A Qualitative Study of Lung Cancer Risk Perceptions and Smoking Beliefs Among National Lung Screening Trial Participants

PubMed Central

2014-01-01

Introduction: The National Comprehensive Cancer Network and the American Cancer Society recently released lung screening guidelines that include smoking cessation counseling for smokers undergoing screening. Previous work indicates that smoking behaviors and risk perceptions of the National Lung Screening Trial (NLST) participants were relatively unchanged. We explored American College of Radiology Imaging Network (ACRIN)/NLST former and current smokers’ risk perceptions specifically to (a) determine whether lung screening is a cue for behavior change, (b) elucidate risk perceptions for lung cancer and smoking-related diseases, and (c) explore postscreening behavioral intentions and changes. Methods: A random sample of 35 participants from 4 ACRIN sites were qualitatively interviewed 1–2 years postscreen. We used a structured interview guide based on Health Belief Model and Self-Regulation Model constructs. Content analyses were conducted with NVivo 8. Results: Most participants endorsed high-risk perceptions for lung cancer and smoking-related diseases, but heightened concern about these risks did not appear to motivate participants to seek screening. Risk perceptions were mostly attributed to participants’ heavy smoking histories; former smokers expressed greatly reduced risk. Lung cancer and smoking-related diseases were perceived as very severe although participants endorsed low worry. Current smokers had low confidence in their ability to quit, and none reported quitting following their initial screen. Conclusions: Lung screening did not appear to be a behavior change cue to action, and high-risk perceptions did not translate into quitting behaviors. Cognitive and emotional dissonance and avoidance strategies may deter engagement in smoking behavior change. Smoking cessation and prevention interventions during lung screening should explore risk perceptions, emotions, and quit confidence. PMID:23999653

The Icelandic economic collapse, smoking, and the role of labor-market changes.

PubMed

Ólafsdóttir, Thorhildur; Hrafnkelsson, Birgir; Ásgeirsdóttir, Tinna Laufey

2015-05-01

Smoking is related to health deterioration through increased risk of various diseases. Changes in this health behavior could contribute to the documented health improvements during economic downturns. Furthermore, the reasons for changes in behavior are not well understood. We explore smoking behavior in Iceland before and after the sudden and unexpected economic crisis in 2008. Furthermore, to explore the mechanisms through which smoking could be affected we focus on the role of labor-market changes. Both real income and working hours fell significantly and economic theory suggests that such changes can affect health behaviors which in turn affect health. We use individual longitudinal data from 2007 to 2009, incidentally before and after the crisis hit. The data originates from a postal survey, collected by The Public Health Institute in Iceland. Two outcomes are explored: smoking participation and smoking intensity, using pooled ordinary least squares (OLS) and linear probability models. The detected reduction in both outcomes is not explained by the changes in labor-market variables. Other factors in the demand function for tobacco play a more important role. The most notable are real prices which increased in particular for imported goods because of the devaluation of the Icelandic currency as a result of the economic collapse.

Cell Phone-Based Expert Systems for Smoking Cessation

DTIC Science & Technology

2011-09-01

computerized tailored intervention (CTI) with feedback messages delivered via cell phone . CTIs have shown increasing promise as useful behavior change programs...behaviors. This will be the first study to adapt a smoking cessation Internet-based CTI to provide personalized feedback on a cell phone to reduce smoking behaviors in military veterans.

Applying the Theory of Planned Behavior to Explore the Relation between Smoke-Free Air Laws and Quitting Intentions

ERIC Educational Resources Information Center

Macy, Jonathan T.; Middlestadt, Susan E.; Seo, Dong-Chul; Kolbe, Lloyd J.; Jay, Stephen J.

2012-01-01

Smoke-free air policies have been shown to reduce smoking, but the mechanism of behavior change is not well understood. The authors used structural equation modeling to conduct a theory of planned behavior analysis with data from 395 smokers living in seven Texas cities, three with a comprehensive smoke-free air law and four without a…

Trends in smoking, diet, physical exercise, and attitudes toward health in European university students from 13 countries, 1990-2000.

PubMed

Steptoe, Andrew; Wardle, Jane; Cui, Weiwei; Bellisle, France; Zotti, Anna-Maria; Baranyai, Reka; Sanderman, Robert

2002-08-01

Smoking, diet, and physical exercise are key determinants of health. This study assessed changes over 10 years and their relationship to changes in health beliefs and risk awareness. A survey was carried out of university students from 13 European countries (Belgium, England, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, The Netherlands, Poland, Portugal, and Spain) in 1990 (4,701 men, 5,729 women) and repeated in 2000 (4,604 men, 5,732 women). We assessed smoking, exercise, fruit and fat intake, beliefs in the importance of behaviors for health, and awareness of the influence of behaviors on heart disease risk. Smoking prevalence increased and fruit consumption decreased between 1990 and 2000, while physical exercise and fat intake were more stable. There were large variations between country samples. Health beliefs weakened, with marked decreases in beliefs about smoking and diet. Across country samples, changes in beliefs correlated with changes in the prevalence of behaviors. Awareness of the effects of smoking and exercise was stable, but knowledge of the role of fat intake increased over the decade. The differences in health behaviors, beliefs, and risk awareness between the two surveys were disappointing in this educated sector of young adult Europeans. The association between changes in beliefs and prevalence of behavior emphasizes the importance of enhancing positive attitudes to healthier lifestyles.

Examination of a Process Model of Adolescent Smoking Self-Change Efforts in Relation to Gender

ERIC Educational Resources Information Center

MacPherson, Laura; Myers, Mark G.

2010-01-01

Little information describes how adolescents change their smoking behavior. This study investigated the role of gender in the relationship of motivation and cognitive variables with adolescent smoking self-change efforts. Self-report and semi-structured interview data from a prospective study of smoking self-change efforts were examined among 98…

Change in smoking, diet, and walking for exercise in Blacks.

PubMed

Berg, Carla J; Thomas, Janet L; An, Lawrence C; Guo, Hongfei; Collins, Tracie; Okuyemi, Kolawole S; Ahluwalia, Jasjit S

2012-04-01

Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers (≤10 cigarettes per day ≥25 days/month) enrolled in a 2 × 2 factorial study (placebo vs. nicotine gum, health education vs. motivational interviewing). Reducing cigarette consumption (p = .02) and quitting smoking (p < .01), as well as receiving the nicotine gum (p = .04), was associated with increased FV intake, after controlling for baseline FV intake. Compared with those who did not reduce their smoking, both reducers (p < .001) and quitters (p < .001) were more likely to walk for exercise at follow-up, after controlling for baseline walking status (p = .01). Thus, addressing one health risk behavior may prompt other positive health behaviors, which may argue for developing interventions targeting multiple health risk behaviors.

Change in Smoking, Diet, and Walking for Exercise in Blacks

PubMed Central

Berg, Carla J.; Thomas, Janet L.; An, Lawrence C.; Guo, Hongfei; Collins, Tracie; Okuyemi, Kolawole S.; Ahluwalia, Jasjit S.

2013-01-01

Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers (≤10 cigarettes per day ≥25 days/month) enrolled in a 2 × 2 factorial study (placebo vs. nicotine gum, health education vs. motivational interviewing). Reducing cigarette consumption (p = .02) and quitting smoking (p < .01), as well as receiving the nicotine gum (p = .04), was associated with increased FV intake, after controlling for baseline FV intake. Compared with those who did not reduce their smoking, both reducers (p < .001) and quitters (p < .001) were more likely to walk for exercise at follow-up, after controlling for baseline walking status (p = .01). Thus, addressing one health risk behavior may prompt other positive health behaviors, which may argue for developing interventions targeting multiple health risk behaviors. PMID:22330092

The German East-West Mortality Difference: Two Crossovers Driven by Smoking.

PubMed

Vogt, Tobias; van Raalte, Alyson; Grigoriev, Pavel; Myrskylä, Mikko

2017-06-01

Before the fall of the Berlin Wall, mortality was considerably higher in the former East Germany than in West Germany. The gap narrowed rapidly after German reunification. The convergence was particularly strong for women, to the point that Eastern women aged 50-69 now have lower mortality despite lower incomes and worse overall living conditions. Prior research has shown that lower smoking rates among East German female cohorts born in the 1940s and 1950s were a major contributor to this crossover. However, after 1990, smoking behavior changed dramatically, with higher smoking intensity observed among women in the eastern part of Germany. We forecast the impact of this changing smoking behavior on East-West mortality differences and find that the higher smoking rates among younger East German cohorts will reverse their contemporary mortality advantage. Mortality forecasting methods that do not account for smoking would, perhaps misleadingly, forecast a growing mortality advantage for East German women. Experience from other countries shows that smoking can be effectively reduced by strict anti-smoking policies. Instead, East Germany is becoming an example warning of the consequences of weakening anti-smoking policies and changing behavioral norms.

Perianal disease, small bowel disease, smoking, prior steroid or early azathioprine/biological therapy are predictors of disease behavior change in patients with Crohn’s disease

PubMed Central

Lakatos, Peter Laszlo; Czegledi, Zsofia; Szamosi, Tamas; Banai, Janos; David, Gyula; Zsigmond, Ferenc; Pandur, Tunde; Erdelyi, Zsuzsanna; Gemela, Orsolya; Papp, Janos; Lakatos, Laszlo

2009-01-01

AIM: To assess the combined effect of disease phenotype, smoking and medical therapy [steroid, azathioprine (AZA), AZA/biological therapy] on the probability of disease behavior change in a Caucasian cohort of patients with Crohn’s disease (CD). METHODS: Three hundred and forty well-characterized, unrelated, consecutive CD patients were analyzed (M/F: 155/185, duration: 9.4 ± 7.5 years) with a complete clinical follow-up. Medical records including disease phenotype according to the Montreal classification, extraintestinal manifestations, use of medications and surgical events were analyzed retrospectively. Patients were interviewed on their smoking habits at the time of diagnosis and during the regular follow-up visits. RESULTS: A change in disease behavior was observed in 30.8% of patients with an initially non-stricturing, non-penetrating disease behavior after a mean disease duration of 9.0 ± 7.2 years. In a logistic regression analysis corrected for disease duration, perianal disease, smoking, steroid use, early AZA or AZA/biological therapy use were independent predictors of disease behavior change. In a subsequent Kaplan-Meier survival analysis and a proportional Cox regression analysis, disease location (P = 0.001), presence of perianal disease (P < 0.001), prior steroid use (P = 0.006), early AZA (P = 0.005) or AZA/biological therapy (P = 0.002), or smoking (P = 0.032) were independent predictors of disease behavior change. CONCLUSION: Our data suggest that perianal disease, small bowel disease, smoking, prior steroid use, early AZA or AZA/biological therapy are all predictors of disease behavior change in CD patients. PMID:19630105

The motivators and barriers to a smoke-free home among disadvantaged caregivers: identifying the positive levers for change.

PubMed

Jones, Laura L; Atkinson, Olesya; Longman, Jo; Coleman, Tim; McNeill, Ann; Lewis, Sarah A

2011-06-01

The aims of this study were to explore home smoking behaviors and the motivators and barriers to smoke-free homes among a group of disadvantaged caregivers for young children and to identify the positive levers that health care professionals can utilize when supporting smoking behavior change. In-depth qualitative interviews were conducted between July and September 2009, with 22 disadvantaged smoking caregivers, accessing Children's Centre Services in Nottingham, UK. Interviews were audiorecorded and transcribed verbatim. Data were coded and analyzed thematically to identify emergent main and subthemes. Caregivers had some general understanding of the dangers of secondhand smoke (SHS), but their knowledge appeared incomplete and confused. All interviewees described rules around smoking in the home; however, these tended to be transient and fluid and unlikely to be effective. Caregivers were often living in difficult and complex circumstances and experienced significant barriers to creating a smoke-free home. The motivators for change were more strongly linked to house decor and smell than children's health, suggesting that visible evidence of the harm done by SHS to children might help promote smoke-free homes. Findings suggest that further tailored information on the effect of SHS is required, but to instigate caregiver behavior change, providing demonstrable evidence of the impact that their smoking is having on their children's health is more likely to be effective.

Change in Smoking, Diet, and Walking for Exercise in Blacks

ERIC Educational Resources Information Center

Berg, Carla J.; Thomas, Janet L.; An, Lawrence C.; Guo, Hongfei; Collins, Tracie; Okuyemi, Kolawole S.; Ahluwalia, Jasjit S.

2012-01-01

Positive changes in one health behavior may be accompanied by other constructive health behavior changes. Thus, the authors investigated the association of smoking reduction and cessation to changes in fruit and vegetable (FV) intake and engaging in walking for exercise. This study included 539 Black light smokers ([less than or equal to]10…

An approach to children's smoking behavior using social cognitive learning theory.

PubMed

Bektas, Murat; Ozturk, Candan; Armstrong, Merry

2010-01-01

This review article discusses the theoretical principles of social cognitive learning theory and children's risk-taking behavior of cigarette smoking, along with preventive initiatives. Social cognitive learning theorists examine the behavior of initiating and sustained smoking using a social systems approach. The authors discuss the reciprocal determinism aspect of the theory as applied to the importance of individual factors, and environment and behavioral interactions that influence smoking behavior. Included is the concept of vicarious capability that suggests that smoking behavior is determined in response to and interaction with feedback provided by the environment. The principle of self-regulatory capability asserts that people have control over their own behavior and thus that behavior change is possible. The principle of self-efficacy proposes that high level of self-efficacy of an individual may decrease the behavior of attempting to or continuing to smoke. Examples of initiatives to be undertaken in order to prevent smoking in accordance with social cognitive learning theory are presented at the end of each principle.

Smoking Behavior Change During Compulsory Military Service in Israel, 1987-2011.

PubMed

Zarka, Salman; Levine, Hagai; Rozhavski, Vladislav; Sela, Tamar; Bar-Ze'ev, Yael; Molina-Hazan, Vered; Rosen, Laura J

2017-11-01

Smoking in military settings is of major concern. We aimed to assess the association between personal, family, and military factors and smoking behavior change during compulsory military service in Israel. Participants were soldiers recruited between 1987 and 2008 who were interviewed at recruitment and reinterviewed at discharge (1987-2011) (total: 29 189; males:15 136; females:14 053). The primary outcome variables were smoking initiation during service among nonsmokers at recruitment, and cessation during service among smokers at recruitment. We examined potential predictors of change, and trends by calendar year. Smoking prevalence increased by 39.4% during military service (recruitment: 26.2%, discharge: 36.5%). 18.4% of nonsmoking recruits initiated smoking, and 12.4% of smoking recruits quit smoking between recruitment and discharge. There was no observed trend in initiation between 1987 and 2011. The strongest predictor of smoking initiation among nonsmokers at recruitment was smoking history (former vs. never-smoker, odds ratio (OR) [95% confidence interval [CI

Smoking Behavior and Healthcare Expenditure in the United States, 1992–2009: Panel Data Estimates

PubMed Central

Lightwood, James; Glantz, Stanton A.

2016-01-01

Background Reductions in smoking in Arizona and California have been shown to be associated with reduced per capita healthcare expenditures in these states compared to control populations in the rest of the US. This paper extends that analysis to all states and estimates changes in healthcare expenditure attributable to changes in aggregate measures of smoking behavior in all states. Methods and Findings State per capita healthcare expenditure is modeled as a function of current smoking prevalence, mean cigarette consumption per smoker, other demographic and economic factors, and cross-sectional time trends using a fixed effects panel data regression on annual time series data for each the 50 states and the District of Columbia for the years 1992 through 2009. We found that 1% relative reductions in current smoking prevalence and mean packs smoked per current smoker are associated with 0.118% (standard error [SE] 0.0259%, p < 0.001) and 0.108% (SE 0.0253%, p < 0.001) reductions in per capita healthcare expenditure (elasticities). The results of this study are subject to the limitations of analysis of aggregate observational data, particularly that a study of this nature that uses aggregate data and a relatively small sample size cannot, by itself, establish a causal connection between smoking behavior and healthcare costs. Historical regional variations in smoking behavior (including those due to the effects of state tobacco control programs, smoking restrictions, and differences in taxation) are associated with substantial differences in per capita healthcare expenditures across the United States. Those regions (and the states in them) that have lower smoking have substantially lower medical costs. Likewise, those that have higher smoking have higher medical costs. Sensitivity analysis confirmed that these results are robust. Conclusions Changes in healthcare expenditure appear quickly after changes in smoking behavior. A 10% relative drop in smoking in every state is predicted to be followed by an expected $63 billion reduction (in 2012 US dollars) in healthcare expenditure the next year. State and national policies that reduce smoking should be part of short term healthcare cost containment. PMID:27163933

Experience of a smoking cessation program among high school students in Taiwan.

PubMed

Chang, Chi-Ping; Lee, Ting-Ting; Mills, Mary Etta

2014-01-01

In Taiwan, the prevalence of smoking among teenagers has led to a required smoking cessation program in schools. Students caught smoking in school are required to participate in a weekly smoking cessation class. The purpose of this study was to explore the experience of high school students in a smoking cessation program. Fifteen adolescents participated in a one-on-one in-depth semistructured interview, and the content was analyzed for patterns based on the methods of Miles and Huberman. In addition, Lewin's change theory of drive forces and restraining forces was used to describe the change in behavior as a result of the program. Five major themes were identified: the onset of smoking-change influenced by families and friends; intention to quit smoking-driving force; the irresistible temptation to smoke-restraining force; limited change effects-more attention and assistance needed; and change in attitude rather than behavior-smoking remained unchanged. Changes were seen in the perceptions and attitudes of these students toward smoking at the end of the program; however, none of them were able to really quit. Most participants revealed that they used improper means to pass the carbon monoxide test requirement that was used as a measure of not smoking. Alternative future intervention strategies for further study include change in health policy to support nicotine replacement methods for heavy adolescent smoker, use of teacher support, and exercise programs to support students going through the smoking cessation period.

Increasing the Value of an Alternative Monetary Reinforcer Reduces Cigarette Choice in Adolescents

PubMed Central

Tidey, Jennifer W.; Kahler, Christopher W.; Wray, Tyler B.; Colby, Suzanne M.

2015-01-01

Introduction: Smoking can be conceptualized as an operant behavior maintained by the reinforcing effects of cigarettes. Changing the magnitude and availability of alternative reinforcers should shift behavior away from smoking. Adults’ smoking behavior is sensitive to the magnitude and availability of alternative reinforcers; however, the extent to which the same is true for adolescents has not yet been shown in the laboratory. Methods: To test the sensitivity of adolescent smoking behavior to changes in the magnitude of alternative reinforcement, we gave adolescents who abstained overnight the opportunity to make 20 choices between receiving two puffs of their usual-brand cigarette or money. The magnitude of the monetary reinforcer was varied across sessions in counterbalanced order ($0.00, $0.10, and $0.50). Results: Results indicated that adolescents’ choices for puffs decreased as a function of increasing monetary reinforcer magnitude, while money choices increased. This effect was moderated by baseline smoking level and by gender, such that heavier-smoking participants and males made more cigarette choices when the alternative monetary value was zero, and decreased their choices more steeply in response to increasing monetary value. Conclusions: The current study validates a laboratory choice procedure for studying smoking in adolescents, and demonstrates that adolescent smoking behavior is sensitive to changes in the magnitude of concurrently available monetary reinforcers. The current paradigm can be adapted and applied to explore the effects of other variables that may affect cigarette choice in adolescents. PMID:25666814

Randomized Controlled Trial for Behavioral Smoking and Weight Control Treatment: Effect of Concurrent versus Sequential Intervention

PubMed Central

Spring, Bonnie; Doran, Neal; Pagoto, Sherry; Schneider, Kristin; Pingitore, Regina; Hedeker, Don

2014-01-01

Prospects for changing multiple health behaviors conjointly remain controversial. We compared effects on tobacco abstinence and weight gain of adding diet and exercise concurrently or after smoking treatment. Female regular smokers (n=315) randomized to 3 conditions received 16 weeks of behavioral smoking treatment, quit at week 5, and were followed for 9 months after the quit date. Weight management was added to the first 8 weeks for Early Diet (ED), the final 8 weeks for Late Diet (LD), and omitted for Control. Both Diet groups tended to show greater bio-verified abstinence than Control although differences were nonsignificant. Compared to Control, ED initially suppressed weight gain but lost that effect over time, whereas LD initially lacked but gradually acquired a weight suppression effect that stabilized [p = .004]. Behavioral weight control did not undermine smoking cessation and slowed the rate of weight gain when initiated after the smoking quit date, supporting a sequential approach to multiple behavior change. PMID:15482037

Cigarette Design Features: Effects on Emission Levels, User Perception, and Behavior.

PubMed

Talhout, Reinskje; Richter, Patricia A; Stepanov, Irina; Watson, Christina V; Watson, Clifford H

2018-01-01

This paper describes the effects of non-tobacco, physical cigarette design features on smoke emissions, product appeal, and smoking behaviors - 3 factors that determine smoker's exposure and related health risks. We reviewed available evidence for the impact of filter ventilation, new filter types, and cigarettes dimensions on toxic emissions, smoker's perceptions, and behavior. For evidence sources we used scientific literature and websites providing product characteristics and marketing information. Whereas filter ventilation results in lower machine-generated emissions, it also leads to perceptions of lighter taste and relative safety in smokers who can unwittingly employ more intense smoking behavior to obtain the desired amount of nicotine and sensory appeal. Filter additives that modify smoke emissions can also modify sensory cues, resulting in changes in smoking behavior. Flavor capsules increase the cigarette's appeal and novelty, and lead to misperceptions of reduced harm. Slim cigarettes have lower yields of some smoke emissions, but smoking behavior can be more intense than with standard cigarettes. Physical design features significantly impact machine-measured emission yields in cigarette smoke, product appeal, smoking behaviors, and exposures in smokers. The influence of current and emerging design features is important in understanding the effectiveness of regulatory actions to reduce smoking-related harm.

The Impact of Smoking Bans on Smoking and Consumer Behavior: Quasi-Experimental Evidence from Switzerland.

PubMed

Boes, Stefan; Marti, Joachim; Maclean, Johanna Catherine

2015-11-01

In this paper, we exploit the progressive implementation of smoking bans in public venues at the state level in Switzerland to evaluate both the direct effects on smoking and the potential unintended consequences of these legislations on consumer behaviors as measured by visiting restaurants/bars and discos ('going out'). Our results indicate that public venue smoking bans in Switzerland reduce smoking rates, but the findings do not emerge until 1 year following the ban. This pattern of results is consistent with delays in ban enforcement on the part of business owners, difficulties in changing addictive behaviors such as smoking, and/or learning on the part of smokers. We find evidence that smoking bans influence going-out behavior and there is substantial heterogeneity across venue and consumer characteristics. Copyright © 2014 John Wiley & Sons, Ltd.

Changes in Smoking-Related Norms in Bars Resulting from California's Smoke-Free Workplace Act

ERIC Educational Resources Information Center

Satterlund, Travis D.; Lee, Juliet P.; Moore, Roland S.

2012-01-01

California's Smoke-Free Workplace Act--CA Labor Code Sec. 6404.5(a)--was extended to bars in 1998. This article analyzes changes in normative beliefs and behaviors related to bar smoking in the decade following the adoption of the Act. In a series of studies evaluating the smoke-free workplace law in bars, researchers conducted extensive…

Impact of a smoke-free policy in a large psychiatric hospital on staff attitudes and patient behavior.

PubMed

Voci, Sabrina; Bondy, Susan; Zawertailo, Laurie; Walker, Louise; George, Tony P; Selby, Peter

2010-01-01

The objectives of this work were to examine changes over time in degree of staff support for the implementation of a smoke-free policy in Canada's largest public mental health and addiction teaching hospital and to assess the impact of the policy on patient behavior. Staff completed an anonymous survey, which assessed views toward the smoke-free policy and perceived change in patient behavior, 2-7 and 31-33 months after an indoor smoke-free policy was implemented (September 21, 2005). Objective indicators of patient behavior were also collected in the form of number of emergency code whites (aggressive behavior) and that of code reds (fire) called 1 year prior to and 2 years following policy implementation. Survey response rates were 19.0% (n=481) and 18.1% (n=500) at 2-7 and 31-33 months, respectively. The proportion of staff who supported the policy increased from pre-implementation (82.6%) to post-implementation (89.1%), and a high level of support was maintained 2 years after policy enactment (90.1%). The number of emergency codes did not significantly change after policy implementation, and staff did not perceive a change in most forms of patient behavior. A smoke-free policy can be implemented in a large psychiatric hospital with a high degree of support from staff and no substantial negative impact on patient behavior. Copyright © 2010 Elsevier Inc. All rights reserved.

A population survey on legislative measures to restrict smoking in Ontario: 4. Variables related to knowledge of active and passive smoking health effects and to predicted behavior of smokers and nonsmokers.

PubMed

Pederson, L L; Bull, S B; Ashley, M J; Lefcoe, N M

1989-01-01

Results from the further analysis of a population survey on legislative measures to restrict smoking revealed that identification of subgroups of smokers is more reliable than identification of subgroups of nonsmokers when a variety of attitudes were the measures of interest. A similar pattern emerged when analyses were carried out on knowledge of active and passive smoking health effects and on predicted personal and general compliance. Because distinct sets of variables were found to be related to distinct outcomes, program planning for changes in knowledge and behavior might, of necessity, have to be different. Media messages might be useful for changes in knowledge, while actual experience might be more important for attitude and behavior change.

Increasing the Value of an Alternative Monetary Reinforcer Reduces Cigarette Choice in Adolescents.

PubMed

Cassidy, Rachel N; Tidey, Jennifer W; Kahler, Christopher W; Wray, Tyler B; Colby, Suzanne M

2015-12-01

Smoking can be conceptualized as an operant behavior maintained by the reinforcing effects of cigarettes. Changing the magnitude and availability of alternative reinforcers should shift behavior away from smoking. Adults' smoking behavior is sensitive to the magnitude and availability of alternative reinforcers; however, the extent to which the same is true for adolescents has not yet been shown in the laboratory. To test the sensitivity of adolescent smoking behavior to changes in the magnitude of alternative reinforcement, we gave adolescents who abstained overnight the opportunity to make 20 choices between receiving two puffs of their usual-brand cigarette or money. The magnitude of the monetary reinforcer was varied across sessions in counterbalanced order ($0.00, $0.10, and $0.50). Results indicated that adolescents' choices for puffs decreased as a function of increasing monetary reinforcer magnitude, while money choices increased. This effect was moderated by baseline smoking level and by gender, such that heavier-smoking participants and males made more cigarette choices when the alternative monetary value was zero, and decreased their choices more steeply in response to increasing monetary value. The current study validates a laboratory choice procedure for studying smoking in adolescents, and demonstrates that adolescent smoking behavior is sensitive to changes in the magnitude of concurrently available monetary reinforcers. The current paradigm can be adapted and applied to explore the effects of other variables that may affect cigarette choice in adolescents. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Presenting the facts about smoking to adolescents: effects of an autonomy-supportive style.

PubMed

Williams, G C; Cox, E M; Kouides, R; Deci, E L

1999-09-01

To test the self-determination model of health-related behavior by examining whether the degree to which adolescents experience an appeal to not smoke as autonomy supportive would affect their autonomous motivation for not smoking and, in turn, their behavior of either refraining from smoking or smoking less, and to validate the measures of perceived autonomy support and autonomous motivation for not smoking. Two studies of physicians presenting information about not smoking using 2 message styles, 1 of which was designed to be more autonomy supportive. The preliminary study involved nonrandomized assignment to message style and only immediate assessment of perceptions, motivation, and behavior, while the primary study involved randomized assignment and 4-month longitudinal assessments. Nearly 400 ninth- through 12th-grade students at 2 suburban high schools in upstate New York. Adolescents' perceptions of the presentations' autonomy supportiveness of the presenters, as well as adolescents' autonomous motivation for not smoking and their self-reports of smoking. The primary study also assessed change in students' autonomous motivation and change in their self-reported smoking during 4 months. In both studies, the measures were reliable and valid. Students perceived significantly (P = .04 and P<.001, respectively) greater autonomy support in the "It's Your Choice" presentation, after controlling for whether the students were smokers. Perceived autonomy supportiveness of the presentation was positively correlated with autonomous reasons for not smoking in the preliminary study and with increases in autonomous motivation for not smoking in the primary study. Change in autonomous reasons for not smoking significantly (P<.001) predicted reduction in smoking during 4 months. When adolescents perceived messages about not smoking as autonomy supportive, they had more autonomous motivation for not smoking, and that, in turn, predicted a decrease in their self-reports of smoking.

Changes in Smoking Behavior over Family Transitions: Evidence for Anticipation and Adaptation Effects.

PubMed

Bricard, Damien; Legleye, Stéphane; Khlat, Myriam

2017-06-07

The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a discrete-time logistic model to explore the timing of changes in terms of leads and lags effects up to three years around the event in order to measure both anticipation and adaptation mechanisms. Retrospective biographical data from the Santé et Itinéraires Professionnels (SIP) survey conducted in France in 2006 are used. Partnership formation was followed for both genders by a fall in smoking initiation and an immediate rise in smoking cessation. Childbirth was associated with increased smoking cessation immediately around childbirth, and additionally, females showed an anticipatory increase in smoking cessation up to two years before childbirth. Couple separation was accompanied by an anticipatory increase in smoking initiation for females up to two years prior to the separation, but this effect only occurred in males during separation. Our findings highlight opportunities for more targeted interventions over the life course to reduce smoking, and therefore have relevance for general practitioners and public policy elaboration.

Tobacco advertising, promotion, and sponsorship (TAPS) exposure, anti-TAPS policies, and students' smoking behavior in Botswana and South Africa.

PubMed

English, Lorna McLeod; Hsia, Jason; Malarcher, Ann

2016-10-01

We examined the change over time in tobacco advertising, promotion and sponsorship exposure and the concurrent changes in cigarette smoking behavior among students age 13 to 15years in two African countries with different anti-tobacco advertising, promotion and sponsorship policies. In South Africa, anti-tobacco advertising, promotion and sponsorship policies became more comprehensive over time and were more strictly enforced, whereas the partial anti-tobacco advertising, promotion and sponsorship policies adopted in Botswana were weakly enforced. We analyzed two rounds of Global Youth Tobacco Survey data from South Africa (1999, n=2342; 2011, n=3713) and in Botswana (2001, n=1073; 2008, n=1605). We assessed several indicators of tobacco advertising, promotion and sponsorship exposure along with prevalence of current cigarette smoking and smoking susceptibility for each data round. Logistic regression was used to examine changes over time in tobacco advertising, promotion and sponsorship exposure and smoking behavior in both countries. Between 1999 and 2011, South African students' exposure to tobacco advertising and sponsorship decreased significantly by 16% (p value, <0.0001) and 14% (p value, <0.0001), respectively. Exposure to tobacco promotion was lower and did not decrease significantly. Botswanan students' tobacco advertising, promotion and sponsorship exposure did not change significantly between 2001 and 2008. South African students' prevalence of cigarette smoking decreased over time (OR, 0.68) as did susceptibility to smoking (OR, 0.75), but declines did not remain significant after adjusting for parents' and friends' smoking. In Botswana, students' prevalence of cigarette smoking increased significantly over time (OR, 1.84), as did susceptibility to smoking (OR, 2.71). Enforcement of strong anti-tobacco advertising, promotion and sponsorship policies is a vital component of effective tobacco control programs in Africa. Such regulations, if effectively implemented, can reduce tobacco advertising, promotion and sponsorship exposure among adolescents and may influence cigarette smoking behavior. Copyright © 2016. Published by Elsevier Inc.

Attributional Processes in Behavior Change and Maintenance: Smoking Cessation and Continued Abstinence.

ERIC Educational Resources Information Center

Harackiewicz, Judith M.; And Others

1987-01-01

Examined the role of attributions in initial and long-term smoking behavior change. Manipulated the externality of treatment. Subjects receiving nicotine gum were superior to the intrinsic self-help group in initial cessation but were inferior in maintaining abstinence. Subjects in the intrinsic self-help group made fewer external attributions for…

Determining Smoking Cessation Related Information, Motivation, and Behavioral Skills among Opiate Dependent Smokers in Methadone Treatment

PubMed Central

Cooperman, Nina A.; Richter, Kimber P.; Bernstein, Steven L.; Steinberg, Marc L.; Williams, Jill M.

2015-01-01

Background Over 80% of people in methadone treatment smoke cigarettes, and existing smoking cessation interventions have been minimally effective. Objective To develop an Information-Motivation-Behavioral Skills (IMB) Model of behavior change based smoking cessation intervention for methadone maintained smokers, we examined smoking cessation related information, motivation, and behavioral skills in this population. Methods Current or former smokers in methadone treatment (n=35) participated in focus groups. Ten methadone clinic counselors participated in an individual interview. A content analysis was conducted using deductive and inductive approaches. Results Commonly known information, motivation, and behavioral skills factors related to smoking cessation were described. These factors included: the health effects of smoking and treatment options for quitting (information); pregnancy and cost of cigarettes (motivators); and coping with emotions, finding social support, and pharmacotherapy adherence (behavioral skills). Information, motivation, and behavioral skills factors specific to methadone maintained smokers were also described. These factors included: the relationship between quitting smoking and drug relapse (information), the belief that smoking is the same as using drugs (motivator); and coping with methadone clinic culture and applying skills used to quit drugs to quitting smoking (behavioral skills). Information, motivation, and behavioral skills strengths and deficits varied by individual. Conclusions Methadone maintained smokers could benefit from research on an IMB Model based smoking cessation intervention that is individualized, addresses IMB factors common among all smokers, and also addresses IMB factors unique to this population. PMID:25559697

A RANDOMIZED CONTROLLED TRIAL OF PROGRESSIVELY REDUCED NICOTINE CONTENT CIGARETTES ON SMOKING BEHAVIORS, BIOMARKERS OF EXPOSURE, AND SUBJECTIVE RATINGS

PubMed Central

Mercincavage, Melissa; Souprountchouk, Valentina; Tang, Kathy Z.; Dumont, Rachel L.; Wileyto, E. Paul; Carmella, Steven G.; Hecht, Stephen S.; Strasser, Andrew A.

2016-01-01

Background The U.S. FDA has the authority to reduce cigarette nicotine content if found to benefit public health. Reduced nicotine content (RNC) cigarette use does not appear to increase harm exposure, but studies have not rigorously assessed smoking behavior or utilized a comprehensive panel of biomarkers. This study examined the effects of progressively decreasing RNC cigarettes on smoking behaviors, biomarkers of exposure, and subjective ratings. Methods 158 daily, non-treatment-seeking smokers participated in a 35-day randomized, unblinded, parallel study. After a 5-day baseline period, participants were randomly assigned to an experimental group (n = 80) that smoked progressively decreasing RNC cigarettes during three 10-day periods, or control group (n =78) that smoked their own brand throughout the study. Results Daily cigarette consumption significantly increased for the intermediate RNCs (P’s < 0.001) but approached baseline rate for the lowest RNC (P = 0.686); in contrast, puffing behavior significantly decreased at intermediate levels and increased for the lowest RNC (P’s < 0.001). Cotinine and NNAL significantly decreased by RNC period (P’s ≤ 0.001–0.02), while CO boost initially increased (P’s = 0.001–0.005). 1-HOP did not change by period (P = 0.109). Conclusions Smoking behaviors changed by RNC period via CPD and puffing behavior. Biomarkers of exposure generally decreased with nicotine content. Impact Findings suggest that RNC use does not ubiquitously reduce smoking behaviors or biomarkers, yet the lowest RNC level tested may reduce harm exposure. This emphasizes the importance of utilizing multiple behavioral and biological measures to address the impact of RNC cigarette smoking. PMID:27197288

Moving Beyond the Behavior-Change Framework for Smoking Cessation: Lessons for a Critical Ontology From the Case of Inpatient Psychiatric Units.

PubMed

Birnbaum, Shira

2018-06-01

Leading scholars have called on nursing schools to pay more attention to smoking cessation in the education of nursing students. This article argues that attention to this subject should include a rethinking of the behavior-change framework that forms the methodological basis of this field. Drawing on classic and contemporary work in sociology, anthropology, and critical public health, this article explores the specific example of smoking in long-term inpatient units to illustrate the limitations of a behavior-based ontology and suggest an alternative conceptual vocabulary. An alternative approach posits smoking as a social practice. It sheds light on situational factors that incentivize smoking and might be contributing to patient resistance to cessation. A different conceptual framing of smoking can point to interventions beyond the level of individuals, focusing instead on the broader interface between people and situations, where decisions and desires meet institutional and organizational dynamics and structures of opportunity and access.

Physician-patient interactions regarding diet, exercise, and smoking.

PubMed

Nawaz, H; Adams, M L; Katz, D L

2000-12-01

The objectives were to determine the rate of physician/patient discussions regarding diet, exercise, and smoking and to assess the effect of such discussions on behavior change. In a telephone survey of Connecticut adults, respondents who had a routine checkup in the past year (n = 433) were asked whether their physicians had asked them about their dietary habits, exercise, or smoking, and about any efforts to modify these behaviors during the preceding year. Diet was addressed with 50% of the subjects, exercise with 56%, and smoking status with 77%. Respondents who were asked about their diet were more likely to have changed their fat or fiber intake in the past year than those not asked (64 vs. 48%, P = 0.002) and were somewhat more likely to have lost weight (46 vs. 37%; P = 0.061); the differences were even greater among 94 overweight subjects (64 vs. 47%; P = 0.099). No behavior change was associated with discussions of exercise or smoking. Physicians have the potential to impact health behaviors, especially those related to diet, through simple discussions during routine checkups, but only about half are using this opportunity. Copyright 2000 American Health Foundation and Academic Press.

Is parenting style a context for smoking-specific parenting practices?

PubMed

Huver, Rose M E; Engels, Rutger C M E; Vermulst, Ad A; de Vries, Hein

2007-07-10

This study examined whether global parenting style can be regarded as a context in which smoking-specific parenting practices relate to adolescent smoking cognitions and behaviors. Data were gathered through self-administered questionnaires from 482 adolescents aged 12-19 years, who participated in the Study of Medical Information and Lifestyles in Eindhoven (SMILE). We assessed parenting style dimensions (support, strict control, psychological control), smoking-specific parenting practices (parent-child communication about smoking, anti-smoking house rules, availability of tobacco products, non-smoking agreement), smoking-related cognitions according to the I-Change Model (attitude, social norm, self-efficacy, intention), and smoking behavior. Structural equation models were computed and compared for adolescents in different parenting climates. Results showed that communication and availability were related to adolescents' attitude towards smoking. Availability was additionally associated with reduced self-efficacy to refrain from smoking. Attitude and self-efficacy were subsequently related to intention to smoke, which in turn was related to smoking behavior. No direct relations were found between anti-smoking parenting practices and adolescent smoking behavior. These results were not dependent on the parenting climate. Parenting style thus did not serve as a context for smoking-specific parenting practices, indicating that these facets of parenting operate independently, and that anti-smoking parenting practices may be effective regardless of parenting climate.

Momentary changes in craving predict smoking lapse behavior: a laboratory study.

PubMed

Motschman, Courtney A; Germeroth, Lisa J; Tiffany, Stephen T

2018-04-27

Current research on factors that predict smoking lapse behavior is limited in its ability to fully characterize the critical moments leading up to decisions to smoke. We used a validated and widely used experimental analogue for smoking lapse to assess how moment-to-moment dynamics of craving relate to decisions to smoke. Heavy smokers (N = 128, M age = 35.9) participated in a 50-min laboratory delay to smoking task on 2 consecutive days, earning money for each 5 min they remained abstinent or ending the task by choosing to smoke. Participants rated craving and negative affect levels immediately prior to each choice. Participants were randomized to smoking as usual (n = 50) or overnight abstinence (n = 50 successfully abstained, n = 22 failed abstaining) prior to session 2. Discrete-time hazard models were used to examine craving and negative affect as time-varying predictors of smoking. Higher craving levels prior to smoking opportunities predicted increased risk of smoking. When controlling for craving levels, incremental increases in craving predicted increased smoking risk. Increases in negative affect incrementally predicted increased smoking risk at session 2 only. Smokers who failed to abstain were at a higher risk of smoking than those who successfully abstained, whereas abstinent and non-abstinent smokers did not differ in smoking risk. Findings demonstrate an extension of the smoking lapse paradigm that can be utilized to capture momentary changes in craving that predict smoking behavior. Evaluations of nuanced craving experiences may inform clinical and pharmacological research on preventing smoking lapse and relapse.

Secondhand smoke avoidance by preteens living with smokers: To leave or stay?

PubMed Central

Ding, Ding; Wahlgren, Dennis R.; Liles, Sandy; Jones, Jennifer A.; Hughes, Suzanne C.; Hovell, Melbourne F.

2010-01-01

Introduction Secondhand smoke (SHS) is hazardous to children’s health. Designing interventions to reduce exposure requires understanding children’s behavior in the presence of smokers, yet little is known about this behavior. Purpose To determine whether children’s avoidance of SHS is associated with lower exposure and to explore predictors of avoidance based on a behavioral ecological model. Method Preteens aged 8–13 (N=358) living with a smoker identified their primary source of SHS exposure, and reported whether they left (avoided exposure) or stayed the last time they were exposed to that person’s smoke. The SHS avoidance measure was validated by examining associations with SHS exposure. Multivariable Logistic Regression was used to determine predictors of SHS avoidance. Results Based on urine cotinine and reported exposure, preteens who left the presence of SHS had lower exposure than those who stayed. Preteens were more likely to leave SHS if they were less physically mature, had not tried smoking, had a firm commitment not to smoke, did not assist family smoking, had family/friends who discouraged breathing SHS, or had friends who disliked smoking. Discussion Most SHS exposure reduction interventions have targeted changes in smokers’ behavior. Reductions can also be achieved by changing exposed nonsmokers’ behavior, such as avoiding the exposure. Future studies should measure young people’s SHS avoidance and test interventions to increase their avoidance practices. PMID:20634003

Evaluation of Two Mobile Health Apps in the Context of Smoking Cessation: Qualitative Study of Cognitive Behavioral Therapy (CBT) Versus Non-CBT-Based Digital Solutions

PubMed Central

Amin, Nima; Chadha, Mehak; Jain, Minal; Karia, Kishan; Kothari, Varun; Patel, Tejus; Suseeharan, Melanie; Ahmed, Maroof; Sherwani, Yusuf; Siddiqui, Sarim; Lin, Yuting

2018-01-01

Background Mobile health (mHealth) apps can offer users numerous benefits, representing a feasible and acceptable means of administering health interventions such as cognitive behavioral therapy (CBT). CBT is commonly used in the treatment of mental health conditions, where it has a strong evidence base, suggesting that it represents an effective method to elicit health behavior change. More importantly, CBT has proved to be effective in smoking cessation, in the context of smoking-related costs to the National Health Service (NHS) having been estimated to be as high as £2.6bn in 2015. Although the evidence base for computerized CBT in mental health is strong, there is limited literature on its use in smoking cessation. This, combined with the cost-effectiveness of mHealth interventions, advocates a need for research into the effectiveness of CBT-based smoking cessation apps. Objective The objective of this study was, first, to explore participants’ perceptions of 2 mHealth apps, a CBT-based app, Quit Genius, and a non-CBT-based app, NHS Smokefree, over a variety of themes. Second, the study aimed to investigate the perceptions and health behavior of users of each app with respect to smoking cessation. Methods A qualitative short-term longitudinal study was conducted, using a sample of 29 smokers allocated to one of the 2 apps, Quit Genius or Smokefree. Each user underwent 2 one-to-one semistructured interviews, 1 week apart. Thematic analysis was carried out, and important themes were identified. Descriptive statistics regarding participants’ perceptions and health behavior in relation to smoking cessation are also provided. Results The thematic analysis resulted in five higher themes and several subthemes. Participants were generally more positive about Quit Genius’s features, as well as about its design and information engagement and quality. Quit Genius users reported increased motivation to quit smoking, as well as greater willingness to continue using their allocated app after 1 week. Moreover, these participants demonstrated preliminary changes in their smoking behavior, although this was in the context of our limited sample, not yet allowing for the finding to be generalizable. Conclusions Our findings underscore the use of CBT in the context of mHealth apps as a feasible and potentially effective smoking cessation tool. mHealth apps must be well developed, preferably with an underlying behavioral change mechanism, to promote positive health behavior change. Digital CBT has the potential to become a powerful tool in overcoming current health care challenges. The present results should be replicated in a wider sample using the apps for a longer period so as to allow for generalizability. Further research is also needed to focus on the effect of greater personalization on behavioral change and on understanding the psychological barriers to the adoption of new mHealth solutions. PMID:29669708

Self-guided Change: The most common form of long-term, maintained health behavior change

PubMed Central

Bishop, F Michler

2018-01-01

Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review—similar in nature to a scoping review—was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80–90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated. PMID:29375888

Self-guided Change: The most common form of long-term, maintained health behavior change.

PubMed

Bishop, F Michler

2018-01-01

Millions of people change risky, health-related behaviors and maintain those changes. However, they often take years to change, and their unhealthy behaviors may harm themselves and others and constitute a significant cost to society. A review-similar in nature to a scoping review-was done of the literature related to long-term health behavior change in six areas: alcohol, cocaine and heroin misuse, gambling, smoking, and overeating. Based on the limited research available, reasons for change and strategies for changing and for maintaining change were also reviewed. Fifty years of research clearly indicate that as people age, in the case of alcohol, heroin and cocaine misuse, smoking, and gambling, 80-90 percent moderate or stop their unhealthy behaviors. The one exception is overeating; only 20 percent maintain their weight loss. Most of these changes, when they occur, appear to be the result of self-guided change. More ways to accelerate self-guided, health-related behavior change need to be developed and disseminated.

[Establishment of a practical training program in smoking cessation for use by pharmacists using cognitive-behavioral therapy and the motivational interview method].

PubMed

Saito, Moemi; Nodate, Yoshitada; Maruyama, Keiji; Tsuchiya, Masao; Watanabe, Machiko; Niwa, Sin-ichi

2012-01-01

We established a practical training program to nurture pharmacists who can give smoking cessation instructions. The program was provided to 85 interns (45 males and 40 females) in Teikyo University Hospital. The one-day practical training was provided to groups comprised of five members each. The training consisted of studies on the adverse effects of smoking, general outlines of the outpatient smoking cessation service, experiencing Smokerlyzer, studies about smoking-cessation drugs, studies about a smoking cessation therapy using cognitive-behavioral therapy and motivational interviewing, and case studies applying role-playing. Before and after the practical training, we conducted a questionnaire survey consisting of The Kano Test for Social Nicotine Dependence (KTSND) and the assessment of the smoking status, changes in attitudes to smoking, and willingness and confidence to give smoking cessation instructions. The overall KTSND score significantly dropped from 14.1±4.8 before the training to 8.9±4.8 after the training. The confidence to give smoking cessation instructions significantly increased from 3.4±1.9 to 6.2±1.3. Regarding the correlation between the smoking status and willingness and confidence to give smoking cessation instructions, the willingness and confidence were lower among the group of interns who either smoked or had smoked previously, suggesting that smoking had an adverse effect. A total of 88.2% of the interns answered that their attitudes to smoking had "changed slightly" or "changed" as a result of the training, indicating changes in their attitudes to smoking. Given the above, we believe that our newly-established smoking cessation instruction training is a useful educational tool.

Effects of Disasters on Smoking and Relapse: An Exploratory Study of Hurricane Katrina Victims.

