Reviewer's report
Title:Are quit attempts among U.S. female nurses different from female smokers
in the general population? An analysis of the 2006/2007 Tobacco Use
Supplement to the Current Population Survey
Version: 1Date:14 December 2011
Reviewer: Tellervo Korhonen
Reviewer's report:
Reviewer's report
-----------------
Major Compulsory Revisions:
Title
I think the first part of the title should be modified; for example as follows:
Are quit attempts among U.S. female smoking nurses different from female
smokers in the general population?
Abstract
Background: The text is not clear; i.e. Was the purpose to describe a) how a
special occupation is related to quit behaviour among women or b) so called
‘female typical quit behavior’ as hinted in the 2nd sentence? As far as I
understand, however, with this design one could describe the occupation specific
characteristics, i.e. option a) seems to be more relevant. This part of abstract
needs clarification.
Methods: Mentioning only one smoking characteristic seems odd in the abstract
text.
Results: Smoking rates seem to be misplaced; should be nurses (12.1%) and
others (16.6%). Also, a p-value for the test of significance should be given.
5th line: I recommend that word ‘however’ is removed because both results are in
line with each other: i.e. more dependent – more likely to quit; less dependent
less likely to quit during the last 12 months.
Conclusions: This part should include only those conclusions which can be
directly derived from the results. Now, this is too long, including too many issues
which are actually not supported directly by the data of this study.
Background
In general, the reasoning for this study is satisfactory. However, at the end of this
section, there should be a clear and well defined statement of the research
question(s) or research objective(s) of this study.
Methods
Sample
I see that occasional smokers and daily smokers have been pooled together in
this study. This decision may be wrong. Occasional and daily smokers are
different in many characteristics (Korhonen et al. Nicotine & Tobacco Research.
2009, 11 (2): 148-155). Thus, I think also in this study, daily smokers and
occasional smokers should be considered as separate categories.
Smoking characteristics and level of addiction
Replace ‘level of addiction’ by ‘level of nicotine dependence’ anywhere where the
term is used.
Why was age 15 used as cut-off for age of initiation? There should be reasoning
for this. Also, was this considered as age of first cigarette or of regular smoking?
The authors used TTF as measure of nicotine dependence. I am surprised why
they did not create the HSI (Heaviness of Smoking Index) because they had
number of cigarettes smoked per day?
Those 2 paragraphs after the paragraph above, should have a subtitle, such as
‘Other characteristics’ or similar.
Statistical analyses
For continuous variables, such as age, age of smoking onset, years of smoking
and number of cigarettes per day, why did the authors not use T-test because
there are two groups to be compared?
Conclusions
As conclusions this paragraph is relatively long. Part of this could be included in
discussion and only those conclusions directly derived from the results should be
included as conclusions.
Minor Essential Revisions:
Sample
Lines 6-7: here must be an error, because how can one response ‘yes’ to a
question with the options: ..every day; some days; not at all! Same problem with
the next sentence as well.
Results
3rd paragraph: Did you have data on use of nicotine replacement therapy? This
would be relevant as you report level of nicotine dependence, so, about half of
the smokers seem to be dependent.
5th paragraph: The test for significance and p-value for the group x TTFC
–interaction should be given.
Discussion
1st paragraph: expression that female nurses who smoke may not have an
easier time quitting, is not the correct way of describing the finding that female
nurse smokers were not significantly more active in making recent quit attempts.
Maybe it could rather be expressed as ‘motivation to quit’.
Is the question posed by the authors well defined?
NO
Are the methods appropriate and well described?
NO
Are the data sound?
I am afraid that the data available in this data set is not very relevant for
comparing nurse smokers to other female smokers. For example, I would be
interested in such issues, if nurse smokers differ from others in terms of reasons
for smoking, and also when they try to quit if the reasons why they quit are
different than in other women who try quitting. I guess such data are not available
in this survey.
Does the manuscript adhere to the relevant standards for reporting and data
deposition?
I would rather suggest that the percentages should be given with one decimal
only (if not against the guidelines of BMC). Thus, instead of 10.73 # 10.7 %, etc.
Are the discussion and conclusions well balanced and adequately supported by
the data?
NO
Are limitations of the work clearly stated?
YES
Do the authors clearly acknowledge any work upon which they are building, both
published and unpublished?
Published YES
Do the title and abstract accurately convey what has been found?
NO
Is the writing acceptable?
NO
Minor issues - not for publication
Background; 5th paragraph:
line 7: replace ‘provide’ by ‘provides’;
line 10: replace ‘An analysis smoking among of healthcare…’ by ‘An analysis of
smoking among healthcare…;
lines 12-13: replace ‘..,with physicians and dentists having the lowest smoking
prevalence.’ by ‘..,with physicians and dentists having clearly lower smoking
prevalence.’
Sample; 2nd paragraph:
line 6: add ‘other’ between ‘or’ and ‘healthcare’
Smoking characteristics and level of addiction: 1st paragraph:
Line 5: ‘(20 cigarettes per pack)’ is not necessary
Results:
1st paragraph: last line: replace ‘..,but neither of these differences were not
statistically significant’ by ‘..,but neither of these differences was statistically
significant’
4th paragraph: replace ‘..,controlling for statistically significant demographic
variables and smoking characteristics, as observed in Tables 1 and 2.’ By
‘..,controlling for statistically significant group differences in demographic
variables and smoking characteristics, as observed in Table 2.’
Level of interest: An article whose findings are important to those with closely
related research interests
Quality of written English: Needs some language corrections before being
published
Statistical review: No, the manuscript does not need to be seen by a
statistician.
Declaration of competing interests:
I declare that I have no competing interests.