal study of the natural course of smoking initiation in a school-based, ethnically diverse (42% White, 37% African American, 20% Hispanic) sample of adolescents in grades 5, 8, and 12 who were followed prospectively for 1 year. A cohort of 659 students was identified who were never smokers at baseline and who completed questionnaires both at baseline and at 1-year follow-up. From this cohort, predictor variables were used to identify ethnic-specific risk factors for (a) "susceptibility to smoking" among the 509 students who were nonsusceptible, never smokers at baseline and (b) "ever smoking" among all 659 students who were never smokers at baseline (both susceptible and nonsusceptible). Logistic regression analyses revealed that parental and household influences (parental education, marital status, household smoking) were important predictors of ever smoking, but not of susceptibility to smoking, for African Americans. Hispanic adolescents were significantly influenced by environmental influences, namely smoking by other household members (ever smoking) and by peers (susceptibility and ever smoking), although peer pro-tobacco influences (friends who smoke or friends' approval of smoking) were important predictors of susceptibility to smoking or ever smoking for all three ethnic groups. Exposure to tobacco-related advertising was a risk factor for White (susceptibility and ever smoking) and African American (susceptibility only) adolescents but not for Hispanic adolescents. Inclusion of the susceptibility to smoking variable in the model predicting ever smoking substantially reduced the importance of other predictors in the model, suggesting that susceptibility to smoking was not an independent risk factor for ever smoking but rather a potential mediating variable. The results of this study offer important insights for designing ethnic-specific strategies for preventing smoking during adolescence.

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Background Given their early age of diagnosis, young breast cancer (BC) survivors face issues that differ widely from their older counterparts. Patients and Methods We mailed a survey to 2209 patients who were ≤45 years at time of BC diagnosis. Each survey was comprised of: the Quality of Life in Adult Cancer Survivors instrument, Menopause Symptom Scale, and questions aimed at obtaining pertinent background information. Results 1090 patients completed the survey. Mean age at time of diagnosis was 39.5 years; median years from diagnosis was 6.6 years. Distress related to vaginal dryness (p=0.0002) and pain from intercourse (p=0.0014) was significantly higher in patients who were <5 years from diagnosis, compared to those >10 years from diagnosis. In the area of financial problems, black women had greater distress than white women (p=0.0010). Compared to white women, Hispanic women had worse family distress scores (p=0.0028) and summary cancer specific scores (p=0.0076). Patients >10 years from diagnosis had poorer sexual interest (p=0.003) than women who were closer to diagnosis. Women ≥40 years at diagnosis had significantly lower sexual interest (p=0.0016) than women <40 years. Stage and neoadjuvant chemotherapy did not have a significant effect on QOL. Conclusion Even in comparison to stage and neoadjuvant chemotherapy, race, age at diagnosis, and time from diagnosis have significant long term effects on QOL following BC treatment.