PubMed

Lanctot, Jennifer Q; Stockton, Michelle B; Mzayek, Fawaz; Read, Mary; McDevitt-Murphy, Meghan; Ward, Kenneth

2008-01-01

Psychosocial stress maintains cigarette use and precipitates relapse, but little is known about how natural disasters in particular affect smoking. To determine the feasibility of recruiting victims soon after a natural disaster for a survey study, and to assess the types and determinants of changes in smoking behavior resulting from exposure to the disaster. A convenience sample of 35 Hurricane Katrina refugees who had smoked more than 100 cigarettes in their lifetime were surveyed one month after the storm to evaluate changes in smoking behavior. Among a small sample of former smokers, more than half relapsed after Katrina, citing stress, urge, and sadness. Among current smokers, 52% increased their smoking after Katrina by more than half a pack per day on average. Most individuals who increased their smoking or relapsed expressed interest in receiving cessation assistance within the next month. Stress-related increases in smoking and relapse may be common after a natural disaster. Health education professionals have an important role to play in responding to changes in tobacco use in the aftermath of disasters. Educational interventions to discourage tobacco use as a coping strategy may be especially warranted given the high level of interest expressed in smoking cessation.

Determining Smoking Cessation Related Information, Motivation, and Behavioral Skills among Opiate Dependent Smokers in Methadone Treatment.

PubMed

Cooperman, Nina A; Richter, Kimber P; Bernstein, Steven L; Steinberg, Marc L; Williams, Jill M

2015-04-01

Over 80% of people in methadone treatment smoke cigarettes, and existing smoking cessation interventions have been minimally effective. To develop an Information-Motivation-Behavioral Skills (IMB) Model of behavior change based smoking cessation intervention for methadone maintained smokers, we examined smoking cessation related IMB factors in this population. Current or former smokers in methadone treatment (n = 35) participated in focus groups. Ten methadone clinic counselors participated in an individual interview. A content analysis was conducted using deductive and inductive approaches. Commonly known IMB factors related to smoking cessation were described. These factors included: the health effects of smoking and treatment options for quitting (information); pregnancy and cost of cigarettes (motivators); and coping with emotions, finding social support, and pharmacotherapy adherence (behavioral skills). IMB factors specific to methadone maintained smokers were also described. These factors included: the relationship between quitting smoking and drug relapse (information), the belief that smoking is the same as using drugs (motivator); and coping with methadone clinic culture and applying skills used to quit drugs to quitting smoking (behavioral skills). IMB strengths and deficits varied by individual. Methadone maintained smokers could benefit from research on an IMB Model based smoking cessation intervention that is individualized, addresses IMB factors common among all smokers, and also addresses IMB factors unique to this population.

Smoking in Video Games: A Systematic Review.

PubMed

Forsyth, Susan R; Malone, Ruth E

2016-06-01

Video games are played by a majority of adolescents, yet little is known about whether and how video games are associated with smoking behavior and attitudes. This systematic review examines research on the relationship between video games and smoking. We searched MEDLINE, psycINFO, and Web of Science through August 20, 2014. Twenty-four studies met inclusion criteria. Studies were synthesized qualitatively in four domains: the prevalence and incidence of smoking imagery in video games (n = 6), video game playing and smoking behavior (n = 11), video game addiction and tobacco addiction (n = 5) and genre-specific game playing and smoking behavior (n = 3). Tobacco content was present in a subset of video games. The literature is inconclusive as to whether exposure to video games as a single construct is associated with smoking behavior. Four of five studies found an association between video game addiction and smoking. For genre-specific game playing, studies suggest that the type of game played affected association with smoking behavior. Research on how playing video games influences adolescents' perceptions of smoking and smoking behaviors is still in its nascence. Further research is needed to understand how adolescents respond to viewing and manipulating tobacco imagery, and whether engaging in game smoking translates into changes in real-world attitudes or behavior. Smoking imagery in video games may contribute to normalizing adolescent smoking. A large body of research has shown that smoking imagery in a variety of media types contributes to adolescent smoking uptake and the normalization of smoking behavior, and almost 90% of adolescents play video games, yet there has never been a published systematic review of the literature on this important topic. This is the first systematic review to examine the research on tobacco and video games.We found that tobacco imagery is indeed present in video games, the relationship between video game playing and smoking remains unclear, there appears to be a correlation between problem gaming and smoking and the genre of games may play a role in adolescent smoking behavior. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Developing a Method for Specifying the Components of Behavior Change Interventions in Practice: The Example of Smoking Cessation

ERIC Educational Resources Information Center

Lorencatto, Fabiana; West, Robert; Seymour, Natalie; Michie, Susan

2013-01-01

Objective: There is a difference between interventions as planned and as delivered in practice. Unless we know what was actually delivered, we cannot understand "what worked" in effective interventions. This study aimed to (a) assess whether an established taxonomy of 53 smoking cessation behavior change techniques (BCTs) may be applied…

Examining causal components and a mediating process underlying self-generated health arguments for exercise and smoking cessation.

PubMed

Baldwin, Austin S; Rothman, Alexander J; Vander Weg, Mark W; Christensen, Alan J

2013-12-01

Self-persuasion-generating one's own arguments for engaging in a specific behavior-can be an effective strategy to promote health behavior change, yet the causal processes that explain why it is effective are not well-specified. We sought to elucidate specific causal components and a mediating process of self-persuasion in two health behavior domains: physical activity and smoking. In two experiments, participants were randomized to write or read arguments about regular exercise (Study 1: N = 76; college students) or smoking cessation (Study 2: N = 107; daily smokers). In Study 2, we also manipulated the argument content (matched vs. mismatched participants' own concerns about smoking) to isolate its effect from the effect of argument source (self vs. other). Study outcomes included participants' reports of argument ratings, attitudes, behavioral intentions (Studies 1 & 2), and cessation attempts at 1 month (Study 2). In Study 1, self-generated arguments about exercise were evaluated more positively than other arguments (p = .01, d = .63), and this biased processing mediated the self-generated argument effect on attitudes toward exercise (β = .08, 95% CI = .01, .18). In Study 2, the findings suggested that biased processing occurs because self-generated argument content matches people's own health concerns and not because of the argument source (self vs. other). In addition, self-generated arguments indirectly led to greater behavior change intentions (Studies 1 & 2) and a greater likelihood of a smoking cessation attempt (Study 2). The findings elucidate a causal component and a mediating process that explain why self-persuasion and related behavior change interventions, such as motivational interviewing, are effective. Findings also suggest that self-generated arguments may be an efficient way to deliver message interventions aimed at changing health behaviors.

Discontinuous Patterns of Cigarette Smoking From Ages 18 to 50 in the United States: A Repeated-Measures Latent Class Analysis.

PubMed

Terry-McElrath, Yvonne M; O'Malley, Patrick M; Johnston, Lloyd D

2017-12-13

Effective cigarette smoking prevention and intervention programming is enhanced by accurate understanding of developmental smoking pathways across the life span. This study investigated within-person patterns of cigarette smoking from ages 18 to 50 among a US national sample of high school graduates, focusing on identifying ages of particular importance for smoking involvement change. Using data from approximately 15,000 individuals participating in the longitudinal Monitoring the Future study, trichotomous measures of past 30-day smoking obtained at 11 time points were modeled using repeated-measures latent class analyses. Sex differences in latent class structure and membership were examined. Twelve latent classes were identified: three characterized by consistent smoking patterns across age (no smoking; smoking < pack per day; smoking pack + per day); three showing uptake to a higher category of smoking across age; four reflecting successful quit behavior by age 50; and two defined by discontinuous shifts between smoking categories. The same latent class structure was found for both males and females, but membership probabilities differed between sexes. Although evidence of increases or decreases in smoking behavior was observed at virtually all ages through 35, 21/22 and 29/30 appeared to be particularly key for smoking category change within class. This examination of latent classes of cigarette smoking among a national US longitudinal sample of high school graduates from ages 18 to 50 identified unique patterns and critical ages of susceptibility to change in smoking category within class. Such information may be of particular use in developing effective smoking prevention and intervention programming. This study examined cigarette smoking among a national longitudinal US sample of high school graduates from ages 18 to 50 and identified distinct latent classes characterized by patterns of movement between no cigarette use, light-to-moderate smoking, and the conventional definition of heavy smoking at 11 time points via repeated-measures latent class analysis. Membership probabilities for each smoking class were estimated, and critical ages of susceptibility to change in smoking behaviors were identified. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Can functional magnetic resonance imaging studies help with the optimization of health messaging for lifestyle behavior change? A systematic review.

PubMed

Whelan, Maxine E; Morgan, Paul S; Sherar, Lauren B; Orme, Mark W; Esliger, Dale W

2017-06-01

Unhealthy behaviors, including smoking, poor nutrition, excessive alcohol consumption, physical inactivity and sedentary lifestyles, are global risk factors for non-communicable diseases and premature death. Functional magnetic resonance imaging (fMRI) offers a unique approach to optimize health messages by examining how the brain responds to information relating to health. Our aim was to systematically review fMRI studies that have investigated variations in brain activation in response to health messages relating to (i) smoking; (ii) alcohol consumption; (iii) physical activity; (iv) diet; and (v) sedentary behavior. The electronic databases used were Medline/PubMed, Web of Science (Core Collection), PsychINFO, SPORTDiscuss, Cochrane Library and Open Grey. Studies were included if they investigated subjects aged ≥10years and were published before January 2017. Of the 13,836 studies identified in the database search, 18 studies (smoking k=15; diet k=2; physical activity/sedentary behavior k=1) were included in the review. The prefrontal cortex was activated in seven (47%) of the smoking-related studies and the physical activity study. Results suggest that activation of the ventromedial, dorsolateral and medial prefrontal cortex regions were predictive of subsequent behavior change following exposure to aversive anti-smoking stimuli. Studies investigating the neurological responses to anti-smoking material were most abundant. Of note, the prefrontal cortex and amygdala were most commonly activated in response to health messages across lifestyle behaviors. The review highlights an important disparity between research focusing on different lifestyle behaviors. Insights from smoking literature suggest fMRI may help to optimize health messaging in relation to other lifestyle behaviors. Copyright © 2017 Elsevier Inc. All rights reserved.

The Influence of Youth Music Television Viewership on Changes in Cigarette Use and Association with Smoking Peers: A Social Identity, Reinforcing Spirals Perspective

PubMed Central

Slater, Michael D.; Hayes, Andrew F.

2010-01-01

Prior research has found strong evidence of a prospective association between R movie exposure and teen smoking. Using parallel process latent-growth modeling, the present study examines prospective associations between viewing of music video channels on television (e.g., MTV and VH-1) and changes over time in smoking and association with smoking peers. Results showed that baseline viewing of music-oriented channels such as MTV and VH-1 robustly predicted increasing trajectories of smoking and of associating with smoking peers, even after application of a variety of controls including parent reports of monitoring behavior. These results are consistent with the arguments from the reinforcing spirals model that such media use serves as a means of developing emergent adolescent social identities consistent with associating with smoking peers and acquiring smoking and other risk behaviors; evidence also suggests that media choice in reinforcing spiral processes are dynamic and evolve as social identity evolves. PMID:21318085

The Influence of Youth Music Television Viewership on Changes in Cigarette Use and Association with Smoking Peers: A Social Identity, Reinforcing Spirals Perspective.

PubMed

Slater, Michael D; Hayes, Andrew F

2010-12-01

Prior research has found strong evidence of a prospective association between R movie exposure and teen smoking. Using parallel process latent-growth modeling, the present study examines prospective associations between viewing of music video channels on television (e.g., MTV and VH-1) and changes over time in smoking and association with smoking peers. Results showed that baseline viewing of music-oriented channels such as MTV and VH-1 robustly predicted increasing trajectories of smoking and of associating with smoking peers, even after application of a variety of controls including parent reports of monitoring behavior. These results are consistent with the arguments from the reinforcing spirals model that such media use serves as a means of developing emergent adolescent social identities consistent with associating with smoking peers and acquiring smoking and other risk behaviors; evidence also suggests that media choice in reinforcing spiral processes are dynamic and evolve as social identity evolves.

Smoking cessation: an application of theory of planned behavior to understanding progress through stages of change.

PubMed

Bledsoe, Linda K

2006-07-01

The purpose of this research was to investigate variables relevant to smoking cessation early in the process of change through an application of the Theory of Planned Behavior [Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl and J. Beckman (Eds). Action-control: From cognition to behavior (pp.11-39). Heidelberg: Springer.] to the temporal structure provided by the Transtheoretical Model. Study 1 was a preliminary elicitation study (n=68) conducted to ground the concepts used in the model testing in Study 2 [Ajzen, I., Fishbein, M. (1980). Understanding attitudes and predicting social behavior, Englewood Cliffs, NJ: Prentice-Hall.]. Study 2 tested the proposed model fit with data from a sample of 230 adult smokers. Structural equation modeling did not support the Theory of Planned Behavior as a model of motivation for progress through the stages of change and highlighted measurement issues with perceived behavioral control. A modified model using the Theory of Reasoned Action provided a good fit to the data, accounting for approximately 64% of the variance in intention to quit smoking and stage of change. This research addresses the need for a more complete theoretical rationale for progress through stages of change.

Reducing Underserved Children’s Exposure to Secondhand Smoke

PubMed Central

Collins, Bradley N.; Nair, Uma S.; Hovell, Melbourne F.; DiSantis, Katie I.; Jaffe, Karen; Tolley, Natalie; Wileyto, E. Paul; Audrain-McGovern, Janet

2015-01-01

Introduction Addressing maternal smoking and child secondhand smoke exposure is a public health priority. Standard care advice and self-help materials to help parents reduce child secondhand smoke exposure is not sufficient to promote change in underserved populations. We tested the efficacy of a behavioral counseling approach with underserved maternal smokers to reduce infant’s and preschooler’s secondhand smoke exposure. Design A two-arm randomized trial: experimental behavior counseling versus enhanced standard care (control). Assessment staff members were blinded. Setting/participants Three hundred randomized maternal smokers were recruited from low-income urban communities. Participants had a child aged <4 years exposed to two or more maternal cigarettes/day at baseline. Intervention Philadelphia Family Rules for Establishing Smokefree Homes (FRESH) included 16 weeks of counseling. Using a behavioral shaping approach within an individualized cognitive–behavioral therapy framework, counseling reinforced efforts to adopt increasingly challenging secondhand smoke exposure–protective behaviors with the eventual goal of establishing a smokefree home. Main outcome measures Primary outcomes were end-of-treatment child cotinine and reported secondhand smoke exposure (maternal cigarettes/day exposed). Secondary outcomes were end-of-treatment 7-day point-prevalence self-reported cigarettes smoked/day and bioverified quit status. Results Participation in FRESH behavioral counseling was associated with lower child cotinine (β= −0.18, p=0.03) and secondhand smoke exposure (β= −0.57, p=0.03) at end of treatment. Mothers in behavioral counseling smoked fewer cigarettes/day (β= –1.84, p=0.03) and had higher bioverified quit rates compared with controls (13.8% vs 1.9%, χ2=10.56, p<0.01). There was no moderating effect of other smokers living at home. Conclusions FRESH behavioral counseling reduces child secondhand smoke exposure and promotes smoking quit rates in a highly distressed and vulnerable population. PMID:26028355

Which Behavior Change Techniques May Help Waterpipe Smokers to Quit? An Expert Consensus Using a Modified Delphi Technique.

PubMed

O'Neill, Nancy; Dogar, Omara; Jawad, Mohammed; Kellar, Ian; Kanaan, Mona; Siddiqi, Kamran

2018-01-05

Waterpipe smoking is addictive and harmful. The determinants of waterpipe smoking may differ from those of cigarette smoking; therefore, behavioral approaches to support quitting may also differ between these two tobacco products. While some evidence exists on effective behavioral change techniques (BCTs) to facilitate cigarette smoking cessation, there is little research on waterpipe smoking cessation. Twenty-four experts were selected from the author lists of peer-reviewed, randomized controlled trials on waterpipe smoking cessation. They were invited to two rounds of a consensus development exercise using modified Delphi technique. Experts ranked 55 BCTs categorized further into those that promote; "awareness of harms of waterpipe smoking and advantages of quitting" (14), "preparation and planning to quit" (29), and "relapse prevention and sustaining an ex-smoker identity" (12) on their potential effectiveness. Kendall's W statistics was used to assess agreement. Fifteen experts responded in round 1 and 14 completed both rounds. A strong consensus was achieved for BCTs that help in "relapse prevention and sustaining ex-smoker identity" (w = 0.7; p < .001) and a moderate for those that promote "awareness of harms of waterpipe smoking and advantages of quitting" (w = 0.6; p < .001) and "preparation and planning to quit" (w = 0.6; p < .001). Providing information on the consequences of waterpipe smoking and its cessation, assessing readiness and ability to quit, and making people aware of the withdrawal symptoms, were the three highest-ranking BCTs. Based on expert consensus, an inventory of BCTs ordered for their potential effectiveness can be useful for health professionals offering cessation support to waterpipe smokers. Waterpipe smoking is addictive, harmful, and gaining global popularity, particularly among youth. An expert consensus on behavior change techniques, likely to be effective in supporting waterpipe smokers to quit, has practice and research implications. Smoking cessation advisors can use these techniques to counsel waterpipe smokers who wish to quit. Behavioral and public health scientists can also use these to develop and evaluate behavioral support interventions for this client group. © The Author(s) 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cognitive-behavioral treatment with behavioral activation for smokers with depressive symptomatology: study protocol of a randomized controlled trial.

PubMed

Becoña, Elisardo; Martínez-Vispo, Carmela; Senra, Carmen; López-Durán, Ana; Rodríguez-Cano, Rubén; Fernández Del Río, Elena

2017-04-08

Smoking is an important risk factor for mental health-related problems. Numerous studies have supported a bi-directional association between cigarette smoking and depression. Despite the advances in understanding the comorbidity between both problems, the most effective psychological treatment that simultaneously targets smoking and depressive symptomatology remains unclear. The objective of this study is to assess the effectiveness of a cognitive-behavioral intervention for smoking cessation with components of behavioral activation for managing depressed mood. A single blind, three-arm, superiority randomized controlled trial is proposed. Participants will be smokers over 18 years old, who smoke at least 8 cigarettes per day. Participants will be randomized to one of three conditions, using a 2:2:1 allocation ratio: 1) standard cognitive-behavioral smoking cessation treatment; 2) standard cognitive-behavioral smoking cessation treatment plus behavioral activation; or 3) a three-month delayed treatment control group. The primary outcome measures will be biochemically verified point-prevalence abstinence (carbon monoxide in expired air) and significant change from baseline in depressive symptoms to the end of treatment, and at the 3-, 6-, and 12-month follow-up. This study aims to assess the efficacy of a cognitive-behavioral intervention with behavioral activation components for smoking cessation and depressive symptoms, compared to a standard cognitive-behavioral intervention to quit smoking. As the relation between depressive symptoms, even at subclinical levels, and quitting smoking difficulties is well known, we expect that such intervention will allow obtaining higher abstinence rates, lower relapse rates, and mood improvement. ClinicalTrials.gov : NCT02844595 . Retrospectively registered 19th July, 2016. The study started in January 2016, and the recruitment is ongoing.

Being questioned and receiving advice about alcohol and smoking in health care: Associations with patients' characteristics, health behavior, and reported stage of change

PubMed Central

2010-01-01

Background Alcohol habits are more rarely addressed than other health behavior topics in Swedish health care. This study examined whether differences between topics could be explained by their different associations with patient characteristics or by the differences in the prevalence of the disadvantageous health behavior, i.e., excessive alcohol use and smoking. The study moreover examined whether simply being asked questions about behavior, i.e., alcohol use or smoking, was associated with reported change. Methods The study was based on a cross-sectional postal survey (n = 4 238, response rate 56.5 percent) representative of the adult population in Stockholm County in 2003. Retrospective self-reports were used to assess health care visits during the past 12 months, the questions and advice received there, patients characteristics, health behavior, and the present stage of change. Logistic regression analysis was used to estimate the associations among the 68 percent who had visited health care. Results Among the health care visitors, 23 percent reported being asked about their alcohol habits, and 3 percent reported receiving advice or/and support to modify their alcohol use - fewer than for smoking, physical exercise, or diet. When regression models adjusted for patient characteristics, the differences between health behaviors in the extent of questioning and advice remained. However, when the models also adjusted for smoking and alcohol consumption there was no difference between smoking and alcohol-related advice. In fact one-third of the present smokers and two-fifths of the persons dependent on alcohol reported having receiving advice the previous 12 months. Those who reported being asked questions or receiving advice more often reported a decreased alcohol use and similarly intended to cease smoking within 6 months. Questions about alcohol use were moreover related to a later stage of stage of change independently of advice among women but not among men. Conclusions While most patients are never addressed, many in the target groups seem to be reached anyway. Besides advice, already addressing alcohol habits appears to be associated with change. The results also indicate that gender possibly plays a role in the relationship between advice and the stage of change. PMID:21114843

Associations of Bar and Restaurant Smoking Bans With Smoking Behavior in the CARDIA Study: A 25-Year Study.

PubMed

Mayne, Stephanie L; Auchincloss, Amy H; Tabb, Loni Philip; Stehr, Mark; Shikany, James M; Schreiner, Pamela J; Widome, Rachel; Gordon-Larsen, Penny

2018-06-01

Indoor smoking bans have often been associated with reductions in smoking prevalence. However, few studies have evaluated their association with within-person changes in smoking behaviors. We linked longitudinal data from 5,105 adults aged 18-30 years at baseline from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1985-2011) to state, county, and local policies mandating 100% smoke-free bars and restaurants by census tract. We used fixed-effects models to examine the association of smoking bans with within-person change in current smoking risk, smoking intensity (smoking ≥10 cigarettes/day on average vs. <10 cigarettes/day), and quitting attempts, using both linear and nonlinear adjustment for secular trends. In models assuming a linear secular trend, smoking bans were associated with a decline in current smoking risk and smoking intensity and an increased likelihood of a quitting attempt. The association with current smoking was greatest among participants with a bachelor's degree or higher. In models with a nonlinear secular trend, pooled results were attenuated (confidence intervals included the null), but effect modification results were largely unchanged. Findings suggest that smoking ban associations may be difficult to disentangle from other tobacco control interventions and emphasize the importance of evaluating equity throughout policy implementation.

The impact of mass communication campaigns in the health field.

PubMed

Alcalay, R

1983-01-01

This article analyzes a series of health education projects that used the mass media to change behavior. First, the article describes how persuasion theories are used to maximize impact in mass communication campaigns. Second, this paper discusses theories of social psychology used in such campaigns. One such theory, cognitive dissonance, explains changes at the level of attitudes, beliefs and opinion. Another theory, social learning, defines strategies of behavior changes. A third theory, concerning diffusion of innovations, helps understand the network of interpersonal relationships essential for the adoption of any innovation. McGuire's inoculation theory suggests strategies to aid resistance to harmful environmental influences (e.g. smoking, excessive drinking, etc.). Third, this work reviews public health campaigns that have used one or more of these theories of social psychology. The first project, dealing with smoking behavior cessation and prevention, mainly used strategies of interpersonal communication for inoculating and modeling useful behavior in order to resist social pressures favorable to smoking. The second project, designed to prevent alcoholism, used the mass media primarily. The objective of this campaign was to obtain changes in knowledge, attitude and behavior in the public through modeling desirable behaviors over public service announcements. The third campaign, a heart disease prevention program, used a combination of mass media and interpersonal communication to achieve changes in lifestyle of the population. Finally, this article describes limitations in using mass media in behavior change health programs.

Exploring Alternate Processes Contributing to the Association Between Maternal Smoking and the Smoking Behavior Among Young Adult Offspring

PubMed Central

2013-01-01

Introduction: Maternal smoking during pregnancy (MSP) is a known risk factor for regular smoking in young adulthood and may pose a risk independently of mother’s lifetime smoking. The processes through which MSP exerts this influence are unknown but may occur through greater smoking quantity and frequency following initiation early in adolescence or increased sensitivity to nicotine dependence (ND) at low levels of smoking. Methods: This study used path analysis to investigate adolescent smoking quantity, smoking frequency, and ND as potential simultaneous mediating pathways through which MSP and mother’s lifetime smoking (whether she has ever smoked) increase the risk of smoking in young adulthood among experimenters (at baseline, <100 cigarettes/lifetime) and current smokers (>100 cigarettes/lifetime). Results: For experimenters, MSP was directly associated with more frequent young adult smoking and was not mediated by adolescent smoking behavior or ND. Independently of MSP, the effect of mother’s lifetime smoking was fully mediated through frequent smoking and was heightened ND during adolescence. Controlling for MSP eliminated a previously observed direct association between mother’s lifetime smoking and future smoking among experimenters. For current smokers, only prior smoking behavior was associated with future smoking frequency. Conclusions: These results seem to rule out sensitivity to ND and increased smoking behavior as contributing pathways of MSP. Further, the impact of MSP on young adult smoking extends beyond that of having an ever-smoking mother. Future work should test other possible mediators; for example, MSP-related epigenetic changes or gene variants influencing the brain’s nicotine response. PMID:23766342

Helping Smokers Quit: The Smoking Cessation Leadership Center Engages Behavioral Health by Challenging Old Myths and Traditions.

PubMed

Schroeder, Steven A; Clark, Brian; Cheng, Christine; Saucedo, Catherine B

2018-01-01

Smoking is much more common among persons with behavioral health conditions (mental illnesses and/or substance use disorders). Persons with these disorders are more likely to die from smoking-related causes than any other reason. Studies have shown that stopping smoking can improve mental health function, as well as improve outcomes for substance use disorders. Yet, for a variety of reasons, smoking cessation has not been integrated into the treatment of behavioral health conditions, and in many instances tobacco use was not only condoned but encouraged. Beginning in 2007, the Smoking Cessation Leadership Center (SCLC) began engaging relevant agencies in an attempt to stimulate more vigorous smoking cessation activities. Partners included the federal Substance Abuse and Mental Health Services Administration, advocacy organizations such as the National Alliance on Mental Illness and Community Anti-Drug Coalitions of America, and clinical groups such as the American Psychiatric Nurses Association, the American Psychiatric Association, American Psychological Association, National Council on Behavioral Health, and National Association of State Mental Health Program Directors. A signature program featured 16 individual state summits involving agencies and groups from multiple sectors, all aiming to lower smoking rates in behavioral health populations. These activities mark an evolving culture change within behavioral health.

Plain packaging of cigarettes and smoking behavior: study protocol for a randomized controlled study.

PubMed

Maynard, Olivia M; Leonards, Ute; Attwood, Angela S; Bauld, Linda; Hogarth, Lee; Munafò, Marcus R

2014-06-25

Previous research on the effects of plain packaging has largely relied on self-report measures. Here we describe the protocol of a randomized controlled trial investigating the effect of the plain packaging of cigarettes on smoking behavior in a real-world setting. In a parallel group randomization design, 128 daily cigarette smokers (50% male, 50% female) will attend an initial screening session and be assigned plain or branded packs of cigarettes to smoke for a full day. Plain packs will be those currently used in Australia where plain packaging has been introduced, while branded packs will be those currently used in the United Kingdom. Our primary study outcomes will be smoking behavior (self-reported number of cigarettes smoked and volume of smoke inhaled per cigarette as measured using a smoking topography device). Secondary outcomes measured pre- and post-intervention will be smoking urges, motivation to quit smoking, and perceived taste of the cigarettes. Secondary outcomes measured post-intervention only will be experience of smoking from the cigarette pack, overall experience of smoking, attributes of the cigarette pack, perceptions of the on-packet health warnings, behavior changes, views on plain packaging, and the rewarding value of smoking. Sex differences will be explored for all analyses. This study is novel in its approach to assessing the impact of plain packaging on actual smoking behavior. This research will help inform policymakers about the effectiveness of plain packaging as a tobacco control measure. Current Controlled Trials ISRCTN52982308 (registered 27 June 2013).

Four-Year Results of a Youth Smoking Prevention Program Using Assertiveness Training.

ERIC Educational Resources Information Center

Del Greco, Linda; And Others

1986-01-01

Seventh graders (N=161) participated in health education classes consisting of either an innovative smoking education program, the program plus assertiveness training, or a traditional smoking education program. Data collected four years later revealed no significant differences in smoking behavior, changes in assertion, or sex differences among…

Evaluation of Two Mobile Health Apps in the Context of Smoking Cessation: Qualitative Study of Cognitive Behavioral Therapy (CBT) Versus Non-CBT-Based Digital Solutions.

PubMed

Tudor-Sfetea, Carina; Rabee, Riham; Najim, Muhammad; Amin, Nima; Chadha, Mehak; Jain, Minal; Karia, Kishan; Kothari, Varun; Patel, Tejus; Suseeharan, Melanie; Ahmed, Maroof; Sherwani, Yusuf; Siddiqui, Sarim; Lin, Yuting; Eisingerich, Andreas B

2018-04-18

Mobile health (mHealth) apps can offer users numerous benefits, representing a feasible and acceptable means of administering health interventions such as cognitive behavioral therapy (CBT). CBT is commonly used in the treatment of mental health conditions, where it has a strong evidence base, suggesting that it represents an effective method to elicit health behavior change. More importantly, CBT has proved to be effective in smoking cessation, in the context of smoking-related costs to the National Health Service (NHS) having been estimated to be as high as £2.6bn in 2015. Although the evidence base for computerized CBT in mental health is strong, there is limited literature on its use in smoking cessation. This, combined with the cost-effectiveness of mHealth interventions, advocates a need for research into the effectiveness of CBT-based smoking cessation apps. The objective of this study was, first, to explore participants' perceptions of 2 mHealth apps, a CBT-based app, Quit Genius, and a non-CBT-based app, NHS Smokefree, over a variety of themes. Second, the study aimed to investigate the perceptions and health behavior of users of each app with respect to smoking cessation. A qualitative short-term longitudinal study was conducted, using a sample of 29 smokers allocated to one of the 2 apps, Quit Genius or Smokefree. Each user underwent 2 one-to-one semistructured interviews, 1 week apart. Thematic analysis was carried out, and important themes were identified. Descriptive statistics regarding participants' perceptions and health behavior in relation to smoking cessation are also provided. The thematic analysis resulted in five higher themes and several subthemes. Participants were generally more positive about Quit Genius's features, as well as about its design and information engagement and quality. Quit Genius users reported increased motivation to quit smoking, as well as greater willingness to continue using their allocated app after 1 week. Moreover, these participants demonstrated preliminary changes in their smoking behavior, although this was in the context of our limited sample, not yet allowing for the finding to be generalizable. Our findings underscore the use of CBT in the context of mHealth apps as a feasible and potentially effective smoking cessation tool. mHealth apps must be well developed, preferably with an underlying behavioral change mechanism, to promote positive health behavior change. Digital CBT has the potential to become a powerful tool in overcoming current health care challenges. The present results should be replicated in a wider sample using the apps for a longer period so as to allow for generalizability. Further research is also needed to focus on the effect of greater personalization on behavioral change and on understanding the psychological barriers to the adoption of new mHealth solutions. ©Carina Tudor-Sfetea, Riham Rabee, Muhammad Najim, Nima Amin, Mehak Chadha, Minal Jain, Kishan Karia, Varun Kothari, Tejus Patel, Melanie Suseeharan, Maroof Ahmed, Yusuf Sherwani, Sarim Siddiqui, Yuting Lin, Andreas B Eisingerich. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 18.04.2018.

Effects of Disasters on Smoking and Relapse: An Exploratory Study of Hurricane Katrina Victims

PubMed Central

Lanctot, Jennifer Q.; Stockton, Michelle B.; Mzayek, Fawaz; Read, Mary; McDevitt-Murphy, Meghan; Ward, Kenneth

2016-01-01

Background Psychosocial stress maintains cigarette use and precipitates relapse, but little is known about how natural disasters in particular affect smoking. Purpose To determine the feasibility of recruiting victims soon after a natural disaster for a survey study, and to assess the types and determinants of changes in smoking behavior resulting from exposure to the disaster. Methods A convenience sample of 35 Hurricane Katrina refugees who had smoked more than 100 cigarettes in their lifetime were surveyed one month after the storm to evaluate changes in smoking behavior. Results Among a small sample of former smokers, more than half relapsed after Katrina, citing stress, urge, and sadness. Among current smokers, 52% increased their smoking after Katrina by more than half a pack per day on average. Most individuals who increased their smoking or relapsed expressed interest in receiving cessation assistance within the next month. Discussion Stress-related increases in smoking and relapse may be common after a natural disaster. Translation to Health Education Practice Health education professionals have an important role to play in responding to changes in tobacco use in the aftermath of disasters. Educational interventions to discourage tobacco use as a coping strategy may be especially warranted given the high level of interest expressed in smoking cessation. PMID:28496561

[Changes in knowledge, attitudes, and smoking behavior among young people in Germany. Results of repeated, representative surveys by the BZgA].

PubMed

Orth, B; Töppich, J

2010-02-01

Following an increase in tobacco consumption among 12 to 17 year olds between 1993 and 1997, a policy mix comprising various structural and behavioral prevention measures was implemented in Germany. One element of this policy mix is the "rauchfrei" ("smoke-free") youth campaign of the BZgA (Federal Centre for Health Education), a combination of media that reaches a large number of youth, personal communication, and setting-based interventions. The aim is to prevent young people from starting to smoke and to promote the cessation of smoking at an early stage. Based on a multistage intervention model, wide coverage of the measures should be achieved among young people, as well as changes in knowledge, attitudes, social norms, and behavioral intentions. Based on the intervention model, repeated, representative cross-sectional surveys were conducted to examine the development of these indicators and of tobacco consumption. Five studies were conducted during the period from 2003 to 2008, each comprising between 1,220 and 2,780 computer-assisted telephone interviews with randomly selected young people between the ages of 12 and 17. The percentage of young people reached by information offered on the subject of not smoking rose between 2003 and 2008. Participation in school-based prevention measures also rose. There was an increase in knowledge regarding the harmful substances contained in cigarette smoke, and in the percentage of young people who rated active and passive smoking as being harmful to health. In addition, the attitude towards smoking of young people who have never smoked became more critical, as did that perceived in the social environment. The proportion of young people who smoke declined substantially, from 27.5% (2001) to 15.4% (2008), and there was been a major rise in the number who have never smoked, from 40.5% (2001) to 60.6% (2008). The change in knowledge-based risk assessments, attitudes, and social norms should be further promoted by mass media and personal communication measures, as well as by setting-based and behavioral prevention measures. In order to encourage them to quit smoking, young smokers must be motivated and convinced by means of suitable behavioral prevention interventions.

The effects of social structure and social capital on changes in smoking status from 8th to 9th grade: results of the Child and Adolescent Behaviors in Long-term Evolution (CABLE) study.

PubMed

Chen, Chun-Yuan; Wu, Chi-Chen; Chang, Hsing-Yi; Yen, Lee-Lan

2014-05-01

Social structure and social capital are important variables for public health strategies seeking to prevent smoking among adolescents. The purpose of this study was to examine the relationships between social structure, social capital and changes in smoking status from the 8th to 9th grade in Taiwan. Data were obtained from the Child and Adolescent Behaviors in Long-term Evolution (CABLE) project. The study analyzed a final sample of 1937 students (50.7% female). Each layer of social structure was associated with a particular form of social capital. Students whose parents were married and living together had higher family social capital. After controlling for background variables, the social structure variable of friends who smoke was significantly associated with changes in smoking status. Students reporting more school attachment were less likely to start smoking. Students with higher parental supervision was associated with less chance of being a consistent smoker, whereas participation of social organization outside of school was associated with continued smoking. Attending school club was associated with higher probability of smoking cessation. Smoking prevention and intervention strategies aimed at junior high school students should be tailored to the particular form of social capital important for each type of smoking status. Copyright © 2013 Elsevier Inc. All rights reserved.

Smoking education programs 1960-1976.

PubMed Central

Thompson, E L

1978-01-01

This paper is a review of published reports, in English, of educational programs designed to change smoking behavior. Attempts to change the smoking behavior of young people have included anti-smoking campaigns, youth-to-youth programs, and a variety of message themes and teaching methods. Instruction has been presented both by teachers who were committed or persuasive and by teachers who were neutral or presented both sides of the issue. Didactic teaching, group discussion, individual study, peer instruction, and mass media have been employed. Health effects of smoking, both short- and long-term effects, have been emphasized. Most methods used with youth have shown little success. Studies of other methods have produced contradictory results. Educational programs for adults have included large scale anti-smoking campaigns, smoking cessation clinics, and a variety of more specific withdrawal methods. These methods have included individual counseling, emotional role playing, aversive conditioning, desensitization, and specific techniques to reduce the likelihood that smoking will occur in situations previously associated with smoking. Some of these techniques have produced poor results while studies of other methods have shown inconsistent results. The two methods showing the most promise are individual counseling and smoking withdrawal clinics. PMID:25026

Smoking education programs 1960-1976.

PubMed

Thompson, E L

1978-03-01

This paper is a review of published reports, in English, of educational programs designed to change smoking behavior. Attempts to change the smoking behavior of young people have included anti-smoking campaigns, youth-to-youth programs, and a variety of message themes and teaching methods. Instruction has been presented both by teachers who were committed or persuasive and by teachers who were neutral or presented both sides of the issue. Didactic teaching, group discussion, individual study, peer instruction, and mass media have been employed. Health effects of smoking, both short- and long-term effects, have been emphasized. Most methods used with youth have shown little success. Studies of other methods have produced contradictory results. Educational programs for adults have included large scale anti-smoking campaigns, smoking cessation clinics, and a variety of more specific withdrawal methods. These methods have included individual counseling, emotional role playing, aversive conditioning, desensitization, and specific techniques to reduce the likelihood that smoking will occur in situations previously associated with smoking. Some of these techniques have produced poor results while studies of other methods have shown inconsistent results. The two methods showing the most promise are individual counseling and smoking withdrawal clinics.

Brain Activity in Self- and Value-Related Regions in Response to Online Antismoking Messages Predicts Behavior Change

PubMed Central

Cooper, Nicole; Tompson, Steve; O’Donnell, Matthew Brook; Falk, Emily B.

2017-01-01

In this study, we combined approaches from media psychology and neuroscience to ask whether brain activity in response to online antismoking messages can predict smoking behavior change. In particular, we examined activity in subregions of the medial prefrontal cortex linked to self- and value-related processing, to test whether these neurocognitive processes play a role in message-consistent behavior change. We observed significant relationships between activity in both brain regions of interest and behavior change (such that higher activity predicted a larger reduction in smoking). Furthermore, activity in these brain regions predicted variance independent of traditional, theory-driven self-report metrics such as intention, self-efficacy, and risk perceptions. We propose that valuation is an additional cognitive process that should be investigated further as we search for a mechanistic explanation of the relationship between brain activity and media effects relevant to health behavior change. PMID:29057013

Promoting smoke-free homes: a novel behavioral intervention using real-time audio-visual feedback on airborne particle levels.

PubMed

Klepeis, Neil E; Hughes, Suzanne C; Edwards, Rufus D; Allen, Tracy; Johnson, Michael; Chowdhury, Zohir; Smith, Kirk R; Boman-Davis, Marie; Bellettiere, John; Hovell, Melbourne F

2013-01-01

Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m(3), and low noise. A linear relationship (R(2) = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m(3). Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches.

Promoting Smoke-Free Homes: A Novel Behavioral Intervention Using Real-Time Audio-Visual Feedback on Airborne Particle Levels

PubMed Central

Klepeis, Neil E.; Hughes, Suzanne C.; Edwards, Rufus D.; Allen, Tracy; Johnson, Michael; Chowdhury, Zohir; Smith, Kirk R.; Boman-Davis, Marie; Bellettiere, John; Hovell, Melbourne F.

2013-01-01

Interventions are needed to protect the health of children who live with smokers. We pilot-tested a real-time intervention for promoting behavior change in homes that reduces second hand tobacco smoke (SHS) levels. The intervention uses a monitor and feedback system to provide immediate auditory and visual signals triggered at defined thresholds of fine particle concentration. Dynamic graphs of real-time particle levels are also shown on a computer screen. We experimentally evaluated the system, field-tested it in homes with smokers, and conducted focus groups to obtain general opinions. Laboratory tests of the monitor demonstrated SHS sensitivity, stability, precision equivalent to at least 1 µg/m3, and low noise. A linear relationship (R2 = 0.98) was observed between the monitor and average SHS mass concentrations up to 150 µg/m3. Focus groups and interviews with intervention participants showed in-home use to be acceptable and feasible. The intervention was evaluated in 3 homes with combined baseline and intervention periods lasting 9 to 15 full days. Two families modified their behavior by opening windows or doors, smoking outdoors, or smoking less. We observed evidence of lower SHS levels in these homes. The remaining household voiced reluctance to changing their smoking activity and did not exhibit lower SHS levels in main smoking areas or clear behavior change; however, family members expressed receptivity to smoking outdoors. This study established the feasibility of the real-time intervention, laying the groundwork for controlled trials with larger sample sizes. Visual and auditory cues may prompt family members to take immediate action to reduce SHS levels. Dynamic graphs of SHS levels may help families make decisions about specific mitigation approaches. PMID:24009742

Neural Activity During Health Messaging Predicts Reductions in Smoking Above and Beyond Self-Report

PubMed Central

Falk, Emily B.; Berkman, Elliot T.; Whalen, Danielle; Lieberman, Matthew D.

2011-01-01

Objective The current study tested whether neural activity in response to messages designed to help smokers quit could predict smoking reduction, above and beyond self-report. Design Using neural activity in an a priori region of interest (a subregion of medial prefrontal cortex [MPFC]), in response to ads designed to help smokers quit smoking, we prospectively predicted reductions in smoking in a community sample of smokers (N = 28) who were attempting to quit smoking. Smoking was assessed via expired carbon monoxide (CO; a biological measure of recent smoking) at baseline and 1 month following exposure to professionally developed quitting ads. Results A positive relationship was observed between activity in the MPFC region of interest and successful quitting (increased activity in MPFC was associated with a greater decrease in expired CO). The addition of neural activity to a model predicting changes in CO from self-reported intentions, self-efficacy, and ability to relate to the messages significantly improved model fit, doubling the variance explained ( Rself−report2=.15,Rself−report+neuralactivity2=.35,Rchange2=.20). Conclusion: Neural activity is a useful complement to existing self-report measures. In this investigation, we extend prior work predicting behavior change based on neural activity in response to persuasive media to an important health domain and discuss potential psychological interpretations of the brain–behavior link. Our results support a novel use of neuroimaging technology for understanding the psychology of behavior change and facilitating health promotion. PMID:21261410

Gender differences in smoking behaviors in an Asian population.

PubMed

Tsai, Yi-Wen; Tsai, Tzu-I; Yang, Chung-Lin; Kuo, Ken N

2008-01-01

Gender-sensitive tobacco control policies are being challenged, and new directions are being sought because public health efforts have reduced cigarette consumption more substantially among men than among women. To better target women, it would help to identify the protective cultural factors that promote resiliency in women and discourage them from smoking. Whereas western cultures have generated a great deal of gender-specific research and programs on the prevention of smoking in women, Asian cultures have not. Taking a personal and sociocultural perspective, this study examines the effect of gender on smoking behaviors in Taiwan. In a 2004 cross-sectional random-sampled interview survey, 827 adult men and 90 adult women smokers in Taiwan were queried about the time they began smoking, maintenance of their habits, and their readiness to change. The male/female smoking rate ratio was 9.5 (45.7% vs. 4.8%). Men smoked significantly more cigarettes per day than women (18 vs. 11). We found Taiwanese women started smoking around 20 years old, much later than their western counterparts. We also found that whereas the smoking behavior of the men was very sensitive to social environment and structural factors, that of women revolved around their desire to control their weight and handle their emotions. Differences in the smoking behavior of men and women are a result of a different sociocultural environment and the life trajectories and social circumstances embedded within it. Comprehensive tobacco control policies need to be tailored to not just smoking behavior alone or one population alone but to the determinants of smoking behavior in specific groups, for example, women. Even when targeting women, some effort may be needed on targeting women of different ethnicities, for instance, Asian women in whom the prevalence is increasing at alarming rates.

Gender Differences in Smoking Behaviors in an Asian Population

PubMed Central

Tsai, Yi-Wen; Yang, Chung-Lin; Kuo, Ken N.

2008-01-01

Abstract Background Gender-sensitive tobacco control policies are being challenged, and new directions are being sought because public health efforts have reduced cigarette consumption more substantially among men than among women. To better target women, it would help to identify the protective cultural factors that promote resiliency in women and discourage them from smoking. Whereas western cultures have generated a great deal of gender-specific research and programs on the prevention of smoking in women, Asian cultures have not. Taking a personal and sociocultural perspective, this study examines the effect of gender on smoking behaviors in Taiwan. Methods In a 2004 cross-sectional random-sampled interview survey, 827 adult men and 90 adult women smokers in Taiwan were queried about the time they began smoking, maintenance of their habits, and their readiness to change. Results The male/female smoking rate ratio was 9.5 (45.7% vs. 4.8%). Men smoked significantly more cigarettes per day than women (18 vs. 11). We found Taiwanese women started smoking around 20 years old, much later than their western counterparts. We also found that whereas the smoking behavior of the men was very sensitive to social environment and structural factors, that of women revolved around their desire to control their weight and handle their emotions. Conclusions Differences in the smoking behavior of men and women are a result of a different sociocultural environment and the life trajectories and social circumstances embedded within it. Comprehensive tobacco control policies need to be tailored to not just smoking behavior alone or one population alone but to the determinants of smoking behavior in specific groups, for example, women. Even when targeting women, some effort may be needed on targeting women of different ethnicities, for instance, Asian women in whom the prevalence is increasing at alarming rates. PMID:18681817

Self-determination, smoking, diet and health.

PubMed

Williams, Geoffrey C; Minicucci, Daryl S; Kouides, Ruth W; Levesque, Chantal S; Chirkov, Valery I; Ryan, Richard M; Deci, Edward L

2002-10-01

A Clinical Trial will test (1) a Self-Determination Theory (SDT) model of maintained smoking cessation and diet improvement, and (2) an SDT intervention, relative to usual care, for facilitating maintained behavior change and decreasing depressive symptoms for those who quit smoking. SDT is the only empirically derived theory which emphasizes patient autonomy and has a validated measure for each of its constructs, and this is the first trial to evaluate an SDT intervention. Adult smokers will be stratified for whether they are at National Cholesterol Education Program (1996) recommended goal for low-density lipoprotein cholesterol (LDL-C). Those with elevated LDL-C will be studied for diet improvement as well as smoking cessation. Six-month interventions involve a behavior-change counselor using principles of SDT to facilitate autonomous motivation and perceived competence for healthier behaving. Cotinine-validated smoking cessation and LDL-C-validated dietary recall of reduced fat intake, as well as depressive symptoms, will be assessed at 6 and 18 months. Structural equation modeling will test the model for both behaviors within the intervention and usual-care conditions.

Changes of Attitudes and Patronage Behaviors in Response to a Smoke-Free Bar Law

PubMed Central

Tang, Hao; Cowling, David W.; Lloyd, Jon C.; Rogers, Todd; Koumjian, Kristi L.; Stevens, Colleen M.; Bal, Dileep G.

2003-01-01

Objectives. We examined patron responses to a California smoke-free bar law. Methods. Three telephone surveys measured attitudes and behavior changes after implementation of the law. Results. Approval of the law rose from 59.8% to 73.2% (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.58, 2.40). Self-reported noncompliance decreased from 24.6% to 14.0% (OR = 0.50; 95% CI = 0.30, 0.85). Likelihood of visiting a bar or of not changing bar patronage after the law was implemented increased from 86% to 91% (OR = 1.76; 95% CI = 1.29, 2.40). Conclusions. California bar patrons increasingly support and comply with the smoke-free bar law. PMID:12660206

The impact of cigarette tax increase on smoking behavior of daily smokers.

PubMed

Kengganpanich, Mondha; Termsirikulchai, Lakkhana; Benjakul, Sarunya

2009-12-01

To assess the impact of excise tax increase on smoking behavior of daily smokers aged 15 years and over and to explore the association between smokers' characteristics and smoking behavior prior and after excise tax increase. This cross-sectional survey was performed in 504 daily smokers, who were selected from data records of Global Adult Tobacco Survey (GATS) between February and April, 2009. The data were collected by telephone interview in the first and second weeks of July, 2009. Data were analyzed by frequency distribution and binary logistic regression. After the cigarette tax increase, 9.7% of daily smokers quitted smoking and 48.0% reduced the amount of cigarettes and/or changed the brands and types of tobacco, from manufactured cigarettes to hand-rolled cigarettes. After other covariance being adjusted, the analysis revealed that the amount of cigarettes per day, the types of cigarettes (manufactured and hand-rolled cigarettes), and the smokers' reaction towards the increased price after the excise tax increase were respectively associated with the fact that the smokers quitted smoking or reduced the amount of cigarettes (p < 0.05). Cigarette tax increase is beneficial for government revenue and it also affects smoking behavior change of daily smokers. However Ministry of Public Health should co-operate with Ministry of Finance to raise the tax rate on both cigarettes and hand-rolled cigarettes continuously and provide sufficient cessation service to respond to the need to quit smoking.

Teacher training as a behavior change process: principles and results from a longitudinal study.

PubMed

Kealey, K A; Peterson, A V; Gaul, M A; Dinh, K T

2000-02-01

For students to realize the benefits of behavior change curricula for disease prevention, programs must be implemented effectively. However, implementation failure is a common problem documented in the literature. In this article, teacher training is conceptualized as a behavior change process with explicit teacher motivation components included to help effect the intended behavior (i.e., implementation). Using this method, the Hutchinson Smoking Prevention Project, a randomized controlled trial in school-based smoking prevention, conducted 65 in-service programs, training nearly 500 teachers (Grades 3-10) from 72 schools. Implementation was monitored by teacher self-report and classroom observations by project staff. The results were favorable. All eligible teachers received training, virtually all trained teachers implemented the research curriculum, and 89% of observed lessons worked as intended. It is concluded that teacher training conceptualized as a behavior change process and including explicit teacher motivation components can promote effective implementation of behavior change curricula in public school classrooms.

Contingency management in the 21st century: technological innovations to promote smoking cessation.

PubMed

Dallery, Jesse; Raiff, Bethany R

2011-01-01

Information technology represents an excellent medium to deliver contingencies of reinforcement to change behavior. Recently, we have linked the Internet with a science-based, behavioral treatment for cigarette smoking: abstinence reinforcement therapy. Under abstinence reinforcement interventions, incentives are provided for objective evidence of abstinence. Several studies suggest that the intervention is effective in initiating abstinence. The intervention addresses limitations (access, cost, sustainability, and dissemination potential) inherent in traditional abstinence reinforcement delivery models. It can also be applied to vulnerable, at-risk populations, and to other behavior to promote health. Information technologies offer unprecedented and rapidly expanding opportunities to facilitate behavior change.

Modeling the Effects of E-cigarettes on Smoking Behavior: Implications for Future Adult Smoking Prevalence.

PubMed

Cherng, Sarah T; Tam, Jamie; Christine, Paul J; Meza, Rafael

2016-11-01

Electronic cigarette (e-cigarette) use has increased rapidly in recent years. Given the unknown effects of e-cigarette use on cigarette smoking behaviors, e-cigarette regulation has become the subject of considerable controversy. In the absence of longitudinal data documenting the long-term effects of e-cigarette use on smoking behavior and population smoking outcomes, computational models can guide future empirical research and provide insights into the possible effects of e-cigarette use on smoking prevalence over time. Agent-based model examining hypothetical scenarios of e-cigarette use by smoking status and e-cigarette effects on smoking initiation and smoking cessation. If e-cigarettes increase individual-level smoking cessation probabilities by 20%, the model estimates a 6% reduction in smoking prevalence by 2060 compared with baseline model (no effects) outcomes. In contrast, e-cigarette use prevalence among never smokers would have to rise dramatically from current estimates, with e-cigarettes increasing smoking initiation by more than 200% relative to baseline model estimates to achieve a corresponding 6% increase in smoking prevalence by 2060. Based on current knowledge of the patterns of e-cigarette use by smoking status and the heavy concentration of e-cigarette use among current smokers, the simulated effects of e-cigarettes on smoking cessation generate substantially larger changes to smoking prevalence compared with their effects on smoking initiation.

Modeling the Effects of E-Cigarettes on Smoking Behavior: Implications for Future Adult Smoking Prevalence

PubMed Central

Cherng, Sarah T.; Tam, Jamie; Christine, Paul; Meza, Rafael

2016-01-01

Background Electronic cigarette (e-cigarette) use has increased rapidly in recent years. Given the unknown effects of e-cigarette use on cigarette smoking behaviors, e-cigarette regulation has become the subject of considerable controversy. In the absence of longitudinal data documenting the long-term effects of e-cigarette use on smoking behavior and population smoking outcomes, computational models can guide future empirical research and provide insights into the possible effects of e-cigarette use on smoking prevalence over time. Methods Agent-based model examining hypothetical scenarios of e-cigarette use by smoking status and e-cigarette effects on smoking initiation and smoking cessation. Results If e-cigarettes increase individual-level smoking cessation probabilities by 20%, the model estimates a 6% reduction in smoking prevalence by 2060 compared to baseline model (no effects) outcomes. In contrast, e-cigarette use prevalence among never smokers would have to rise dramatically from current estimates, with e-cigarettes increasing smoking initiation by more than 200% relative to baseline model estimates in order to achieve a corresponding 6% increase in smoking prevalence by 2060. Conclusions Based on current knowledge of the patterns of e-cigarette use by smoking status and the heavy concentration of e-cigarette use among current smokers, the simulated effects of e-cigarettes on smoking cessation generate substantially larger changes to smoking prevalence relative to their effects on smoking initiation. PMID:27093020

The effect of a multi-component smoking cessation intervention in African American women residing in public housing.

PubMed

Andrews, Jeannette O; Felton, Gwen; Ellen Wewers, Mary; Waller, Jennifer; Tingen, Martha

2007-02-01

The purpose of this study was to test the effectiveness of a multi-component smoking cessation intervention in African American women residing in public housing. The intervention consisted of: (a) nurse led behavioral/empowerment counseling; (b) nicotine replacement therapy; and, (c) community health workers to enhance smoking self-efficacy, social support, and spiritual well-being. The results showed a 6-month continuous smoking abstinence of 27.5% and 5.7% in the intervention and comparison groups. Changes in social support and smoking self-efficacy over time predicted smoking abstinence, and self-efficacy mediated 6-month smoking abstinence outcomes. Spiritual well-being did not predict or mediate smoking abstinence outcomes. These findings support the use of a nurse/community health worker model to deliver culturally tailored behavioral interventions with marginalized communities.

Smoke-free Policy and Alcohol Use among Undergraduate College Students

PubMed Central

Butler, Karen M.; Rayens, Mary Kay; Hahn, Ellen J.; Adkins, Sarah M.; Staten, Ruth R.

2012-01-01

Objectives The purpose of this study was to assess attitudes and behaviors related to smoke-free policy among undergraduate student alcohol drinkers on a campus in a community with smoke-free bars. Design and Sample This was a secondary data analysis of a study in which participants completed mailed surveys assessing demographic characteristics, attitudes and behaviors related to alcohol and tobacco use and smoke-free policy (n=337). Opinion and behavior items were summarized descriptively; associations were examined using Kruskal Wallis tests and chi-square tests of association. Logistic regression tested for predictors of importance of smoke-free policy. Results Respondents were predominantly female and Caucasian; mean age 20.3 years. One-fourth were current smokers. Seventy-nine percent said the community smoke-free law had no effect on frequency of visiting bars. Eighty-seven percent said smoke-free policy in campus buildings was ‘somewhat’ or ‘very important’. Predictors of perceived importance of smoke-free policy included gender and smoking status. Conclusions Most smokers in this sample did not experience a change in their motivation to quit smoking or in number of cigarettes smoked daily. Implementation of a community smoke-free law did not reduce the likelihood of visiting bars. Women and nonsmokers were more likely to rate smoke-free campus policy as very important. PMID:22512427

Behavior change techniques used in group-based behavioral support by the English stop-smoking services and preliminary assessment of association with short-term quit outcomes.

PubMed

West, Robert; Evans, Adam; Michie, Susan

2011-12-01

To develop a reliable coding scheme for components of group-based behavioral support for smoking cessation, to establish the frequency of inclusion in English Stop-Smoking Service (SSS) treatment manuals of specific components, and to investigate the associations between inclusion of behavior change techniques (BCTs) and service success rates. A taxonomy of BCTs specific to group-based behavioral support was developed and reliability of use assessed. All English SSSs (n = 145) were contacted to request their group-support treatment manuals. BCTs included in the manuals were identified using this taxonomy. Associations between inclusion of specific BCTs and short-term (4-week) self-reported quit outcomes were assessed. Fourteen group-support BCTs were identified with >90% agreement between coders. One hundred and seven services responded to the request for group-support manuals of which 30 had suitable documents. On average, 7 BCTs were included in each manual. Two were positively associated with 4-week quit rates: "communicate group member identities" and a "betting game" (a financial deposit that is lost if a stop-smoking "buddy" relapses). It is possible to reliably code group-specific BCTs for smoking cessation. Fourteen such techniques are present in guideline documents of which 2 appear to be associated with higher short-term self-reported quit rates when included in treatment manuals of English SSSs.

Tracing the cigarette epidemic: an age-period-cohort study of education, gender and smoking using a pseudo-panel approach.

PubMed

Vedøy, Tord F

2014-11-01

This study examined if temporal variations in daily cigarette smoking and never smoking among groups with different levels of education fit the pattern proposed by the theory of diffusion of innovations (TDI), while taking into account the separate effects of age, period and birth cohort (APC). Aggregated data from nationally representative interview surveys from Norway from 1976 to 2010 was used to calculate probabilities of smoking using an APC approach in which the period variable was normalized to pick up short term cyclical effects. Results showed that educational differences in smoking over time were more strongly determined by birth cohort membership than variations in smoking behavior across the life course. The probability of daily smoking decreased faster across cohorts among higher compared to lower educated. In contrast, the change in probability of never having smoked across cohorts was similar in the two education groups, but stronger among men compared to women. Moreover, educational differences in both daily and never smoking increased among early cohorts and leveled off among late cohorts. The results emphasizes the importance of birth cohort for social change and are consistent with TDI, which posits that smoking behavior diffuse through the social structure over time. Copyright © 2014 Elsevier Inc. All rights reserved.

Educational Differences in Healthy Behavior Changes and Adherence Among Middle-aged Americans

PubMed Central

Margolis, Rachel

2014-01-01

Although the better-educated are more likely to practice healthy behaviors when measured at one point in time, there is no clear evidence regarding whether more educated people are more likely to initiate healthy behavior changes in the face of new chronic conditions and whether they are better able to adhere to these healthy changes, once made. I use data from the Health and Retirement Study (HRS) (1992–2010) to examine smoking cessation and starting physical activity by educational attainment over an 18-year period among 16,606 respondents ages 50 to 75. The more-educated are the least likely to smoke and most likely to be physically active in middle age. They are also most likely to make healthy changes overall and better adhere to them. Education also shapes behavior change after a new diagnosis, which likely contributes to socioeconomic status differences in chronic disease management and health outcomes. PMID:23988727

Missing the mark for patient engagement: mHealth literacy strategies and behavior change processes in smoking cessation apps.

PubMed

Paige, Samantha R; Alber, Julia M; Stellefson, Michael L; Krieger, Janice L

2018-05-01

To examine how Transtheoretical Model (TTM)'s processes of change and mHealth literacy strategies are employed in mobile smoking cessation apps. A purposive sample of 100 iTunes apps were coded to assess descriptive (price, type, developer, user-rating) and engagement metrics, including processes of change and mHealth literacy strategies (plain language, usability, interactivity). One-way ANOVAs and independent samples t-tests examined associations between descriptive and engagement metrics. Over half of the apps included 7 (78%) processes of change. Fewer included self-liberation (36%) and reinforcement management (34%). Most apps incorporated plain language, but few integrated usability and interactivity strategies. Hypnotherapy and informational apps included more behavioral processes of change than apps incorporating a combination of features, including gaming, cigarette trackers, and motivational coaching (p<0.01). Apps included behavior change processes but rarely incorporated usability and interactivity features to promote patient engagement. Engagement metrics did not vary by app user-ratings, price-to-download, or developer, including for-profit organizations or government and educational institutions. Providers should acknowledge the popularity of smoking cessation apps as potential cessation aids and communicate their benefits and drawbacks to patients. Future efforts to improve smoking cessation apps should focus on enhancing the quality of tailored and interactive content. Copyright © 2017 Elsevier B.V. All rights reserved.

Impact on Smoking Behavior of the New Zealand Annual Increase in Tobacco Tax: Data for the Fifth and Sixth Year of Increases.

PubMed

Li, Judy; Newcombe, Rhiannon; Guiney, Hayley; Walton, Darren

2017-11-07

New Zealand has implemented a series of seven annual increases in tobacco tax since 2010. All tax increases, except for the first in the series, were preannounced. It is unusual for governments to introduce small, persistent, and predictable increases in tobacco tax, and little is known about the impact of such a strategy. This paper evaluates the impact of the fifth and sixth annual increases. Smokers' behaviors were self-reported during the 3-month period before, and the 3-month period after, the two annual increases. Responses to the two increases were analyzed separately, and generalized estimating equations models were used to control for sociodemographic variables, recent quit attempts, and the research design. Findings were consistent across years. The proportion of participants who made a smoking-related (54%-56% before and after each tax increase) or product-related change (fifth tax increase: 17%-19%; sixth tax increase: 21%-22%) did not significantly alter from before to after each tax increase. However, it should be noted that the proportion of participants making smoking-related changes was generally high, even prior to each increase. For example, before the 2015 tax increase, 1% reported quitting completely, 21% trying to quit, and 53% cutting down. In New Zealand, with its series of annual tobacco tax increases since 2010, there were no significant changes in smoking- or product-related behavior associated with the fifth and sixth increases. Nevertheless, overall cessation-related activity was high, with a majority of participants reporting either quitting and/or cutting down recently. Little is known about the impact of small, persistent, predictable tobacco tax increases on smoking behavior. This study evaluated the impact of the fifth (in 2014) and sixth (2015) tax increases in an annual series implemented in New Zealand. Although there were no detectable changes in smoking behaviors from before to after each tax increase, self-reported cessation-related activity was high overall (i.e., even prior to each increase). Given that there are multiple possible interpretations for these findings, more in-depth time-series analyses are needed to understand how such a tax strategy influences smoking behavior. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The effects of interventions targeting multiple health behaviors on smoking cessation outcomes: a rapid realist review protocol.

PubMed

Minian, Nadia; deRuiter, Wayne K; Lingam, Mathangee; Corrin, Tricia; Dragonetti, Rosa; Manson, Heather; Taylor, Valerie H; Zawertailo, Laurie; Ebnahmady, Arezoo; Melamed, Osnat C; Rodak, Terri; Hahn, Margaret; Selby, Peter

2018-03-01

Health behaviors directly impact the health of individuals, and populations. Since individuals tend to engage in multiple unhealthy behaviors such as smoking, excessive alcohol use, physical inactivity, and eating an unhealthy diet simultaneously, many large community-based interventions have been implemented to reduce the burden of disease through the modification of multiple health behaviors. Smoking cessation can be particularly challenging as the odds of becoming dependent on nicotine increase with every unhealthy behavior a smoker exhibits. This paper presents a protocol for a rapid realist review which aims to identify factors associated with effectively changing tobacco use and target two or more additional unhealthy behaviors. An electronic literature search will be conducted using the following bibliographic databases: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library, Social Science Abstracts, Social Work Abstracts, and Web of Science. Two reviewers will screen titles and abstracts for relevant research, and the selected full papers will be used to extract data and assess the quality of evidence. Throughout this process, the rapid realist approach proposed by Saul et al., 2013 will be used to refine our initial program theory and identify contextual factors and mechanisms that are associated with successful multiple health behavior change. This review will provide evidence-based research on the context and mechanisms that may drive the success or failure of interventions designed to support multiple health behavior change. This information will be used to guide curriculum and program development for a government funded project on improving smoking cessation by addressing multiple health behaviors in people in Canada. PROSPERO CRD42017064430.

An expectancy-value theory approach to the long-term modification of smoking behavior.

PubMed

Rogers, R W; Deckner, C W; Mewborn, C R

1978-04-01

Despite the research interest in modifying smoking behavior, therapeutic treatments that can produce long-term cessation have not been demonstrated rigorously. A follow-up study of two attitude change experiments (N = 173) examined the effects of a fear appeal, that is, increasing smokers' awareness and appreciation of the highly noxious consequences of smoking. Although this familiar type of information may be an integral component of many smoking treatment programs, its long-term suppressive effect has not been demonstrated in well-controlled experiments. The results disclosed that 3 months and also 1 year after treatment, a high-fear manipulation had increased significantly the percentage of smokers who were able to stop smoking completely.

Neighborhood context and youth cardiovascular health behaviors.

PubMed

Lee, Rebecca E; Cubbin, Catherine

2002-03-01

This study sought to determine the relationships between race/ethnicity, socioeconomic status (SES), and cardiovascular health behaviors among youths and whether neighborhood characteristics are associated with such behaviors independently of individual characteristics. Linear models determined the effects of individual and neighborhood characteristics (SES, social disorganization, racial/ethnic minority concentration, urbanization) on dietary habits, physical activity, and smoking among 8165 youths aged 12 to 21 years. Low SES was associated with poorer dietary habits, less physical activity, and higher odds of smoking. After adjustment for SES, Black race was associated with poorer dietary habits and lower odds of smoking. Hispanic ethnicity was associated with healthier dietary habits, lower levels of physical activity, and lower odds of smoking than non-Hispanic ethnicity. Low neighborhood SES and high neighborhood social disorganization were independently associated with poorer dietary habits, while high neighborhood Hispanic concentration and urbanicity were associated with healthier dietary habits. Neighborhood characteristics were not associated with physical activity or smoking. Changes in neighborhood social structures and policies that reduce social inequalities may enhance cardiovascular health behaviors.

Optimizing Decision Support for Tailored Health Behavior Change Applications.

PubMed

Kukafka, Rita; Jeong, In cheol; Finkelstein, Joseph

2015-01-01

The Tailored Lifestyle Change Decision Aid (TLC DA) system was designed to provide support for a person to make an informed choice about which behavior change to work on when multiple unhealthy behaviors are present. TLC DA can be delivered via web, smartphones and tablets. The system collects a significant amount of information that is used to generate tailored messages to consumers to persuade them in certain healthy lifestyles. One limitation is the necessity to collect vast amounts of information from users who manually enter. By identifying an optimal set of self-reported parameters we will be able to minimize the data entry burden of the app users. The study was to identify primary determinants of health behavior choices made by patients after using the system. Using discriminant analysis an optimal set of predictors was identified. The resulting set included smoking status, smoking cessation success estimate, self-efficacy, body mass index and diet status. Predicting smoking cessation choice was the most accurate, followed by weight management. Physical activity and diet choices were better identified in a combined cluster.

The First Day is Always the Hardest: Functional Connectivity during Cue Exposure and the Ability to Resist Smoking in the Initial Hours of a Quit Attempt

PubMed Central

Zelle, Shannon L.; Gates, Kathleen M.; Fiez, Julie A.; Sayette, Michael A.; Wilson, Stephen J.

2016-01-01

Quitting smoking is the single best change in behavior that smokers can make to improve their health and extend their lives. Although most smokers express a strong desire to stop using cigarettes, the vast majority of quit attempts end in relapse. Relapse is particularly likely when smokers encounter cigarette cues. A striking number of relapses occur very quickly, with many occurring within as little as 24 hrs. Characterizing what distinguishes successful quit attempts from unsuccessful ones, particularly just after cessation is initiated, is a research priority. We addressed this significant issue by examining the association between functional connectivity during cigarette cue exposure and smoking behavior during the first 24 hrs of a quit attempt. Functional MRI was used to measure brain activity during cue exposure in nicotine-deprived daily smokers during the first day of a quit attempt. Participants were then given the opportunity to smoke. Using data collected in two parent studies, we identified a subset of participants who chose to smoke and a matched subset who declined (n = 38). Smokers who were able to resist smoking displayed significant functional connectivity between the left anterior insula and the dorsolateral prefrontal cortex, whereas there was no such connectivity for those who chose to smoke. Notably, there were no differences in mean levels of activation in brain regions of interest, underscoring the importance of assessing interregional connectivity when investigating the links between cue-related neural responses and overt behavior. To our knowledge, this is the first study to link patterns of functional connectivity and actual cigarette use during the pivotal first hours of attempt to change smoking behavior. PMID:26975550

Prenatal and Early Postnatal Exposure to Cigarette Smoke Decreases BDNF/TrkB Signaling and Increases Abnormal Behaviors Later in Life

PubMed Central

Xiao, Lan; Kish, Vincent L.; Benders, Katherine M.

2016-01-01

Background: Cigarette smoke exposure during prenatal and early postnatal periods increases the incidence of a variety of abnormal behaviors later in life. The purpose of this study was to identify the possible critical period of susceptibility to cigarette smoke exposure and evaluate the possibe effects of cigarette smoke during early life on brain-derived neurotrophic factor/neurotrophic tyrosine kinase receptor B signaling in the brain. Methods: Three different age of imprinting control region mice were exposed to cigarette smoke or filtered air for 10 consecutive days beginning on either gestational day 7 by maternal exposure, or postnatal days 2 or 21 by direct inhalation. A series of behavioral profiles and neurotrophins in brain were measured 24 hours after mice received acute restraint stress for 1 hour on postnatal day 59. Results: Cigarette smoke exposure in gestational day 7 and postnatal day 2 produced depression-like behaviors as evidenced by significantly increased immobility in both tail suspension and forced-swim test. Increased entry latencies, but not ambulation in the open field test, were also observed in the gestational day 7 and postnatal day 2 cigarette smoke exposure groups. Genetic analysis showed that gestational day 7 cigarette smoke exposure significantly altered mRNA level of brain-derived neurotrophic factor/tyrosine kinase receptor B in the hippocampus. However, behavioral profiles and brain-derived neurotrophic factor/tyrosine kinase receptor B signaling were not significantly changed in PND21 cigarette smoke exposure group compared with FA group. Conclusions: These results suggest that a critical period of susceptibility to cigarette smoke exposure exists in the prenatal and early postnatal period, which results a downregulation in brain-derived neurotrophic factor/tyrosine kinase receptor B signaling in the hippocampus and enhances depression-like behaviors later in life. PMID:26503133

Changing implicit attitudes toward smoking: results from a web-based approach-avoidance practice intervention.

PubMed

Macy, Jonathan T; Chassin, Laurie; Presson, Clark C; Sherman, Jeffrey W

2015-02-01

Implicit attitudes have been shown to predict smoking behaviors. Therefore, an important goal is the development of interventions to change these attitudes. This study assessed the effects of a web-based intervention on implicit attitudes toward smoking and receptivity to smoking-related information. Smokers (N = 284) were recruited to a two-session web-based study. In the first session, baseline data were collected. Session two contained the intervention, which consisted of assignment to the experimental or control version of an approach-avoidance task and assignment to an anti-smoking or control public service announcement (PSA), and post-intervention measures. Among smokers with less education and with plans to quit, implicit attitudes were more negative for those who completed the approach-avoidance task. Smokers with more education who viewed the anti-smoking PSA and completed the approach-avoidance task spent more time reading smoking-related information. An approach-avoidance task is a potentially feasible strategy for changing implicit attitudes toward smoking and increasing receptivity to smoking-related information.

Changing Implicit Attitudes toward Smoking: Results from a Web-Based Approach-Avoidance Practice Intervention

PubMed Central

Macy, Jonathan T.; Chassin, Laurie; Presson, Clark C.; Sherman, Jeffrey W.

2014-01-01

Implicit attitudes have been shown to predict smoking behaviors. Therefore, an important goal is the development of interventions to change these attitudes. This study assessed the effects of a web-based intervention on implicit attitudes toward smoking and receptivity to smoking-related information. Smokers (N=284) were recruited to a two-session web-based study. In the first session, baseline data were collected. Session two contained the intervention, which consisted of assignment to the experimental or control version of an approach-avoidance task and assignment to an anti-smoking or control public service announcement (PSA), and post-intervention measures. Among smokers with less education and with plans to quit, implicit attitudes were more negative for those who completed the approach-avoidance task. Smokers with more education who viewed the anti-smoking PSA and completed the approach-avoidance task spent more time reading smoking-related information. An approach-avoidance task is a potentially feasible strategy for changing implicit attitudes toward smoking and increasing receptivity to smoking-related information. PMID:25059750

The Changing Public Image of Smoking in the United States: 1964–2014

PubMed Central

Cummings, K. Michael; Proctor, Robert N.

2013-01-01

Tobacco use behaviors have changed significantly over the past century. After a steep increase in cigarette use rates over the first half of the 20th century, adult smoking prevalence rates started declining from their peak reached in 1964. Improved understanding of the health risks of smoking has been aided by the United States Surgeon General’s Reports, issued on a nearly annual basis starting in 1964. Among the many forces driving down smoking prevalence were the recognition of tobacco use as an addiction and cause of cancer, along with concerns about the ill-effects of breathing secondhand smoke. These factors contributed to the declining social acceptance of smoking, especially with the advent of legal restrictions on smoking in public spaces, mass media counter- marketing campaigns, and higher taxes on cigarettes. This paper reviews some of the forces that have helped change the public image of smoking, focusing on the 50 years since the 1964 Surgeon General’s report on smoking and health. PMID:24420984

Predictors of smoking cessation and relapse in older adults.

PubMed Central

Salive, M E; Cornoni-Huntley, J; LaCroix, A Z; Ostfeld, A M; Wallace, R B; Hennekens, C H

1992-01-01

We examined longitudinal changes in smoking behavior among older adults in three community cohorts of the Established Populations for Epidemiologic Studies of the Elderly. Smoking prevalence declined from 15% at baseline to 9% during 6 years of follow-up. Annual smoking cessation and relapse rates were 10% and less than 1%, respectively. Interval diagnosis of myocardial infarction, stroke, or cancer increased subsequent smoking cessation but not relapse. Although smoking cessation around diagnosis is increased, primary prevention could yield greater benefits. PMID:1503170

Determinants of intention to change health-related behavior and actual change in patients with TIA or minor ischemic stroke.

PubMed

Brouwer-Goossensen, Dorien; Genugten, Lenneke van; Lingsma, Hester; Dippel, Diederik; Koudstaal, Peter; Hertog, Heleen den

2016-04-01

To assess determinants of intention to change health-related behavior and actual change in patients with TIA or ischemic stroke. In this prospective cohort study, 100 patients with TIA or minor ischemic stroke completed questionnaires on behavioral intention and sociocognitive factors including perception of severity, susceptibility, fear, response-efficacy and self-efficacy at baseline. Questionnaires on physical activity, diet and smoking were completed at baseline and at 3 months. Associations between sociocognitive factors and behavioral intention and actual change were studied with multivariable linear and logistic regression. Self-efficacy, response efficacy, and fear were independently associated with behavioral intention, with self-efficacy as the strongest determinant of intention to increase physical activity (aBeta 0.40; 95% CI 0.12-0.71), adapt a healthy diet (aBeta 0.49; 95% CI 0.23-0.75), and quit smoking (aBeta 0.51; 95% CI 0.13-0.88). Intention to change tended to be associated with actual health-related behavior change. Self-efficacy, fear, and response-efficacy were determinants of intention to change health-related behavior after TIA or ischemic stroke. These determinants of intention to change health-related behavior after TIA or ischemic stroke should be taken into account in the development of future interventions promoting health-related behavior change in these group of patients. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

How people think about the chemicals in cigarette smoke: a systematic review.

PubMed

Morgan, Jennifer C; Byron, M Justin; Baig, Sabeeh A; Stepanov, Irina; Brewer, Noel T

2017-08-01

Laws and treaties compel countries to inform the public about harmful chemicals (constituents) in cigarette smoke. To encourage relevant research by behavioral scientists, we provide a primer on cigarette smoke toxicology and summarize research on how the public thinks about cigarette smoke chemicals. We systematically searched PubMed in July 2016 and reviewed citations from included articles. Four central findings emerged across 46 articles that met inclusion criteria. First, people were familiar with very few chemicals in cigarette smoke. Second, people knew little about cigarette additives, assumed harmful chemicals are added during manufacturing, and perceived cigarettes without additives to be less harmful. Third, people wanted more information about constituents. Finally, well-presented chemical information increased knowledge and awareness and may change behavior. This research area is in urgent need of behavioral science. Future research should investigate whether educating the public about these chemicals increases risk perceptions and quitting.

When Pregnant Patients Disclose Substance Use: Missed Opportunities for Behavioral Change Counseling

PubMed Central

Chang, Judy C.; Dado, Diane; Frankel, Richard M.; Rodriguez, Keri L.; Zickmund, Susan; Ling, Bruce S.; Arnold, Robert M.

2008-01-01

Objective The first obstetric visit is an opportunity to provide counseling to women with substance abuse risks, including smoking, drug use, and alcohol use. Little is known about how obstetric care providers and patients discuss these issues. Our objective was to examine patient-provider communication about substance use behaviors during these visits. Methods We audiotaped and transcribed verbatim first prenatal visits in an outpatient hospital clinic, then qualitatively analyzed them for content and process of communication using modified grounded theory methods. Results Twenty-nine providers (21 residents, 5 midwives, 3 nurse practitioners) and 51 patients participated. Twenty-five patients were smokers, 4 used alcohol, and 11 used drugs. Provider responses to smoking disclosures included discussions of risks, encouragement to quit-cut down, affirmation of attempts to quit-cut down, and referral to smoking cessation programs. Responses to alcohol or drug disclosures included only a general statement regarding risks and referral to genetics. Conclusion Providers were less attentive to alcohol and drugs than smoking where they had pre-established patterns of response. Practice Implications Providers should discuss behavioral change strategies and motivations with pregnant patients who use drugs and/or alcohol as well as those who smoke. PMID:18620835

The Systematic Development of an Internet-Based Smoking Cessation Intervention for Adults.

PubMed

Dalum, Peter; Brandt, Caroline Lyng; Skov-Ettrup, Lise; Tolstrup, Janne; Kok, Gerjo

2016-07-01

Objectives The objective of this project was to determine whether intervention mapping is a suitable strategy for developing an Internet- and text message-based smoking cessation intervention. Method We used the Intervention Mapping framework for planning health promotion programs. After a needs assessment, we identified important changeable determinants of cessation behavior, specified objectives for the intervention, selected theoretical methods for meeting our objectives, and operationalized change methods into practical intervention strategies. Results We found that "social cognitive theory," the "transtheoretical model/stages of change," "self-regulation theory," and "appreciative inquiry" were relevant theories for smoking cessation interventions. From these theories, we selected modeling/behavioral journalism, feedback, planning coping responses/if-then statements, gain frame/positive imaging, consciousness-raising, helping relationships, stimulus control, and goal-setting as suitable methods for an Internet- and text-based adult smoking cessation program. Furthermore, we identified computer tailoring as a useful strategy for adapting the intervention to individual users. Conclusion The Intervention Mapping method, with a clear link between behavioral goals, theoretical methods, and practical strategies and materials, proved useful for systematic development of a digital smoking cessation intervention for adults. © 2016 Society for Public Health Education.

Behavior change techniques used by the English Stop Smoking Services and their associations with short-term quit outcomes.

PubMed

West, Robert; Walia, Asha; Hyder, Natasha; Shahab, Lion; Michie, Susan

2010-07-01

To help identify effective components of behavioral support for smoking cessation, this study identified the behavior change techniques (BCTs) specified in the treatment manuals of 43 English Stop Smoking Services (SSSs) and assessed association between inclusion of specific BCTs and SSS success rates. SSSs (n = 144) were contacted to request their treatment manuals. BCTs included in the manuals were identified using a previously established taxonomy. Associations between inclusion of specific BCTs and short-term (4-week) quit outcomes were assessed. Ninety-eight services responded, of which 43 had suitable treatment manuals. Out of 43 possible BCTs, SSS manuals included a mean of 22 (range 9-37). The number of sessions used for delivery of the smoking cessation intervention differed markedly (range 1-13) across services. Nine of the BCTs were significantly associated with both self-reported and carbon monoxide (CO)-verified 4-week quit rates (e.g., strengthen ex-smoker identity, provide rewards contingent on abstinence, advise on medication, measure CO) and a further 5 were associated with CO-verified 4-week quit rates but not self-reported quit rates (e.g., advise on/facilitate use of social support, provide reassurance). SSSs that scheduled in more sessions had higher quit rates. English SSSs vary widely in how far their treatment manuals include specific behavior change techniques and how many do not have manuals. It is possible to identify BCTs that are reliably associated with better quit outcomes. Behavioral support for smoking cessation could be improved by a more systematic approach to identifying and applying BCTs that are associated with better quit outcomes.

The Experience of Peer Mentors in an Intervention to Promote Smoking Cessation in Persons with Psychiatric Illness.

PubMed

Dickerson, Faith; Savage, Christina L G; Schweinfurth, Lucy A B; Goldberg, Richard W; Bennett, Melanie; Dixon, Lisa; Daumit, Gail; Chinman, Matthew; Lucksted, Alicia

2016-05-01

Peer support is an important component of services for persons with psychiatric illness but the experience of peer mentors is not well understood. This study explored the experiences of peer mentors, all former smokers and persons with psychiatric illness, who provided smoking cessation counseling as part of a 6 month professionally-led intervention. Data was obtained from 383 contact log entries and in-depth interviews with eight peer mentors. Qualitative analysis indicated that mentor roles were unexpectedly varied beyond the focus on smoking cessation. Of the two aspects of "peer-ness," shared smoking history was more prominent, while the shared experience of psychiatric illness was sometimes overlooked. Peer mentors experienced multiple challenges trying to help participants to change their smoking behaviors. Nonetheless, they described their experience as personally rewarding. Future interventions may be improved by anticipating peer mentor role complexity and the inherent tension between providing person-centered support and promoting behavior change.

Improving Behavioral Support for Smoking Cessation in Pregnancy: What Are the Barriers to Stopping and Which Behavior Change Techniques Can Influence Them? Application of Theoretical Domains Framework

PubMed Central

Coleman-Haynes, Tom; Lorencatto, Fabiana; Ussher, Michael; Dyas, Jane; Coleman, Tim

2018-01-01

Behavioral support interventions are used to help pregnant smokers stop; however, of those tested, few are proven effective. Systematic research developing effective pregnancy-specific behavior change techniques (BCTs) is ongoing. This paper reports contributory work identifying potentially-effective BCTs relative to known important barriers and facilitators (B&Fs) to smoking cessation in pregnancy; to detect priority areas for BCTs development. A Nominal Group Technique with cessation experts (n = 12) elicited an expert consensus on B&Fs most influencing women’s smoking cessation and those most modifiable through behavioral support. Effective cessation interventions in randomized trials from a recent Cochrane review were coded into component BCTs using existing taxonomies. B&Fs were categorized using Theoretical Domains Framework (TDF) domains. Matrices, mapping BCT taxonomies against TDF domains, were consulted to investigate the extent to which BCTs in existing interventions target key B&Fs. Experts ranked ‘smoking a social norm’ and ‘quitting not a priority’ as most important barriers and ‘desire to protect baby’ an important facilitator to quitting. From 14 trials, 23 potentially-effective BCTs were identified (e.g., ‘information about consequences). Most B&Fs fell into ‘Social Influences’, ‘Knowledge’, ‘Emotions’ and ‘Intentions’ TDF domains; few potentially-effective BCTs mapped onto every TDF domain. B&Fs identified by experts as important to cessation, are not sufficiently targeted by BCT’s currently within interventions for smoking cessation in pregnancy. PMID:29462994

Improving Behavioral Support for Smoking Cessation in Pregnancy: What Are the Barriers to Stopping and Which Behavior Change Techniques Can Influence These? Application of Theoretical Domains Framework.

PubMed

Campbell, Katarzyna A; Fergie, Libby; Coleman-Haynes, Tom; Cooper, Sue; Lorencatto, Fabiana; Ussher, Michael; Dyas, Jane; Coleman, Tim

2018-02-17

Behavioral support interventions are used to help pregnant smokers stop; however, of those tested, few are proven effective. Systematic research developing effective pregnancy-specific behavior change techniques (BCTs) is ongoing. This paper reports contributory work identifying potentially-effective BCTs relative to known important barriers and facilitators (B&Fs) to smoking cessation in pregnancy; to detect priority areas for BCTs development. A Nominal Group Technique with cessation experts ( n = 12) elicited an expert consensus on B&Fs most influencing women's smoking cessation and those most modifiable through behavioral support. Effective cessation interventions in randomized trials from a recent Cochrane review were coded into component BCTs using existing taxonomies. B&Fs were categorized using Theoretical Domains Framework (TDF) domains. Matrices, mapping BCT taxonomies against TDF domains, were consulted to investigate the extent to which BCTs in existing interventions target key B&Fs. Experts ranked "smoking a social norm" and "quitting not a priority" as most important barriers and "desire to protect baby" an important facilitator to quitting. From 14 trials, 23 potentially-effective BCTs were identified (e.g., information about consequences). Most B&Fs fell into "Social Influences", "Knowledge", "Emotions" and "Intentions" TDF domains; few potentially-effective BCTs mapped onto every TDF domain. B&Fs identified by experts as important to cessation, are not sufficiently targeted by BCT's currently within interventions for smoking cessation in pregnancy.

Influences on food choice and dietary behavior.

PubMed

Shepherd, Richard

2005-01-01

There are a number of possible reasons for the lack of effectiveness of attempts at changing dietary behaviors. While lack of information and knowledge about foods and nutrient contents might play a part, motivation to change is likely to be much more important. Food choice, like any complex human behavior, is influenced by many interrelating factors, including various physiological, social and cultural factors, and these need to be taken into account when considering dietary interventions. In many cases people lack motivation to change. This can be related to optimistic bias, where people underestimate the risk to themselves relative to others from a variety of hazards. People feel less at risk personally for many dietary risks and this is related both to the control they feel they have over dietary behaviors and also to their considering themselves to have better diets than the average. The 'stages of change' model is a possible means for trying to address these motivational issues. While this model has been applied to various forms of behavior such as smoking, there are a number of problems transferring such a model from smoking to dietary behaviors, including the lack of clear cut specific behaviors and behavior change targets in the dietary field.

Prevalence of smoke-free car and home rules in Maine before and after passage of a smoke-free vehicle law, 2007-2010.

PubMed

Murphy-Hoefer, Rebecca; Madden, Patrick; Maines, Dorean; Coles, Carol

2014-01-16

This is the first study to examine the prevalence of self-reported smoke-free rules for private cars and homes before and after the passage of a smoke-free vehicle law. Data were examined for 13,461 Maine adults aged 18 or older who participated in the Behavioral Risk Factor Surveillance System, a state-based telephone survey covering health topics. Self-reported smoke-free car and home rules, smoking behavior, and demographic variables of age, sex, education, income, and children in household were analyzed for prevalence before and after the state's smoke-free vehicle law was passed. Prevalence of smoke-free car and home rules was significantly higher after Maine's smoke-free vehicle law was passed in the state (P = .004 for car rules and P = .009 for home rules). Variations in smoking rules differed by smoking and demographic variables. People with household incomes of less than $20,000 saw an increase of 14.3% in smoke-free car rules; overall, those with annual incomes of less than $20,000 and those with less than a high school education reported a lower prevalence of smoke-free car rules both before and after the law was passed than did people with higher incomes and higher education levels. The prevalence of smoke-free home rules after the law was implemented was higher among those with 4 or more years of college education than among those with lower levels of education (P = .02). The prevalence of smoke-free car and home rules among Maine adults was significantly higher after the passage of a statewide smoke-free vehicle law. This apparent change in smoke-free rule prevalence may be indicative of changing social norms related to the unacceptability of secondhand smoke exposure.

Bacoside A: Role in Cigarette Smoking Induced Changes in Brain

PubMed Central

Vani, G.; Anbarasi, K.; Shyamaladevi, C. S.

2015-01-01

Cigarette smoking (CS) is a major health hazard that exerts diverse physiologic and biochemical effects mediated by the components present and generated during smoking. Recent experimental studies have shown predisposition to several biological consequences from both active and passive cigarette smoke exposure. In particular, passive smoking is linked to a number of adverse health effects which are equally harmful as active smoking. A pragmatic approach should be considered for designing a pharmacological intervention to combat the adverse effects of passive smoking. This review describes the results from a controlled experimental condition, testing the effect of bacoside A (BA) on the causal role of passive/secondhand smoke exposure that caused pathological and neurological changes in rat brain. Chronic exposure to cigarette smoke induced significant changes in rat brain histologically and at the neurotransmitter level, lipid peroxidation states, mitochondrial functions, membrane alterations, and apoptotic damage in rat brain. Bacoside A is a neuroactive agent isolated from Bacopa monnieri. As a neuroactive agent, BA was effective in combating these changes. Future research should examine the effects of BA at molecular level and assess its functional effects on neurobiological and behavioral processes associated with passive smoke. PMID:26413118

Bacoside A: Role in Cigarette Smoking Induced Changes in Brain.

PubMed

Vani, G; Anbarasi, K; Shyamaladevi, C S

2015-01-01

Cigarette smoking (CS) is a major health hazard that exerts diverse physiologic and biochemical effects mediated by the components present and generated during smoking. Recent experimental studies have shown predisposition to several biological consequences from both active and passive cigarette smoke exposure. In particular, passive smoking is linked to a number of adverse health effects which are equally harmful as active smoking. A pragmatic approach should be considered for designing a pharmacological intervention to combat the adverse effects of passive smoking. This review describes the results from a controlled experimental condition, testing the effect of bacoside A (BA) on the causal role of passive/secondhand smoke exposure that caused pathological and neurological changes in rat brain. Chronic exposure to cigarette smoke induced significant changes in rat brain histologically and at the neurotransmitter level, lipid peroxidation states, mitochondrial functions, membrane alterations, and apoptotic damage in rat brain. Bacoside A is a neuroactive agent isolated from Bacopa monnieri. As a neuroactive agent, BA was effective in combating these changes. Future research should examine the effects of BA at molecular level and assess its functional effects on neurobiological and behavioral processes associated with passive smoke.

Impact of economic policies on reducing tobacco use among Medicaid clients in New York.

PubMed

Murphy, Jill M; Shelley, Donna; Repetto, Patricia M; Cummings, K Michael; Mahoney, Martin C

2003-07-01

New York State (NYS) recently implemented Medicaid coverage for prescription pharmacologic adjuncts for cessation and a 55-cent excise tax on a pack of cigarettes. This study examined awareness and use of stop smoking medications and changes in smoking/purchasing behavior among Medicaid clients. Participants (n = 173) were English-speaking Medicaid clients ages 18-64 years who currently smoked cigarettes and volunteered to be interviewed while waiting to reregister with the NYC Medicaid Office during early 2001. Data were collected using a brief (10-min) interviewer-administered questionnaire. Over 80% of Medicaid clients reported some desire to stop smoking and 40% intended to stop smoking in the next 6 months. Awareness of Medicaid coverage for tobacco cessation pharmacotherapy was 7% for nicotine replacement therapy and 13% for bupropion. Use of these stop smoking medications varied across products but in general was low (<10%). Half of the Medicaid clients reported changing their smoking behavior as a result of the cigarette tax increase. The majority of Medicaid clients report a desire to stop smoking, but these economic influences alone are insufficient to substantially reduce smoking in this population. These findings emphasize the importance of allocating a portion of tobacco tax revenue to promote both expanded awareness of this prescription benefit among Medicaid clients and to support programs to further assist low-income smokers in their attempts to stop smoking.

Peer beliefs and smoking in adolescence: a longitudinal social network analysis.

PubMed

Ragan, Daniel T

2016-03-01

Peer smoking is one of the strongest predictors of adolescent cigarette use, but less is known about whether other peer characteristics also contribute to this behavior. This study examined the links between adolescent cigarette use and peer beliefs about smoking. It tested whether peer beliefs about smoking are associated with changes in cigarette use, whether this association is a result of changes in individual beliefs about smoking, and how beliefs inform friendship choices. Analyses drew on data collected from 29 school-based networks, each measured at five occasions as students moved from 6th through 9th grade, as part of the study of the PROSPER partnership model. Longitudinal social network models provided estimates of friendship selection and behavior for an average of 6,200 students at each measurement point and more than 9,000 students overall. Peer beliefs about smoking influenced cigarette use both directly and through their impact on individual beliefs. Respondents tended to name friends whose beliefs about smoking were similar to their own, and the likelihood of being named as a friend was higher for those who reported more positive beliefs about smoking. The results from this study suggest that peer beliefs about smoking, in addition to peer cigarette use itself, are associated with adolescent smoking through several mechanisms. Because beliefs favorable to cigarette use are present before adolescents actually smoke, these results underscore the importance of implementing smoking prevention programs in early adolescence.

Preventing Smoking Progression in Young Adults: the Concept of Prevescalation.

PubMed

Villanti, Andrea C; Niaura, Raymond S; Abrams, David B; Mermelstein, Robin

2018-03-10

As adolescents cross the threshold to young adulthood, they encounter more opportunities to engage in or accelerate previously discouraged or prohibited behaviors. Young adults, therefore, are more apt to initiate cigarette smoking and, more importantly, to accelerate their use if they tried and experimented as an adolescent. Preventing the escalation and entrenchment of smoking in the young adult years is critically important to reducing tobacco's long-term health toll. However, traditional interventions for youth have focused on preventing smoking initiation, and interventions for adults have focused on smoking cessation; both have failed to address the needs of young adults. We introduce the concept of "prevescalation" to capture the need and opportunity to prevent the escalation of risk behaviors that typically occur during young adulthood, with a focus on the example of cigarette smoking. Prevescalation negates the notion that prevention has failed if tobacco experimentation occurs during adolescence and focuses on understanding and interrupting transitions between experimentation with tobacco products and established tobacco use that largely occur during young adulthood. However, since risk behaviors often co-occur in young people, the core concept of prevescalation may apply to other behaviors that co-occur and become harder to change in later adulthood. We present a new framework for conceptualizing, developing, and evaluating interventions that better fit the unique behavioral, psychosocial, and socio-environmental characteristics of the young adult years. We discuss the need to target this transitional phase, what we know about behavioral pathways and predictors of cigarette smoking, potential intervention considerations, and research challenges.

Cigarette Nicotine Content as a Moderator of the Relationship Between Negative Affect and Smoking.

PubMed

Robinson, Jason D; Kypriotakis, George; Karam-Hage, Maher; Green, Charles E; Hatsukami, Dorothy K; Cinciripini, Paul M; Donny, Eric C

2017-09-01

Research suggests a strong association between negative affect (NA) and smoking. However, little is known about the association between NA and smoking among individuals who switch to reduced-nicotine cigarettes. The goal of this study was to examine the extent to which cigarette nicotine content moderates the relationship between NA and smoking over time. Seven hundred and seventeen participants, 237 in the normal nicotine content (NNC; 15.8 mg/g and usual brand) cigarette group and 480 in the very low nicotine content (VLNC; 2.4 mg/g nicotine or less) cigarette group, participated in a randomized trial that examined the effects of cigarette nicotine content on smoking behavior over 6 weeks. We used parallel process latent growth curve modeling to estimate the relationship between changes in NA and changes in the numbers of cigarettes smoked per day (CPD), from baseline to 6 weeks, as a function of cigarette nicotine content. The relationship between NA and investigational CPD reduced over time for those in the VLNC group, but not for those in the NNC group. There was no significant relationship between change in PA and CPD over time for either cigarette group. Smoking VLNC cigarettes disrupts the relationship between smoking and negative affect, which may help reduce nicotine dependence. This study suggests that the association between NA and smoking behavior is reduced over time among those that smoked reduced-nicotine content cigarettes. This provides additional evidence that smoking reduced-nicotine content cigarettes may help reduce nicotine dependence. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Impact of Reduced Ignition Propensity Cigarette Regulation on Smoking Behavior in a Cohort of Ontario Smokers

PubMed Central

O’Connor, Richard J.; Fix, Brian V.; Hammond, David; Giovino, Gary A.; Hyland, Andrew; Fong, Geoffrey T.; Cummings, K. Michael

2016-01-01

Introduction This study examined the degree to which legislation intended to reduce the incidence of cigarette-caused fires influenced the behaviors of a cohort of smokers in Ontario, Canada. Evaluating the effectiveness of existing cigarette fire-safety has the potential to inform the development of similar standards in other jurisdictions. Methods A random digit dialed telephone survey of adult smokers residing in the Province of Ontario was conducted between July and September of 2005, ending one month prior to the RIP regulation’s implementation date. A follow-up survey was conducted between August and November of 2006 to examine changes in engaging in fire risk behaviors, perceptions of changes to cigarettes, and behavioral changes in response to smoking reduced ignition propensity cigarettes. Of the baseline participants, 73.0% (n=435) completed the follow-up survey. Results The frequency of fire risk behaviors was similar across both surveys. At baseline, only 3.7% (95% CI: 2.20–5.76) of smokers interviewed reported that their cigarettes went out on their own ‘often’ while smoking. Following the implementation of the reduced ignition propensity legislation, this increased significantly to 14.7% (95% CI: 11.41–18.42). Discussion The results observed in this study suggest that the proportion of Ontario smokers who reported engaging in behavior such as leaving a cigarette burning unattended and smoking in bed actually declined, although these declines were not statistically significant across all measures of fire risk. As other nations look to implement RIP regulations, the Canadian experience thus far has revealed no risk compensatory behaviors that would offset the potential public health benefit of the regulations. PMID:20643872

Determinants of cigarette smoking among school adolescents on the island of Java, Indonesia.

PubMed

Bigwanto, Mouhamad; Mongkolcharti, Aroonsri; Peltzer, Karl; Laosee, Orapin

2017-04-01

The Integrated Model of Change has successfully explained the behavior change process. Cigarette smoking is a social phenomenon, which needs to be understood for devising effective preventive strategies. The study aims to apply the Integrated Model of Change to determine predictive factors of cigarette smoking behavior among school adolescents in Indonesia. A school-based cross-sectional study was designed to collect data in Banten, Indonesia. A total of 698 students from eight high schools were recruited by multi-stage cluster sampling. The association between cigarette smoking and the independent variables was examined by multiple logistic regressions. The majority of respondents (86.4%) were between the ages of 15 and 17 years (Mean=16.4 years; SD=1.01). Approximately half (48.8%) of the students ever tried a cigarette while 29.6% were current smokers. Curiosity was reported as the main reason for experimenting with cigarettes (32%). The significant factors regarding current cigarette smoking were attitude [adjusted odds ratio (AOR)=2.68], social norms (AOR=12.80), self-efficacy (AOR=15.85), and accessibility (AOR=4.39). The study revealed social influence and self-efficacy that were strongly associated with cigarette smoking can help authorities in guiding possible intervention programs for school adolescents.

Personality Traits, Perceived Risk, and Risk-Reduction Behaviors: A Further Study of Smoking and Radon

PubMed Central

Hampson, Sarah E.; Andrews, Judy A.; Barckley, Maureen; Lichtenstein, Edward; Lee, Michael E.

2008-01-01

Personality traits and risk perceptions were examined as predictors of changes in smoking behavior. Participants (N = 697) were part of a randomized controlled trial of interventions to reduce exposure to the combined hazard of radon and cigarette smoke. Participants with higher perceived risk at baseline for the combination of smoking and radon were more likely to have a more restrictive household smoking ban in place at 12 months follow-up (p <. 05). Risk perceptions also predicted reductions in the total number of cigarettes smoked in the home for participants in the video intervention who had high or moderate levels of Extraversion (p <.001). Greater perceived risk predicted quitting for highly or moderately conscientious women (p <.05). The moderating effects of personality traits should be considered when evaluating risk-reduction interventions. PMID:16846328

Changes in tobacco use among adolescent smokers in substance abuse treatment.

PubMed

Shelef, Karni; Diamond, Guy S; Diamond, Gary M; Myers, Mark G

2009-06-01

Adolescents with substance use disorders (SUDs) smoke cigarettes more than youth in the general population. Little is known about changes in smoking patterns during and after outpatient SUD treatment. We examined whether receiving SUD treatment had a differential impact on cigarette smoking behaviors of mild (<10 cigarettes per day [CPD]), moderate (10-19 CPD), and heavy (>or=20 CPD) smokers (smoked on >or=60 days in the past 90). Our sample included 378 adolescents from the Cannabis Youth Treatment study, who were assessed at intake, and after 3, 6, 9, and 12 months. Results indicate that after controlling for the effect of changes in cannabis use, mild smokers decreased days of smoking during treatment and follow-up, whereas moderate and heavy smokers demonstrated a small decrease over treatment, and no change over follow-up. Heavy smokers demonstrated a slight decrease in CPD during the treatment phase. These results suggest that, whereas cigarette smoking may decrease for mild smokers while in SUD treatment, the addition of specialized smoking interventions may be necessary to effect change in cigarette smoking for moderate and heavy smokers. Copyright (c) 2009 APA, all rights reserved.

Payroll contracting for smoking cessation: a worksite pilot study.

PubMed

Jeffery, R W; Pheley, A M; Forster, J L; Kramer, F M; Snell, M K

1988-01-01

Twenty-one men and 38 women participated in a worksite smoking cessation/smoking reduction program that combined financial contracts, organized through payroll deduction, and biweekly group treatment sessions. At the end of the program the smoking cessation rate was 51%, validated by expired air carbon monoxide. Six months later the validated cessation rate was 12%. We conclude that payroll incentives may be effective in helping workers quit smoking and offer suggestions for ways to promote better maintenance of this important behavior change.

Capturing the Energy of Peer Pressure: Insights from a Longitudinal Study of Adolescent Cigarette Smoking.

ERIC Educational Resources Information Center

Newman, Ian M.

1984-01-01

Studies indicate that adolescents smoke to obtain a desirable image, rather than from direct pressure from peers. Suggestions for using peer influence to make favorable changes in health behaviors are offered. (DF)

Escalating doses of transdermal nicotine in heavy smokers: effects on smoking behavior and craving.

PubMed

Selby, Peter; Andriash, Katherine; Zawertailo, Laurie; Persad, Desmond; Zack, Martin; Busto, Usoa E

2013-10-01

Fixed-dose nicotine replacement therapy (NRT) is efficacious for smoking cessation in the general population of smokers. However, it is less effective in populations with psychiatric comorbidities and/or severe tobacco dependence where the percent nicotine replacement is suboptimal. The objective of this pilot study was to determine the effectiveness of nicotine patch dose titration in response to continued smoking in heavily dependent smokers with psychiatric comorbidity. In a single-arm, open-label study adult smokers (mean cigarettes per day, 25.4 ± 13.4; range, 14-43; n = 12) willing to quit were treated with escalating doses of transdermal nicotine and brief counseling intervention if they continued to smoke over a 9-week treatment period. Plasma nicotine and cotinine, along with expired carbon monoxide levels, and the subjective effects of smoking, urge to smoke, demand elasticity, and mood symptoms were also assessed. The mean NRT dose was 32.7 (SD, 16.4) mg/d (range, 7-56 mg/d). Smokers reported significant reductions in both cigarettes per day (mean decrease, 18.4 ± 11.5) confirmed by expired carbon monoxide (mean decrease, 13.5 ± 13.0) with no significant changes in plasma nicotine concentrations during the course of NRT dose titration. There were significant effects on the subjective effects of smoking and measures of smoking behavior. Most commonly reported adverse events were respiratory infections, skin irritation at patch site, nausea, and sleep disturbances, which were generally mild and transient. Titrating doses of NRT to effect with brief intervention hold promise as an effective clinical strategy to assist heavily dependent psychiatrically ill smokers to change their smoking behavior.

Counseling for health behavior change in people with COPD: systematic review.

PubMed

Williams, Marie T; Effing, Tanja W; Paquet, Catherine; Gibbs, Carole A; Lewthwaite, Hayley; Li, Lok Sze Katrina; Phillips, Anna C; Johnston, Kylie N

2017-01-01

Counseling has been suggested as a promising approach for facilitating changes in health behavior. The aim of this systematic review of counseling interventions for people with COPD was to describe: 1) counseling definitions, 2) targeted health behaviors, 3) counseling techniques and 4) whether commonalities in counseling techniques were associated with improved health behaviors. Ten databases were searched for original randomized controlled trials which included adults with COPD, used the term "counseling" as a sole or component of a multifaceted intervention and were published in the previous 10 years. Data extraction, study appraisal and coding for behavior change techniques (BCTs) were completed by two independent reviewers. Data were synthesized descriptively, with meta-analysis conducted where possible. Of the 182 studies reviewed as full-text, 22 were included. A single study provided a definition for counseling. Two key behaviors were the main foci of counseling: physical activity (n=9) and smoking cessation (n=8). Six studies (27%) reported underlying models and/or theoretical frameworks. Counseling was the sole intervention in 10 studies and part of a multicomponent intervention in 12. Interventions targeting physical activity included a mean of 6.3 (±3.1) BCTs, smoking cessation 4.9 (±2.9) BCTs and other behaviors 6.5 (±3.9) BCTs. The most frequent BCTs were social support unspecified (n=22; 100%), goal setting behavior (n=11), problem-solving (n=11) and instructions on how to perform the behavior (n=10). No studies shared identical BCT profiles. Counseling had a significant positive effect for smoking cessation and positive but not significant effect for physical activity. Counseling for health behavior change was rarely defined and effectiveness varied by target behavior. Provision of specific details when reporting studies of counseling interventions (definition, BCTs, dosage) would allow clarification of the effectiveness of counseling as an approach to health behavior change in people with COPD.

Counseling for health behavior change in people with COPD: systematic review

PubMed Central

Williams, Marie T; Effing, Tanja W; Paquet, Catherine; Gibbs, Carole A; Lewthwaite, Hayley; Li, Lok Sze Katrina; Phillips, Anna C; Johnston, Kylie N

2017-01-01

Counseling has been suggested as a promising approach for facilitating changes in health behavior. The aim of this systematic review of counseling interventions for people with COPD was to describe: 1) counseling definitions, 2) targeted health behaviors, 3) counseling techniques and 4) whether commonalities in counseling techniques were associated with improved health behaviors. Ten databases were searched for original randomized controlled trials which included adults with COPD, used the term “counseling” as a sole or component of a multifaceted intervention and were published in the previous 10 years. Data extraction, study appraisal and coding for behavior change techniques (BCTs) were completed by two independent reviewers. Data were synthesized descriptively, with meta-analysis conducted where possible. Of the 182 studies reviewed as full-text, 22 were included. A single study provided a definition for counseling. Two key behaviors were the main foci of counseling: physical activity (n=9) and smoking cessation (n=8). Six studies (27%) reported underlying models and/or theoretical frameworks. Counseling was the sole intervention in 10 studies and part of a multicomponent intervention in 12. Interventions targeting physical activity included a mean of 6.3 (±3.1) BCTs, smoking cessation 4.9 (±2.9) BCTs and other behaviors 6.5 (±3.9) BCTs. The most frequent BCTs were social support unspecified (n=22; 100%), goal setting behavior (n=11), problem-solving (n=11) and instructions on how to perform the behavior (n=10). No studies shared identical BCT profiles. Counseling had a significant positive effect for smoking cessation and positive but not significant effect for physical activity. Counseling for health behavior change was rarely defined and effectiveness varied by target behavior. Provision of specific details when reporting studies of counseling interventions (definition, BCTs, dosage) would allow clarification of the effectiveness of counseling as an approach to health behavior change in people with COPD. PMID:28794621

Nicotine addiction through a neurogenomic prism

PubMed Central

Caron, Lorraine; Karkazis, Katrina; Raffin, Thomas A.; Swan, Gary; Koenig, Barbara A.

2008-01-01

Studies are under way to examine the neurogenetic factors contributing to smoking behaviors. The combined approaches of genomics, molecular biology, neuroscience, and pharmacology are expected to fuel developments in pharmacogenetics, to create new genetic tests, and ultimately to provide the basis for innovative strategies for smoking cessation and prevention. The emergence of a neurogenomic understanding of nicotine addiction is likely to induce fundamental changes in popular, clinical, and public health views of smoking, which could significantly shape existing practices and policies to reduce tobacco use. Still a nascent area of research, nicotine addiction provides an excellent case study through which to anticipate key ethical and policy issues in both behavioral genetics and the neurogenomics of addictive behaviors. PMID:16036275

Smoking Cessation Intervention on Facebook: Which Content Generates the Best Engagement?

PubMed

Thrul, Johannes; Klein, Alexandra B; Ramo, Danielle E

2015-11-11

Social media offer a great opportunity to deliver smoking cessation treatment to young adults, but previous online and social media interventions targeting health behavior change have struggled with low participant engagement. We examined engagement generated by content based on the Transtheoretical Model of Behavior Change (TTM) in a motivationally tailored smoking cessation intervention on Facebook. This study aimed to identify which intervention content based on the TTM (Decisional Balance and 10 processes of change) generated the highest engagement among participants in pre-action stages of change (Precontemplation, Contemplation, and Preparation). Participants (N=79, 20% female, mean age 20.8) were assessed for readiness to quit smoking and assigned to one of 7 secret Facebook groups tailored to their stage of change. Daily postings to the groups based on TTM Decisional Balance and the 10 processes of change were made by research staff over 3 months. Engagement was operationalized as the number of participant comments to each post. TTM content-based predictors of number of comments were analyzed and stratified by baseline stage of change, using negative binomial regression analyses with and without zero inflation. A total of 512 TTM-based posts generated 630 individual comments. In Precontemplation and Contemplation groups, Decisional Balance posts generated above average engagement (P=.01 and P<.001). In Contemplation groups, posts based on the TTM processes Dramatic Relief and Self-Liberation resulted in below average engagement (P=.01 and P=.005). In Preparation groups, posts based on Consciousness Raising generated above average engagement (P=.009). Participant engagement decreased over time and differed between groups within Precontemplation and Contemplation stages, but was independent of day of the week and time of day the content was posted to the groups. No participant baseline characteristics significantly predicted engagement. Participants not ready to quit in the next 30 days (in Precontemplation or Contemplation) engaged most when prompted to think about the pros and cons of behavior change, while those in the Preparation stage engaged most when posts increased awareness about smoking and smoking cessation. Findings support tailoring intervention content to readiness to quit and suggest intervention components that may be most effective in generating high participant engagement on social media.

When Movies Matter: Exposure to Smoking in Movies and Changes in Smoking Behavior

PubMed Central

Dal Cin, Sonya; Stoolmiller, Mike; Sargent, James D.

2011-01-01

The authors investigated the association between exposure to smoking in movies and the initiation and progression of adolescent smoking over time among 6,522 U.S. adolescents (between the ages of 10 and 14 years, at baseline) in a nationally representative, 4-wave random-digit-dial telephone survey. They conducted a hazard (survival) analysis testing whether exposure to movie smoking and demographic, personality, social, and structural factors predict (a) earlier smoking onset and (b) faster transition to experimental (1–99 cigarettes/lifetime) and established smoking (>100 cigarettes/lifetime). Results suggest that higher exposure to movie smoking is associated with less time to trying cigarettes for the first time (adjusted hazard ratio = 1.66; 95% CI [1.37, 2.01]) but not with faster escalation of smoking behavior following initiation (adjusted hazard ratio = 1.53; 95% CI [0.84, 2.79]). In contrast, age, peer smoking, parenting style, and availability of cigarettes in the home were predictors of earlier onset and faster transition to established smoking. Thus, the authors concluded that the effect of exposure to mass-mediated images of smoking in movies may decline once adolescents have started to smoke, whereas peers and access to tobacco remain influential. PMID:22085232

When movies matter: exposure to smoking in movies and changes in smoking behavior.

PubMed

Dal Cin, Sonya; Stoolmiller, Mike; Sargent, James D

2012-01-01

The authors investigated the association between exposure to smoking in movies and the initiation and progression of adolescent smoking over time among 6,522 U.S. adolescents (between the ages of 10 and 14 years, at baseline) in a nationally representative, 4-wave random-digit-dial telephone survey. They conducted a hazard (survival) analysis testing whether exposure to movie smoking and demographic, personality, social, and structural factors predict (a) earlier smoking onset and (b) faster transition to experimental (1-99 cigarettes/lifetime) and established smoking (>100 cigarettes/lifetime). Results suggest that higher exposure to movie smoking is associated with less time to trying cigarettes for the first time (adjusted hazard ratio = 1.66; 95% CI [1.37, 2.01]) but not with faster escalation of smoking behavior following initiation (adjusted hazard ratio = 1.53; 95% CI [0.84, 2.79]). In contrast, age, peer smoking, parenting style, and availability of cigarettes in the home were predictors of earlier onset and faster transition to established smoking. Thus, the authors concluded that the effect of exposure to mass-mediated images of smoking in movies may decline once adolescents have started to smoke, whereas peers and access to tobacco remain influential.

Hooked on a feeling: affective anti-smoking messages are more effective than cognitive messages at changing implicit evaluations of smoking

PubMed Central

Smith, Colin Tucker; De Houwer, Jan

2015-01-01

Because implicit evaluations are thought to underlie many aspects of behavior, researchers have started looking for ways to change them. We examine whether and when persuasive messages alter strongly held implicit evaluations of smoking. In smokers, an affective anti-smoking message led to more negative implicit evaluations on four different implicit measures as compared to a cognitive anti-smoking message which seemed to backfire. Additional analyses suggested that the observed effects were mediated by the feelings and emotions raised by the messages. In non-smokers, both the affective and cognitive message engendered slightly more negative implicit evaluations. We conclude that persuasive messages change implicit evaluations in a way that depends on properties of the message and of the participant. Thus, our data open new avenues for research directed at tailoring persuasive messages to change implicit evaluations. PMID:26557099

Hooked on a feeling: affective anti-smoking messages are more effective than cognitive messages at changing implicit evaluations of smoking.

PubMed

Smith, Colin Tucker; De Houwer, Jan

2015-01-01

Because implicit evaluations are thought to underlie many aspects of behavior, researchers have started looking for ways to change them. We examine whether and when persuasive messages alter strongly held implicit evaluations of smoking. In smokers, an affective anti-smoking message led to more negative implicit evaluations on four different implicit measures as compared to a cognitive anti-smoking message which seemed to backfire. Additional analyses suggested that the observed effects were mediated by the feelings and emotions raised by the messages. In non-smokers, both the affective and cognitive message engendered slightly more negative implicit evaluations. We conclude that persuasive messages change implicit evaluations in a way that depends on properties of the message and of the participant. Thus, our data open new avenues for research directed at tailoring persuasive messages to change implicit evaluations.

Promising Themes for Antismoking Campaigns Targeting Youth and Young Adults.

PubMed

Brennan, Emily; Gibson, Laura A; Kybert-Momjian, Ani; Liu, Jiaying; Hornik, Robert C

2017-01-01

Behavior change campaigns typically try to change beliefs that influence behaviors, with targeted beliefs comprising the campaign theme. We present an empirical approach for choosing among a large number of potential themes, and results from the implementation of this approach for campaigns aimed at 4 behavioral targets: (1) preventing smoking initiation among youth, and (2) preventing initiation, (3) stopping progression to daily smoking and (4) encouraging cessation among young adults. An online survey of 13- to 17-year-olds and 18- to 25-year-olds in the United States (US), in which 20 potential campaign themes were represented by 154 beliefs. For each behavioral target, themes were ranked based on the strength of belief-intention and belief-behavior associations and size of the population not already endorsing the beliefs. The most promising themes varied across behavioral targets but 3 were consistently promising: consequences of smoking for mood, social acceptance and social popularity. Using a robust and systematic approach, this study provides campaign developers with empirical data to inform their selection of promising themes. Findings related to the campaign to prevent initiation among youth informed the development of the US Food and Drug Administration's "The Real Cost" campaign.

Promising Themes for Antismoking Campaigns Targeting Youth and Young Adults

PubMed Central

Brennan, Emily; Gibson, Laura A.; Kybert-Momjian, Ani; Liu, Jiaying; Hornik, Robert C.

2017-01-01

Objectives Behavior change campaigns typically try to change beliefs that influence behaviors, with targeted beliefs comprising the campaign theme. We present an empirical approach for choosing among a large number of potential themes, and results from the implementation of this approach for campaigns aimed at 4 behavioral targets: (1) preventing smoking initiation among youth, and (2) preventing initiation, (3) stopping progression to daily smoking and (4) encouraging cessation among young adults. Methods An online survey of 13- to 17-year-olds and 18- to 25-year-olds in the United States (US), in which 20 potential campaign themes were represented by 154 beliefs. For each behavioral target, themes were ranked based on the strength of belief-intention and belief-behavior associations and size of the population not already endorsing the beliefs. Results The most promising themes varied across behavioral targets but 3 were consistently promising: consequences of smoking for mood, social acceptance and social popularity. Conclusions Using a robust and systematic approach, this study provides campaign developers with empirical data to inform their selection of promising themes. Findings related to the campaign to prevent initiation among youth informed the development of the US Food and Drug Administration’s “The Real Cost” campaign. PMID:28989949

Detection of Hand-to-Mouth Gestures Using a RF Operated Proximity Sensor for Monitoring Cigarette Smoking.

PubMed

Lopez-Meyer, Paulo; Patil, Yogendra; Tiffany, Tiffany; Sazonov, Edward

2013-01-01

Common methods for monitoring of cigarette smoking, such as portable puff-topography instruments or self-report questionnaires, tend to be biased due to conscious or unconscious underreporting. Additionally, these methods may change the natural smoking behavior of individuals. Our long term objective is the development of a wearable non-invasive monitoring system (Personal Automatic Cigarette Tracker - PACT) to reliably monitor cigarette smoking behavior under free living conditions. PACT monitors smoking by observing characteristic breathing patterns of smoke inhalations that follow a cigarette-to-mouth hand gesture. As envisioned, PACT does not rely on self-report or require any conscious effort from the user. A major element of the PACT is a proximity sensor that detects typical cigarette-to-mouth gesture during cigarette smoking. This study describes the design and validation of a prototype RF proximity sensor that captures hand-to-mouth gestures with a high sensitivity (0.90), and a methodology that can reject up to 68% of artifacts gestures originating from activities other than cigarette smoking.

Predicting Relationship of Smoking Behavior Among Male Saudi Arabian College Students Related to Their Religious Practice.

PubMed

Almutairi, Khalid M

2016-04-01

This study describes the relationships of smoking behavior among a sample of male college students in Kingdom of Saudi Arabia (KSA) to their religious practice, parents' smoking behaviors and attitudes, peers' smoking behaviors and attitudes, and knowledge about the dangers of smoking. A 49-item questionnaire was developed and pilot tested in KSA. This questionnaire was completed during the academic year 2013 by 715 undergraduate male students at the King Saud University in Riyadh. 29.8% of the students were smokers (13.8% cigarette smokers, 7.3% sheesha smokers, and 27% cigarette and sheesha smokers). Students in the College of Education were much more likely to be smokers than the students in the College of Science. The differences between the College of Education and the College of Science was statistically significant (χ (2) = 16.864. df = 1, p = .001). Logistic regression analysis suggested that students who were more faithful in their practice of Islam were 15% less likely to smoke. Students who were more knowledgeable about the dangers of smoking were 8% less likely to smoke. The logistic analysis identified peers (friends) as the most powerful factor in predicting smoking. The four-factor model had an overall classification accuracy of 78%. The need to understand more fully the dynamics of peer relations among Saudi Arabian males as a basis for developing tobacco education/prevention programs. Prevention programs will need to include education and changes in the college level or earlier in KSA.

Effect of stressful life events on changes in smoking among the French: longitudinal findings from GAZEL

PubMed Central

Okechukwu, Cassandra; Marino, Miguel; Guéguen, Alice; Goldberg, Marcel; Zins, Marie

2015-01-01

Background: Changes in life events may play a contributing role in changes in smoking behaviors. The objective was to examine the impact of stressful life events (SLEs) on smoking among French adults. Methods: We examined smoking prevalence in 20 625 employees of the French GAZEL cohort for up to 5 years before and after a SLE during three time periods (years −1 vs. −5; years +1 vs. −1; years +5 vs. +1). Repeated measures analysis of time series data indexed to events were used, employing generalized estimating equations. Results: For women, comparing 1 year after vs. 1 year before SLEs, decreased odds of smoking were found for employment promotion (OR: 0.80; 95% CI = 0.67–0.95), marriage (OR: 0.57; 95% CI = 0.48–0.68) and divorce (OR: 0.78; 95% CI = 0.68–0.90). Comparing 5 years after to 1 year after SLEs, women had decreased odds of smoking for important purchase (OR: 0.87; 95% CI = 0.79–0.96), children leaving home (OR: 0.83; 95% CI = 0.74–0.93), retirement (OR: 0.73; 95% CI = 0.64–0.83) and death of loved one (OR: 0.86; 95% CI = 0.79–0.93). For men, decreased odds of smoking were observed in all three time periods for all SLEs except when comparing 1 year before to 5 years before marriage (OR: 1.66; 95% CI = 1.09–2.52) and divorce (OR: 1.49; 95% CI = 1.25–1.77). Conclusion: Time surrounding SLEs during which individuals are susceptible to changing smoking behaviors may be an important consideration. PMID:25762691

Effect of stressful life events on changes in smoking among the French: longitudinal findings from GAZEL.

PubMed

Tamers, Sara L; Okechukwu, Cassandra; Marino, Miguel; Guéguen, Alice; Goldberg, Marcel; Zins, Marie

2015-08-01

Changes in life events may play a contributing role in changes in smoking behaviors. The objective was to examine the impact of stressful life events (SLEs) on smoking among French adults. We examined smoking prevalence in 20 625 employees of the French GAZEL cohort for up to 5 years before and after a SLE during three time periods (years -1 vs. -5; years +1 vs. -1; years +5 vs. +1). Repeated measures analysis of time series data indexed to events were used, employing generalized estimating equations. For women, comparing 1 year after vs. 1 year before SLEs, decreased odds of smoking were found for employment promotion (OR: 0.80; 95% CI = 0.67-0.95), marriage (OR: 0.57; 95% CI = 0.48-0.68) and divorce (OR: 0.78; 95% CI = 0.68-0.90). Comparing 5 years after to 1 year after SLEs, women had decreased odds of smoking for important purchase (OR: 0.87; 95% CI = 0.79-0.96), children leaving home (OR: 0.83; 95% CI = 0.74-0.93), retirement (OR: 0.73; 95% CI = 0.64-0.83) and death of loved one (OR: 0.86; 95% CI = 0.79-0.93). For men, decreased odds of smoking were observed in all three time periods for all SLEs except when comparing 1 year before to 5 years before marriage (OR: 1.66; 95% CI = 1.09-2.52) and divorce (OR: 1.49; 95% CI = 1.25-1.77). Time surrounding SLEs during which individuals are susceptible to changing smoking behaviors may be an important consideration. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Meanings of smoking and adolescent smoking across ethnicities.

PubMed

Spruijt-Metz, Donna; Gallaher, Peggy E; Unger, Jennifer B; Anderson-Johnson, Carl

2004-09-01

To develop insight into population-specific meanings of smoking in our highly multicultural middle schools in order to provide effective and appropriate tools for smoking prevention efforts. We used focus group interviews to develop the Meanings of Smoking Index (MSI), a nine-item scale that uses a "mark all that apply" strategy to assess what smoking means to children who have tried smoking as well as to those who are susceptible to smoking. In 24 public and parochial middle schools in the greater Los Angeles area, 2336 7th graders (1483 Latino, 565 Asian/ Pacific Islander and 288 white, 55.2% of the sample was female) completed the MSI as part of a school-based trial of culturally-targeted smoking prevention strategies. Items were rank ordered according to salience (rate of endorsement) and relevance (strength of relationship with lifetime smoking) across the entire sample and separately for Hispanic/Latino, Asian/Asian-American and white respondents. Spearman correlation coefficient was used to compare results between ethnicities. The most frequently endorsed meanings were similar across ethnicities. Magnitude of associations between smoking behaviors and meanings were dissimilar across ethnicities. The meaning with the strongest relationship to lifetime smoking for whites and Latinos was "it helps me study" (OR 3.4 and 2.6 respectively), and for Asians was "don't want to make another smoke alone" (OR 5.4). We have shown previously that interventions on meanings of eating behaviors changed dietary behaviors in adolescents. The present findings suggest that meanings are powerful determinants of adolescent smoking in culturally diverse populations and could offer powerful intervention tools to prevent adolescent smoking.

Assessing the impact of the national smoking ban in indoor public places in china: evidence from quit smoking related online searches.

PubMed

Huang, Jidong; Zheng, Rong; Emery, Sherry

2013-01-01

Despite the tremendous economic and health costs imposed on China by tobacco use, China lacks a proactive and systematic tobacco control surveillance and evaluation system, hampering research progress on tobacco-focused surveillance and evaluation studies. This paper uses online search query analyses to investigate changes in online search behavior among Chinese Internet users in response to the adoption of the national indoor public place smoking ban. Baidu Index and Google Trends were used to examine the volume of search queries containing three key search terms "Smoking Ban(s)," "Quit Smoking," and "Electronic Cigarette(s)," along with the news coverage on the smoking ban, for the period 2009-2011. Our results show that the announcement and adoption of the indoor public place smoking ban in China generated significant increases in news coverage on smoking bans. There was a strong positive correlation between the media coverage of smoking bans and the volume of "Smoking Ban(s)" and "Quit Smoking" related search queries. The volume of search queries related to "Electronic Cigarette(s)" was also correlated with the smoking ban news coverage. To the extent it altered smoking-related online searches, our analyses suggest that the smoking ban had a significant effect, at least in the short run, on Chinese Internet users' smoking-related behaviors. This research introduces a novel analytic tool, which could serve as an alternative tobacco control evaluation and behavior surveillance tool in the absence of timely or comprehensive population surveillance system. This research also highlights the importance of a comprehensive approach to tobacco control in China.

Policy support, norms, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico city.

PubMed

Thrasher, James F; Pérez-Hernández, Rosaura; Swayampakala, Kamala; Arillo-Santillán, Edna; Bottai, Matteo

2010-09-01

We assessed attitudes and beliefs about smoke-free laws, compliance, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico City. Trends and odds of change in attitudes and beliefs were analyzed across 3 representative surveys of Mexico City inhabitants: before implementation of the policy (n=800), 4 months after implementation (n=961), and 8 months after implementation (n=761). Results indicated high and increasing support for 100% smoke-free policies, although support did not increase for smoke-free bars. Agreement that such policies improved health and reinforced rights was high before policy implementation and increased thereafter. Social unacceptability of smoking increased substantially, although 25% of nonsmokers and 50% of smokers agreed with smokers' rights to smoke in public places at the final survey wave. Secondhand smoke exposure declined generally as well as in venues covered by the law, although compliance was incomplete, especially in bars. Comprehensive smoke-free legislation in Mexico City has been relatively successful, with changes in perceptions and behavior consistent with those revealed by studies conducted in high-income countries. Normative changes may prime populations for additional tobacco control interventions.

Developing a method for specifying the components of behavior change interventions in practice: the example of smoking cessation.

PubMed

Lorencatto, Fabiana; West, Robert; Seymour, Natalie; Michie, Susan

2013-06-01

There is a difference between interventions as planned and as delivered in practice. Unless we know what was actually delivered, we cannot understand "what worked" in effective interventions. This study aimed to (a) assess whether an established taxonomy of 53 smoking cessation behavior change techniques (BCTs) may be applied or adapted as a method for reliably specifying the content of smoking cessation behavioral support consultations and (b) develop an effective method for training researchers and practitioners in the reliable application of the taxonomy. Fifteen transcripts of audio-recorded consultations delivered by England's Stop Smoking Services were coded into component BCTs using the taxonomy. Interrater reliability and potential adaptations to the taxonomy to improve coding were discussed following 3 coding waves. A coding training manual was developed through expert consensus and piloted on 10 trainees, assessing coding reliability and self-perceived competence before and after training. An average of 33 BCTs from the taxonomy were identified at least once across sessions and coding waves. Consultations contained on average 12 BCTs (range = 8-31). Average interrater reliability was high (88% agreement). The taxonomy was adapted to simplify coding by merging co-occurring BCTs and refining BCT definitions. Coding reliability and self-perceived competence significantly improved posttraining for all trainees. It is possible to apply a taxonomy to reliably identify and classify BCTs in smoking cessation behavioral support delivered in practice, and train inexperienced coders to do so reliably. This method can be used to investigate variability in provision of behavioral support across services, monitor fidelity of delivery, and identify training needs.

Effects of bupropion on simulated demand for cigarettes and the subjective effects of smoking.

PubMed

Madden, Gregory J; Kalman, David

2010-04-01

The biobehavioral mechanism(s) mediating bupropion's efficacy are not well understood. Behavioral economic measures such as demand curves have proven useful in investigations of the reinforcing effects of drugs of abuse. Behavioral economic measures may also be used to measure the effect of pharmacotherapies on the reinforcing effects of drugs of abuse. The effects of bupropion on simulated demand for cigarettes were investigated in a placebo-controlled double-blind clinical trial. Participants reported the number of cigarettes they would purchase and consume in a single day at a range of prices. The effects of medication on the subjective effects of smoking were also explored. Demand for cigarettes was well described by an exponential demand equation. Bupropion did not significantly decrease the maximum number of cigarettes that participants said they would smoke in a single day nor did it significantly alter the relation between price per cigarette and demand. Baseline demand elasticity did not predict smoking cessation, but changes in elasticity following 1 week of treatment did. Medication group had no effect on any subjective effects of smoking. Bupropion had no significant effects on demand for cigarettes. The exponential demand equation, recently introduced in behavioral economics, proved amenable to human simulated demand and might be usefully employed in other pharmacotherapy studies as it provides a potentially useful measure of changes in the essential value of the drug as a reinforcer. Such changes may be useful in predicting the efficacy of medications designed to reduce drug consumption.

Differences in ERP topographies during color matching of smoking-related and neutral pictures in smokers and non-smokers.

PubMed

Fehr, Thorsten; Wiedenmann, Patrick; Herrmann, Manfred

2007-09-01

The concept of a specific memory network that drives addictive behavior has often been discussed in relation to the phenomenon of sudden relapse into addiction after years of abstinence. But there is still a lack of data that shows a link between drug-related cue processing and specific changes of behavior in addicts. In the present study we investigated the relationship between smoking-related picture processing, performance in a color matching task, and ERP topographies. Fifteen smokers and 19 non-smoking participants performed a color matching task including monochromic pictures with smoking-related and neutral content. Smokers and non-smokers showed remarkable differences between stimulus category-related ERP topographies. Furthermore, both smokers and non-smokers showed increased reaction times during color matching when the picture contents were related to smoking behavior. The results are discussed with respect to different drug-cue-related patterns of information processing in smokers and non-smokers.

Social-cognitive beliefs, alcohol, and tobacco use: a prospective community study of change following a ban on smoking in public places.

PubMed

Orbell, Sheina; Lidierth, Patrick; Henderson, Caroline J; Geeraert, Nicolas; Uller, Claudia; Uskul, Ayse K; Kyriakaki, Maria

2009-11-01

To examine social-cognitive change associated with behavior change after the introduction of a smoke-free public places policy. Adults (N = 583) who use public houses licensed to sell alcohol (pubs) completed questionnaires assessing alcohol and tobacco consumption and social-cognitive beliefs 2 months prior to the introduction of the smoking ban in England on July 1, 2007. Longitudinal follow-up (N = 272) was 3 months after the introduction of the ban. Social-cognitive beliefs, daily cigarette consumption, and weekly alcohol consumption. Smokers consumed considerably more alcohol than did nonsmokers at both time points. However, a significant interaction of Smoking Status x Time showed that while smokers had consumed fewer units of alcohol after the ban, nonsmokers showed an increase over the same period. There was a significant reduction in number of cigarettes consumed after the ban. Subjective norms concerning not smoking, and perceived severity of smoking-related illness increased across time. Negative outcomes associated with not smoking were reduced among former smokers and increased across time among smokers. Regression analyses showed that changes in subjective norm and negative outcome expectancies accounted for significant variance in change in smoking across time. Results suggest that the smoking ban may have positive health benefits that are supported by social-cognitive change. PsycINFO Database Record (c) 2009 APA, all rights reserved.

Reward-related frontostriatal activity and smoking behavior among adolescents in treatment for smoking cessation.

PubMed

Garrison, Kathleen A; Yip, Sarah W; Balodis, Iris M; Carroll, Kathleen M; Potenza, Marc N; Krishnan-Sarin, Suchitra

2017-08-01

Tobacco use is often initiated during adolescence and continued into adulthood despite desires to quit. A better understanding of the neural correlates of abstinence from smoking in adolescents may inform more effective smoking cessation interventions. Neural reward systems are implicated in tobacco use disorder, and adolescent smokers have shown reduced reward-related ventral striatal activation related to increased smoking. The current study evaluated nondrug reward anticipation in adolescent smokers using a monetary incentive delay task in fMRI pre- and post- smoking cessation treatment (n=14). This study tested how changes in neural responses to reward anticipation pre- to post-treatment were related to reduced smoking. An exploratory analysis in a larger sample of adolescents with only pre-treatment fMRI (n=28) evaluated how neural responses to reward anticipation were related to behavioral inhibition and behavioral activation scales. Adolescent smokers showed pre- to post-treatment increases in reward anticipation-related activity in the bilateral nucleus accumbens and insula, and medial prefrontal cortex, and greater increases in reward anticipation-related activity were correlated with larger percent days of smoking abstinence during treatment. These findings suggest that reduced smoking during smoking cessation treatment is associated with a "recovery of function" in frontostriatal responses to nondrug reward anticipation in adolescent smokers, although comparison with a developmental control group of adolescent nonsmokers is warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

Cue reactivity in converted and native intermittent smokers.

PubMed

Shiffman, Saul; Dunbar, Michael S; Kirchner, Thomas R; Li, Xiaoxue; Tindle, Hilary A; Anderson, Stewart J; Scholl, Sarah M; Ferguson, Stuart G

2015-01-01

Nondaily, or intermittent smokers (ITS), who constitute a substantial fraction of U.S. smokers, are thought to smoke in response to cues. Previous cue reactivity research showed no difference between ITS and daily smokers in response to cues. This report examines whether "converted" ITS (CITS) with a history of past daily smoking differ from "native" ITS (NITS) in craving and smoking in response to cues. A total of 146 CITS (who previously smoked daily for at least 6 months) and 73 NITS participated. Participants were exposed to 5 active cues (smoking, alcohol, negative affect, positive affect, and smoking prohibitions) and a control neutral cue, in separate sessions. Changes in craving were assessed pre-post cue exposure. Smoking behavior (smoking [y/n], smoking latency, number of cigarettes, number of puffs, and increase in carbon monoxide [CO]) was observed. Analyses contrasted response to each active cue compared to the neutral cue and controlled for order effects and for time since last cigarette, which differed between groups. Regardless of cues, CITS reported higher craving and greater change in craving, were more likely to smoke, tended to progress faster to smoking, and showed greater increases in CO when they did smoke. NITS and CITS showed similar cue reactivity on most measures, though NITS took more puffs after viewing smoking cues (compared to neutral) than did CITS. Though CITS show some remnants of their history of daily smoking, CITS and NITS demonstrate similar cue reactivity, suggesting that they would not require different behavioral approaches to help them quit. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Social imagery, tobacco independence, and the truthsm campaign.

PubMed

Evans, W Douglas; Price, Simani; Blahut, Steven; Hersey, James; Niederdeppe, Jeffrey; Ray, Sarah

2004-01-01

This study investigated relationships among exposure to the truthsm campaign, differences in social imagery about not smoking and related measures, and smoking behavior. We asked, "How does truthsm work? Through what psychological mechanisms does it affect smoking behavior?" We developed a framework to explain how receptivity to truthsm ads might influence youth cognitive states and subsequent effects on progression to established smoking. The main hypotheses were that social imagery about not smoking and related beliefs and attitudes about tobacco use mediate the relationship between truthsm exposure and smoking status. The study was based on data from the Legacy Media Tracking Survey (LMTS), waves I-III, which were conducted at three time points from 1999 through 2001. A nationally representative sample of 20,058 respondents aged 12-24 from the three time points was used in the analysis. We developed a structural equation model (SEM) based on constructs drawn from the LMTS. We investigated the model and tested our hypotheses about the psychological and behavioral effects of campaign exposure. We tested our constructs and model using a two-stage structural equation modeling approach. We first conducted a confirmatory factor analysis (CFA) to test the measurement model. Our model achieved satisfactory fit, and we conducted the SEM to test our hypotheses. We found that social imagery and perceived tobacco independence mediate the relationship between truthsm exposure and smoking status. We found meaningful differences between paths for segmented samples based on age, gender, and race/ethnicity subgroups and over time. The truthsm campaign operates through individuals'sense of tobacco independence and social imagery about not smoking. This study indicates that the campaign's strategy has worked as predicted and represents an effective model for social marketing to change youth risk behaviors. Future studies should further investigate subgroup differences in campaign reactions and utilize contextual information about the truthsm campaign's evolution to explain changes in reactions over time.

Longitudinal patterns and predictors of multiple health risk behaviors among adolescents: The TRAILS study.

PubMed

de Winter, Andrea F; Visser, Leenke; Verhulst, Frank C; Vollebergh, Wilma A M; Reijneveld, Sijmen A

2016-03-01

Most studies on multiple health risk behaviors among adolescents have cross-sectionally studied a limited number of health behaviors or determinants. To examine the prevalence, longitudinal patterns and predictors of individual and multiple health risk behaviors among adolescents. Eight health risk behaviors (no regular consumption of fruit, vegetables or breakfast, overweight or obesity, physical inactivity, smoking, alcohol use and cannabis use) were assessed in a prospective population study (second and third wave). Participants were assessed in three waves between ages 10 and 17 (2001-2008; n=2230). Multiple linear regression was used to assess the influence of gender, self-control, parental health risk behaviors, parental monitoring and socioeconomic factors on the number of health risk behaviors adjusted for preceding multiple health risk behaviors (analysis: 2013-2014). Rates of >5 health risk behaviors were high: 3.6% at age 13.5 and 10.2% at age 16. Smoking at age 13.5 was frequently associated with health risk behaviors at age 16. No regular consumption of fruit, vegetables and breakfast, overweight or obesity, physical inactivity and smoking predicted the co-occurrence of health risk behaviors at follow-up. Significant predictors of the development of multiple health risk behaviors were adolescents' levels of self-control, socioeconomic status and maternal smoking. Multiple health risk behaviors are common among adolescents. Individual and social factors predict changes in multiple health risk behaviors, showing that prevention targeting multiple risk behaviors is needed. Special attention should be paid to adolescents with low self-control and families with low socioeconomic status or a mother who smokes. Copyright © 2015 Elsevier Inc. All rights reserved.

Smoking Beliefs Among Chinese Secondary School Students: A Theory-Based Qualitative Study.

PubMed

Zhao, Xiang; White, Katherine M; Young, Ross McD; Obst, Patricia L

2018-02-07

China has the world's greatest number of smokers but theory-based smoking interventions are rare. To develop an effective intervention, understanding the determinants of Chinese adolescent smoking is crucial. The Theory of Planned Behavior (TPB) is empirically supported to predict and assist in informing intervention strategies to change health-related behaviors. Based on the TPB, the elicitation of shared smoking beliefs among adolescents can inform future intervention designs among this at-risk population. We investigated the beliefs from six focus groups (N = 30) of one senior secondary school in Kunming, Yunnan Province, China. We used semi-structured questions based on the TPB framework, including prompts about behavioral (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs. Following the Consensual Qualitative Research (CQR) methodology, data were discussed until consensus was reached. Auditing was undertaken by an external researcher. Seven domains (advantages, disadvantages, approvers, disapprovers, facilitators, barriers, and smoker images) were examined. Smoking as a gendered behavior, smoking as influenced by cultural and environmental contexts, smoking as a strategy to cope with stress, and awareness of the harm of smoking, are highlighted themes across domains. Data suggested an extended-TPB framework as an appropriate approach to adopt when addressing smoking beliefs among the target population. These beliefs can be utilized to inform future school-based interventions and public health campaigns targeting smoking among Chinese adolescents. A modified TPB approach has potential for future smoking interventions among Chinese adolescents. Beliefs elicited in this study form a strong basis for designing a location- and population-specific antismoking programme. © The Author 2017. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

'They don't live in my house every day': How understanding lives can aid understandings of smoking.

PubMed

Robinson, Jude; Holdsworth, Clare

2013-03-01

While the prevalence of smoking in western countries has substantially reduced following the introduction of comprehensive tobacco control programs, reduction strategies such as the introduction of smokefree legislation, media campaigns and individual and group support for people trying to quit have been less successful with people living on low income, suggesting the need for new ways to engage with people who smoke. We argue that, rather than focusing solely on researching smoking behaviors to generate new understandings of why people smoke, people working in the broad area of public health should look more widely at peoples' lives in order to understand their smoking. Using a biographical, narrative perspective as part of a wider ethnographic study of 12 families living in one community within Liverpool in 2006, we argue that understandings that position smoking purely as a harmful, deviant behavior, fail to capture the cultural complexity of the lives of smokers and the changing place and meaning of cigarettes over a person's lifetime, and may explain why smokers fail to engage with smoking cessation services and continue to smoke.

Readiness to Quit Smoking and Quit Attempts Among Australian Mental Health Inpatients

PubMed Central

2013-01-01

Introduction: Mental health inpatients smoke at higher rates than general population smokers. However, provision of nicotine-dependence treatment in inpatient settings is low, with barriers to the provision of such care including staff views that patients do not want to quit. This paper reports the findings of a survey of mental health inpatients at a psychiatric hospital in New South Wales, Australia, assessing smoking and quitting motivations and behaviors. Methods: Smokers (n = 97) were surveyed within the inpatient setting using a structured survey tool, incorporating the Fagerström Test for Nicotine Dependence, Reasons for Quitting Scale, Readiness and Motivation to Quit Smoking Questionnaire, and other measures of smoking and quitting behavior. Results: Approximately 47% of smokers reported having made at least one quit attempt within the past 12 months, despite nearly three quarters (71.2%) being classified as in a “precontemplative” stage of change. Multinomial logistic regressions revealed that self-reporting “not enjoying being a smoker” and having made a quit attempt in the last 12 months predicted having advanced beyond a precontemplative stage of change. A high self-reported desire to quit predicted a quit attempt having been made in the last 12 months. Conclusions: The majority of smokers had made several quit attempts, with a large percentage occurring recently, suggesting that the actual quitting behavior should be considered as an important indication of the “desire to quit.” This paper provides further data supporting the assertion that multimodal smoking cessation interventions combining psychosocial and pharmacological support should be provided to psychiatric inpatients who smoke. PMID:23089486

Attitudes and beliefs about smoking among African-American college students at historically black colleges and universities.

PubMed

Powe, Barbara D; Ross, Louie; Cooper, Dexter L

2007-04-01

Smoking rates are lower among African Americans compared to Caucasians, but African Americans have higher lung cancer mortality. Guided by the Powe Fatalism Model, this descriptive study reports on attitudes and beliefs and predictors of lifetime cigarette smoking behaviors among students at historically black colleges and universities (HBCUs). Data were collected using the Attitudes and Beliefs about Perceived Consequences of Smoking Scale and a Demographic Data Questionnaire. The majority (N = 438) were female and single. More than 50% reported trying cigarettes in their lifetime and reported smoking a whole cigarette at age 15.5 years. Only 7.5% of the sample were lifetime smokers. The likelihood that a student would smoke was 15 times greater if their friends smoked and almost seven times greater if they were not members of a Greek organization compared to other students. Males associated smoking with self-confidence, endorsed the emotional benefits and influencing factors of smoking compared to females. Intervention efforts should focus on preventing the initiation of smoking as well as cessation efforts for students at HBCUs. Campus clubs and organizations can play a vital role in long-term changes in smoking behaviors for these students.

Embedded health behaviors from adolescence to adulthood: the impact of tobacco.

PubMed

Booth-Butterfield, Melanie

2003-01-01

Prevention of cancer risk behaviors before they become embedded in an individual's life is crucial. Health-related behaviors should be viewed for their embeddedness, critical aspects of which are (a) the complexity of the behavior itself; (.b) factors, both biological and psychological, within the individual communicator; (c) and external situational or sociocultural factors. The more extensively a behavior is embedded, the more difficult it will be to alter. Relative levels of embeddedness of the risk behavior and its entanglement with other nonrisky behaviors will evolve and change throughout one's life course. Smoking across the life span provides an excellent example of a thoroughly integrated, embedded behavior. How smoking is embedded with other behaviors changes from adolescence, where biological factors may be less salient and habit strength less pronounced, through adulthood, where habit strength is greater but health concerns are a more predictive factor. Researchers can produce more focused communication interventions by examining how health-endangering behaviors are embedded among benign behaviors or among other potentially dangerous behaviors. Ideally, the pattern of health behavior embeddedness should be analyzed prior to developing intervention communication strategies.

An application of the Continuous Opinions and Discrete Actions (CODA) model to adolescent smoking initiation.

PubMed

Sun, Ruoyan; Mendez, David

2017-01-01

We investigated the impact of peers' opinions on the smoking initiation process among adolescents. We applied the Continuous Opinions and Discrete Actions (CODA) model to study how social interactions change adolescents' opinions and behaviors about smoking. Through agent-based modeling (ABM), we simulated a population of 2500 adolescents and compared smoking prevalence to data from 9 cohorts of adolescents in the National Survey on Drug Use and Health (NSDUH) from year 2001 till 2014. Our model adjusts well for NSDUH data according to pseudo R2 values, which are at least 96%. Optimal parameter values indicate that adolescents exhibit imitator characteristics with regard to smoking opinions. The imitator characteristics suggests that teenagers tend to update their opinions consistently according to what others do, and these opinions later translate into smoking behaviors. As a result, peer influence from social networks plays a big role in the smoking initiation process and should be an important driver in policy formulation.

Monitoring the tobacco use epidemic II. The Agent: Current and Emerging Tobacco Products

PubMed Central

Stellman, Steven D.; Djordjevic, Mirjana V.

2009-01-01

Objective This Agent paper summarizes the findings and recommendations of the Agent (product) Working Group of the November, 2002, National Tobacco Monitoring, Research and Evaluation Workshop. Methods The Agent Working Group evaluated the need to develop new surveillance systems for quantifying ingredients and emissions of tobacco and tobacco smoke and to improve methods to assess uptake and metabolism of these constituents taking into account variability in human smoking behavior. Results The toxic properties of numerous tobacco and tobacco smoke constituents are well known, yet systematic monitoring of tobacco products has historically been limited to tar, nicotine, and CO in mainstream cigarette smoke using a machine-smoking protocol that does not reflect human smoking behavior. Toxicity of smokeless tobacco products has not been regularly monitored. Tobacco products are constantly changing and untested products are introduced into the marketplace with great frequency, including potential reduced-exposure products (PREPs). The public health impact of new or modified tobacco products is unknown. Conclusions Systematic surveillance is recommended for mainstream smoke constituents such as polycyclic aromatic hydrocarbons (PAH), tobacco-specific nitrosamines (TSNA), total and free-base nicotine, volatile organic compounds, aromatic amines, and metals; and design attributes including tobacco blend, additives, and filter ventilation. Research on smoking topography is recommended to help define machine-smoking protocols for monitoring emissions reflective of human smoking behavior. Recommendations are made for marketplace product sampling and for population monitoring of smoking topography, emissions of toxic constituents, biomarkers of exposure and, eventually, risk of tobacco-related diseases. PMID:18848577

From Willingness to Intention: Experience Moderates the Shift From Reactive to Reasoned Behavior

PubMed Central

Pomery, Elizabeth A.; Gibbons, Frederick X.; Reis-Bergan, Monica; Gerrard, Meg

2009-01-01

Three studies compared the predictive validity of three proximal antecedents to risk behavior: behavioral intention (BI), behavioral expectation (BE), and behavioral willingness (BW). In Study 1, BW was the only significant predictor of change in substance use in early adolescence (age 13), whereas only BI was significant in middle adolescence (age 16). In Study 2, BW was a better predictor of change in smoking among young adolescents than was BE, but BE became predominant by middle adolescence. By late adolescence, previous behavior surpassed both BE and BW. When only smoking initiation was examined, BW was a better predictor than was BE. In Study 3, BI, BW, and BE independently predicted class skipping. However, BI was a better predictor for students more experienced with the behavior, whereas BW was superior for less experienced students. The findings provide evidence of a developmental shift from more reactive to more reasoned processing, as experience with the behavior increases. PMID:19429884

Romantic attraction and adolescent smoking trajectories.

PubMed

Pollard, Michael S; Tucker, Joan S; Green, Harold D; Kennedy, David P; Go, Myong-Hyun

2011-12-01

Research on sexual orientation and substance use has established that lesbian, gay, and bisexual (LGB) individuals are more likely to smoke than heterosexuals. This analysis furthers the examination of smoking behaviors across sexual orientation groups by describing how same- and opposite-sex romantic attraction, and changes in romantic attraction, are associated with distinct six-year developmental trajectories of smoking. The National Longitudinal Study of Adolescent Health dataset is used to test our hypotheses. Multinomial logistic regressions predicting smoking trajectory membership as a function of romantic attraction were separately estimated for men and women. Romantic attraction effects were found only for women. The change from self-reported heterosexual attraction to lesbian or bisexual attraction was more predictive of higher smoking trajectories than was a consistent lesbian or bisexual attraction, with potentially important differences between the smoking patterns of these two groups. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prevalence of Smoke-Free Car and Home Rules in Maine Before and After Passage of a Smoke-Free Vehicle Law, 2007–2010

PubMed Central

Madden, Patrick; Maines, Dorean; Coles, Carol

2014-01-01

Introduction This is the first study to examine the prevalence of self-reported smoke-free rules for private cars and homes before and after the passage of a smoke-free vehicle law. Methods Data were examined for 13,461 Maine adults aged 18 or older who participated in the Behavioral Risk Factor Surveillance System, a state-based telephone survey covering health topics. Self-reported smoke-free car and home rules, smoking behavior, and demographic variables of age, sex, education, income, and children in household were analyzed for prevalence before and after the state’s smoke-free vehicle law was passed. Results Prevalence of smoke-free car and home rules was significantly higher after Maine’s smoke-free vehicle law was passed in the state (P = .004 for car rules and P = .009 for home rules). Variations in smoking rules differed by smoking and demographic variables. People with household incomes of less than $20,000 saw an increase of 14.3% in smoke-free car rules; overall, those with annual incomes of less than $20,000 and those with less than a high school education reported a lower prevalence of smoke-free car rules both before and after the law was passed than did people with higher incomes and higher education levels. The prevalence of smoke-free home rules after the law was implemented was higher among those with 4 or more years of college education than among those with lower levels of education (P = .02). Conclusion The prevalence of smoke-free car and home rules among Maine adults was significantly higher after the passage of a statewide smoke-free vehicle law. This apparent change in smoke-free rule prevalence may be indicative of changing social norms related to the unacceptability of secondhand smoke exposure. PMID:24433624

E-cigarette use among smokers with serious mental illness.

PubMed

Prochaska, Judith J; Grana, Rachel A

2014-01-01

We examined electronic cigarette (EC) use, correlates of use, and associated changes in smoking behavior among smokers with serious mental illness in a clinical trial. Adult smokers were recruited during acute psychiatric hospitalization (N = 956, 73% enrollment among approached smokers) in the San Francisco Bay Area between 2009-2013. At baseline, participants averaged 17 (SD = 10) cigarettes per day for 19 (SD = 14) years; 24% intended to quit smoking in the next month. Analyses examined frequency and correlates of EC use reported over the 18-month trial and changes in smoking behavior by EC use status. EC use was 11% overall, and by year of enrollment, increased from 0% in 2009 to 25% in 2013. In multiple logistic regression, the likelihood of EC use was significantly greater with each additional year of recruitment, for those aged 18-26, and for those in the preparation versus precontemplation stage of change, and unlikely among Hispanic participants. EC use was unrelated to gender, psychiatric diagnosis, and measures of tobacco dependence at baseline. Further, over the 18-month trial, EC use was not associated with changes in smoking status or, among continued smokers, with reductions in cigarettes per day. Within a clinical trial with smokers with serious mental illness, EC use increased over time, particularly among younger adults and those intending to quit tobacco. EC use was unrelated to changes in smoking. The findings are of clinical interest and warrant further study.

Smoking in movies, implicit associations of smoking with the self, and intentions to smoke.

PubMed

Dal Cin, Sonya; Gibson, Bryan; Zanna, Mark P; Shumate, Roberta; Fong, Geoffrey T

2007-07-01

We examined whether identifying with a film character who smokes increases implicit associations of the self with smoking. Undergraduate men were randomly assigned to view film clips in which the male protagonist either smoked or did not smoke. We measured subsequent levels of self-smoking associations using a reaction time task, as well as self-reported beliefs about smoking and smokers. Greater identification with the smoking protagonist predicted stronger implicit associations between the self and smoking (for both smokers and nonsmokers) and increased intention to smoke (among the smokers). Stronger implicit self-smoking associations uniquely predicted increases in smokers' intentions to smoke, over and above the effects of explicit beliefs about smoking. The results provide evidence that exposure to smoking in movies is causally related to changes in smoking-related thoughts, that identification with protagonists is an important feature of narrative influence, and that implicit measures may be useful in predicting deliberative behavior.

Link Between Perceived Body Weight and Smoking Behavior Among Adolescents.

PubMed

Yoon, Jangho; Bernell, Stephanie L

2016-11-01

This study investigates a relationship between overweight perception and smoking among adolescents. Data were retrieved from the Youth Risk Behavior Survey (YRBS), a biennial survey of a nationally representative sample of students in grades 9 through 12 in the United States. We analyze five waves of repeated cross-sections (N = 73 376) for the years 2005-2013. We estimate a recursive simultaneous-equations system in which body weight perception, which is a function of actual weight, influences smoking status. Outcome measures are binary indicators for current smoking and frequent current smoking. Perceived weight is categorized into very overweight perception, slightly overweight perception, and about the right weight/underweight perception. In comparison to adolescents who perceive themselves to be the right weight or underweight, adolescents who perceive themselves to be very overweight are 6.1 percentage points (pp) (standard error [SE] = 1.6pp) more likely to currently smoking and 3.3pp (SE = 1.2pp) more likely to frequently smoke. Adolescents with slightly overweight perception are 7.9pp (SE = 1.0pp) and 2.5pp (SE = 0.6pp) more likely to currently smoke and frequently smoke, respectively, as compared to those with the right weight/underweight perception. The relationships are larger for females, and appear to be mediated by weight-loss activity. In an era of tight budgets, it is crucial to address both obesity and smoking in manners that do not work at cross purposes. Strategies to combat youth smoking may be more effective if the perception of being overweight is considered an important risk factor, especially among female adolescents. We find that perception of being overweight is an important causal risk factor for adolescent smoking. Main findings of this study imply that even a slight change in the perception of body weight may lead to a significant change in smoking behavior among adolescents, especially among females and that the perception of being overweight induces adolescents to smoke regularly. Unlike most prior studies, we discovered a positive effect of slight overweight perception on smoking for adolescent males. Our findings emphasize the importance of addressing both obesity and smoking in manners that do not work at cross purposes. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Policy Support, Norms, and Secondhand Smoke Exposure Before and After Implementation of a Comprehensive Smoke-Free Law in Mexico City

PubMed Central

Thrasher, James F.; Pérez-Hernández, Rosaura; Swayampakala, Kamala; Arillo-Santillán, Edna; Bottai, Matteo

2010-01-01

Objectives. We assessed attitudes and beliefs about smoke-free laws, compliance, and secondhand smoke exposure before and after implementation of a comprehensive smoke-free law in Mexico City. Methods. Trends and odds of change in attitudes and beliefs were analyzed across 3 representative surveys of Mexico City inhabitants: before implementation of the policy (n = 800), 4 months after implementation (n = 961), and 8 months after implementation (n = 761). Results. Results indicated high and increasing support for 100% smoke-free policies, although support did not increase for smoke-free bars. Agreement that such policies improved health and reinforced rights was high before policy implementation and increased thereafter. Social unacceptability of smoking increased substantially, although 25% of nonsmokers and 50% of smokers agreed with smokers' rights to smoke in public places at the final survey wave. Secondhand smoke exposure declined generally as well as in venues covered by the law, although compliance was incomplete, especially in bars. Conclusions. Comprehensive smoke-free legislation in Mexico City has been relatively successful, with changes in perceptions and behavior consistent with those revealed by studies conducted in high-income countries. Normative changes may prime populations for additional tobacco control interventions. PMID:20466952

Transition and Change: The Prospective Effects of Post-Traumatic Stress on Smoking Trajectories in the First Year of College

PubMed Central

Read, Jennifer P.; Wardell, Jeffrey D.; Vermont, Leah N.; Colder, Craig R.; Ouimette, Paige; White, Jacquelyn

2014-01-01

College matriculation begins a period of transition that is marked by new freedoms and responsibilities by and increases in a variety of risky behaviors, including smoking. Trauma and post-traumatic stress disorder (PTSD) are well-established risk factors for smoking outcomes, and thus may be a point of intervention for college smoking. Yet, no studies have examined associations among trauma, PTSD, and smoking in college students. The present study provides such an examination. Matriculating student smokers (N=346) completed surveys in September (T1) and at five subsequent time points (T2-T6) over their first year of college. With latent growth analysis, we modeled smoking trajectories conditioned on PTSD symptom status (i.e., No PTSD Symptoms vs. Partial PTSD vs. Full PTSD). Results showed that, although smoking tended to decline during the first semester for all groups, significant risk for escalation in smoking during the second semester was conferred specifically by the presence of PTSD at matriculation. Interventions that offer support and resources to students entering college with PTSD may help to prevent smoking behaviors from escalating, and may ultimately prevent the adoption of daily smoking in later adulthood. PMID:22888814

Price effects on the smoking behaviour of adult age groups.

PubMed

Franz, G A

2008-12-01

To provide a cigarette price elasticity reference for adult age groups, and to estimate the smoking behaviour changes in US adults in light of unprecedented state excise tax increases on cigarettes during the 1990s. Individual-level data from the Behavioral Risk Factor Surveillance System for 1993-2000 were merged with state-level cigarette price and tax data. Data were analysed for different age groups using a weighted least squares regression framework. The outcome variables measured were whether an individual was a smoker, whether he/she had tried to quit smoking during the previous year, and how many cigarettes were smoked per day among the total population and among active smokers. This study confirmed previous results that younger individuals are more responsive to price changes than older individuals. Although older age groups are less sensitive to price changes, their smoking behaviour changes are still statistically significant. This study found that while older individuals are less responsive to price changes than younger individuals, their behavioural changes due to cigarette price increases should not be ignored.

Cigarette Smoking and Drinking Behavior of Migrant Adolescents and Young Adults in Hanoi, Vietnam

PubMed Central

Nguyen, Liem T.; Rahman, Zarah; Emerson, Mark R.; Nguyen, Minh H.; Zabin, Laurie Schwab

2014-01-01

Background There has been a large migration from rural to urban areas in much of the developing world. In the past this was less true in Vietnam, which remains largely agricultural; however, since the 1990’s, economic reforms and loosening of government policies that had previously limited movement have led to a large increase in this rural to urban population movement. Risky health behaviors have been found among migrants in many other settings. The purpose of this research is to determine whether migrant adolescents and young adults in the city of Hanoi are more or less likely than local ones to engage in cigarette smoking and alcohol drinking health risk behaviors, to identify factors associated with these behaviors and to suggest interventions to reduce these health risk behaviors among the study population. Methods A cross-sectional survey of 4550 adolescents and young adults aged 15–24 was conducted in urban Hanoi in 2006. This study examines current use of cigarettes and alcohol by migration status using multivariate logistic regressions. Results Cigarette smoking and drinking alcohol are male phenomena. The prevalence of cigarette smoking and alcohol drinking is high among adolescents and young adults in Hanoi, and is more common among migrants who came from rural areas of other provinces than non-migrants in the city. However, multivariate analysis revealed that migrants were neither more likely to smoke cigarettes nor drink alcohol than non-migrants after controlling for other factors such as age, full-time worker status, depression, and having close friends who smoke and/or drink. Conclusion The results suggest that interventions aiming at smoking and/or drinking reduction should pay more attention to adolescents, especially males, changing health risk behaviors at school and at work, and peer influence than their migration status. PMID:22340858

Assessing the Impact of the National Smoking Ban in Indoor Public Places in China: Evidence from Quit Smoking Related Online Searches

PubMed Central

Huang, Jidong; Zheng, Rong; Emery, Sherry

2013-01-01

Background Despite the tremendous economic and health costs imposed on China by tobacco use, China lacks a proactive and systematic tobacco control surveillance and evaluation system, hampering research progress on tobacco-focused surveillance and evaluation studies. Methods This paper uses online search query analyses to investigate changes in online search behavior among Chinese Internet users in response to the adoption of the national indoor public place smoking ban. Baidu Index and Google Trends were used to examine the volume of search queries containing three key search terms “Smoking Ban(s),” “Quit Smoking,” and “Electronic Cigarette(s),” along with the news coverage on the smoking ban, for the period 2009–2011. Findings Our results show that the announcement and adoption of the indoor public place smoking ban in China generated significant increases in news coverage on smoking bans. There was a strong positive correlation between the media coverage of smoking bans and the volume of “Smoking Ban(s)” and “Quit Smoking” related search queries. The volume of search queries related to “Electronic Cigarette(s)” was also correlated with the smoking ban news coverage. Interpretation To the extent it altered smoking-related online searches, our analyses suggest that the smoking ban had a significant effect, at least in the short run, on Chinese Internet users’ smoking-related behaviors. This research introduces a novel analytic tool, which could serve as an alternative tobacco control evaluation and behavior surveillance tool in the absence of timely or comprehensive population surveillance system. This research also highlights the importance of a comprehensive approach to tobacco control in China. PMID:23776504

Perceptions and influences of a state prison smoking ban.

PubMed

Thibodeau, Laura; Seal, David W; Jorenby, Douglas E; Corcoran, Kerri; Sosman, James M

2012-10-01

Prison smoking bans are increasingly common. It is important to consider how those who are incarcerated respond to these bans and to the subsequent development of contraband tobacco markets. Since there are high rates of smoking in individuals who become incarcerated, along with high rates of chronic illnesses that are exacerbated by smoking, it is critical to examine whether there are health promoting changes in perceptions of and intentions toward smoking and other health behaviors that can be maintained on release to the community. Interviews with incarcerated men experiencing a prison smoking ban revealed their responses to being smoke-free, reactions to the presence of contraband smoking, and the influences of this experience on their intentions to smoke following release.

The Relationship between Self-Efficacy and Help Evasion

ERIC Educational Resources Information Center

Persson, Roger; Cleal, Bryan; Jakobsen, Mette Øllgaard; Villadsen, Ebbe; Andersen, Lars L.

2014-01-01

Objective: To examine the relationship between self-efficacy and not wanting help to change health behaviors. Method: All employees in the Danish police department were invited to respond to an electronic questionnaire. All respondents expressing a desire to change health behaviors in relation to smoking ("n" = 845), alcohol…

A Randomized Trial of an Avatar-Hosted Multiple Behavior Change Intervention for Young Adult Smokers

PubMed Central

2013-01-01

Background Young adulthood is a critical transition period for the development of health behaviors. We present here the results of a randomized controlled trial of an online avatar-hosted personal health makeover program designed for young adult smokers. Methods We conducted a three-group randomized trial comparing delivery of general lifestyle content (Tx1), personally tailored health information (Tx2), and personally tailored health information plus online video–based peer coaching (Tx3) as part of a 6-week online health program. Participants were asked to set weekly goals around eating breakfast, exercise, alcohol use, and cigarette smoking. Eligibility criteria included age (18–30 years) and smoking status (any cigarette use in the previous 30 days). The primary outcome was self-reported 30-day abstinence measured 12 weeks postenrollment. Results Participant (n = 1698) characteristics were balanced across the groups (72% women, mean age 24, 26% nonwhite, 32% high school education or less, and 50% daily smokers). Considering intention to treat, 30-day smoking abstinence rates were statistically significantly higher in the intervention groups (Tx1 = 11%, Tx2 = 23%, Tx3 = 31%, P < .001). Participants in the intervention groups were also more likely to reduce their number of days spent on binge drinking and increase their number of days eating breakfast and exercising. Overall, intervention group participants were much more likely to make positive changes in at least three or four of the target behaviors (Tx1 = 19%, Tx2 = 39%, Tx3 = 41%, P < .001). Conclusions This online avatar-hosted personal health makeover “show” increased smoking abstinence and induced positive changes in multiple related health behaviors. Addition of the online video–based peer coaching further improved behavioral outcomes. PMID:24395994

A randomized trial of an avatar-hosted multiple behavior change intervention for young adult smokers.

PubMed

An, Lawrence C; Demers, Michele R S; Kirch, Matthias A; Considine-Dunn, Shannon; Nair, Vijay; Dasgupta, Kohinoor; Narisetty, Naveen; Resnicow, Ken; Ahluwalia, Jasjit

2013-12-01

Young adulthood is a critical transition period for the development of health behaviors. We present here the results of a randomized controlled trial of an online avatar-hosted personal health makeover program designed for young adult smokers. We conducted a three-group randomized trial comparing delivery of general lifestyle content (Tx1), personally tailored health information (Tx2), and personally tailored health information plus online video-based peer coaching (Tx3) as part of a 6-week online health program. Participants were asked to set weekly goals around eating breakfast, exercise, alcohol use, and cigarette smoking. Eligibility criteria included age (18-30 years) and smoking status (any cigarette use in the previous 30 days). The primary outcome was self-reported 30-day abstinence measured 12 weeks postenrollment. Participant (n = 1698) characteristics were balanced across the groups (72% women, mean age 24, 26% nonwhite, 32% high school education or less, and 50% daily smokers). Considering intention to treat, 30-day smoking abstinence rates were statistically significantly higher in the intervention groups (Tx1 = 11%, Tx2 = 23%, Tx3 = 31%, P < .001). Participants in the intervention groups were also more likely to reduce their number of days spent on binge drinking and increase their number of days eating breakfast and exercising. Overall, intervention group participants were much more likely to make positive changes in at least three or four of the target behaviors (Tx1 = 19%, Tx2 = 39%, Tx3 = 41%, P < .001). This online avatar-hosted personal health makeover "show" increased smoking abstinence and induced positive changes in multiple related health behaviors. Addition of the online video-based peer coaching further improved behavioral outcomes.

Distress Intolerance during Smoking Cessation Treatment

PubMed Central

Farris, Samantha G.; Leyro, Teresa M.; Allan, Nicholas P.; Øverup, Camilla S.; Schmidt, Norman B.; Zvolensky, Michael J.

2016-01-01

Distress intolerance is a key vulnerability factor implicated in the maintenance and relapse of cigarette smoking. Yet, past work has not examined changes in these processes during smoking cessation treatment or their relation to smoking cessation outcomes. The aim of the present study was to examine the effect of two smoking cessation interventions on changes in self-report and behavioral distress intolerance indices during treatment, and whether these changes are associated with smoking cessation outcomes. Treatment-seeking smokers (N = 384) were randomly assigned to one of two 4-session smoking cessation treatment programs: Standard Cessation Program (SCP) or Smoking Treatment and Anxiety Management Program (STAMP). Quit dates were scheduled to coincide with the final treatment session. Physical domains of distress intolerance were assessed at baseline and at each weekly session, via the Discomfort Intolerance Scale (DIS; higher scores indicate more intolerance for discomfort) and Breath Holding Duration Task (shorter durations indicate more intolerance for respiratory distress). The STAMP condition produced a greater rate of reduction in DIS scores than did the SCP condition. Changes in DIS scores during treatment mediated the effect of STAMP treatment on 7-day point prevalence abstinence at Month 3 post-quit attempt. There were no treatment conditions differences in changes in Breath-Holding duration. Data suggest self-reported distress intolerance is malleable in the context of stress sensitivity reduction treatment, but not standard smoking cessation treatment, and such reductions may result in promotion of smoking abstinence. PMID:27565398

Impact of drinking and smoking habits on cerebrovascular disease risk among male employees.

PubMed

Hatanaka, Yoko; Shimokata, Keiko; Osugi, Shigeki; Kaneko, Noriyo

2016-10-07

We aimed to analyze the impact of drinking and smoking behavior on the risk of developing cerebrovascular diseases among male employees aged 20-46 years. Twenty years of follow-up data of male employees enrolled in the DENSO Health Insurance Program were used for analyses. Of 29,048 male employees aged 20-46 years who were enrolled in the insurance program in 1994, 25,084 (86.4%) employees underwent annual health check-ups until 2003 without missing an appointment. Of these 25,084 employees, the data of 11,784 (40.6%) employees who self-reported drinking and smoking habits were used for analyses. The hazard ratio and 95% confidence intervals (CIs) for developing cerebrovascular disease in 2004-2013 were calculated in four risk groups categorized as per drinking and smoking behavior in the young group who were in their 20s and the middle-aged group who were in their 30s-40s in 1994. Based on their drinking behavior, participants were categorized into two groups: "not drinking or drinking sometimes" and "drinking every day." Based on their smoking behavior, participants were also categorized into two groups: "not smoking for 10 years" and "smoking for 10 years." A Cox's proportional hazard model revealed that after controlling for body mass index, systolic blood pressure, triglycerides, total cholesterol, fasting plasma glucose, and age, the hazard ratios for "smoking and drinking every day" were 3.82 (95% CI: 1.40-10.41) in the young group and 2.31 (95% CI: 1.27-4.17) in the middle-aged group. Male employees who had been drinking and smoking for 10 years had a higher risk of developing cerebrovascular diseases. To prevent cerebrovascular diseases among male employees, it may be effective to offer behavior change interventions for both drinking and smoking habits, regardless of the age group.

Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial.

PubMed

Hawkes, Anna L; Chambers, Suzanne K; Pakenham, Kenneth I; Patrao, Tania A; Baade, Peter D; Lynch, Brigid M; Aitken, Joanne F; Meng, Xingqiong; Courneya, Kerry S

2013-06-20

Colorectal cancer survivors are at risk for poor health outcomes because of unhealthy lifestyles, but few studies have developed translatable health behavior change interventions. This study aimed to determine the effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes among colorectal cancer survivors. In this two-group randomized controlled trial, 410 colorectal cancer survivors were randomly assigned to the health coaching intervention (11 theory-based telephone-delivered health coaching sessions delivered over 6 months focusing on physical activity, weight management, dietary habits, alcohol, and smoking) or usual care. Assessment of primary (ie, physical activity [Godin Leisure Time Index], health-related quality of life [HRQoL; Short Form-36], and cancer-related fatigue [Functional Assessment of Chronic Illness Therapy Fatigue Scale]) and secondary outcomes (ie, body mass index [kg/m(2)], diet and alcohol intake [Food Frequency Questionnaire], and smoking) were conducted at baseline and 6 and 12 months. At 12 months, significant intervention effects were observed for moderate physical activity (28.5 minutes; P = .003), body mass index (-0.9 kg/m(2); P = .001), energy from total fat (-7.0%; P = .006), and energy from saturated fat (-2.8%; P = .016). A significant intervention effect was reported for vegetable intake (0.4 servings per day; P = .001) at 6 months. No significant group differences were found at 6 or 12 months for HRQoL, cancer-related fatigue, fruit, fiber, or alcohol intake, or smoking. The CanChange intervention was effective for improving physical activity, dietary habits, and body mass index in colorectal cancer survivors. The intervention is translatable through existing telephone cancer support and information services in Australia and other countries.

Behavior intentions of the public after bans on smoking in restaurants and bars.

PubMed Central

Biener, L; Siegel, M

1997-01-01

OBJECTIVES: This study assessed the potential effect of smoke-free policies on bar and restaurant patronage. METHODS: Random-digit dialing techniques were used in surveying a representative sample of Massachusetts adults (n = 2356) by telephone. RESULTS: Approximately 61% of the respondents predicted no change in their use of restaurants in response to smoke-free policies, 30% predicted increased use, and 8% predicted decreased use. In turn, 69% of the respondents predicted no change in their patronage of bars, while 20% predicted increased use and 11% predicted decreased use. CONCLUSIONS: These results suggest that smoke-free policies are likely to increase overall patronage of bars and restaurants. PMID:9431301

Predictors of urge to smoke under stressful conditions: An experimental investigation utilizing the PASAT-C task to induce negative affect in smokers.

PubMed

Karekla, Maria; Panayiotou, Georgia; Collins, Bradley N

2017-11-01

Experimental evidence has demonstrated that the presence of cues previously associated with smoking behavior can increase urges to smoke in abstinent smokers. This study examined the effect of a laboratory-induced negative affective task (paced auditory serial addition task) on smoking urges among a sample of 35 abstinent college smokers (Mage = 20.83 years, SD = 1.71). Emotional states and physiological reactions experienced during the experiment, as well as individual differences in stress intolerance (anxiety sensitivity and experiential avoidance) were examined as predictors of the association between stressful states and smoking cravings. Smoking urges (smoking desire and negative affect relief) and negative emotions (frustration, irritability, stress) significantly increased, whereas positive emotions decreased from pre- to posttask. No significant interactions between individual differences and changes in urge were found. Results suggest that changes in negative affect may in part explain the association between induced stress and smoking cravings. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The effect of a major cigarette price change on smoking behavior in california: a zero-inflated negative binomial model.

PubMed

Sheu, Mei-Ling; Hu, Teh-Wei; Keeler, Theodore E; Ong, Michael; Sung, Hai-Yen

2004-08-01

The objective of this paper is to determine the price sensitivity of smokers in their consumption of cigarettes, using evidence from a major increase in California cigarette prices due to Proposition 10 and the Tobacco Settlement. The study sample consists of individual survey data from Behavioral Risk Factor Survey (BRFS) and price data from the Bureau of Labor Statistics between 1996 and 1999. A zero-inflated negative binomial (ZINB) regression model was applied for the statistical analysis. The statistical model showed that price did not have an effect on reducing the estimated prevalence of smoking. However, it indicated that among smokers the price elasticity was at the level of -0.46 and statistically significant. Since smoking prevalence is significantly lower than it was a decade ago, price increases are becoming less effective as an inducement for hard-core smokers to quit, although they may respond by decreasing consumption. For those who only smoke occasionally (many of them being young adults) price increases alone may not be an effective inducement to quit smoking. Additional underlying behavioral factors need to be identified so that more effective anti-smoking strategies can be developed.

The approach of smokers to the new tobacco law and the change in their behaviour.

PubMed

Atilla, Nurhan; Köksal, Nurhan; Özer, Ali; Kahraman, Hasan; Ekerbiçer, Hasan

2012-01-01

The aim of our study is; to assess the approach of smokers to tobacco law, examine changes in their smoking related behaviors after the new law and determine the factors associated with these changes. Data collected by questionnaire including 30 question. We applied the questionnaire to 1509 current smokers, and ex-smokers who quitted smoking after the law. SPSS packet programme was used for analyses. Participants consisted of 419 (28.0%) female, 1090 (72.0%) male with an average age of 33.6 ± 10.5 years. Although 80% of them knew that passive smoking is harmful to non-smokers, rate of smoking at home and in the car were very high. 869 (58.0%) of participants supported the law. 87 (5.8%) smokers quitted smoking after the law, 316 (20.9%) reduced. While health problems (37.3%) were the most frequent reason for quitting, restriction of smoking area had the most effect to reduce (54.2%). We satisfied that; the new tobacco law encouraged smokers to quit smoking. In addition, the majority of smokers supported the law.

Understanding Motivation to Implement Smoking Bans among Mothers with a Hospitalized Infant

PubMed Central

Stotts, Angela L.; Klawans, Michelle R.; Northrup, Thomas F.; Villarreal, Yolanda; Hovell, Melbourne F.

2016-01-01

Objective Secondhand smoke exposure (SHSe) poses risks to hospitalized children upon discharge and no uniformly effective interventions have been identified. Understanding change-related processes and social-contextual factors related to motivation for implementing home and car smoking bans may inform interventions to reduce infant SHSe among mothers with a hospitalized infant. Methods In this cross-sectional, secondary analysis, mothers of neonatal ICU infants who reported smoking or living with a smoker (N=205) were assigned to stages of change (pre-contemplation, contemplation, preparation, or action) based on behaviors and intentions for establishing smoking bans in their homes and cars. Processes of change (POC) for SHSe reduction practices, self-efficacy, depressive symptoms, generalized anxiety, and social support for not smoking in the home were examined across all four stages. Results The majority of mothers were in the action stage for having a home smoking ban in place (55%); only 35% of participants were in action for a car smoking ban. POC use differed across the stages of change for having a home ban (p=0.004) and car ban (p=0.02), with earlier stages using fewer overall and relatively fewer cognitive/affective processes. Earlier stage women also reported lower self-efficacy to change, less familial and partner support for in-home smoking bans, and more depressive symptoms. Conclusions Novel intervention targets were identified, including cognitive/affective change processes, mental health, and familial/social contingencies for implementing SHSe protective practices. Creative ways in which to affect change at the individual and household level are needed in order to fully address the complexity of child SHSe. PMID:26914262

Meditation-induced changes in high-frequency heart rate variability predict smoking outcomes

PubMed Central

Libby, Daniel J.; Worhunsky, Patrick D.; Pilver, Corey E.; Brewer, Judson A.

2012-01-01

Background: High-frequency heart rate variability (HF-HRV) is a measure of parasympathetic nervous system (PNS) output that has been associated with enhanced self-regulation. Low resting levels of HF-HRV are associated with nicotine dependence and blunted stress-related changes in HF-HRV are associated with decreased ability to resist smoking. Meditation has been shown to increase HF-HRV. However, it is unknown whether tonic levels of HF-HRV or acute changes in HF-HRV during meditation predict treatment responses in addictive behaviors such as smoking cessation. Purpose: To investigate the relationship between HF-HRV and subsequent smoking outcomes. Methods: HF-HRV during resting baseline and during mindfulness meditation was measured within two weeks of completing a 4-week smoking cessation intervention in a sample of 31 community participants. Self-report measures of smoking were obtained at a follow up 17-weeks after the initiation of treatment. Results: Regression analyses indicated that individuals exhibiting acute increases in HF-HRV from resting baseline to meditation smoked fewer cigarettes at follow-up than those who exhibited acute decreases in HF-HRV (b = −4.89, p = 0.008). Conclusion: Acute changes in HF-HRV in response to meditation may be a useful tool to predict smoking cessation treatment response. PMID:22457646

Effects of cognitive load on neural and behavioral responses to smoking cue distractors

PubMed Central

MacLean, R. Ross; Nichols, Travis T.; LeBreton, James M.; Wilson, Stephen J.

2017-01-01

Smoking cessation failures are frequently thought to reflect poor top-down regulatory control over behavior. Previous studies suggest that smoking cues occupy limited working memory resources, an effect that may contribute to difficulty achieving abstinence. Few studies have evaluated the effects of cognitive load on the ability to actively maintain information in the face of distracting smoking cues. The current study adapted an fMRI probed recall task under low and high cognitive load with three distractor conditions: control, neutral images, or smoking-related images. Consistent with a limited-resource model of cue reactivity, we predicted that performance of daily smokers (n=17) would be most impaired when high load was paired with smoking distractors. Results demonstrated a main effect of load, with decreased accuracy under high, compared to low, cognitive load. Surprisingly, an interaction revealed the effect of load was weakest in the smoking cue distractor condition. Along with this behavioral effect, we observed significantly greater activation of the right inferior frontal gyrus (rIFG) in the low load condition relative to the high load condition for trials containing smoking cue distractors. Furthermore, load-related changes in rIFG activation partially mediated the effects of load on task accuracy in the smoking cue distractor condition. These findings are discussed in the context of prevailing cognitive and cue reactivity theories. Results suggest that high cognitive load does not necessarily make smokers more susceptible to interference from smoking-related stimuli, and that elevated load may even have a buffering effect in the presence of smoking cues under certain conditions. PMID:27012714

[Coexistence of risky behaviors amongst group of students. Tendencies of changes between 2009-2012. Prospective studies].

PubMed

Sałacińska, Izabela; Binkowska-Bury, Monika; Wiech, Paweł; Januszewicz, Paweł

2015-01-01

Aim of conducted studies was to asses changes in time and coexistence of improper behavior patterns among students in year 2009 and 2012. The study included 905 students of the University of Rzeszow and Rzeszow University of Technology who have studied on medical, humanistic and science fields. Research was conducted by diagnostic sounding with usage of survey technique. In statistical elaboration squared-chi test and logical regression models were used. The study was conducted between October and December 2009 (study T1). It was repeated in 2012 among the same group of students (T2). Conducted in year 2009 and 2012 studies indicated that over half of surveyed students did not smoke cigarettes (T1 67.8%; T2 66.5%) and that daily smoking was declared only by 11.5% (T1) and 10.9% (T2) of asked youths. Majority of examined youth academic people drank alcohol once a month (T1 30.7%; T2 32.1%). Only 4.7% (T1) i 6.3% (T2) declared themselves as abstainers. Research pointed on significant increase of systematic drugs use (T1 0.4%; T2 1.7%). Vast majority of surveyed youths did not use legal highs in both research periods (89.3%--T2 and 91.5%--T2). There were no differences shown on the level of statistical significance in neither category (tobacco smoking, alcohol drinking, usage of drugs and legal highs). Students who smokes have bigger chance to addict themselves to alcohol, legal highs and drugs then the ones who do not smoke cigarettes. Conducted studies shows that tobacco smoking is a predictor of risky behaviors. Students who smoke are more exposed to addiction to alcohol, drugs and legal highs then those who reject tobacco.

The role of lifestyle in preventing low birth weight.

PubMed

Chomitz, V R; Cheung, L W; Lieberman, E

1995-01-01

Lifestyle behaviors such as cigarette smoking, weight gain during pregnancy, and use of other drugs play an important role in determining fetal growth. The relationship between lifestyle risk factors and low birth weight is complex and is affected by psychosocial, economic, and biological factors. Cigarette smoking is the largest known risk factor for low birth weight. Approximately 20% of all low birth weight could be avoided if women did not smoke during pregnancy. Reducing heavy use of alcohol and other drugs during pregnancy could also reduce the rate of low birth weight births. Pregnancy and the prospect of pregnancy provide an important window of opportunity to improve women's health and the health of children. The adoption before or during pregnancy of more healthful lifestyle behaviors, such as ceasing to smoke, eating an adequate diet and gaining enough weight during pregnancy, and ceasing heavy drug use, can positively affect the long-term health of women and the health of their infants. Detrimental lifestyles can be modified, but successful modification will require large-scale societal changes. In the United States, these societal changes should include a focus on preventive health, family-centered workplace policies, and changes in social norms.

The Role of Psychosocial and Belief Factors in Self-Reported Cigarette Smoking Among University Students in Malaysia

PubMed Central

Al-Dubai, Sami; Ganasegeran, Kurubaran; Alshagga, Mustafa; Hawash, Aamenah; Wajih, Wahid; Kassim, Saba

2014-01-01

This study aimed to explore factors associated, specifically belief factors, with self-reported tobacco smoking status. A sample of 300 students was recruited from a private university in Malaysia. Data was collected using a pre-tested self-administrated questionnaire that investigated various factors including socio-demographics, socio-economic status, smoking behavior and beliefs on tobacco smoking. The main tobacco use in this study sample was cigarettes and the estimated prevalence of self-reported cigarette smoking was 10.3%. In bivariate analysis, self-reported cigarette smoking was significantly associated with socio-demographic, behavioral factors and faculty of study (P<0.05). In multivariate modeling, being male and a non-medical student, did not exercise, having a smoker father and brother or sister, suffering from financial difficulties and having the belief that smokers had more friends, all had statistically significant associations (P<0.05) with self-reported cigarette smoking. Social and interpersonal factors were associated with self-reported cigarette smoking status. A comprehensive health model focusing on changing the social norms of parent and sibling tobacco smoking and students’ beliefs, alongside nurturing skills of dealing with stressful situations, warrant implementation. PMID:26973928

The reciprocal relationships between changes in adolescent perceived prevalence of smoking in movies and progression of smoking status

PubMed Central

Forster, Jean; Erickson, Darin; Lazovich, DeAnn; Southwell, Brian G.

2014-01-01

Background Smoking in movies is associated with adolescent smoking worldwide. To date, studies of the association mostly are restricted to the exposure to smoking images viewed by 9–15 year-olds. The association among older adolescents is rarely examined. In addition, the reciprocal effect of smoking behavior on subsequent reported exposure to smoking in movies has not been reported. Methods Data were from the Minnesota Adolescent Community Cohort Study collected every six months from 2000–2007 when participants were between the ages of 12 and 18 (n=4745). We estimated the prospective effect of the perceived prevalence of smoking in movies (four levels, from never to most of the time) on smoking stage measured six months later (six stages, from never smoker to established smoker), and the reciprocal prospective association between the two factors. Estimates were adjusted for demographic factors. Results The perceived prevalence of smoking in movies measured between ages 13½–15½ consistently predicted subsequent smoking stage. The association was inconsistent after the age of 15½. Smoking stage did not consistently predict subsequent perception of the prevalence of smoking in movies. Conclusions Perceived exposure to movie smoking primarily influenced teenagers’ smoking behavior at younger ages. If future studies confirm this finding, developing and evaluating interventions to improve young teenagers resistance to these images may complement policies to reduce smoking in movies to reduce prevalence of adolescent smoking. PMID:21828229

Does it matter what friends think, say, or do? The role of friends' smoking attitudes and behavior for Dutch adolescents' smoking behavior.

PubMed

Huisman, Chip

2014-05-01

Using stochastic actor-based models for longitudinal network analysis, this study examines the role of friends' smoking attitudes and behavior for Dutch adolescents' smoking behavior in four secondary schools (N = 875). The data were collected in two waves in two small suburban towns under second graders in 2008 to 2009 by means of a standardized questionnaire. Stochastic actor-based models for longitudinal network analysis can control for friendship selection while examining the effect of friends' attitudes and smoking behavior on the smoking behavior of a student. The findings suggest that friends tend to select each other on similar smoking behavior. Influence of friends' smoking behavior seems to play no role. In one school, an effect of friends' attitudes towards smoking on the smoking behavior is found. The implications for future research are to consider attitudes when examining the influence of friendship network on smoking behavior. The main limitation of this study lies in the limited sample, which makes generalizations to the general population difficult.

Adolescents' Smoking Behavior and Attitudes: The Influence of Mothers' Smoking Communication, Behavior and Attitudes

ERIC Educational Resources Information Center

Herbert, Diane F.; Schiaffino, Kathleen M.

2007-01-01

This study investigated adolescents' and parents' perceptions regarding smoking behavior, attitudes toward smoking, and smoking communication. Instruments were developed to measure multidimensional smoking communication messages and smoking attitudes in 140 mother-adolescent dyads. The prediction of relevant adolescent smoking variables is…

Changes and specificities in health behaviors among healthcare students over an 8-year period

PubMed Central

Delay, J.; Grigioni, S.; Déchelotte, P.; Ladner, J.

2018-01-01

Background Healthcare students are future health care providers and serve as role models and coaches to enhance behaviors for healthy lifestyles. However healthcare students face multiple stressors that could lead to adopting risk behaviors. Objectives To assess the changes in health risk factors among healthcare students between 2007 and 2015, and to identify specific health behaviors based on the curriculum in a population of healthcare students: Methods Two cross sectionnal studies were conducted in 2007 and 2015 among nursing, medical, pharmacy, and physiotherapy students (Rouen, France). During compulsory courses and examination sessions students filled self-administered questionnaires on socio-demographic characteristics and behavior as: tobacco smoking, alcohol consumption, cannabis consumption, eating disorders, regular practice of sport, perceived health, stress and use of psychotropic drugs. Results 2,605 healthcare students were included (1,326 in 2007 and 1,279 in 2015), comprising 1,225 medical students (47.0%), 738 nursing students (28.3%), 362 pharmacy students (13.9%), and 280 physiotherapy students (10.8%). Between 2007 and 2015, occasional binge drinking and regular practice of sport increased significantly among healthcare students, respectively AOR = 1.48 CI95% (1.20–1.83) and AOR = 1.33 CI95% (1.11–1.60), regular cannabis consumption decreased significantly, AOR = 0.32 CI95% (0.19–0.54). There was no change in smoking or overweight/obese. There was a higher risk of frequent binge drinking and a lower risk of tobacco smoking in all curricula than in nursing students. Medical students practiced sport on a more regular basis, were less overweight/obese, had fewer eating disorders than nursing students. Conclusion Our findings demonstrate a stable frequency of classic behaviors as smoking but a worsening of emerging behaviors as binge drinking among healthcare students between 2007 and 2015. Health behaviors differed according to healthcare curricula and nursing students demonstrated higher risks. As health behaviors are positively related to favorable attitudes towards preventive counseling, therefore healthcare students should receive training in preventive counseling and develop healthy lifestyles targeted according to the health curriculum. PMID:29566003

Comparing Two Web-Based Smoking Cessation Programs: Randomized Controlled Trial

PubMed Central

McKay, H Garth; Seeley, John R; Lichtenstein, Edward; Gau, Jeff M

2008-01-01

Background Smoking cessation remains a significant public health problem. Innovative interventions that use the Internet have begun to emerge that offer great promise in reaching large numbers of participants and encouraging widespread behavior change. To date, the relatively few controlled trials of Web-based smoking cessation programs have been limited by short follow-up intervals. Objective We describe the 6-month follow-up results of a randomized controlled trial in which participants recruited online were randomly assigned to either a Web-based smoking cessation program (Quit Smoking Network; QSN) or a Web-based exercise enhancement program (Active Lives) adapted somewhat to encourage smoking cessation. Methods The study was a two-arm randomized controlled trial that compared two Web-based smoking cessation programs: (1) the QSN intervention condition presented cognitive-behavioral strategies, and (2) the Active Lives control condition provided participants with guidance in developing a physical activity program to assist them with quitting. The QSN condition provided smoking cessation information and behavior change strategies while the Active Lives condition provided participants with physical activity recommendations and goal setting. The QSN condition was designed to be more engaging (eg, it included multimedia components) and to present much greater content than is typically found in smoking cessation programs. Results Contrary to our hypotheses, no between-condition differences in smoking abstinence were found at 3- and 6-month follow-up assessments. While participants in the QSN intervention condition spent more time than controls visiting the online program, the median number of 1.0 visit in each condition and the substantial attrition (60.8% at the 6-month follow-up) indicate that participants were not as engaged as we had expected. Conclusions Contrary to our hypothesis, our test of two Web-based smoking cessation conditions, an intervention and an attention placebo control, failed to show differences at 3- and 6-month assessments. We explored possible reasons for this finding, including limited engagement of participants and simplifying program content and architecture. Future research needs to address methods to improve participant engagement in online smoking cessation programs. Possible approaches in this regard can include new informed consent procedures that better explain the roles and responsibilities of being a research participant, new program designs that add more vitality (changing content from visit to visit), and new types of reminders pushed out to participants to encourage return visits. Simplifying program content through a combination of enhanced tailoring and information architecture also merits further research attention. PMID:19017582

Teaching Motivational Interviewing Skills to Third-Year Psychiatry Clerkship Students

ERIC Educational Resources Information Center

Roman, Brenda; Borges, Nicole; Morrison, Ann K.

2011-01-01

Background: Despite a large percentage of health care costs being related to smoking, obesity, and substance abuse, most physicians are not confident in motivating patients to change health behaviors. Motivational interviewing (MI) is a directive, patient-centered approach for eliciting behavior change. The purpose of this study was to teach…

Sex differences in negative affect and lapse behavior during acute tobacco abstinence: a laboratory study.

PubMed

Pang, Raina D; Leventhal, Adam M

2013-08-01

Heightened negative affect during acute tobacco abstinence in women relative to men could be an important factor underlying sex differences in smoking motivation. However, little controlled experimental work addresses this hypothesis. The current study investigated sex differences in withdrawal-related negative affect, time to start smoking on a lab analogue smoking lapse task, and the interrelation between sex, withdrawal-related negative affect, and smoking lapse behavior. Following a baseline session, current smokers (women: n = 68, men: n = 131) attended two counterbalanced lab sessions (16 hours smoking abstinence and ad libitum smoking) during which they completed self-report measures of mood and withdrawal symptoms followed by a laboratory analogue smoking lapse task. In this task participants are monetarily rewarded for delaying smoking. Performance on this task serves as an analogue model of smoking lapse behavior by measuring smoker's capability to resist temptation to smoke under conditions where abstinence is advantageous. Females showed greater abstinence induced increases in composite negative affect as well as several particular negative affect states (i.e., POMS Anger, Anxiety, Depression, and Confusion, ps < .05) but no differences in abstinence induced changes in other forms of affect or craving. Females also exhibited marginally greater abstinence induced decreases in their willingness to delay smoking for money (p = .10), which was mediated by abstinence induced increases in anger (p < .05). These results suggest that differential sensitivity to abstinence induced negative affect, particularly anger, could underlie sex specific smoking patterns. Negative affect during tobacco abstinence may be an important factor for understanding and treating nicotine addiction in women. PsycINFO Database Record (c) 2013 APA, all rights reserved

The interplay of friendship networks and social networking sites: longitudinal analysis of selection and influence effects on adolescent smoking and alcohol use.

PubMed

Huang, Grace C; Soto, Daniel; Fujimoto, Kayo; Valente, Thomas W

2014-08-01

We examined the coevolution of adolescent friendships and peer influences with respect to their risk behaviors and social networking site use. Investigators of the Social Network Study collected longitudinal data during fall 2010 and spring 2011 from 10th-grade students in 5 Southern California high schools (n = 1434). We used meta-analyses of stochastic actor-based models to estimate changes in friendship ties and risk behaviors and the effects of Facebook and MySpace use. Significant shifts in adolescent smoking and drinking occurred despite little change in overall prevalence rates. Students with higher levels of alcohol use were more likely to send and receive friendship nominations and become friends with other drinkers. They were also more likely to increase alcohol use if their friends drank more. Adolescents selected friends with similar Facebook and MySpace use habits. Exposure to friends' risky online pictures increased smoking behaviors but had no significant effects on alcohol use. Our findings support a greater focus on friendship selection mechanisms in school-based alcohol use interventions. Social media platforms may help identify at-risk adolescent groups and foster positive norms about risk behaviors.

The influence of celebrity exemplars on college students' smoking.

PubMed

Yoo, Woohyun

2016-01-01

This study examined the effect of celebrity smoking exemplars in health news on college students' perceptions of smoking-related health risks and smoking intentions. The data were collected using a Web-based survey of 219 undergraduate students at a large midwestern university in March 2011. Separate analyses of covariance were conducted. The influence of negative exemplars of celebrity smoking on perceptions of smoking-related health risks and smoking intentions varied according to smoking status. Ever-smokers who read smoking news with negative exemplars of celebrity smoking were more likely than ever-smokers who read the same news absent any exemplar to report higher levels of perceptions of smoking-related health risks and lower levels of smoking intentions. However, these patterns were not found in never-smokers. Exemplification theory enhanced by the celebrity element may be effectively applied as a strategy to change health behavior in college students.

Why do women stop smoking during pregnancy? Cigarettes taste and smell bad.

PubMed

Pletsch, Pamela K; Kratz, Anna Thornton

2004-08-01

There are high rates of cigarette smoking resumption among women who have quit smoking while pregnant, and the reasons for this are poorly understood. Our purpose in this study was to obtain an in-depth description of the context surrounding smoking behaviors during pregnancy and the first 3 months after women give birth in order to gain insight into the reasons women resume smoking. We used a longitudinal qualitative descriptive approach with in-depth interviews conducted early in pregnancy, at 36 weeks of pregnancy, and 3 months postpartum. Our purposive sample consisted of 15 pregnant women who had stopped smoking without assistance by their first prenatal visit. All women smoked mentholated cigarettes prior to pregnancy and 40% were primiparas. A thematic content analysis of 43 interviews revealed that the majority of women experienced an aversion to the taste or smell of tobacco smoke while pregnant and attributed these sensation changes to being pregnant. The taste and smell of tobacco smoke returned to prepregnancy states postpartum, and by 3 months postpartum 73% of the women had resumed smoking. This physiologic change can be conceptualized as a pregnancy-specific motivation for smoking cessation that can inform our efforts toward relapse prevention.

The Relationship of Dysthymia, Minor Depression, and Gender to Changes in Smoking for Current and Former Smokers: Longitudinal Evaluation in the U.S. Population

PubMed Central

Weinberger, Andrea H.; Pilver, Corey E.; Desai, Rani A.; Mazure, Carolyn M.; McKee, Sherry A.

2012-01-01

BACKGROUND Although data clearly link major depression and smoking, little is known about the association between dysthymia and minor depression and smoking behavior. The current study examined changes in smoking over three years for current and former smokers with and without dysthymia and minor depression. METHODS Participants who were current or former daily cigarette smokers at Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions and completed the Wave 2 assessment were included in these analyses (n=11,973; 46% female). Analyses examined the main and gender-specific effects of current dysthymia, lifetime dysthymia, and minor depression (a single diagnostic category that denoted current and or lifetime prevalence) on continued smoking for Wave 1 current daily smokers and continued abstinence for Wave 1 former daily smokers. RESULTS Wave 1 current daily smokers with current dysthymia (OR=2.13, 95% CI=1.23, 3.70) or minor depression (OR=1.53, 95% CI=1.07, 2.18) were more likely than smokers without the respective diagnosis to report continued smoking at Wave 2. Wave 1 former daily smokers with current dysthymia (OR=0.44, 95% CI=0.20, 0.96) and lifetime dysthymia (OR=0.37, 95% CI=0.15, 0.91) were less likely than those without the diagnosis to remain abstinent from smoking at Wave 2. The gender-by-diagnosis interactions were not significant, suggesting that the impact of dysthymia and minor depression on smoking behavior is similar among men and women. CONCLUSIONS Current dysthymia and minor depression are associated with a greater likelihood of continued smoking; current and lifetime dysthymia are associated with a decreased likelihood of continued smoking abstinence. PMID:22809897

The relationship of dysthymia, minor depression, and gender to changes in smoking for current and former smokers: longitudinal evaluation in the U.S. population.

PubMed

Weinberger, Andrea H; Pilver, Corey E; Desai, Rani A; Mazure, Carolyn M; McKee, Sherry A

2013-01-01

Although data clearly link major depression and smoking, little is known about the association between dysthymia and minor depression and smoking behavior. The current study examined changes in smoking over 3 years for current and former smokers with and without dysthymia and minor depression. Participants who were current or former daily cigarette smokers at Wave 1 of the National Epidemiologic Survey on Alcohol and Related Conditions and completed the Wave 2 assessment were included in these analyses (n=11,973; 46% female). Analyses examined the main and gender-specific effects of current dysthymia, lifetime dysthymia, and minor depression (a single diagnostic category that denoted current and/or lifetime prevalence) on continued smoking for Wave 1 current daily smokers and continued abstinence for Wave 1 former daily smokers. Wave 1 current daily smokers with current dysthymia (OR=2.13, 95% CI=1.23, 3.70) or minor depression (OR=1.53, 95% CI=1.07, 2.18) were more likely than smokers without the respective diagnosis to report continued smoking at Wave 2. Wave 1 former daily smokers with current dysthymia (OR=0.44, 95% CI=0.20, 0.96) and lifetime dysthymia (OR=0.37, 95% CI=0.15, 0.91) were less likely than those without the diagnosis to remain abstinent from smoking at Wave 2. The gender-by-diagnosis interactions were not significant, suggesting that the impact of dysthymia and minor depression on smoking behavior is similar among men and women. Current dysthymia and minor depression are associated with a greater likelihood of continued smoking; current and lifetime dysthymia are associated with a decreased likelihood of continued smoking abstinence. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

See Me Smoke-Free: Protocol for a Research Study to Develop and Test the Feasibility of an mHealth App for Women to Address Smoking, Diet, and Physical Activity.

PubMed

Giacobbi, Peter; Hingle, Melanie; Johnson, Thienne; Cunningham, James K; Armin, Julie; Gordon, Judith S

2016-01-21

This paper presents the protocol for an ongoing research study to develop and test the feasibility of a multi-behavioral mHealth app. Approximately 27 million women smoke in the US, and more than 180,000 women die of illnesses linked to smoking annually. Women report greater difficulties quitting smoking. Concerns about weight gain, negative body image, and low self-efficacy may be key factors affecting smoking cessation among women. Recent studies suggest that a multi-behavioral approach, including diet and physical activity, may be more effective at helping women quit. Guided imagery has been successfully used to address body image concerns and self-efficacy in our 3 target behaviors-exercise, diet and smoking cessation. However, it has not been used simultaneously for smoking, diet, and exercise behavior in a single intervention. While imagery is an effective therapeutic tool for behavior change, the mode of delivery has generally been in person, which limits reach. mHealth apps delivered via smart phones offer a unique channel through which to distribute imagery-based interventions. The objective of our study is to evaluate the feasibility of an mHealth app for women designed to simultaneously address smoking, diet, and physical activity behaviors. The objectives are supported by three specific aims: (1) develop guided imagery content, user interface, and resources to reduce weight concern, and increase body image and self-efficacy for behavior change among women smokers, (2) program a prototype of the app that contains all the necessary elements of text, graphics, multimedia and interactive features, and (3) evaluate the feasibility, acceptability, and preliminary efficacy of the app with women smokers. We created the program content and designed the prototype application for use on the Android platform in collaboration with 9 participants in multiple focus groups and in-depth interviews. We programmed and tested the application's usability with 6 participants in preparation for an open, pre- and posttest trial. Currently, we are testing the feasibility and acceptability of the application, evaluating the relationship of program use to tobacco cessation, dietary behaviors, and physical activity, and assessing consumer satisfaction with approximately 70 women smokers with Android-based smart phones. The study was started January 1, 2014. The app was launched and feasibility testing began in April 1, 2015. Participants were enrolled from April 1-June 30, 2015. During that time, the app was downloaded over 350 times using no paid advertising. Participants were required to use the app "most days" for 30 days or they would be dropped from the study. We enrolled 151 participants. Of those, 78 were dropped or withdrew from the study, leaving 73 participants. We have completed the 30-day assessment, with a 92% response rate. The 90-day assessment is ongoing. During the final phase of the study, we will be conducting data analyses and disseminating study findings via presentations and publications. Feasibility will be demonstrated by successful participant retention and a high level of app use. We will examine individual metrics (eg, duration of use, number of screens viewed, change in usage patterns over time) and engagement with interactive activities (eg, activity tracking). We will aggregate these data into composite exposure scores that combine number of visits and overall duration to calculate correlations between outcome and measures of program exposure and engagement. Finally, we will compare app use between participants and non-participants using Google Analytics.

Self-efficacy: a mediator of smoking behavior and depression among college students.

PubMed

Mee, Susan

2014-01-01

Cigarette smoking is a growing problem among adolescents. This correlational study tested theoretical relationships between the dependent variable (smoking behavior) and the independent variables (depression and smoking resistance self-efficacy) in a convenience sample of 364 college students ages 18 to 21 years recruited from a large urban public college. An a priori mediational model tested the role of smoking resistance self-efficacy as a mediator in the relationship between smoking behavior and depression. Findings showed there was a statistically significant positive relationship between depression and smoking behavior (r = 0.122, p = 0.01). There was a statistically significant negative relationship between smoking resistance self-efficacy and smoking behavior (r = -0.744, p = 0.01). Additionally, smoking resistance self-efficacy was a mediator of the relationship between depression and smoking behavior (beta = -0.757, p = 0.001). This study identifies a need for further theory-driven study of the relation of adolescent depression and smoking behavior. The findings of this study have implications for nursing interventions targeted to both current smokers and smoking initiation prevention programs.

Understanding motivation to implement smoking bans among mothers with a hospitalized infant.

PubMed

Stotts, Angela L; Klawans, Michelle R; Northrup, Thomas F; Villarreal, Yolanda; Hovell, Melbourne F

2016-07-01

Secondhand smoke exposure (SHSe) poses risks to hospitalized children upon discharge and no uniformly effective interventions have been identified. Understanding change-related processes and social-contextual factors related to motivation for implementing home and car smoking bans may inform interventions to reduce infant SHSe among mothers with a hospitalized infant. In this cross-sectional, secondary analysis, mothers of neonatal ICU infants who reported smoking or living with a smoker (N=205) were assigned to stages of change (pre-contemplation, contemplation, preparation, or action) based on behaviors and intentions for establishing smoking bans in their homes and cars. Processes of change (POC) for SHSe reduction practices, self-efficacy, depressive symptoms, generalized anxiety, and social support for not smoking in the home were examined across all four stages. The majority of mothers were in the action stage for having a home smoking ban in place (55%); only 35% of participants were in action for a car smoking ban. POC use differed across the stages of change for having a home ban (p=0.004) and car ban (p=0.02), with earlier stages using fewer overall and relatively fewer cognitive/affective processes. Earlier stage women also reported lower self-efficacy to change, less familial and partner support for in-home smoking bans, and more depressive symptoms. Novel intervention targets were identified, including cognitive/affective change processes, mental health, and familial/social contingencies for implementing SHSe protective practices. Creative ways in which to affect change at the individual and household level are needed in order to fully address the complexity of child SHSe. Copyright © 2016 Elsevier Ltd. All rights reserved.

Behavioral Interventions Associated with Smoking Cessation in the Treatment of Tobacco Use

PubMed Central

Roberts, Nicola J.; Kerr, Susan M.; Smith, Sheree M.S.

2013-01-01

Tobacco smoke is the leading cause of preventable premature death worldwide. While the majority of smokers would like to stop, the habitual and addictive nature of smoking makes cessation difficult. Clinical guidelines suggest that smoking cessation interventions should include both behavioural support and pharmacotherapy (e.g. nicotine replacement therapy). This commentary paper focuses on the important role of behavioural interventions in encouraging and supporting smoking cessation attempts. Recent developments in the field are discussed, including ‘cut-down to quit’, the behaviour change techniques taxonomy (BCTT) and very brief advice (VBA) on smoking. The paper concludes with a discussion of the important role that health professionals can and should play in the delivery of smoking cessation interventions. PMID:25114563

Income, occupation and education: Are they related to smoking behaviors in China?

PubMed

Wang, Qing; Shen, Jay J; Sotero, Michelle; Li, Casey A; Hou, Zhiyuan

2018-01-01

The association between socioeconomic status (SES) and smoking behaviors may differ across countries. This study aimed to estimate the association between socioeconomic status (income, occupation and education) and multiple measures of smoking behaviors among the Chinese elderly population. Using data from the China Health and Retirement Longitudinal Study in 2013, we examined the relationship between socioeconomic status and smoking behaviors through multivariate regression analysis. Sample selection models were applied to correct for sample selection bias. Smoking behaviors were measured by four indicators: smoking status, cigarette consumption, health risks related to smoking, and smoking dependence. Analyses were stratified by gender and urban-rural residence. Among Chinese people aged 45 years or older, smokers accounted for 40% of the population in 2013, smoking 19 cigarettes per day. It was also found that 79% of smokers were at an increased health risk. Overall, although the influence of income on smoking behaviors was small and even insignificant, occupation and education levels were significantly associated with smoking behaviors. Managers or professionals were more likely to smoke, however there was no significant relationship with smoking dependence. Individuals with higher educational attainment were less likely to be associated with smoking behaviors. In addition, gender and urban-rural differences existed in the relationship between SES and smoking behaviors. Smoking disparities among diverse levels of socioeconomic status existed but varied greatly by SES indicators and population characteristics. Tobacco control policies in China should be increasingly focused on populations with low socioeconomic status in order to break the link between socioeconomic disadvantage and smoking behaviors. Further actions should mitigate inequalities in education, improve the social culture of cigarette use, and tailor interventions based on characteristics of the population.

Income, occupation and education: Are they related to smoking behaviors in China?

PubMed Central

Wang, Qing; Shen, Jay J.; Sotero, Michelle; Li, Casey A.

2018-01-01

Background The association between socioeconomic status (SES) and smoking behaviors may differ across countries. This study aimed to estimate the association between socioeconomic status (income, occupation and education) and multiple measures of smoking behaviors among the Chinese elderly population. Methods Using data from the China Health and Retirement Longitudinal Study in 2013, we examined the relationship between socioeconomic status and smoking behaviors through multivariate regression analysis. Sample selection models were applied to correct for sample selection bias. Smoking behaviors were measured by four indicators: smoking status, cigarette consumption, health risks related to smoking, and smoking dependence. Analyses were stratified by gender and urban-rural residence. Results Among Chinese people aged 45 years or older, smokers accounted for 40% of the population in 2013, smoking 19 cigarettes per day. It was also found that 79% of smokers were at an increased health risk. Overall, although the influence of income on smoking behaviors was small and even insignificant, occupation and education levels were significantly associated with smoking behaviors. Managers or professionals were more likely to smoke, however there was no significant relationship with smoking dependence. Individuals with higher educational attainment were less likely to be associated with smoking behaviors. In addition, gender and urban-rural differences existed in the relationship between SES and smoking behaviors. Conclusions Smoking disparities among diverse levels of socioeconomic status existed but varied greatly by SES indicators and population characteristics. Tobacco control policies in China should be increasingly focused on populations with low socioeconomic status in order to break the link between socioeconomic disadvantage and smoking behaviors. Further actions should mitigate inequalities in education, improve the social culture of cigarette use, and tailor interventions based on characteristics of the population. PMID:29420649

Short-term Effects of a Smoking Prevention Website in American Indian Youth

PubMed Central

Henderson, Patricia Nez; Harvill, Jessica; Buchwald, Dedra

2012-01-01

Background The rate of smoking commercial tobacco products among American Indian youth is double the rate for white youth. Interventions are needed to reduce this disparity. Objective To test the feasibility of a Web-based intervention to influence attitudes toward and intentions about smoking cigarettes among American Indian youth who attended a Native summer camp in the Northern Plains. Methods The study website, the SmokingZine, was originally developed and tested in Canadian youth, then adapted to be appropriate for American Indian youth. We conducted a randomized controlled trial to test the influence of exposure to the adapted SmokingZine website on smoking attitudes and behaviors among American Indian youth 12–18 years of age. Participants assigned to the intervention group were given access to the website for 1 hour per day during their camp experience and asked to sign in to the site and use it. Control group participants were not given access to the site. Results A total of 52% of intervention youth signed in to the website at least once. Among nonsmokers, intentions to try a cigarette in the intervention group declined from 16% to 0%, and increased from 8% to 25% in the control group (P < .05). Compared with the control group, youth in the intervention group were more likely to help others quit (21 percentage point change in intervention versus no change in control; P < .05) and had less positive attitudes about the drug effects of smoking (–0.19 change in intervention versus 0.67 in control; P < .05). Conclusion These data indicate that SmokingZine needs more long-term, rigorous investigation as a way to keep American Indian youth from becoming regular smokers. Because the intervention group could use computers only 1 hour per day, increasing access might result in more visits and a greater effect of the website on smoking behaviors. PMID:22659390

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study

PubMed Central

Eisingerich, Andreas B

2016-01-01

Background Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. Objective The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. Methods We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Conclusions Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond. PMID:27777216

Game On? Smoking Cessation Through the Gamification of mHealth: A Longitudinal Qualitative Study.

PubMed

El-Hilly, Abdulrahman Abdulla; Iqbal, Sheeraz Syed; Ahmed, Maroof; Sherwani, Yusuf; Muntasir, Mohammed; Siddiqui, Sarim; Al-Fagih, Zaid; Usmani, Omar; Eisingerich, Andreas B

2016-10-24

Finding ways to increase and sustain engagement with mHealth interventions has become a challenge during application development. While gamification shows promise and has proven effective in many fields, critical questions remain concerning how to use gamification to modify health behavior. The objective of this study is to investigate how the gamification of mHealth interventions leads to a change in health behavior, specifically with respect to smoking cessation. We conducted a qualitative longitudinal study using a sample of 16 smokers divided into 2 cohorts (one used a gamified intervention and the other used a nongamified intervention). Each participant underwent 4 semistructured interviews over a period of 5 weeks. Semistructured interviews were also conducted with 4 experts in gamification, mHealth, and smoking cessation. Interviews were transcribed verbatim and thematic analysis undertaken. Results indicated perceived behavioral control and intrinsic motivation acted as positive drivers to game engagement and consequently positive health behavior. Importantly, external social influences exerted a negative effect. We identified 3 critical factors, whose presence was necessary for game engagement: purpose (explicit purpose known by the user), user alignment (congruency of game and user objectives), and functional utility (a well-designed game). We summarize these findings in a framework to guide the future development of gamified mHealth interventions. Gamification holds the potential for a low-cost, highly effective mHealth solution that may replace or supplement the behavioral support component found in current smoking cessation programs. The framework reported here has been built on evidence specific to smoking cessation, however it can be adapted to health interventions in other disease categories. Future research is required to evaluate the generalizability and effectiveness of the framework, directly against current behavioral support therapy interventions in smoking cessation and beyond.

Personal motivation, exercise, and smoking behaviors among young adults.

PubMed

Scioli, Erica Rose; Biller, Henry; Rossi, Joseph; Riebe, Deborah

2009-01-01

This study explored the motivational factors that influence individuals across the stages of change for exercise. The authors compared physically active nonsmokers with physically active smokers in a college student population. Half of regular exercisers identified themselves as smokers. Compared with their nonsmoking peers, young smokers have higher rates of physical and emotional distress. Those participants who exercise and do not smoke are more likely to exhibit intrinsic factors for exercise. Undergraduate psychology students (N = 614) completed an Internet survey on exercise and smoking behavior as well as motivational factors for exercise. Multivariate analyses of variance revealed that intrinsic motivational factors for exercise were significantly higher for the active nonsmokers than for the active smokers. Interventions promoting consistent exercise and smoking abstinence should continue to be directed toward young adults, focusing on fostering intrinsic motivational factors for exercise.

Effects of cognitive load on neural and behavioral responses to smoking-cue distractors.

PubMed

MacLean, R Ross; Nichols, Travis T; LeBreton, James M; Wilson, Stephen J

2016-08-01

Smoking cessation failures are frequently thought to reflect poor top-down regulatory control over behavior. Previous studies have suggested that smoking cues occupy limited working memory resources, an effect that may contribute to difficulty achieving abstinence. Few studies have evaluated the effects of cognitive load on the ability to actively maintain information in the face of distracting smoking cues. For the present study, we adapted an fMRI probed recall task under low and high cognitive load with three distractor conditions: control, neutral images, or smoking-related images. Consistent with a limited-resource model of cue reactivity, we predicted that the performance of daily smokers (n = 17) would be most impaired when high load was paired with smoking distractors. The results demonstrated a main effect of load, with decreased accuracy under high, as compared to low, cognitive load. Surprisingly, an interaction revealed that the effect of load was weakest in the smoking cue distractor condition. Along with this behavioral effect, we observed significantly greater activation of the right inferior frontal gyrus (rIFG) in the low-load condition than in the high-load condition for trials containing smoking cue distractors. Furthermore, load-related changes in rIFG activation partially mediated the effects of load on task accuracy in the smoking-cue distractor condition. These findings are discussed in the context of prevailing cognitive and cue reactivity theories. These results suggest that high cognitive load does not necessarily make smokers more susceptible to interference from smoking-related stimuli, and that elevated load may even have a buffering effect in the presence of smoking cues under certain conditions.

Communication, Reasoning, and Planned Behaviors: Unveiling the Effect of Interactive Communication in an Anti-Smoking Social Media Campaign.

PubMed

Namkoong, Kang; Nah, Seungahn; Record, Rachael A; Van Stee, Stephanie K

2017-01-01

This study examines direct and indirect effects of interactive communication in an antismoking social media campaign. To that end, we pose a multitheoretical framework that integrates communication mediation models and the Theory of Planned Behavior. To test the theorized model, we conducted an experiment using a two-group pretest-posttest design. Participants (N = 201) were randomly assigned into two experimental conditions: "campaign message reception only" as a control group and "message reception and social interaction" as a treatment group, in which the participants contributed to the antismoking campaign by posting their own campaign ideas and information they found through mediated and interpersonal communication. The findings show that interactive communication catalyzes the participants' information searching behaviors through diverse communication channels. In turn, increased media use plays a crucial role in changing their attitudes and perceived social norms about smoking behaviors, and eventually reducing smoking intention. This study affirms that the theory of planned behavior is effective in predicting behavioral intention and demonstrates the usefulness of a multitheoretical approach in interactive campaign research on social media.

Purchasing patterns and smoking behaviors after a large tobacco tax increase: a study of Chinese Americans living in New York City.

PubMed

Cantrell, Jennifer; Hung, Dorothy; Fahs, Marianne C; Shelley, Donna

2008-01-01

Tobacco taxes are one of the most effective policy interventions to reduce tobacco use. Tax avoidance, however, lessens the public health benefits of higher-priced cigarettes. Few studies examine responses to cigarette tax policies, particularly among high-risk minority populations. This study examined the prevalence and correlates of tax avoidance and changes in smoking behaviors among Chinese American smokers in New York City after a large tax increase. We conducted a cross-sectional study with data for 614 male smokers from in-person and telephone interviews using a comprehensive household-based survey of 2,537 adults aged 18-74 years. Interviews were conducted in multiple Chinese dialects. A total of 54.7% of respondents reported engaging in at least one low- or no-tax strategy after the New York City and New York State tax increases. The more common strategies for tax avoidance were purchasing cigarettes from a private supplier/importer and purchasing duty free/overseas. Higher consumption, younger age, and number of years in the U.S. were consistently associated with engaging in tax avoidance. Younger and heavier continuing smokers were less likely to make a change in smoking behavior in response to the tax increase. Despite high levels of tax avoidance and varying prices, nearly half of continuing smokers made a positive change in smoking behavior after the tax increase. Expanded legislation and enforcement must be directed toward minimizing the availability of legal and illegal low- or no-tax cigarette outlets. Public education and cessation assistance customized for the Chinese American community is key to maximizing the effectiveness of tobacco tax policies in this population.

The Role of Ethnic Pride and Parental Disapproval of Smoking on Smoking Behaviors among Minority and White Adolescents in a Suburban High School

PubMed Central

Kong, Grace; Camenga, Deepa; Cavallo, Dana; Connell, Christian M.; Pflieger, Jacqueline C.; Krishnan-Sarin, Suchitra

2012-01-01

Background Adolescence is a critical developmental period when tobacco use is initiated and progression to regular smoking occurs. Another growing concern is the mounting evidence of ethnic/racial disparities in the smoking rates and adverse health consequences related to smoking. To reduce ethnic/racial disparities in smoking behaviors, understanding the protective influences against smoking behaviors among minority adolescents is important. Therefore, we examined the role of ethnic pride and parental disapproval of smoking on a wide range of smoking behaviors in ethnic/racial minority and White adolescents attending a suburban high school in Connecticut. Methods A total of 870 adolescents (ethnic/racial minority: n = 202) completed questions on susceptibility to smoking, ever trying a cigarette, smoking at least 1 cigarette daily in the past 30 days, as well as parental disapproval of smoking and ethnic pride in a school-wide survey. Results Logistic regression analyses indicated that perceived parental disapproval of adolescent smoking and ethnic pride were associated with susceptibility to smoking, ever trying a cigarette, and daily smoking differently for minority and White adolescents. For White youth, high parental disapproval of smoking was protective against all three smoking behaviors while ethnic pride was not. For minority youth, the combined protective effect of higher ethnic pride and higher parental disapproval of smoking was protective against all smoking behaviors. Conclusion The protective role of parental disapproval of smoking and ethnic pride on smoking behaviors may inform culturally sensitive smoking interventions aimed at diverse, multi-ethnic youth, and future studies are needed to examine this. PMID:22882393

Association between Family and Friend Smoking Status and Adolescent Smoking Behavior and E-Cigarette Use in Korea.

PubMed

Joung, Myoung Jin; Han, Mi Ah; Park, Jong; Ryu, So Yeon

2016-11-25

Smoking is harmful to the health of adolescents because their bodies are still growing. The aim of this study was to analyze the association between the smoking status of Korean adolescents' parents and friends and their own smoking behavior. The study assessed a nationwide sample of 72,060 middle and high students from the 10th Korea Youth Risk Behavior Web-based Survey (2014). Descriptive analysis, chi-square tests, and multiple logistic regression analysis were used to probe the association between family and friend smoking status and adolescent smoking behavior. The current cigarette smoking rates were 13.3% of boys and 4.1% of girls. The corresponding rates for electronic cigarette smoking were 4.1% and 1.5%, respectively. Higher exposure to secondhand smoke, smoking by any family member, more friends smoking, and witnessed smoking at school were associated with current smoking and electronic smoking. The smoking status of family and friends was significantly related to adolescent smoking behavior. These results should be considered in designing programs to control adolescent smoking.

Association between Family and Friend Smoking Status and Adolescent Smoking Behavior and E-Cigarette Use in Korea

PubMed Central

Joung, Myoung Jin; Han, Mi Ah; Park, Jong; Ryu, So Yeon

2016-01-01

Smoking is harmful to the health of adolescents because their bodies are still growing. The aim of this study was to analyze the association between the smoking status of Korean adolescents’ parents and friends and their own smoking behavior. The study assessed a nationwide sample of 72,060 middle and high students from the 10th Korea Youth Risk Behavior Web-based Survey (2014). Descriptive analysis, chi-square tests, and multiple logistic regression analysis were used to probe the association between family and friend smoking status and adolescent smoking behavior. The current cigarette smoking rates were 13.3% of boys and 4.1% of girls. The corresponding rates for electronic cigarette smoking were 4.1% and 1.5%, respectively. Higher exposure to secondhand smoke, smoking by any family member, more friends smoking, and witnessed smoking at school were associated with current smoking and electronic smoking. The smoking status of family and friends was significantly related to adolescent smoking behavior. These results should be considered in designing programs to control adolescent smoking. PMID:27898019

Development of a Conceptual Model for Smoking Cessation: Physical Activity, Neurocognition, and Executive Functioning.

PubMed

Loprinzi, Paul D; Herod, Skyla M; Walker, Jerome F; Cardinal, Bradley J; Mahoney, Sara E; Kane, Christy

2015-01-01

Considerable research has shown adverse neurobiological effects of chronic alcohol use, including long-term and potentially permanent changes in the structure and function of the brain; however, much less is known about the neurobiological consequences of chronic smoking, as it has largely been ignored until recently. In this article, we present a conceptual model proposing the effects of smoking on neurocognition and the role that physical activity may play in this relationship as well as its role in smoking cessation. Pertinent published peer-reviewed articles deposited in PubMed delineating the pathways in the proposed model were reviewed. The proposed model, which is supported by emerging research, demonstrates a bidirectional relationship between smoking and executive functioning. In support of our conceptual model, physical activity may moderate this relationship and indirectly influence smoking behavior through physical activity-induced changes in executive functioning. Our model may have implications for aiding smoking cessation efforts through the promotion of physical activity as a mechanism for preventing smoking-induced deficits in neurocognition and executive function.

Genetic and Environmental Influences on Smoking Behavior across Adolescence and Young Adulthood in the Virginia Twin Study of Adolescent Behavioral Development and the Transitions to Substance Abuse Follow-Up

PubMed Central

Do, Elizabeth K.; Prom-Wormley, Elizabeth C.; Eaves, Lindon J.; Silberg, Judy L.; Miles, Donna R.; Maes, Hermine H.

2016-01-01

Little is known regarding the underlying relationship between smoking initiation and current quantity smoked during adolescence into young adulthood. It is possible that the influences of genetic and environmental factors on this relationship vary across sex and age. To investigate this further, the current study applied a common causal contingency model to data from a Virginia-based twin study to determine: (1) if the same genetic and environmental factors are contributing to smoking initiation and current quantity smoked; (2) whether the magnitude of genetic and environmental factor contributions are the same across adolescence and young adulthood; and (3) if qualitative and quantitative differences in the sources of variance between males and females exist. Study results found no qualitative or quantitative sex differences in the relationship between smoking initiation and current quantity smoked, though relative contributions of genetic and environmental factors changed across adolescence and young adulthood. More specifically, smoking initiation and current quantity smoked remain separate constructs until young adulthood, when liabilities are correlated. Smoking initiation is explained by genetic, shared, and unique environmental factors in early adolescence and by genetic and unique environmental factors in young adulthood; while current quantity smoked is explained by shared environmental and unique environmental factors until young adulthood, when genetic and unique environmental factors play a larger role. PMID:25662421

Genetic and Environmental Influences on Smoking Behavior across Adolescence and Young Adulthood in the Virginia Twin Study of Adolescent Behavioral Development and the Transitions to Substance Abuse Follow-Up.

PubMed

Do, Elizabeth K; Prom-Wormley, Elizabeth C; Eaves, Lindon J; Silberg, Judy L; Miles, Donna R; Maes, Hermine H

2015-02-01

Little is known regarding the underlying relationship between smoking initiation and current quantity smoked during adolescence into young adulthood. It is possible that the influences of genetic and environmental factors on this relationship vary across sex and age. To investigate this further, the current study applied a common causal contingency model to data from a Virginia-based twin study to determine: (1) if the same genetic and environmental factors are contributing to smoking initiation and current quantity smoked; (2) whether the magnitude of genetic and environmental factor contributions are the same across adolescence and young adulthood; and (3) if qualitative and quantitative differences in the sources of variance between males and females exist. Study results found no qualitative or quantitative sex differences in the relationship between smoking initiation and current quantity smoked, though relative contributions of genetic and environmental factors changed across adolescence and young adulthood. More specifically, smoking initiation and current quantity smoked remain separate constructs until young adulthood, when liabilities are correlated. Smoking initiation is explained by genetic, shared, and unique environmental factors in early adolescence and by genetic and unique environmental factors in young adulthood; while current quantity smoked is explained by shared environmental and unique environmental factors until young adulthood, when genetic and unique environmental factors play a larger role.

"I Smoke Like This to Suppress These Issues That Are Flaws of My Character": Challenges and Facilitators of Cessation Among Smokers With Bipolar Disorder.

PubMed

Heffner, Jaimee L; Watson, Noreen L; McClure, Jennifer B; Anthenelli, Robert M; Hohl, Sarah; Bricker, Jonathan B

2018-01-01

Smokers with bipolar disorder (BD) have low rates of successful quitting, yet no prior studies have evaluated the process of quitting among these smokers in the context of a current quit attempt. To facilitate development of more effective interventions, we conducted a qualitative exploration of challenges and facilitators of quitting in an intervention study for smokers with BD. Participants were adult daily smokers with BD (n = 10) who completed a 10-week smoking cessation intervention consisting of Acceptance and Commitment Therapy (ACT) and nicotine patch. We administered semistructured interviews focused on the quitting process at the end of treatment and used inductive content analysis to extract themes. Emergent themes representing challenges of quitting included social impediments, lack of awareness, avoidance, maladaptive beliefs, ambivalence, benefits of smoking, and difficulties with nicotine replacement. Themes representing change facilitators included positive treatment effects (ACT-specific, nonspecific, and nicotine patch-related), coping behaviors, reasons to quit, changes in self-perception, and social benefits. Results suggest a need for assistance with obtaining social support and handling social impediments, interrupting the automaticity of smoking, expanding the behavioral repertoire to handle aversive internal states that tend to be avoided by smoking, preventing maladaptive beliefs from interfering with quitting, taking meaningful action toward change while experiencing ambivalence, either replacing the benefits of smoking or accepting their loss, and troubleshooting difficulties with nicotine replacement. Findings regarding facilitators of quitting supported previous quantitative findings that the ACT intervention impacted theory-based targets and highlighted the importance of the counseling relationship.

Motivation is not enough: prediction of risk behavior following diagnosis of coronary heart disease from the theory of planned behavior.

PubMed

Johnston, Derek W; Johnston, Marie; Pollard, Beth; Kinmonth, Ann-Louise; Mant, David

2004-09-01

Perceived behavioral control (PBC) and intention, the proximal predictors from the theory of planned behavior (TPB), were used to predict cardiovascular risk behaviors in 597 patients 1 year after diagnosis with coronary heart disease. The outcome measures were self-report measures of exercise plus objective measures of fitness (distance walked in 6 min) and cotinine-confirmed smoking cessation. In multivariate analyses incorporating both PBC and intention, PBC predicted exercise, distance walked, and smoking cessation, but intention was not a reliable independent predictor of any health behavior measured. Thus, the effective theoretical component of the TPB was PBC. Similar predictions could derive from social-cognitive theory. In coronary patients, behavioral change needs to address issues of action implementation rather than motivational factors alone. ((c) 2004 APA, all rights reserved)

Quit smoking for life--social marketing strategy for youth: a case for Pakistan.

PubMed

Khowaja, Liaquat Ali; Khuwaja, Ali Khan; Nayani, Parvez; Jessani, Saleem; Khowaja, Malika Parveen; Khowaja, Saima

2010-12-01

Smoking is the single most avoidable risk factor for cancers. Majority of smokers know about this fact but it is difficult for them to give it up mainly in the face of widespread smoking advertisements by the tobacco industries. To reduce the prevalence of smoking and its associated cancers, immediate actions are required by public health authorities. Social marketing is an effective strategy to promote healthy attitudes and influence people to make real, sustained health behavior change by transiting through different stages which include precontemplation, contemplation, preparation, action, and maintenance. Social marketing can influence smokers to voluntarily accept, reject, modify, or abandon their smoking behavior. In Pakistan, the smoking prevalence has been increasing, necessitating effective measures. The trend of its usage has been going upwards and, according to the World Health Organization, in Pakistan, the usage of cigarette smoking is increased by 30% compared to 1998 figures. The Pakistan Pediatrics Association has estimated 1,000 to 1,200 school-going children between the ages of 6 and 16 years take up smoking every day. In Pakistan, ex-smokers in the low socioeconomic group reported spending 25% of the total household income on this habit. This paper focuses on the antismoking social marketing strategy in Pakistan with an aim to reduce smoking prevalence, especially among the youth.

Risk Factors for Smoking in Rural Women: The Role of Gender-Based Sexual and Intimate Partner Violence.

PubMed

Nemeth, Julianna M; Bonomi, Amy E; Lu, Bo; Lomax, Richard G; Wewers, Mary Ellen

2016-12-01

Women living in Ohio Appalachia experience cervical cancer at disproportionately high rates. Intimate partner and sexual gender-based violence (GBV) and smoking are independent risk factors for cervical cancer and interact to heighten risk. Appalachian women smoke at higher rates than other Ohio women, but little is known about GBV exposure in the region. The purpose of this study was to establish prevalence of women's exposure to GBV in Ohio Appalachia and examine the association between GBV and smoking among women in the region. A two-phase address-based random sampling approach was used in three purposefully selected Ohio Appalachian counties to identify women to complete an interviewer administered cross-sectional survey (n = 398). The primary exposure variable was GBV Index Score, a 4 level indices representing increasing exposure to eight abuse types. Correlation analysis and logistic regression were used to examine smoking correlations and risk. Almost 57% of women in the three selected Ohio Appalachian counties experienced GBV, with rate increasing to 77.5% among current smokers. The distribution of the GBV Exposure Index Score was significantly different across smoking status (p < = 0.0001), with exposure of GBV increasing when moving from never, to former, to current smokers. When controlling for depression, age, and adult socioeconomic position, GBV Exposure Index was significantly associated with current smoking behavior (OR:1.62, 95% CI [1.21-2.17]). Professionals working to reduce disparate disease burden among women in Ohio Appalachia should consider the role GBV plays in health behavior and behavioral change interventions, including smoking and smoking cessation.

Parents' and peers' normative influence on adolescents' smoking: results from a Swiss-Italian sample of middle schools students.

PubMed

Scalici, Francesca; Schulz, Peter J

2017-01-21

Adolescents observe and imitate people to whom they are associated in their social context, and the normative factors sent out by reference groups are crucial determinants of their decision to smoke. The aim of the study is to investigate how adolescents' smoking changes when they are exposed to factors of pro-smoking normative influence by parents and peers, and how age moderate this relation. A cross sectional survey collected data from 5657 students, aged between 11 and 14, from public and private middle schools in the Italian region of Switzerland (Ticino) on their smoking habits, perceived parents' and peers' approval and smoking. Multinomial logistic regression show that, as adolescents get older, more of the pro-smoking factors come from peers and parents, the higher the risk gets of being a "heavy smoker" has compared against having no experience with smoking. Living in a context with no factor of normative influence toward smoking play a protective role against smoking, and this effect becomes more important than more harmful the smoking behavior in question is. Furthermore, peers' descriptive norms are more influential for adolescents to become "light" and "heavy smokers", while smoking being approved by peers is important for adolescents to become accustomed to smoking. Findings support the different influence of parents' and peers' norms on adolescents' smoking, and highlight the importance of peers' model behavior as the most important factor influencing smoking during adolescence. Such results have implications for programs that aim to prevent or reduce smoking in early adolescence when friendship choice starts to become crucial.

Community-level Adult Daily Smoking Prevalence Moderates the Association between Adolescents’ Cigarette Smoking and Perceived Smoking by Friends

PubMed Central

Thrul, Johannes; Lipperman-Kreda, Sharon; Grube, Joel W.; Friend, Karen B.

2014-01-01

Few studies have investigated the complex interactions among the individual- and community-level social risk factors that underlie adolescents’ smoking behaviors. This study investigated whether community-level adult daily smoking prevalence is associated with adolescents’ smoking and whether it moderates the associations between perceived friends’ smoking approval and smoking behavior and adolescents’ own smoking. Self-reported data from 1,190 youths (50.3% female; 13–18 years old) in 50 midsized Californian cities were obtained through telephone interviews. Community characteristics were obtained from 2010 GeoLytics data. Community adult daily smoking prevalence was ascertained from telephone interviews with 8,918 adults conducted in the same 50 cities. Multilevel analyses, controlling for individual and city characteristics, were used to predict adolescents’ past 12-month smoking from perceived friends’ smoking approval and smoking behavior and from community adult daily smoking prevalence. Results showed that perceived friends’ smoking approval and behavior were associated positively with adolescents’ smoking, as was the community-level prevalence of adult daily smoking. Furthermore, the association between perceived friends’ smoking behavior and adolescents’ own smoking was moderated by the prevalence of adult daily smokers in the community. Specifically, the association was stronger in cities with higher prevalence of adult smokers. These results suggest that adult community norms that are more supportive of smoking may enhance the influence of friends’ smoking behavior. Therefore, interventions designed to prevent or reduce youths’ smoking should also focus on reducing smoking by adults. PMID:24241785

Effects of a randomized controlled trial to assess the six-months effects of a school based smoking prevention program in Saudi Arabia.

PubMed

Mohammed, Mutaz; Eggers, Sander Matthijs; Alotaiby, Fahad F; de Vries, Nanne; de Vries, Hein

2016-09-01

To examine the efficacy of a smoking prevention program which aimed to address smoking related cognitions and smoking behavior among Saudi adolescents age 13 to 15. A randomized controlled trial was used. Respondents in the experimental group (N=698) received five in-school sessions, while those in the control group (N=683) received no smoking prevention information (usual curriculum). Post-intervention data was collected six months after baseline. Logistic regression analysis was applied to assess effects on smoking initiation, and linear regression analysis was applied to assess changes in beliefs and analysis of covariance (ANCOVA) was used to assess intervention effects. All analyses were adjusted for the nested structure of students within schools. At post-intervention respondents from the experimental group reported in comparison with those from the control group a significantly more negative attitude towards smoking, stronger social norms against smoking, higher self-efficacy towards non-smoking, more action planning to remain a non-smoker, and lower intentions to smoke in the future. Smoking initiation was 3.2% in the experimental group and 8.8% in the control group (p<0.01). The prevention program reinforced non-smoking cognitions and non-smoking behavior. Therefore it is recommended to implement the program at a national level in Saudi-Arabia. Future studies are recommended to assess long term program effects and the conditions favoring national implementation of the program. Copyright © 2016 Elsevier Inc. All rights reserved.

Smoking in movies: impact on adolescent smoking.

PubMed

Sargent, James D

2005-06-01

This article examines the evidence that supports an association between seeing smoking depictions in movies and adolescent smoking. The portrayal of tobacco use is common in movies and often is modeled by stars, who, from a social influences standpoint, should be powerful behavior change agents. The results of studies that assess audience responses to tobacco portrayal in movies are remarkably consistent in showing a moderate to strong association between seeing movie smoking and more positive attitudes toward smoking and adolescent smoking initiation. The two published longitudinal studies show an independent link between exposure to movie smoking at baseline and initiation in the future, with estimates of the effect size being remarkably consistent with their cross-sectional counterparts. Pediatricians should support public health campaigns to pressure the movie industry to voluntarily reduce smoking in movies and encourage parents to adhere to the Motion Picture Ratings System to reduce adolescent exposure to this powerful social influence to smoke.

Support for smoke-free restaurants among Massachusetts adults, 1992-1999.

PubMed Central

Brooks, D R; Mucci, L A

2001-01-01

OBJECTIVES: The authors examined trends and predictors of public support for smoke-free restaurants in Massachusetts. METHODS: Since 1992, the Massachusetts Behavioral Risk Factor Surveillance System has asked survey respondents about their attitudes toward smoking in restaurants. Analyses using data from 1992 to 1999 characterized changes over time in support for smoke-free restaurants and the role of demographic and smoking-related factors in predicting support. RESULTS: During 1992 to 1999, the rate of support for smoke-free restaurants increased from 37.5% to 59.8%, with similar increases among current, former, and never smokers. After adjustment for smoking status, support was associated with socioeconomic characteristics, race/ethnicity, and household smoking rules. Among current smokers, lighter smokers and those who were trying to quit were more likely to endorse smoke-free restaurants. CONCLUSIONS: There has been a substantial increase in support for smoke-free restaurants among both smokers and nonsmokers in Massachusetts. PMID:11211644

Process of smoking cessation. Implications for clinicians.

PubMed

Prochaska, J O; Goldstein, M G

1991-12-01

The process of smoking cessation involves progression through five stages of change: precontemplation, contemplation, preparation, action, and maintenance. Most patients are not prepared to take action on their smoking, yet most smoking cessation programs are designed for smokers who are so prepared. Small percentages of smokers register for action-oriented cessation programs. How much progress patients make after an intervention is directly related to what stage they are in prior to intervention. The stages of change can be quickly assessed with four questions. Physicians can then be more effective with a broader range of patients by matching their interventions to the patients' stage of change. Helping patients progress just one stage can double their chances of not smoking 6 months later. Providing personalized information about the cons of smoking, asking affect-arousing questions, and encouraging patients to re-evaluate themselves as smokers are interventions physicians can use to help patients who are not prepared to quit smoking. Behavioral interventions, such as providing substitutes like nicotine gum and removing or altering cues for smoking, are most helpful for patients who are ready to take action. The use of a stage-matched, patient-centered counseling intervention can help physicians to feel less frustrated and more effective in their efforts to help a broad range of their patients.

Parental Influence on Adolescent Smoking Cessation: Is there a Gender Difference?

PubMed Central

Kong, Grace; Camenga, Deepa; Krishnan-Sarin, Suchitra

2011-01-01

We examined the association of parental disapproval of adolescent smoking and parental smoking status, with past smoking quit behaviors among daily-smoking, high school-aged adolescents, and also tested whether these associations differ for boys and girls. Adolescent regular smokers (N = 253) completed questions on smoking behaviors, past smoking cessation behaviors, parental disapproval of smoking, and parental smoking. Past smoking cessation behaviors were defined as “the number of quit attempts that lasted longer than 24 hours” and “the longest number of days of abstinence”. Logistic regression analyses showed that for all adolescents, even having one smoking parent was associated with decreased odds of being abstinent for longer than 2 days. However, for girls, not having any smoking parents was associated with greater duration of abstinence (> 2 weeks). Having both parents, compared with not having any parents disapprove of smoking, was associated with greater number of quit attempts in boys, but this effect was not found in girls. The results indicate that parents have a salient role in adolescent smoking cessation behaviors, and this association appears to be gender-specific. However, further research is needed to understand the mechanisms that explain gender differences in parental influence on adolescent smoking cessation behaviors. PMID:22070852

Transportation into narrative worlds: implications for entertainment media influences on tobacco use.

PubMed

Green, Melanie C; Clark, Jenna L

2013-03-01

A growing body of research suggests that smoking portrayals in movies influence adolescent tobacco use. However, the mechanism for this influence remains unclear. The aim of this paper is to provide an overview of research on narrative transportation theory, particularly as applied to movies and smoking. We propose that this theory can provide a valuable framework for guiding research on the role of entertainment media in smoking and other addictive behaviors. We review empirical work on transportation theory and highlight the psychological mechanisms underlying transportation effects. 'Transportation into narrative worlds' refers to cognitive, emotional and imagery engagement into a narrative (including movies and entertainment media). We link this work with research on the effects of movie smoking. Research suggests that individuals who are more highly transported into narratives show greater attitude, belief and behavior change. Transportation effects work through reducing counterarguing, creating connections (identification and liking) with characters and increasing perceptions of realism and emotional involvement. We propose several future directions and research challenges for applying a transportation framework to the issue of entertainment media effects on smoking and tobacco disparities. Understanding factors contributing to transportation may provide a more nuanced view of who will be affected by movie smoking, and understanding the psychological processes underlying narrative persuasion may guide intervention efforts. Narrative transportation theory suggests that individuals' cognitive, emotional and imagery immersion in a narrative is a key mechanism of attitude, belief and behavior change. This theory provides a potentially generative and psychologically grounded framework for increasing knowledge about the boundary conditions and processes underlying the effects of entertainment media on tobacco use. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Social Network Behavior and Engagement Within a Smoking Cessation Facebook Page.

PubMed

Cole-Lewis, Heather; Perotte, Adler; Galica, Kasia; Dreyer, Lindy; Griffith, Christopher; Schwarz, Mary; Yun, Christopher; Patrick, Heather; Coa, Kisha; Augustson, Erik

2016-08-02

Social media platforms are increasingly being used to support individuals in behavior change attempts, including smoking cessation. Examining the interactions of participants in health-related social media groups can help inform our understanding of how these groups can best be leveraged to facilitate behavior change. The aim of this study was to analyze patterns of participation, self-reported smoking cessation length, and interactions within the National Cancer Institutes' Facebook community for smoking cessation support. Our sample consisted of approximately 4243 individuals who interacted (eg, posted, commented) on the public Smokefree Women Facebook page during the time of data collection. In Phase 1, social network visualizations and centrality measures were used to evaluate network structure and engagement. In Phase 2, an inductive, thematic qualitative content analysis was conducted with a subsample of 500 individuals, and correlational analysis was used to determine how participant engagement was associated with self-reported session length. Between February 2013 and March 2014, there were 875 posts and 4088 comments from approximately 4243 participants. Social network visualizations revealed the moderator's role in keeping the community together and distributing the most active participants. Correlation analyses suggest that engagement in the network was significantly inversely associated with cessation status (Spearman correlation coefficient = -0.14, P=.03, N=243). The content analysis of 1698 posts from 500 randomly selected participants identified the most frequent interactions in the community as providing support (43%, n=721) and announcing number of days smoke free (41%, n=689). These findings highlight the importance of the moderator for network engagement and provide helpful insights into the patterns and types of interactions participants are engaging in. This study adds knowledge of how the social network of a smoking cessation community behaves within the confines of a Facebook group.

Attitudes toward E-Cigarettes, Reasons for Initiating E-Cigarette Use, and Changes in Smoking Behavior after Initiation: A Pilot Longitudinal Study of Regular Cigarette Smokers.

PubMed

Berg, Carla J; Barr, Dana Boyd; Stratton, Erin; Escoffery, Cam; Kegler, Michelle

2014-10-01

We examined 1) changes in smoking and vaping behavior and associated cotinine levels and health status among regular smokers who were first-time e-cigarette purchasers and 2) attitudes, intentions, and restrictions regarding e-cigarettes. We conducted a pilot longitudinal study with assessments of the aforementioned factors and salivary cotinine at weeks 0, 4, and 8. Eligibility criteria included being ≥18 years old, smoking ≥25 of the last 30 days, smoking ≥5 cigarettes per day (cpd), smoking regularly ≥1 year, and not having started using e-cigarettes. Of 72 individuals screened, 40 consented, 36 completed the baseline survey, and 83.3% and 72.2% were retained at weeks 4 and 8, respectively. Participants reduced cigarette consumption from baseline to week 4 and 8 (p's < 0.001); 23.1% reported no cigarette use in the past month at week 8. There was no significant decrease in cotinine from baseline to week 4 or 8 (p's = ns). At week 8, the majority reported improved health (65.4%), reduced smoker's cough (57.7%), and improved sense of smell (53.8%) and taste (50.0%). The majority believed that e-cigarettes versus regular cigarettes have fewer health risks (97.2%) and that e-cigarettes have been shown to help smokers quit (80.6%) and reduce cigarette consumption (97.2%). In addition, the majority intended to use e-cigarettes as a complete replacement for regular cigarettes (69.4%) and reported no restriction on e-cigarette use in the home (63.9%) or car (80.6%). Future research is needed to document the long-term impact on smoking behavior and health among cigarette smokers who initiate use of e-cigarettes.

Risk Factors for Smoking Behaviors among Adolescents

ERIC Educational Resources Information Center

Chung, Sung Suk; Joung, Kyoung Hwa

2014-01-01

Many students in Korea begin to use tobacco and develop a regular smoking habit before they reach adulthood. Yet, little is known about various signs contributing to the transition of the student smoking behaviors. This study used a national sample to explore and compare risk factors for smoking behaviors. Three types of smoking behaviors were…

Parental factors and adolescents' smoking behavior: an extension of The theory of planned behavior.

PubMed

Harakeh, Zeena; Scholte, Ron H J; Vermulst, Ad A; de Vries, Hein; Engels, Rutger C M E

2004-11-01

The aim of the present study is to investigate whether general parenting factors (i.e., quality parent-child relationship, psychological control, strict control, parental knowledge) and parental smoking add to The theory of planned behaviour [Organ Behav. Hum. Dec. 50 (1991) 179] in predicting the onset of smoking. A mediation model is applied in which parental factors affect smoking behavior indirectly by affecting smoking cognitions (i.e., attitude, self-efficacy, and social norm). The model was tested in a longitudinal study on 1,070 adolescents, aged 10-14 years old. Structural equation models (SEM) on current and on future smoking behavior were tested. The findings showed that the quality of the parent-child relationship and parental knowledge affected adolescents' smoking behavior indirectly, while parental smoking behavior had a direct effect. Strict control and psychological control were found to be unrelated to adolescents' smoking onset. In prevention campaigns, parents should be informed of the extent to which they exert influence on their child's smoking behavior and should be given advice and information on how they can prevent their children from starting to smoke.

Smoking-Related Knowledge, Attitudes, Behaviors, Smoking Cessation Idea and Education Level among Young Adult Male Smokers in Chongqing, China

PubMed Central

Xu, Xianglong; Liu, Lingli; Sharma, Manoj; Zhao, Yong

2015-01-01

Introduction: In 2012 in China, 52.9% of men were reported to smoke while only 2.4% of women smoked. This study explored the smoking-related Knowledge, Attitudes and Practices (KAP) among young adult male smokers. Methods: A cross-sectional study was conducted in four municipal areas of Chongqing using a questionnaire administered to 536 natives young male smokers aged 18–45 years old. Results: The total score of smoking cognition, the total score of smoking attitude and the total score of positive behavior to quit smoking was significantly different among the three groups by education. Besides, 30.97% of male smokers never seriously thought about quitting smoking. Logistic regression analysis found smoking-related knowledge, attitudes, behaviors and sociodemographic factors affect having smoking cessation idea. But no statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking in a sample of higher education. No statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking (Pearson correlation coefficient = 0.03012, p = 0.6811), and also no statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking (Pearson correlation coefficient = 0.08869, p = 0.2364)  in the sample of higher education young adult males Conclusions: Young adult males with higher education have a better knowledge of smoking hazards and a more positive attitude toward smoking, however, this knowledge and attitude do not necessarily translate into health behavioral outcomes such as not smoking. Overall the present findings indicate that no statistically significant correlation between the education level and quitting smoking idea exists among young adult male smokers in China. This survey gives a snapshot of the impact of education on smoking-related KAP among young adults male smokers. PMID:25689992

Smoking-related knowledge, attitudes, behaviors, smoking cessation idea and education level among young adult male smokers in Chongqing, China.

PubMed

Xu, Xianglong; Liu, Lingli; Sharma, Manoj; Zhao, Yong

2015-02-16

In 2012 in China, 52.9% of men were reported to smoke while only 2.4% of women smoked. This study explored the smoking-related Knowledge, Attitudes and Practices (KAP) among young adult male smokers. A cross-sectional study was conducted in four municipal areas of Chongqing using a questionnaire administered to 536 natives young male smokers aged 18-45 years old. The total score of smoking cognition, the total score of smoking attitude and the total score of positive behavior to quit smoking was significantly different among the three groups by education. Besides, 30.97% of male smokers never seriously thought about quitting smoking. Logistic regression analysis found smoking-related knowledge, attitudes, behaviors and sociodemographic factors affect having smoking cessation idea. But no statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking in a sample of higher education. No statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking (Pearson correlation coefficient = 0.03012, p = 0.6811), and also no statistically significant correlation was observed between smoking cognition and positive behavior to quit smoking (Pearson correlation coefficient = 0.08869, p = 0.2364) in the sample of higher education young adult males Young adult males with higher education have a better knowledge of smoking hazards and a more positive attitude toward smoking, however, this knowledge and attitude do not necessarily translate into health behavioral outcomes such as not smoking. Overall the present findings indicate that no statistically significant correlation between the education level and quitting smoking idea exists among young adult male smokers in China. This survey gives a snapshot of the impact of education on smoking-related KAP among young adults male smokers.

The dynamics of smoking-related disturbed methylation: a two time-point study of methylation change in smokers, non-smokers and former smokers.

PubMed

Wilson, Rory; Wahl, Simone; Pfeiffer, Liliane; Ward-Caviness, Cavin K; Kunze, Sonja; Kretschmer, Anja; Reischl, Eva; Peters, Annette; Gieger, Christian; Waldenberger, Melanie

2017-10-18

The evidence for epigenome-wide associations between smoking and DNA methylation continues to grow through cross-sectional studies. However, few large-scale investigations have explored the associations using observations for individuals at multiple time-points. Here, through the use of the Illumina 450K BeadChip and data collected at two time-points separated by approximately 7 years, we investigate changes in methylation over time associated with quitting smoking or remaining a former smoker, and those associated with continued smoking. Our results indicate that after quitting smoking the most rapid reversion of altered methylation occurs within the first two decades, with reversion rates related to the initial differences in methylation. For 52 CpG sites, the change in methylation from baseline to follow-up is significantly different for former smokers relative to the change for never smokers (lowest p-value 3.61 x 10 -39 for cg26703534, gene AHRR). Most of these sites' respective regions have been previously implicated in smoking-associated diseases. Despite the early rapid change, dynamism of methylation appears greater in former smokers vs never smokers even four decades after cessation. Furthermore, our study reveals the heterogeneous effect of continued smoking: the methylation levels of some loci further diverge between smokers and non-smokers, while others re-approach. Though intensity of smoking habit appears more significant than duration, results remain inconclusive. This study improves the understanding of the dynamic link between cigarette smoking and methylation, revealing the continued fluctuation of methylation levels decades after smoking cessation and demonstrating that continuing smoking can have an array of effects. The results can facilitate insights into the molecular mechanisms behind smoking-induced disturbed methylation, improving the possibility for development of biomarkers of past smoking behavior and increasing the understanding of the molecular path from exposure to disease.

The influence of self-esteem, parental smoking, and living in a tobacco production region on adolescent smoking behaviors.

PubMed

Murphy, N T; Price, C J

1988-12-01

Selected antecedents of smoking initiation among 1,513 eighth grade students in an urban tobacco producing county of North Carolina were studied using the Tobacco Cigarette Smoking Questionnaire and the Rosenberg Self-Esteem Scale. Fifteen percent of students reported currently smoking, and 17.2% indicated an intention to smoke upon graduation from high school. Self-esteem and parental smoking behavior related significantly to adolescents' smoking behavior and future intention to smoke. Significantly more females intended to smoke and had lower self-esteem than males. Family involvement in the tobacco industry related significantly to adolescents' intention to smoke but not their smoking behavior. Overall, low self-esteem and parental smoking models may be important to developing the smoking habit among young adolescents. Prevention of smoking initiation should involve promotion of children's self-esteem and avoidance of parental smoking modeling prior to the eighth grade.

Nicotine reduction as an increase in the unit price of cigarettes: a behavioral economics approach.

PubMed

Smith, Tracy T; Sved, Alan F; Hatsukami, Dorothy K; Donny, Eric C

2014-11-01

Urgent action is needed to reduce the harm caused by smoking. Product standards that reduce the addictiveness of cigarettes are now possible both in the U.S. and in countries party to the Framework Convention on Tobacco Control. Specifically, standards that required substantially reduced nicotine content in cigarettes could enable cessation in smokers and prevent future smoking among current non-smokers. Behavioral economics uses principles from the field of microeconomics to characterize how consumption of a reinforcer changes as a function of the unit price of that reinforcer (unit price=cost/reinforcer magnitude). A nicotine reduction policy might be considered an increase in the unit price of nicotine because smokers are paying more per unit of nicotine. This perspective allows principles from behavioral economics to be applied to nicotine reduction research questions, including how nicotine consumption, smoking behavior, use of other tobacco products, and use of other drugs of abuse are likely to be affected. This paper reviews the utility of this approach and evaluates the notion that a reduction in nicotine content is equivalent to a reduction in the reinforcement value of smoking-an assumption made by the unit price approach. Copyright © 2014 Elsevier Inc. All rights reserved.

Smiling Instead of Smoking: Development of a Positive Psychology Smoking Cessation Smartphone App for Non-daily Smokers.

PubMed

Hoeppner, Bettina B; Hoeppner, Susanne S; Kelly, Lourah; Schick, Melissa; Kelly, John F

2017-10-01

The usefulness of mobile technology in supporting smoking cessation has been demonstrated, but little is known about how smartphone apps could best be leveraged. The purpose of this paper is to describe the program of research that led to the creation of a smoking cessation app for non-daily smokers, so as to stimulate further ideas to create "smart" smartphone apps to support health behavior change. Literature reviews to evaluate the appropriateness of the proposed app, content analyses of existing apps, and smoking cessation sessions with non-daily smokers (n = 38) to inform the design of the app. The literature reviews showed that (1) smoking cessation apps are sought after by smokers, (2) positive affect plays an important role in smoking cessation, (3) short, self-administered exercises consistently bring about enduring positive affect enhancements, and (4) low treatment-seeking rates of non-daily smokers despite high motivation to quit indicate a need for novel smoking cessation support. Directed content analyses of existing apps indicated that tailoring, two-way interactions, and proactive features are under-utilized in existing apps, despite the popularity of such features. Conventional content analyses of audio-recorded session tapes suggested that difficulty in quitting was generally linked to specific, readily identifiable occasions, and that social support was considered important but not consistently sought out. The "Smiling Instead of Smoking" (SIS) app is an Android app that is designed to act as a behavioral, in-the-pocket coach to enhance quitting success in non-daily smokers. It provides proactive, tailored behavioral coaching, interactive tools (e.g., enlisting social support), daily positive psychology exercises, and smoking self-monitoring.

The Association between the Nature of the Goal Committed to and Quitting Smoking

ERIC Educational Resources Information Center

Borland, Ron; Li, Lin; Balmford, James

2017-01-01

Commitments to goals are theorized to affect behavior change outcomes, but competing theories argue for hard to achieve goals and strategic sub-goals as optimum strategies for success. This study aimed to explore whether the nature of the goal affects smoking cessation outcomes. A total of 1043 participants in a randomized controlled trial of…

Psychosocial Factors and Enrollment in a Televised Smoking Cessation Program.

ERIC Educational Resources Information Center

Kviz, Frederick J.; And Others

1991-01-01

Interviews with random samples of 641 registrants for a smoking cessation program on Chicago television news and 2,398 smokers who regularly viewed the news determined that registration was associated with (1) recognition of the need to change behavior; (2) high expectation for quitting; (3) concern about the burden of lung cancer on significant…

Repeated Administration of Cigarette Smoke Condensate Increases Glutamate Levels and Behavioral Sensitization

PubMed Central

Ryu, In Soo; Kim, Jieun; Seo, Su Yeon; Yang, Ju Hwan; Oh, Jeong Hwan; Lee, Dong Kun; Cho, Hyun-Wook; Lee, Kyuhong; Yoon, Seong Shoon; Seo, Joung-Wook; Shim, Insop; Choe, Eun Sang

2018-01-01

Nicotine, a nicotinic acetylcholine receptor agonist, produces the reinforcing effects of tobacco dependence by potentiating dopaminergic and glutamatergic neurotransmission. Non-nicotine alkaloids in tobacco also contribute to dependence by activating the cholinergic system. However, glutamatergic neurotransmission in the dorsal striatum associated with behavioral changes in response to cigarette smoking has not been investigated. In this study, the authors investigated alterations in glutamate levels in the rat dorsal striatum related to behavioral alterations after repeated administration of cigarette smoke condensate (CSC) using the real-time glutamate biosensing and an open-field behavioral assessment. Repeated administration of CSC including 0.4 mg nicotine (1.0 mL/kg/day, subcutaneous) for 14 days significantly increased extracellular glutamate concentrations more than repeated nicotine administration. In parallel with the hyperactivation of glutamate levels, repeated administration of CSC-evoked prolonged hypersensitization of psychomotor activity, including locomotor and rearing activities. These findings suggest that the CSC-induced psychomotor activities are closely associated with the elevation of glutamate concentrations in the rat dorsal striatum. PMID:29615877

See Me Smoke-Free: Protocol for a Research Study to Develop and Test the Feasibility of an mHealth App for Women to Address Smoking, Diet, and Physical Activity

PubMed Central

Johnson, Thienne; Gordon, Judith S

2016-01-01

Background This paper presents the protocol for an ongoing research study to develop and test the feasibility of a multi-behavioral mHealth app. Approximately 27 million women smoke in the US, and more than 180,000 women die of illnesses linked to smoking annually. Women report greater difficulties quitting smoking. Concerns about weight gain, negative body image, and low self-efficacy may be key factors affecting smoking cessation among women. Recent studies suggest that a multi-behavioral approach, including diet and physical activity, may be more effective at helping women quit. Guided imagery has been successfully used to address body image concerns and self-efficacy in our 3 target behaviors—exercise, diet and smoking cessation. However, it has not been used simultaneously for smoking, diet, and exercise behavior in a single intervention. While imagery is an effective therapeutic tool for behavior change, the mode of delivery has generally been in person, which limits reach. mHealth apps delivered via smart phones offer a unique channel through which to distribute imagery-based interventions. Objective The objective of our study is to evaluate the feasibility of an mHealth app for women designed to simultaneously address smoking, diet, and physical activity behaviors. The objectives are supported by three specific aims: (1) develop guided imagery content, user interface, and resources to reduce weight concern, and increase body image and self-efficacy for behavior change among women smokers, (2) program a prototype of the app that contains all the necessary elements of text, graphics, multimedia and interactive features, and (3) evaluate the feasibility, acceptability, and preliminary efficacy of the app with women smokers. Methods We created the program content and designed the prototype application for use on the Android platform in collaboration with 9 participants in multiple focus groups and in-depth interviews. We programmed and tested the application’s usability with 6 participants in preparation for an open, pre- and posttest trial. Currently, we are testing the feasibility and acceptability of the application, evaluating the relationship of program use to tobacco cessation, dietary behaviors, and physical activity, and assessing consumer satisfaction with approximately 70 women smokers with Android-based smart phones. Results The study was started January 1, 2014. The app was launched and feasibility testing began in April 1, 2015. Participants were enrolled from April 1-June 30, 2015. During that time, the app was downloaded over 350 times using no paid advertising. Participants were required to use the app “most days” for 30 days or they would be dropped from the study. We enrolled 151 participants. Of those, 78 were dropped or withdrew from the study, leaving 73 participants. We have completed the 30-day assessment, with a 92% response rate. The 90-day assessment is ongoing. During the final phase of the study, we will be conducting data analyses and disseminating study findings via presentations and publications. Feasibility will be demonstrated by successful participant retention and a high level of app use. We will examine individual metrics (eg, duration of use, number of screens viewed, change in usage patterns over time) and engagement with interactive activities (eg, activity tracking). Conclusions We will aggregate these data into composite exposure scores that combine number of visits and overall duration to calculate correlations between outcome and measures of program exposure and engagement. Finally, we will compare app use between participants and non-participants using Google Analytics. PMID:26795257

Heterosexual Gender Relations and Masculinity in Fathers Who Smoke

PubMed Central

Kwon, Jae-Yung; Oliffe, John L; Bottorff, Joan L; Kelly, Mary T

2014-01-01

The purpose of this research was to explore the role of masculinity and heterosexual gender relations in new and expectant fathers’ explanations of their continued smoking. We conducted a secondary analysis of in-depth interviews with 20 fathers. Two themes were identified: (1) reconciling with partners to maintain a smoke-free family home; and (2) smoking to self-regulate emotions and maintain relationships. Fathers’ decisions to smoke and changes in smoking behavior were shaped by ideals of masculinity and by partner relationships and family and social contexts, including division of domestic duties and childcare. Recognizing the influence of both masculinity and gender relations could provide new directions for supporting men’s smoking cessation efforts during early parenthood. © 2014 The Authors. Research in Nursing & Health Published by Wiley Periodicals, Inc. PMID:25155799

Heterosexual gender relations and masculinity in fathers who smoke.

PubMed

Kwon, Jae-Yung; Oliffe, John L; Bottorff, Joan L; Kelly, Mary T

2014-10-01

The purpose of this research was to explore the role of masculinity and heterosexual gender relations in new and expectant fathers' explanations of their continued smoking. We conducted a secondary analysis of in-depth interviews with 20 fathers. Two themes were identified: (1) reconciling with partners to maintain a smoke-free family home; and (2) smoking to self-regulate emotions and maintain relationships. Fathers' decisions to smoke and changes in smoking behavior were shaped by ideals of masculinity and by partner relationships and family and social contexts, including division of domestic duties and childcare. Recognizing the influence of both masculinity and gender relations could provide new directions for supporting men's smoking cessation efforts during early parenthood. © 2014 The Authors. Research in Nursing & Health Published by Wiley Periodicals, Inc.

Integrated medical care management and behavioral risk factor reduction for multicondition patients: behavioral outcomes of the TEAMcare trial.

PubMed

Rosenberg, Dori; Lin, Elizabeth; Peterson, Do; Ludman, Evette; Von Korff, Michael; Katon, Wayne

2014-01-01

The purpose of the study was to compare behavioral outcomes (physical activity, sedentary behavior, smoking cessation, diet) between the intervention and usual care conditions from the TEAMcare trial. TEAMcare was a randomized trial among 214 adults with depression and poorly controlled diabetes and/or coronary heart disease that promoted health behavior change and pharmacotherapy to improve health. Behavioral outcomes were measured with the International Physical Activity Questionnaire (physical activity, sitting time) and the Summary of Diabetes Self-Care Activities Measure (smoking, diet, exercise). Poisson regression models among completers (N=185) were conducted adjusting for age, education, smoking status and depression. Intervention participants had more days/week following a healthy eating plan [relative rate=1.2, 95% confidence interval (CI)=1.1-1.4] and more days of participation in 30 min of physical activity (relative rate=1.2, 95% CI=1.1-2.0) compared to usual care. Intervention participants were more likely to meet physical activity guidelines (7.5% increase) compared to usual care (12% decrease; P=.053). Diet and activity generally improved for those receiving the intervention, while there were no differences in some aspects of diet (fruit and vegetable and high-fat food intake), smoking status and sitting time between conditions in the TEAMcare trial. Copyright © 2014 Elsevier Inc. All rights reserved.

An exploration of health beliefs and attitudes of smokers with vascular disease who participate in or decline a smoking cessation program.

PubMed

Clarke, Kim E; Aish, Arlene

2002-09-01

The descriptive cross-sectional aspect of this study compared a group of smokers with peripheral arterial disease who chose to participate in a smoking intervention with a group of smokers with peripheral arterial disease who declined to participate. The longitudinal aspect of this study used Ajzen and Fishbein's(1) Theory of Reasoned Action, Keeney's(2) Expected Utility Decision Theory, and Prochaska and DiClemente's(3) Transtheoretical Model of Change to describe the influence of this smoking cessation program on the beliefs and attitudes about smoking in group 1. Smokers completed a smoking beliefs questionnaire with vascular disease at baseline and after 13 weeks of smoking cessation intervention. Smokers who did not want to participate in the smoking cessation program also completed this questionnaire for comparison. Statistically significant differences were found to differentiate people who enrolled in the smoking cessation program from those who did not. Subjects in group 2 smoked less per day, were less educated, were less often diagnosed as having peripheral arterial disease, were found to be more in the precontemplation stage of change in smoking cessation, cared more about what their physician and family thought they should do, and perceived themselves to be at less risk for developing more severe circulatory problems if they did not quit smoking. After 13 weeks, participants in both groups 1 and 2 were found to smoke significantly less per day. No support was found for the expectation that the smoking intervention would influence stage of change in smoking behavior or attitudes and beliefs about the risks of smoking to the participants' health after 13 weeks.

The influence of HIV disease events/stages on smoking attitudes and behaviors: project STATE (Study of Tobacco Attitudes and Teachable Events).

PubMed

Vidrine, Damon J; Fletcher, Faith E; Buchberg, Meredith K; Li, Yisheng; Arduino, Roberto C; Gritz, Ellen R

2014-02-11

Given the increase in life expectancy among HIV-positive individuals attributable to antiretroviral therapies, cigarette smoking now represents one of the most salient health risks confronting the HIV-positive population. Despite this risk, very few efforts to date have been made to target persons living with HIV for smoking cessation treatment, and no efforts have been made to explore the role of cognitions and HIV disease events/stages on smoking outcomes. The purpose of the study, Project STATE (Study of Tobacco Attitudes and Teachable Events), is to prospectively examine the relationship between HIV events/stages, perceived impact of HIV disease, attitudes about cigarette smoking, and smoking behaviors. This study employs a prospective design. Patients are recruited at the time of their first physician visit at a large inner city HIV-clinic--Thomas Street Health Center (TSHC). Consenting participants then complete a baseline assessment. All participants are offered standard care smoking cessation treatment. Follow-up assessments are completed on four subsequent occasions: 3, 6, 9, and 12 months post-baseline. These follow-up assessments are scheduled to coincide with routine clinic appointments with their TSHC physicians. In addition, each participant is given a prepaid cell phone at the time of enrollment and asked to complete brief phone assessments weekly for the first three months of the study period. By evaluating events/stages of HIV disease as potential teaching moments for smoking cessation, findings from this study could be used to develop treatments tailored to an individual's stage of HIV disease. This study design will enable us to carefully track changes in smoking behavior over time, and to link these changes to both the course of HIV disease and/or to the participant's' perceived impact of HIV. By identifying optimal time points for intervention, the findings from this study will have the potential to maximize the efficiency and efficacy of cessation treatments delivered in resource-limited settings. In addition, the findings will be instrumental in identifying specific constructs that should be targeted for intervention and will provide a strong foundation for the development of future cessation interventions targeting smokers living with HIV/AIDS.

Calls to Poison Centers for hookah smoking exposures.

PubMed

Retzky, Sandra S; Spiller, Henry A; Callahan-Lyon, Priscilla

2018-06-01

Over the past decade, smoking behaviors have changed in the US. Hookah or waterpipe smoking is increasing, especially among youth and young adults. Social media sites describe the "hookah high" or "buzz", which may be related to nicotine, carbon monoxide, or other inhalants in hookah smoke. Most important is the risk of carbon monoxide poisoning. Case reports include a high number of victims presenting with loss of consciousness from either syncope or seizures. Anaphylaxis and a very rare respiratory hypersensitivity reaction, acute eosinophilic pneumonia, have also been reported from hookah smoking in previously healthy young adults. This article provides background information on hookah smoking, describes hookah-induced acute injuries that could precipitate poison center calls, and offers suggestions for exposure characterization.

Search query data to monitor interest in behavior change: application for public health.

PubMed

Carr, Lucas J; Dunsiger, Shira I

2012-01-01

There is a need for effective interventions and policies that target the leading preventable causes of death in the U.S. (e.g., smoking, overweight/obesity, physical inactivity). Such efforts could be aided by the use of publicly available, real-time search query data that illustrate times and locations of high and low public interest in behaviors related to preventable causes of death. This study explored patterns of search query activity for the terms 'weight', 'diet', 'fitness', and 'smoking' using Google Insights for Search. Search activity for 'weight', 'diet', 'fitness', and 'smoking' conducted within the United States via Google between January 4(th), 2004 (first date data was available) and November 28(th), 2011 (date of data download and analysis) were analyzed. Using a generalized linear model, we explored the effects of time (month) on mean relative search volume for all four terms. Models suggest a significant effect of month on mean search volume for all four terms. Search activity for all four terms was highest in January with observable declines throughout the remainder of the year. These findings demonstrate discernable temporal patterns of search activity for four areas of behavior change. These findings could be used to inform the timing, location and messaging of interventions, campaigns and policies targeting these behaviors.

The Interplay of Friendship Networks and Social Networking Sites: Longitudinal Analysis of Selection and Influence Effects on Adolescent Smoking and Alcohol Use

PubMed Central

Soto, Daniel; Fujimoto, Kayo; Valente, Thomas W.

2014-01-01

Objectives. We examined the coevolution of adolescent friendships and peer influences with respect to their risk behaviors and social networking site use. Methods. Investigators of the Social Network Study collected longitudinal data during fall 2010 and spring 2011 from 10th-grade students in 5 Southern California high schools (n = 1434). We used meta-analyses of stochastic actor-based models to estimate changes in friendship ties and risk behaviors and the effects of Facebook and MySpace use. Results. Significant shifts in adolescent smoking and drinking occurred despite little change in overall prevalence rates. Students with higher levels of alcohol use were more likely to send and receive friendship nominations and become friends with other drinkers. They were also more likely to increase alcohol use if their friends drank more. Adolescents selected friends with similar Facebook and MySpace use habits. Exposure to friends’ risky online pictures increased smoking behaviors but had no significant effects on alcohol use. Conclusions. Our findings support a greater focus on friendship selection mechanisms in school-based alcohol use interventions. Social media platforms may help identify at-risk adolescent groups and foster positive norms about risk behaviors. PMID:24922126

Individual and spousal unemployment as predictors of smoking and drinking behavior

PubMed Central

Arcaya, Mariana; Glymour, M. Maria; Christakis, Nicholas A; Kawachi, Ichiro; Subramanian, S V

2014-01-01

The effects of unemployment on health behaviors, and substance use in particular, is still unclear despite substantial existing research. This study aimed to assess the effects of individual and spousal unemployment on smoking and alcohol consumption. The study was based on eight waves of geocoded Framingham Heart Study Offspring Cohort data (US) from 1971-2008 that contained social network information. We fit three series of models to assess whether lagged 1) unemployment, and 2) spousal unemployment predicted odds of being a current smoker or drinks consumed per week, adjusting for a range of socioeconomic and demographic covariates. Compared with employment, unemployment was associated with nearly twice the subsequent odds of smoking, and with increased cigarette consumption among male, but not female, smokers. In contrast, unemployment predicted a one drink reduction in weekly alcohol consumption, though effects varied according to intensity of consumption, and appeared stronger among women. While spousal unemployment had no effect on substance use behaviors among men, wives responded to husbands' unemployment by reducing their alcohol consumption. We conclude that individual, and among women, spousal unemployment predicted changes in substance use behaviors, and that the direction of the change was substance-dependent. Complex interactions among employment status, sex, and intensity and type of consumption appear to be at play and should be investigated further. PMID:24727666

Recruitment, training outcomes, retention, and performance of community health advisors in two tobacco control interventions for Latinos.

PubMed

Woodruff, Susan I; Candelaria, Jeanette I; Elder, John P

2010-04-01

Community Health Advisors (CHAs) are indigenous lay health advisors who, with training, can create health awareness, disseminate health information and support behavior change in their communities. Little data are available that describe the characteristics, recruitment, training, retention, and performance of CHAs. The present study described the characteristics, recruitment process, training outcomes, retention activities, and performance of two sets of CHAs who delivered tobacco-related interventions in the local Latino community. The Tobacco Control in Latino Communities (TCLC) Center trained 35 CHAs to conduct either a smoking cessation program for Spanish-speaking adult smokers or a behavioral problem-solving intervention to reduce environmental tobacco smoke (ETS) exposure among low-income Latino children. Theoretical psychosocial constructs related to behavior change, general self-esteem, general self-efficacy, and demographics were collected from CHAs before and after training. Additional measures captured the level of professionalism exercised and effort undertaken by the CHAs, as well actual outcomes of their efforts. Of the 33 women and 2 men CHAs recruited, 86% were originally from Mexico, most had a high school education, most were married, and the average monthly household income was $1,100-$1,400. Mean participant age was 42 years, and level of acculturation was relatively low. There were changes in the desired direction pre-to-post training for both ETS and smoking cessation program CHAs for most of the psychosocial constructs. Expert ratings of CHA performance were good, and recipients of the CHAs' efforts showed positive changes in behavior. This information may aid in planning for recruitment and evaluation of CHAs for future tobacco control programs.

CYP2A6 genotype and smoking behavior in current smokers screened for lung cancer.

PubMed

Styn, Mindi A; Nukui, Tomoko; Romkes, Marjorie; Perkins, Kenneth A; Land, Stephanie R; Weissfeld, Joel L

2013-05-01

Functional CYP2A6 genetic variation partially determines nicotine metabolism. In 2005, we examined functional CYP2A6 variants associated with reduced metabolism (CYP2A6*2, CYP2A6*9, CYP2A6*4), smoking history, and change in smoking in 878 adult smokers undergoing lung cancer screening in an urban setting. At one year, 216 quit smoking for more than 30 days while 662 continued smoking. Compared to subjects who smoked 30 cigarettes per day at baseline, the odds of a reduced metabolism genotype was 52% higher in subjects smoking 20-29 cigarettes per day and 86% higher in subjects smoking less than 20 cigarettes per day (p-trend = 0.016). Reduced metabolism genotypes appeared unrelated to quitting. Though related to smoking dose, CYP2A6 may not influence cessation.

Editorial: 3rd Special Issue on behavior change, health, and health disparities.

PubMed

Higgins, Stephen T

2016-11-01

This Special Issue of Preventive Medicine (PM) is the 3rd that we have organized on behavior change, health, and health disparities. This is a topic of critical importance to improving U.S. population health. There is broad scientific consensus that personal behaviors such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. Hence, effectively promoting health-related behavior change needs to be a key component of health care research and policy. There is also broad recognition that while these problems extend throughout the population, they disproportionately impact economically disadvantaged populations and other vulnerable populations and represent a major contributor to health disparities. Thus, behavior change represents an essential step in curtailing health disparities, which receives special attention in this 3rd Special Issue. We also devote considerable space to the longstanding challenges of reducing cigarette smoking and use of other tobacco and nicotine delivery products in vulnerable populations, obesity, and for the first time food insecurity. Across each of these topics we include contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges. Copyright © 2016 Elsevier Inc. All rights reserved.

Developmental Trajectories of Cigarette Smoking from Adolescence to the Early Thirties: Personality and Behavioral Risk Factors

PubMed Central

Brook, David W.; Brook, Judith S.; Zhang, Chenshu; Whiteman, Martin; Cohen, Patricia; Finch, Stephen J.

2013-01-01

The purpose of this study was to identify distinct trajectories of cigarette smoking from ages 14 to 32, and to examine adolescent personality factors that distinguish trajectories of smoking behavior. Participants (N=975) were randomly selected and followed prospectively since 1975. Follow-up data on cigarette use and personality and behavioral attributes were collected at five points in time, using structured interviews given in private by trained interviewers. Of these subjects, 746 comprised the cohort used in this study. Growth mixture modeling identified five smoking trajectory groups: nonsmokers, occasional smokers, late starters, quitters, and heavy/continuous smokers. Adolescent personality and behavioral risk factors such as lower ego integration, more externalizing behavior, and lower educational aspirations distinguished the trajectory groups. No gender differences were noted. The findings supported the hypotheses indicating multiple distinct trajectory groups of smoking behavior. Smoking behavior appeared in early adolescence and most often continued into adulthood. Emotional difficulties (i.e., lower ego integration), externalizing behavior, and lower educational aspirations in early adolescence were associated both with smoking at an early age and with continuing to smoke into the thirties. To be more effective, smoking prevention programs should target personality and behavioral variations, before smoking becomes habitual, particularly focused on characteristics reflecting behavioral problems as manifested in emotional difficulties, externalizing behavior, and low educational aspirations in early adolescence. The implications for research, prevention, and treatment are discussed. PMID:18686175

Cigarette Smoking among Adolescents aged 13-15 in Viet Nam and Correlates of Current Cigarette Smoking: Results from GYTS 2014 Data.

PubMed

Huong, Le Thi; Vu, Nga Thi Thu; Dung, Nguyen Ngoc; Xuan, Le Thi Thanh; Giang, Kim Bao; Hai, Phan Thi; Huyen, Doan Thu; Khue, Luong Ngoc; Lam, Nguyen Tuan; Minh, Hoang Van; Nga, Pham Thi Quynh

2016-01-01

The aim of this paper is to report the rate of current and ever cigarette smoking and explore correlates of current cigarette smoking among adolescents aged 13-15 in Viet Nam. This analysis was derived from GYTS survey, which comprised of 3,430 adolescents aged 13-15, conducted in 2014 in 13 cities and provinces of Viet Nam. We calculated the weighted rates of current and ever cigarette smoking and reported patterns of smoking behavior. We also performed logistic regression to explore correlates of current cigarette smoking behavior. The weighted rate of ever cigarette smoking was 9.5% (95% confidence interval (CI): 8.5 %-10.5%), in which the weighted rate among males (15.4%; 95% CI: 13.6%-17.0%) was higher than that among females (4.2%; 95% CI: 3.3%-5.1%). The weighted rate of current cigarette smoking was relatively low at 2.5% (95%CI: 2.0%- 3.0%) with higher weighted rate among males (4.9%; 95% CI: 3.8%-5.9%) compared to the corresponding figure among females (0.2%; 95% CI: 0.0 %-0.5%). Current cigarette smoking was significantly higher among males than females, in students aged 15 versus 13 years old, and in students who had several or all close friends smoking and students with daily observation of smoking at school. For greater smoking reduction outcomes, we recommend that tobacco interventions for adolescents should consider targeting more male students at older ages, establish stricter adherence to school-based banning of cigarette smoking, engage both smoking and nonsmoking adolescents and empower adolescents to resist peer smoking influence as well as changing their norms or beliefs towards smoking benefits.

The case for investigating social context in laboratory studies of smoking.

PubMed

Dimoff, John D; Sayette, Michael A

2017-03-01

With increasing frequency, addiction is conceived of as a brain disease, and such accounts seem especially pertinent with regard to the rapid delivery of nicotine to the brain via cigarette smoke. Moreover, drug administration trials (cigarette puffs) suggest that the behavior of smoking becomes automatized, with individuals developing prototypical approaches to smoking a cigarette. Compared with presumably more social activities, such as drinking alcohol, there may be little opportunity for social processes to influence smoking behavior. However, survey research examining smoking motivation often reveals a broadly defined 'social' factor and field research suggests that social context does influence smoking. We posit that laboratory smoking research has largely ignored social contextual factors that may help to understand better the precise mechanisms underlying smoking behavior and smoking motivation. We reviewed laboratory studies examining the effect of social context (operationalized as modeling) on smoking behavior. Studies were identified by searching PsychInfo and Medline using the following keywords: smoking, nicotine, tobacco, cigarette, consumption, topography, puff, smoking behavior, cigarettes smoked, modeling, imitation, social context, social influence and peer pressure. The reference and citation lists of these studies were then searched to identify additional studies. Few laboratory smoking studies target social context. Those few studies indicate that smoking behavior can be influenced by the presence of others. There is also some evidence that social context influences the effects of smoking as well as processes related to self-perception and self-regulation that reinforce smoking and hamper smoking cessation efforts. © 2016 Society for the Study of Addiction.

Decision Aid for Cigarette Smokers Scheduled for Elective Surgery.

PubMed

Warner, David O; LeBlanc, Annie; Kadimpati, Sandeep; Vickers, Kristin S; Shi, Yu; Montori, Victor M

2015-07-01

Decision aids can increase patient involvement in decision-making about health care. The study goal was to develop and test a decision aid for use by clinicians in discussion options for changing smoking behavior before and after elective surgery. In formative work, a decision aid was designed to facilitate patient-clinician discussion regarding three options: continue smoking, attempt a period of temporary abstinence, and attempt to quit smoking for good. A randomized, two-group pilot study was then conducted in smokers evaluated in preparation for elective surgery in a preoperative clinic to test the hypothesis that the decision aid would improve measures of decisional quality compared with usual care. The final decision aid consisted of three laminated cards. The front of each card included a colorful graphic describing each choice; the reverse including two to three pros and cons for each decision, a simple graphic illustrating the effects of smoking on the body, and a motivational phrase. In the randomized trial of 130 patients, the decision aid significantly (P < 0.05) improved measures of decisional quality and patient involvement in decision making (Cohen's d effect sizes of 0.76 and 1.20 for the Decisional Conflict Scale and Observing PatienT involvement In decisiON-making scale, respectively). However, the decision aid did not affect any aspect of perioperative smoking behavior, including the distribution of or adherence to choices. Although the use of a decision aid to facilitate clinician-patient discussions regarding tobacco use around the time of surgery substantially improved measures of decisional quality, it alone did not change perioperative tobacco use behavior.

Identification of cigarette smoke inhalations from wearable sensor data using a Support Vector Machine classifier.

PubMed

Lopez-Meyer, Paulo; Tiffany, Stephen; Sazonov, Edward

2012-01-01

This study presents a subject-independent model for detection of smoke inhalations from wearable sensors capturing characteristic hand-to-mouth gestures and changes in breathing patterns during cigarette smoking. Wearable sensors were used to detect the proximity of the hand to the mouth and to acquire the respiratory patterns. The waveforms of sensor signals were used as features to build a Support Vector Machine classification model. Across a data set of 20 enrolled participants, precision of correct identification of smoke inhalations was found to be >87%, and a resulting recall >80%. These results suggest that it is possible to analyze smoking behavior by means of a wearable and non-invasive sensor system.

Exposure to electronic nicotine delivery systems (ENDS) visual imagery increases smoking urge and desire.

PubMed

King, Andrea C; Smith, Lia J; Fridberg, Daniel J; Matthews, Alicia K; McNamara, Patrick J; Cao, Dingcai

2016-02-01

Use and awareness of electronic nicotine delivery systems (ENDS; also known as electronic cigarettes or e-cigarettes) has increased rapidly in recent years, particularly among young adults. As use of ENDS resembles traditional smoking in both hand-to-mouth movements and inhalation and exhalation behaviors, we determined whether exposure to e-cigarette use via video exposure would act as a cue to elicit urge and desire for a combustible cigarette. Young adult smokers (mean age of 26.3 ± 4.1 years) were randomized to view a brief video montage of advertisements depicting either e-cigarette vaping (n = 38) or bottled water drinking (n = 40). Pre- and postcue exposure assessments were conducted in a controlled laboratory setting without other smoking or vaping cues present or behaviors allowed. Primary outcomes included change from pre-exposure baseline in smoking urge (Brief Questionnaire of Smoking Urges) and desire for a combustible and e-cigarette (visual analogue scales). Results showed that relative to exposure to the bottled water video, exposure to the ENDS video significantly increased smoking urge (p < .001) as well as desire for a regular cigarette (p < .05) and an e-cigarette (p < .001). These findings provide preliminary evidence that passive exposure to video imagery of ENDS use may generalize as a condition cue and evoke urges for a combustible cigarette in young adult smokers. It remains to be determined whether such increases in urge and desire correspond to increases in actual smoking behavior. (c) 2016 APA, all rights reserved).

The impact of tailored self-help smoking cessation guides on young mothers.

PubMed

Davis, S W; Cummings, K M; Rimer, B K; Sciandra, R; Stone, J C

1992-01-01

It has been suggested that tailoring self-help materials for specific target populations will increase their effectiveness. This study tested the value of a self-help guide tailored specifically for women with young children. These women were recruited through a media campaign that encouraged smokers to call the Cancer Information Service (CIS) for assistance in stopping smoking. Women smokers with young children (under the age of 6) who called the CIS were given telephone counseling on quitting and were mailed one of three stop smoking guides. One third of callers received Quitting Times, a guide written specifically for women with young children; one third received the American Lung Association guide, Freedom from Smoking for You and Your Family; and one third received Clearing the Air, a guide developed by the National Cancer Institute. Six months after calling the CIS, these women were contacted by telephone to assess changes in smoking behavior. Overall, 12.5% of the women reported not smoking for at least 1 week at the time of the 6-month follow-up interview. There were no significant differences between subjects in the three groups in use of the self-help guides, methods used to attempt quitting, and quitting behavior. Findings from this study do not support the hypothesis that using a tailored stop smoking guide increases the targeted audience's cessation rate or affects quitting-related behavior. However, it should be noted that the smokers who called were predominantly in the contemplation or action stages.

[Influences of genetic and environmental factors on smoking related behaviors among male twin adults in China].

PubMed

Bao, Z Q; Yu, C Q; Wang, B Q; Cao, W H; Gao, W J; Lyu, J; Wang, S F; Pang, Z C; Cong, L M; Dong, Z; Wu, F; Wang, H; Wu, X P; Wang, D Z; Wang, X J; Wang, B Y; Li, L M

2016-05-01

To analyze the influences of genetic and environmental factors on smoking behavior, smoking cessation and onset age of smoking less than 20 years in male twin adults. A face-to-face questionnaire was conducted to collect data from 6 458 pair male twins aged ≥25 years registered in 9 provinces(municipality)in China. The heritability of three smoking related behaviors were calculated by using structural equation models. The ACE models were the best models of the three dimensions of smoking, i.e. smoking behavior, smoking cessation and onset age of smoking less than 20 years for male twins, and the corresponding heritability of these behaviors were 0.26(0.19-0.34), 0.27(0.19-0.37)and 0.05(0.00-0.14), respectively. When adjusted for area and age, the heritability of these three behaviors were 0.26(0.19-0.34), 0.31(0.00-0.74)and 0.05(0.00-0.14), respectively. All the three smoking related behaviors were affected by genetic factors, but environment factors had more effect on them. For smoking cessation, the heritability was highest, but the influence of environmental factors was lowest. Meanwhile, for onset age of smoking, the influence of environmental factors was highest.

Nicotine Dependence, “Background” and Cue-Induced Craving and Smoking in the Laboratory

PubMed Central

Dunbar, Michael S.; Shiffman, Saul; Kirchner, Thomas; Tindle, Hilary; Scholl, Sarah

2014-01-01

Background Nicotine dependence has been associated with higher “background” craving and smoking, independent of situational cues. Due in part to conceptual and methodological differences across past studies, the relationship between dependence and cue-reactivity (CR; e.g., cue-induced craving and smoking) remains unclear. Methods 207 daily smokers completed six pictorial CR sessions (smoking, negative affect, positive affect, alcohol, smoking prohibitions, and neutral). Individuals rated craving before (background craving) and after cues, and could smoke following cue exposure. Session videos were coded to assess smoking. Participants completed four nicotine dependence measures. Regression models assessed the relationship of dependence to cue-independent (i.e., pre-cue) and cue-specific (i.e., pre-post cue change for each cue, relative to neutral) craving and smoking (likelihood of smoking, latency to smoke, puff count). Results Dependence was associated with background craving and smoking, but did not predict change in craving across the entire sample for any cue. Among alcohol drinkers, dependence was associated with greater increases in craving following the alcohol cue. Only one dependence measure (Wisconsin Inventory of Smoking Dependence Motives) was consistently associated with smoking reactivity (higher likelihood of smoking, shorter latency to smoke, greater puff count) in response to cues. Conclusion While related to cue-independent background craving and smoking, dependence is not strongly associated with laboratory cue-induced craving under conditions of minimal deprivation. Dependence measures that incorporate situational influences on smoking correlate with greater cue-provoked smoking. This may suggest independent roles for CR and traditional dependence as determinants of smoking, and highlights the importance of assessing behavioral CR outcomes. PMID:25028339

Nicotine dependence, "background" and cue-induced craving and smoking in the laboratory.

PubMed

Dunbar, Michael S; Shiffman, Saul; Kirchner, Thomas R; Tindle, Hilary A; Scholl, Sarah M

2014-09-01

Nicotine dependence has been associated with higher "background" craving and smoking, independent of situational cues. Due in part to conceptual and methodological differences across past studies, the relationship between dependence and cue-reactivity (CR; e.g., cue-induced craving and smoking) remains unclear. 207 daily smokers completed six pictorial CR sessions (smoking, negative affect, positive affect, alcohol, smoking prohibitions, and neutral). Individuals rated craving before (background craving) and after cues, and could smoke following cue exposure. Session videos were coded to assess smoking. Participants completed four nicotine dependence measures. Regression models assessed the relationship of dependence to cue-independent (i.e., pre-cue) and cue-specific (i.e., pre-post cue change for each cue, relative to neutral) craving and smoking (likelihood of smoking, latency to smoke, puff count). Dependence was associated with background craving and smoking, but did not predict change in craving across the entire sample for any cue. Among alcohol drinkers, dependence was associated with greater increases in craving following the alcohol cue. Only one dependence measure (Wisconsin Inventory of Smoking Dependence Motives) was consistently associated with smoking reactivity (higher likelihood of smoking, shorter latency to smoke, greater puff count) in response to cues. While related to cue-independent background craving and smoking, dependence is not strongly associated with laboratory cue-induced craving under conditions of minimal deprivation. Dependence measures that incorporate situational influences on smoking correlate with greater cue-provoked smoking. This may suggest independent roles for CR and traditional dependence as determinants of smoking, and highlights the importance of assessing behavioral CR outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Does the exposure to smoking cues in movies affect adolescents' immediate smoking behavior?

PubMed

Lochbuehler, Kirsten; Kleinjan, Marloes; Engels, Rutger C M E

2013-05-01

Various studies have demonstrated that environmental smoking cues elicit smoking-related responses in smokers. However, cue reactivity studies among adolescent smokers are scarce. Therefore, the aim of this study was to examine the effect of smoking portrayal in movies on immediate smoking behavior in adolescent smokers. A total of 65 adolescent daily smokers (between the ages of 16 and 18 years) were exposed to a one-hour movie clip, with or without smoking characters, and were allowed to smoke while watching the movie. The exposure to smoking cues in movies had no effect on immediate smoking behavior. This association was not affected by several smoking- and movie-related variables. No influence of smoking cues in movies on immediate smoking behavior in adolescent daily smokers was found. More experimental research on the effects of environmental cues on adolescent smokers in different stages of addiction is needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

Covert Conditioning: Case Studies in Self-Management.

ERIC Educational Resources Information Center

Yager, Geoffrey G.

The self-management of thoughts and mental images was used in a series of empirical case studies to influence behavior changes. The target behaviors in the cases reported were smoking, overeating, fingernail biting, thinking self-depreciative thoughts, and responding assertively. Self-monitoring, covert positive reinforcement, covert…

Modeling Environmental Tobacco Smoke (ETS) Infiltration in Low-Income Multifamily Housing before and after Building Energy Retrofits

PubMed Central

Fabian, Maria Patricia; Lee, Sharon Kitman; Underhill, Lindsay Jean; Vermeer, Kimberly; Adamkiewicz, Gary; Levy, Jonathan Ian

2016-01-01

Secondhand exposure to environmental tobacco smoke (ETS) in multifamily housing remains a health concern despite strong recommendations to implement non-smoking policies. Multiple studies have documented exposure to ETS in non-smoking units located in buildings with smoking units. However, characterizing the magnitude of ETS infiltration or measuring the impact of building interventions or resident behavior on ETS is challenging due to the complexities of multifamily buildings, which include variable resident behaviors and complex airflows between numerous shared compartments (e.g., adjacent apartments, common hallways, elevators, heating, ventilating and air conditioning (HVAC) systems, stack effect). In this study, building simulation models were used to characterize changes in ETS infiltration in a low income, multifamily apartment building in Boston which underwent extensive building renovations targeting energy savings. Results suggest that exterior wall air sealing can lead to increases in ETS infiltration across apartments, while compartmentalization can reduce infiltration. The magnitude and direction of ETS infiltration depends on apartment characteristics, including construction (i.e., level and number of exterior walls), resident behavior (e.g., window opening, operation of localized exhaust fans), and seasonality. Although overall ETS concentrations and infiltration were reduced post energy-related building retrofits, these trends were not generalizable to all building units. Whole building smoke-free policies are the best approach to eliminate exposure to ETS in multifamily housing. PMID:26999174

Modeling Environmental Tobacco Smoke (ETS) Infiltration in Low-Income Multifamily Housing before and after Building Energy Retrofits.

PubMed

Fabian, Maria Patricia; Lee, Sharon Kitman; Underhill, Lindsay Jean; Vermeer, Kimberly; Adamkiewicz, Gary; Levy, Jonathan Ian

2016-03-16

Secondhand exposure to environmental tobacco smoke (ETS) in multifamily housing remains a health concern despite strong recommendations to implement non-smoking policies. Multiple studies have documented exposure to ETS in non-smoking units located in buildings with smoking units. However, characterizing the magnitude of ETS infiltration or measuring the impact of building interventions or resident behavior on ETS is challenging due to the complexities of multifamily buildings, which include variable resident behaviors and complex airflows between numerous shared compartments (e.g., adjacent apartments, common hallways, elevators, heating, ventilating and air conditioning (HVAC) systems, stack effect). In this study, building simulation models were used to characterize changes in ETS infiltration in a low income, multifamily apartment building in Boston which underwent extensive building renovations targeting energy savings. Results suggest that exterior wall air sealing can lead to increases in ETS infiltration across apartments, while compartmentalization can reduce infiltration. The magnitude and direction of ETS infiltration depends on apartment characteristics, including construction (i.e., level and number of exterior walls), resident behavior (e.g., window opening, operation of localized exhaust fans), and seasonality. Although overall ETS concentrations and infiltration were reduced post energy-related building retrofits, these trends were not generalizable to all building units. Whole building smoke-free policies are the best approach to eliminate exposure to ETS in multifamily housing.

Assessing the feasibility, acceptability and potential effectiveness of an integrated approach to smoking cessation for new and expectant fathers: The Dads in Gear study protocol.

PubMed

Bottorff, Joan L; Oliffe, John L; Sarbit, Gayl; Caperchione, Cristina; Clark, Marianne; Anand, Anima; Howay, Kym

2017-03-01

Evidence related to the effects of tobacco exposure in pregnancy and on infant and child health have focused on women's smoking cessation. Less often addressed is men's smoking, which when continued in fatherhood, reduces the chances of female partners' cessation and can negatively impact children's health as well as men's health. Dads in Gear (DIG) is an innovative program designed specifically for new fathers who want to reduce and quit smoking that includes three components: smoking cessation, fathering, and physical activity. The over-arching purpose of this study is to evaluate the feasibility of the DIG program and provide estimates of program efficacy. The purpose of this article is to describe the rationale and protocol for evaluating the DIG program's feasibility, acceptability and potential effectiveness. Using a prospective, non-comparative design, the DIG program will be implemented and evaluated in six communities. The program will be offered by trained facilitators to fathers who currently smoke and want to quit. The RE-AIM framework will guide the evaluation. Open-ended questions in participant surveys, and semi-structured interviews and weekly telephone de-briefs with facilitators will provide data for a process evaluation. Estimates of effectiveness include smoking behavior, fathering and physical activity measures at baseline, end of program, and 3-month follow up. The DIG program could support positive changes with respect to smoking cessation, physical activity and overall health for men. These effects could also promote family health. The program might also provide an effective model for engaging men in other health behavior change. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

The path to quit: how awareness of a large-scale mass-media smoking cessation campaign promotes quit attempts.

PubMed

Richardson, Amanda; Cullen, Jennifer; Mowery, Paul; McCausland, Kristen; Vallone, Donna

2011-11-01

Although awareness of mass-media smoking cessation campaigns is hypothesized to affect quit behavior through changes in cessation-related attitudes, intentions, and motivation (cognitions), this has yet to be formally tested. Structural equation modeling was used to examine whether changes in cessation-related cognitions mediate the relationship between awareness of a national mass-media smoking cessation campaign, the EX campaign, and quit attempts in a cohort of 3,571 current smokers drawn from eight U.S. Designated Market Areas and followed over an approximate six-month period. Models were examined in the total sample and within racial/ethnic, gender, age, and educational strata. Data suggest that there are both a direct effect of confirmed awareness of EX on quit attempts as well as an indirect effect mediated by positive changes in cessation-related cognitions. Results are not uniform across subgroups; stratified analyses reveal that awareness of EX is significantly associated with positive changes in cessation-related cognitions and quit attempts only in Blacks, males, and those with less than a high-school education. Those developing health communication mass-media campaigns need to consider how media messages might differentially impact U.S. subpopulations in order to elicit desired behavioral change across target subgroups.

Risk Factors for Smoking in Rural Women: The Role of Gender-Based Sexual and Intimate Partner Violence

PubMed Central

Nemeth, Julianna M.; Bonomi, Amy E.; Lu, Bo; Lomax, Richard G.; Wewers, Mary Ellen

2016-01-01

Abstract Background: Women living in Ohio Appalachia experience cervical cancer at disproportionately high rates. Intimate partner and sexual gender-based violence (GBV) and smoking are independent risk factors for cervical cancer and interact to heighten risk. Appalachian women smoke at higher rates than other Ohio women, but little is known about GBV exposure in the region. The purpose of this study was to establish prevalence of women's exposure to GBV in Ohio Appalachia and examine the association between GBV and smoking among women in the region. Methods: A two-phase address-based random sampling approach was used in three purposefully selected Ohio Appalachian counties to identify women to complete an interviewer administered cross-sectional survey (n = 398). The primary exposure variable was GBV Index Score, a 4 level indices representing increasing exposure to eight abuse types. Correlation analysis and logistic regression were used to examine smoking correlations and risk. Results: Almost 57% of women in the three selected Ohio Appalachian counties experienced GBV, with rate increasing to 77.5% among current smokers. The distribution of the GBV Exposure Index Score was significantly different across smoking status (p < = 0.0001), with exposure of GBV increasing when moving from never, to former, to current smokers. When controlling for depression, age, and adult socioeconomic position, GBV Exposure Index was significantly associated with current smoking behavior (OR:1.62, 95% CI [1.21–2.17]). Discussion: Professionals working to reduce disparate disease burden among women in Ohio Appalachia should consider the role GBV plays in health behavior and behavioral change interventions, including smoking and smoking cessation. PMID:27548468

Cigarette smoking and brain regulation of energy homeostasis.

PubMed

Chen, Hui; Saad, Sonia; Sandow, Shaun L; Bertrand, Paul P

2012-01-01

Cigarette smoking is an addictive behavior, and is the primary cause of cardiovascular and pulmonary disease, and cancer (among other diseases). Cigarette smoke contains thousands of components that may affect caloric intake and energy expenditure, although nicotine is the major addictive substance present, and has the best described actions. Nicotine exposure from cigarette smoke can change brain feeding regulation to reduce appetite via both energy homeostatic and reward mechanisms, causing a negative energy state which is characterized by reduced energy intake and increased energy expenditure that are linked to low body weight. These findings have led to the public perception that smoking is associated with weight loss. However, its effects at reducing abdominal fat mass (a predisposing factor for glucose intolerance and insulin resistance) are marginal, and its promotion of lean body mass loss in animal studies suggests a limited potential for treatment in obesity. Smoking during pregnancy puts pressure on the mother's metabolic system and is a significant contributor to adverse pregnancy outcomes. Smoking is a predictor of future risk for respiratory dysfunction, social behavioral problems, cardiovascular disease, obesity, and type-2 diabetes. Catch-up growth is normally observed in children exposed to intrauterine smoke, which has been linked to subsequent childhood obesity. Nicotine can have a profound impact on the developing fetal brain, via its ability to rapidly and fully pass the placenta. In animal studies this has been linked with abnormal hypothalamic gene expression of appetite regulators such as downregulation of NPY and POMC in the arcuate nucleus of the hypothalamus. Maternal smoking or nicotine replacement leads to unhealthy eating habits (such as junk food addiction) and other behavioral disorders in the offspring.

Systematic review of social network analysis in adolescent cigarette smoking behavior.

PubMed

Seo, Dong-Chul; Huang, Yan

2012-01-01

Social networks are important in adolescent smoking behavior. Previous research indicates that peer context is a major causal factor of adolescent smoking behavior. To date, however, little is known about the influence of peer group structure on adolescent smoking behavior. Studies that examined adolescent social networks with regard to their cigarette smoking behavior were identified through online and manual literature searches. Ten social network analysis studies involving a total of 28,263 adolescents were included in the final review. Of the 10 reviewed studies, 6 identify clique members, liaisons, and isolates as contributing factors to adolescent cigarette smoking. Significantly higher rates of smoking are noted among isolates than clique members or liaisons in terms of peer network structure. Eight of the reviewed studies indicate that peer selection or influence precedes adolescents' smoking behavior and intent to smoke. Such peer selection or influence accounts for a large portion of similarities among smoking adolescents. Adolescents who are identified as isolates are more likely to smoke and engage in risk-taking behaviors than others in the peer network structure. Given that the vast majority of current adult smokers started their smoking habits during adolescence, adolescent smoking prevention efforts will likely benefit from incorporating social network analytic approaches and focusing the efforts on isolates and other vulnerable adolescents from a peer selection and influence perspective. © 2011, American School Health Association.

Exploring the benefits of conscientiousness: an investigation of the role of daily stressors and health behaviors.

PubMed

O'Connor, Daryl B; Conner, Mark; Jones, Fiona; McMillan, Brian; Ferguson, Eamonn

2009-04-01

This study investigated the impact of conscientiousness and its facets on health behaviors and daily hassles (stressors) and the moderating effects of conscientiousness on the hassles-health behavior relationship Four hundred and twenty-two employees completed daily diaries over 4 weeks. Day-to-day within-person effects of daily hassles on health behaviors were examined, together with the influence of conscientiousness. Using hierarchical multivariate linear modeling, the results showed that conscientiousness was associated with lower consumption of high-fat snacks and more fruit and higher caffeine intake and smoking (in smokers) across the 28-day study period. Facets of conscientiousness were also found to moderate the effects of daily hassles on vegetable consumption, smoking, and likelihood of exercising each day. Participants with higher levels of order exercised more on days when they experienced daily hassles, whereas participants with lower levels of self-efficacy consumed less vegetables on stressful days. Among smokers, those with higher levels of self-discipline reported smoking more on days when they encountered hassles. These findings indicate that conscientiousness and its facets may influence health status directly via changes in health behaviors and indirectly through influencing stress-health behavior relations.

Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care

PubMed Central

Efraimsson, Eva Österlund; Klang, Birgitta; Ehrenberg, Anna; Larsson, Kjell; Fossum, Bjöörn; Olai, Lena

2015-01-01

Background Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes. Objective To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care. Methods A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations. Results Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communication was mainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation. Conclusion The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking. Practice implications To make patients more active, the nurses need more education and continuous training in motivational communication. PMID:26672958

Current status of tobacco policy and control.

PubMed

Paoletti, Luca; Jardin, Bianca; Carpenter, Matthew J; Cummings, K Michael; Silvestri, Gerard A

2012-07-01

Behaviors pertaining to tobacco use have changed significantly over the past century. Compared with 1964, smoking prevalence rates have halved from 40% to 20%, and as a result there has been a slow but steady decline in the rates of tobacco-induced diseases such as heart disease and cancer. Growing awareness of the health risks of smoking was aided by the US Surgeon Reports that were issued on a nearly annual basis starting from 1964. Concerns about the hazards of breathing in second-hand smoke further contributed to the declining social acceptance of smoking, which evolved into regulatory actions restricting smoking on buses, planes, retail outlets, restaurants, and bars. Today, 23 states and 493 localities have comprehensive laws restricting indoor smoking. This paper examines public policies that have made a significant impact on smoking and lung cancer rates and discusses potential future research directions to further reduce the diseases caused by smoking.

Multiple health behavior change in adults with or at risk for cancer: a systematic review.

PubMed

Green, Amanda C; Hayman, Laura L; Cooley, Mary E

2015-05-01

To identify components of efficacious interventions for multiple health behavior change (MHBC) in adult cancer survivors or adults at high risk for cancer. A systematic review of MHBC interventions was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. Ten studies met inclusion criteria. Most studies changed at least 2 health behaviors. Diet, exercise, and smoking cessation were consistently changed with in-person interventions. Longer duration interventions using phone or mail contact had a positive association with changing diet and exercise. MHBC interventions positively influenced behavior change in adults with cancer and those at high risk for cancer. Future studies should focus on increasing dissemination and implementation of efficacious interventions.

Neural responses to smoking stimuli are influenced by smokers' attitudes towards their own smoking behaviour.

PubMed

Stippekohl, Bastian; Winkler, Markus H; Walter, Bertram; Kagerer, Sabine; Mucha, Ronald F; Pauli, Paul; Vaitl, Dieter; Stark, Rudolf

2012-01-01

An important feature of addiction is the high drug craving that may promote the continuation of consumption. Environmental stimuli classically conditioned to drug-intake have a strong motivational power for addicts and can elicit craving. However, addicts differ in the attitudes towards their own consumption behavior: some are content with drug taking (consonant users) whereas others are discontent (dissonant users). Such differences may be important for clinical practice because the experience of dissonance might enhance the likelihood to consider treatment. This fMRI study investigated in smokers whether these different attitudes influence subjective and neural responses to smoking stimuli. Based on self-characterization, smokers were divided into consonant and dissonant smokers. These two groups were presented smoking stimuli and neutral stimuli. Former studies have suggested differences in the impact of smoking stimuli depending on the temporal stage of the smoking ritual they are associated with. Therefore, we used stimuli associated with the beginning (BEGIN-smoking-stimuli) and stimuli associated with the terminal stage (END-smoking-stimuli) of the smoking ritual as distinct stimulus categories. Stimulus ratings did not differ between both groups. Brain data showed that BEGIN-smoking-stimuli led to enhanced mesolimbic responses (amygdala, hippocampus, insula) in dissonant compared to consonant smokers. In response to END-smoking-stimuli, dissonant smokers showed reduced mesocortical responses (orbitofrontal cortex, subcallosal cortex) compared to consonant smokers. These results suggest that smoking stimuli with a high incentive value (BEGIN-smoking-stimuli) are more appetitive for dissonant than consonant smokers at least on the neural level. To the contrary, smoking stimuli with low incentive value (END-smoking-stimuli) seem to be less appetitive for dissonant smokers than consonant smokers. These differences might be one reason why dissonant smokers experience difficulties in translating their attitudes into an actual behavior change.

Neural Responses to Smoking Stimuli Are Influenced by Smokers' Attitudes towards Their Own Smoking Behaviour

PubMed Central

Stippekohl, Bastian; Winkler, Markus H.; Walter, Bertram; Kagerer, Sabine; Mucha, Ronald F.; Pauli, Paul; Vaitl, Dieter; Stark, Rudolf

2012-01-01

An important feature of addiction is the high drug craving that may promote the continuation of consumption. Environmental stimuli classically conditioned to drug-intake have a strong motivational power for addicts and can elicit craving. However, addicts differ in the attitudes towards their own consumption behavior: some are content with drug taking (consonant users) whereas others are discontent (dissonant users). Such differences may be important for clinical practice because the experience of dissonance might enhance the likelihood to consider treatment. This fMRI study investigated in smokers whether these different attitudes influence subjective and neural responses to smoking stimuli. Based on self-characterization, smokers were divided into consonant and dissonant smokers. These two groups were presented smoking stimuli and neutral stimuli. Former studies have suggested differences in the impact of smoking stimuli depending on the temporal stage of the smoking ritual they are associated with. Therefore, we used stimuli associated with the beginning (BEGIN-smoking-stimuli) and stimuli associated with the terminal stage (END-smoking-stimuli) of the smoking ritual as distinct stimulus categories. Stimulus ratings did not differ between both groups. Brain data showed that BEGIN-smoking-stimuli led to enhanced mesolimbic responses (amygdala, hippocampus, insula) in dissonant compared to consonant smokers. In response to END-smoking-stimuli, dissonant smokers showed reduced mesocortical responses (orbitofrontal cortex, subcallosal cortex) compared to consonant smokers. These results suggest that smoking stimuli with a high incentive value (BEGIN-smoking-stimuli) are more appetitive for dissonant than consonant smokers at least on the neural level. To the contrary, smoking stimuli with low incentive value (END-smoking-stimuli) seem to be less appetitive for dissonant smokers than consonant smokers. These differences might be one reason why dissonant smokers experience difficulties in translating their attitudes into an actual behavior change. PMID:23155368

Influence of Smoking Puff Parameters and Tobacco Varieties on Free Radicals Yields in Cigarette Mainstream Smoke.

PubMed

Goel, Reema; Bitzer, Zachary T; Reilly, Samantha M; Foulds, Jonathan; Muscat, Joshua; Elias, Ryan J; Richie, John P

2018-05-07

Cigarette smoke is a major exogenous source of free radicals, and the resulting oxidative stress is one of the major causes of smoking-caused diseases. Yet, many of the factors that impact free radical delivery from cigarettes remain unclear. In this study, we machine-smoked cigarettes and measured the levels of gas- and particulate-phase radicals by electron paramagnetic resonance (EPR) spectroscopy using standardized smoking regimens (International Organization of Standardization (ISO) and Canadian Intense (CI)), puffing parameters, and tobacco blends. Radical delivery per cigarette was significantly greater in both gas (4-fold) and particulate (6-fold) phases when cigarettes were smoked under the CI protocol compared to the ISO protocol. Total puff volume per cigarette was the major factor with radical production being proportional to total volume, regardless of whether volume differences were achieved by changes in individual puff volume or puff frequency. Changing puff shape (bell vs sharp vs square) or puff duration (1-5 s), without changing volume, had no effect on radical yields. Tobacco variety did have a significant impact on free radical production, with gas-phase radicals highest in reconstituted > burley > oriental > bright tobacco and particulate-phase radicals highest in burley > bright > oriental > reconstituted tobacco. Our findings show that modifiable cigarette design features and measurable user smoking behaviors are key factors determining free radical exposure in smokers.

The relationship between counselors' technical skills, clients' in-session verbal responses, and outcome in smoking cessation treatment.

PubMed

Lindqvist, Helena; Forsberg, Lars; Enebrink, Pia; Andersson, Gerhard; Rosendahl, Ingvar

2017-06-01

The technical component of Motivational Interviewing (MI) posits that client language mediates the relationship between counselor techniques and subsequent client behavioral outcomes. The purpose of this study was to examine this hypothesized technical component of MI in smoking cessation treatment in more depth. Secondary analysis of 106 first treatment sessions, derived from the Swedish National Tobacco Quitline, and previously rated using the Motivational Interviewing Sequential Code for Observing Process Exchanges (MI-SCOPE) Coder's Manual and the Motivational Interviewing Treatment Integrity code (MITI) Manual, version 3.1. The outcome measure was self-reported 6-month continuous abstinence at 12-month follow-up. Sequential analyses indicated that clients were significantly more likely than expected by chance to argue for change (change talk) following MI-consistent behaviors and questions and reflections favoring change. Conversely, clients were more likely to argue against change (sustain talk) following questions and reflections favoring status-quo. Parallel mediation analysis revealed that a counselor technique (reflections of client sustain talk) had an indirect effect on smoking outcome at follow-up through client language mediators. The study makes a significant contribution to our understanding of how MI works in smoking cessation treatment and adds further empirical support for the hypothesized technical component in MI. The results emphasize the importance of counselors avoiding unintentional reinforcement of sustain talk and underline the need for a greater emphasis on the direction of questions and reflections in MI trainings and fidelity measures. Copyright © 2017 Elsevier Inc. All rights reserved.

Use Behaviors, Dependence, and Nicotine Exposure Associated with Ad Libitum Cigar Smoking

PubMed Central

Claus, Eric D.; Moeller, Benjamin C.; Harbour, Darlene; Kuehl, Philip J.; McGuire, Michael; Vivar, Juan C.; Schroeder, Megan J.

2018-01-01

Objectives To examine factors important to cigar smoking and subsequent nicotine exposure, we evaluated the impact of cigar type, cigarette smoking history, and inhalation behaviors on nicotine dependence, smoking topography, and biomarkers of exposure in current exclusive cigar smokers. Methods Adult, exclusive cigar smokers (N = 77) were recruited based on cigar type, cigarette smoking history, and self-reported inhalation behaviors. Participants smoked their own brand product ad libitum for up to one hour; dependence symptoms, smoking topography, and biomarkers of exposure were assessed. Results Cigar smokers showed low levels of dependence. Cigar smoking alleviated withdrawal and craving symptoms, increased plasma nicotine concentration, and increased exhaled CO. Multiple regression analyses indicate that inhalation behaviors were associated with increased dependence and greater reductions in withdrawal symptoms upon cigar smoking. Large cigar smokers smoked longer and smoked more tobacco than small cigar and cigarillo smokers. Furthermore, large cigar smokers and self-reported inhalers were exposed to more nicotine than small cigar smokers and non-inhalers. Conclusions Our study suggests that cigar type and smoking behaviors affect dependence and nicotine exposure upon cigar smoking. These findings provide additional insight into the substantial risks associated with cigar smoking. PMID:29516029

Perspectives of Mexican-origin smokers on healthy eating and physical activity

PubMed Central

Strong, Larkin L.; Hoover, Diana S.; Heredia, Natalia I.; Krasny, Sarah; Spears, Claire A.; Correa-Fernández, Virmarie; Wetter, David W.; Fernandez, Maria E.

2016-01-01

Key modifiable risk behaviors such as smoking, poor diet and physical inactivity often cluster and may have multiplicative adverse effects on health. This study investigated barriers and facilitators to healthy eating and physical activity (PA) in overweight Mexican-origin smokers to inform the adaptation of an evidence-based smoking cessation program into a multiple health behavior change intervention. Five focus groups were conducted with overweight Mexican-origin men (n = 9) and women (n = 21) who smoked. Barriers and facilitators of healthy eating and PA were identified, and gender differences were assessed. Participants expressed some motivation to eat healthfully and identified strategies for doing so, yet many women experienced difficulties related to personal, family and work-related circumstances. Barriers to healthy eating among men were related to food preferences and lack of familiarity with fruits and vegetables. Participants performed PA primarily within the context of work and domestic responsibilities. Stress/depressed mood, lack of motivation and concern for physical well-being limited further PA engagement. Routines involving eating, PA and smoking highlight how these behaviors may be intertwined. Findings emphasize the importance of social, structural and cultural contexts and call for additional investigation into how to integrate healthy eating and PA into smoking cessation interventions for overweight Mexican-origin smokers. PMID:27240536

Smoking behaviors and intentions among adolescents in rural China: the application of the Theory of Planned Behavior and the role of social influence.

PubMed

Su, Xuefen; Li, Liping; Griffiths, Sian M; Gao, Yang; Lau, Joseph T F; Mo, Phoenix K H

2015-09-01

This study investigated the associations between the variables of the theory of planned behavior (TPB), influence of significant others, and smoking intentions and behaviors among adolescents living in rural southern China. A cross-sectional study was conducted among 2609 students in two junior high schools in rural Shantou, Guangdong province, using a self-administered questionnaire. Logistic regression models were fitted to estimate univariate and adjusted odds ratios and corresponding 95% confidence intervals. Multivariate analyses showed that having favorable attitudes towards smoking on psychological and social aspects, perceived behavioral control, and having most friends who were current smokers were significantly associated with smoking intentions in the next six months and in the next five years. Having most family members who were current smokers was also significantly related to smoking intention in the next five years. Having favorable attitudes towards smoking on psychological aspect and negative attitudes on physical aspect, perceived support from friends on smoking, and having most friends and senior relatives being current smokers were significantly associated with increased likelihood of ever smoking. Perceived behavioral control and having most friends being current smokers were also significantly associated with regular smoking and smoking in the past 30days. Our results suggest that the key constructs of the TPB model and friends' smoking behaviors play important roles in accounting for smoking intentions and behaviors among a sample of rural Chinese adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

Parental Smoking and Adult Offspring's Smoking Behaviors in Ethnic Minority Groups: An Intergenerational Analysis in the HELIUS Study.

PubMed

Ikram, Umar Z; Snijder, Marieke B; Derks, Eske M; Peters, Ron J G; Kunst, Anton E; Stronks, Karien

2018-05-03

To understand smoking behaviors among ethnic minority groups, studies have largely focused on societal factors, with little attention to family influences. Yet studies among majority groups have identified parental smoking as an important risk factor. It is unknown whether this applies to ethnic minority groups. We investigated the association between parental smoking and adult offspring's smoking behaviors among ethnic minority groups with an immigrant background. We used data from the Healthy Life in an Urban Setting study from Amsterdam (the Netherlands) from January 2011 to December 2015. The sample consisted of 2184 parent-offspring pairs from South-Asian Surinamese, African Surinamese, Turkish, Moroccan, and Ghanaian origin. We collected self-reported smoking data: current status, duration of exposure to parental smoking, number of daily cigarettes, heavy smoking ( > 10 cigarettes/day), and nicotine dependency (using the Fagerström Test). Analyses were stratified by offspring's age, cohabitation with parent, education (parent/offspring), offspring's cultural orientation, and gender concordance within pairs. Logistic regression was used. Overall, parental smoking was associated with offspring's smoking behaviors (eg, current smoking: odds ratio 2.33; 95% confidence interval 1.79-3.03), with little ethnic variation. We found dose-response associations between exposure to parental smoking and offspring's smoking. The associations were similar across different strata but stronger in gender-concordant pairs (3.16; 2.12-4.51 vs. 1.73; 1.15-2.59 in gender-discordant pairs; p-value for interaction .017). Parental smoking is associated with offspring's smoking behaviors in ethnic minority groups across different strata but particularly in gender-concordant pairs. Similar to majority groups, family influences matter to smoking behaviors in ethnic minority groups. Our findings have deepened our understanding of smoking behaviors among ethnic minority groups. Future studies should simultaneously consider societal factors and parental influences, to comprehensively understand their impact on smoking among ethnic minority groups. Also, smoking patterns among family members should be addressed in individual counselling, irrespective of ethnicity.

Successful behavior changes in a man with hypertension

NASA Technical Reports Server (NTRS)

Hollenberg, N. K.

1988-01-01

Several years of stress, smoking, increased alcohol use, and weight gain accompanied hypertension in a young man with an ominous family history. Aided by short-term drug therapy, he changed his ways and reduced his blood pressure for the long term.

Systematic Review of Social Network Analysis in Adolescent Cigarette Smoking Behavior

ERIC Educational Resources Information Center

Seo, Dong-Chul; Huang, Yan

2012-01-01

Background: Social networks are important in adolescent smoking behavior. Previous research indicates that peer context is a major causal factor of adolescent smoking behavior. To date, however, little is known about the influence of peer group structure on adolescent smoking behavior. Methods: Studies that examined adolescent social networks with…

Determinants of physical activity promotion by smoking cessation advisors.

PubMed

Mas, Sébastien; Bernard, Paquito; Gourlan, Mathieu

2018-05-17

To investigate the cross-sectional association between personal physical activity (PA) level, Theory of Planned Behavior (TPB) constructs toward PA promotion, and PA promotion behavior among smoking cessation advisors. 149 smoking cessation advisors were invited to complete online questionnaires. Hypotheses were tested using Bayesian path analysis. Attitudes and perceived behavioral control (PBC) of smoking cessation advisors were related to PA promotion intentions; intentions were in turn related to PA promotion behaviors. Advisors' personal PA level was indirectly associated with PA promotion behaviors through PBC and PA promotion intentions. The TPB is a relevant theoretical framework with which to explore determinants of PA promotion behavior among smoking cessation advisors. The PA level of health care professionals may be linked to PA promotion behavior through some TPB constructs. Smoking cessation advisor training should include education on attitude development (e.g., PA benefits on smoking cessation), PBC (e.g., modality of PA prescription) and PA promotion intentions (e.g., goal setting). Smoking cessation advisors should also be encouraged to regularly practice PA in order to improve their PA promotion behaviors. Copyright © 2018 Elsevier B.V. All rights reserved.

A Longitudinal Examination of the Relation Between Internalizing Problem Behaviors and Early Adolescent Cigarette Smoking.

PubMed

Aloise-Young, Patricia A; Zaleski, Adam C; Swaim, Randall C

2017-01-01

The purpose of the present study was to investigate the longitudinal relation between internalizing problem behaviors (measured with the anxious/depressed and somatic complaints subscales of the Achenbach Teacher's Report Form) and self-reported cigarette smoking behavior and intentions during early adolescence. In addition, a possible mediating role of perceived harm was investigated. Sixth graders and their teachers were surveyed in the sixth grade and students were surveyed again in the seventh grade. Smoking behavior and intentions were assessed with five items including lifetime use, 30-day use, tobacco user status (nonsmoker to heavy smoker), and two intentions/behavioral expectations items. In addition to perceived harm from smoking, reasons for smoking and reasons for not smoking were included on the survey. As hypothesized, teacher reports of sixth-grade internalizing problem behaviors were negatively related to seventh-grade smoking behavior and intentions. Moreover, perceived harm from smoking was negatively related to smoking and intentions. The hypothesized mediating role of perceived harm in the internalizing to smoking relationship was not supported. Potential differences in the relation between internalizing and smoking across adolescence are discussed. Specifically, the results of the present study and an examination of prior literature suggest that in early adolescence internalizing problems are negatively related to cigarette smoking, whereas in middle and late adolescence the opposite is true.

Engagement Within a Mobile Phone-Based Smoking Cessation Intervention for Adolescents and its Association With Participant Characteristics and Outcomes.

PubMed

Paz Castro, Raquel; Haug, Severin; Filler, Andreas; Kowatsch, Tobias; Schaub, Michael P

2017-11-01

Although mobile phone-delivered smoking cessation programs are a promising way to promote smoking cessation among adolescents, little is known about how adolescents might actually use them. The aim of this study was to determine adolescents' trajectories of engagement with a mobile phone-delivered smoking cessation program over time and the associations these trajectories have with baseline characteristics and treatment outcomes. We performed secondary data analysis on a dataset from a study that compared a mobile phone-delivered integrated smoking cessation and alcohol intervention with a smoking cessation only intervention for adolescents recruited in vocational and upper secondary school classes (N=1418). Throughout the 3-month intervention, participants in both intervention groups received one text message prompt per week that either assessed smoking-related target behaviors or encouraged participation in a quiz or a message contest. Sequence analyses were performed to identify engagement trajectories. Analyses were conducted to identify predictors of engagement trajectory and associations between engagement trajectories and treatment outcomes. Three engagement trajectories emerged: (1) stable engagement (646/1418, 45.56%), (2) decreasing engagement (501/1418, 35.33%), and (3) stable nonengagement (271/1418, 19.11%). Adolescents who were younger, had no immigrant background, perceived more benefits of quitting smoking, and reported binge drinking preceding the baseline assessment were more likely to exhibit stable engagement. Due to different reach of more engaged and less engaged participants at follow-up, three statistical models (complete-cases, last-observation-carried-forward, and multiple imputation) for the associations of engagement trajectory and smoking outcome were tested. For 7-point smoking abstinence, no association was revealed to be statistically significant over all three models. However, decreasing engagement with the program was associated over all three models, with greater reductions in daily tobacco use than nonengagement. The majority of tobacco-smoking adolescents engaged extensively with a mobile phone-based smoking cessation program. However, not only stable engagement but also decreasing engagement with a program might be an indicator of behavioral change. Measures to avoid nonengagement among adolescents appear especially necessary for older smokers with an immigrant background who do not drink excessively. In addition, future studies should not only examine the use of specific program components but also users' engagement trajectories to better understand the mechanisms behind behavioral change. ©Raquel Paz Castro, Severin Haug, Andreas Filler, Tobias Kowatsch, Michael P Schaub. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 01.11.2017.

Social Determinants of Health and Attempt to Change Unhealthy Lifestyle: A Population-based Study.

PubMed

Danaei, Mina; Palenik, Charles John; Abdollahifard, Gholamreza; Askarian, Mehrdad

2017-01-01

A healthy lifestyle is important because of its long-term benefits; however, there is a paucity of information concerning health choices among Iranians. We evaluated personal health behaviors, attempts to change unhealthy behaviors, and factors affecting attempts at change. The design of this cross-sectional study was to assemble a representative cadre of >18-year-old adults in Shiraz, Iran, using a multistage cluster sampling technique. Validated questionnaires collected participant's demographic information, such as weight, height, cigarette smoking history, physical activity, and attempts at lifestyle changes during the previous year. To determine predictors of attempts to change unhealthy lifestyle and to identify confounders, we applied single and multivariable logistic regression methods, respectively. A confidence interval of 95% was calculated for each odds ratio. The prevalence of attempts to change unhealthy lifestyle was 42%, 64.8%, and 27.8%, respectively, for losing weight, being more physically active, and smoking cessation. Unemployment, low levels of education, and decreased socioeconomic status have important roles in attempts to change lifestyle conditions. Low socioeconomic status was a risk factor for quitting smoking. Occupation (unemployed/homemaker) and low level of education were two significant factors for being more physically active. The prevalence of inadequate physical activity and being overweight or obese was considerable in Shiraz, Iran. Attempts to change unhealthy lifestyle were less than ideal. Social determinants of health factors including unemployment and low levels of education and socioeconomic status play important roles in attempts to change current lifestyles.

Cigarette Smoking Cessation Intervention for Buprenorphine Treatment Patients.

PubMed

Hall, Sharon M; Humfleet, Gary L; Gasper, James J; Delucchi, Kevin L; Hersh, David F; Guydish, Joseph R

2018-04-02

Patients receiving medication assisted therapy (MAT) for opioid use disorder have high cigarette smoking rates. Cigarette smoking interventions have had limited success. We evaluated an intervention to increase cigarette abstinence rates in patients receiving buprenorphine-assisted therapy. Cigarette smokers (N = 175; 78% male; 69% Caucasian; 20% Hispanic), recruited from a buprenorphine clinic were randomly assigned to either an extended innovative system intervention (E-ISI) or to Standard Treatment Control (STC). The E-ISI combined motivational intervention with extended treatment (long-term nicotine replacement therapy , varenicline, and extended cognitive behavioral therapy). STC received written information about quit-lines, medication, and resources. Assessments were held at baseline and 3, 6, 12, and 18 months. Seven-day biochemically verified point-prevalence cigarette abstinence was the primary outcome measure. Fifty-four percent of E-ISI participants entered the extended treatment intervention; E-ISI and STC differed at 3 months on abstinence status but not at months 6, 12, and 18. E-ISI participants were more likely to attempt to quit, to have a goal of complete abstinence, and to be in a more advanced stage of change than STC participants. A higher number of cigarettes smoked and the use of cannabis in the previous 30 days predicted continued smoking. The E-ISI was successful in increasing motivation to quit smoking but did not result in long-term abstinence. The failure of treatments that have been efficacious in the general population to produce abstinence in patients receiving MAT of opioid use disorder suggests that harm reduction and other innovative interventions should be explored. This study demonstrates that an intervention combining motivational interviewing with an extended treatment protocol can increase cigarette quit attempts, enhance cigarette abstinence goals, and further movement through stages of change about quitting smoking in patients receiving MAT for opioid use disorder who smoke cigarettes. The intervention did not increase abstinence rates over those observed in a standard treatment control, however. The latter finding supports those of earlier investigators who also failed to find efficacy for smoking cessation in this population and who also used interventions effective in the general population. This pattern of findings suggests that patients with opioid use disorder can be motivated to change smoking behavior, but alternative and innovative approaches to cigarette smoking treatment should be studied.

μ-Opioid receptor availability in the amygdala is associated with smoking for negative affect relief.

PubMed

Falcone, Mary; Gold, Allison B; Wileyto, E Paul; Ray, Riju; Ruparel, Kosha; Newberg, Andrew; Dubroff, Jacob; Logan, Jean; Zubieta, Jon-Kar; Blendy, Julie A; Lerman, Caryn

2012-08-01

The perception that smoking relieves negative affect contributes to smoking persistence. Endogenous opioid neurotransmission, and the μ-opioid receptor (MOR) in particular, plays a role in affective regulation and is modulated by nicotine. We examined the relationship of MOR binding availability in the amygdala to the motivation to smoke for negative affect relief and to the acute effects of smoking on affective responses. Twenty-two smokers were scanned on two separate occasions after overnight abstinence using [¹¹C]carfentanil positron emission tomography imaging: after smoking a nicotine-containing cigarette and after smoking a denicotinized cigarette. Self-reports of smoking motives were collected at baseline, and measures of positive and negative affect were collected pre- and post- cigarette smoking. Higher MOR availability in the amygdala was associated with motivation to smoke to relieve negative affect. However, MOR availability was unrelated to changes in affect after smoking either cigarette. Increased MOR availability in amygdala may underlie the motivation to smoke for negative affective relief. These results are consistent with previous data highlighting the role of MOR neurotransmission in smoking behavior.

The effect of Taiwan's tax-induced increases in cigarette prices on brand-switching and the consumption of cigarettes.

PubMed

Tsai, Yi-Wen; Yang, Chung-Lin; Chen, Chin-Shyan; Liu, Tsai-Ching; Chen, Pei-Fen

2005-06-01

The effect of raising cigarette taxes to reduce smoking has been the subject of several studies, which often treat the price of cigarettes as an exogenous factor given to smokers who respond to it by adjusting their smoking behavior. However, cigarette prices vary with brand and quality, and smokers can and do switch to lower-priced brands to reduce the impact of the tax on the cost of cigarettes as they try to consume the same number of cigarettes as they had before a tax hike. Using data from a two-year follow-up interview survey conducted before and after a new cigarette tax scheme was imposed in Taiwan in 2002, this study examines three behavioral changes smokers may make to respond to tax-induced cigarette price increase: brand-switching, amount consumed, and amount spent on smoking. These changes were studied in relation to smoker income, before-tax cigarette price, level of addiction, exposure to advertizing, and consumer loyalty. We found that smokers, depending upon exposure to advertizing, level of consumer loyalty and initial price of cigarettes, switched brands to maintain current smoking habits and control costs. We also found that the initial amount smoked and level of addiction, not price, at least not at the current levels in Taiwan, determined whether a smoker reduced the number of cigarettes he consumed. Copyright 2005 John Wiley & Sons, Ltd.

Barriers and motivators to reducing secondhand smoke exposure in African American families of head start children: a qualitative study.

PubMed

Hoehn, Jessica L; Riekert, Kristin A; Borrelli, Belinda; Rand, Cynthia S; Eakin, Michelle N

2016-08-01

To identify barriers and motivators for reducing secondhand smoke exposure (SHSe) for families of African-American, low-income, urban children. Audiotaped intervention sessions of 52 African-American caregivers of Head Start children who reported being a smoker and/or had at least one smoker in the home were randomly sampled from a larger trial examining the effectiveness of a motivational-interviewing intervention in reducing child's SHSe. Counseling sessions were qualitatively coded to identify barriers and motivators to implementing a home smoking ban or quitting smoking. African-American families identified several themes that were either or both barriers and motivators for SHSe reduction, including: asking others not to smoke, other family living in the home, neighborhood safety, absence of childcare, cost/availability of cessation tools, physician support and prevention of health problems. Urban, low-income African-American families face numerous barriers to reducing SHSe. Families were able to identify many motivators for reducing SHSe, suggesting an awareness of the importance for SHSe reduction but uncertainty in their confidence to change behaviors. Counseling should include tailoring to be most effective in supporting health behavior change. Greater emphasis on motivators is needed, such as low-cost/free cessation tools, engagement from physicians and greater involvement of extended family members. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Effects of smoking marijuana on brain perfusion and cognition.

PubMed

O'Leary, Daniel S; Block, Robert I; Koeppel, Julie A; Flaum, Michael; Schultz, Susan K; Andreasen, Nancy C; Ponto, Laura Boles; Watkins, G Leonard; Hurtig, Richard R; Hichwa, Richard D

2002-06-01

The effects of smoking marijuana on regional cerebral blood flow (rCBF) and cognitive performance were assessed in 12 recreational users in a double-blinded, placebo-controlled study. PET with [(15)Oxygen]-labeled water ([(15)O]H(2)O) was used to measure rCBF before and after smoking of marijuana and placebo cigarettes, as subjects repeatedly performed an auditory attention task. Smoking marijuana resulted in intoxication, as assessed by a behavioral rating scale, but did not significantly alter mean behavioral performance on the attention task. Heart rate and blood pressure increased dramatically following smoking of marijuana but not placebo cigarettes. However, mean global CBF did not change significantly. Increased rCBF was observed in orbital and mesial frontal lobes, insula, temporal poles, anterior cingulate, as well as in the cerebellum. The increases in rCBF in anterior brain regions were predominantly in "paralimbic" regions and may be related to marijuana's mood-related effects. Reduced rCBF was observed in temporal lobe auditory regions, in visual cortex, and in brain regions that may be part of an attentional network (parietal lobe, frontal lobe and thalamus). These rCBF decreases may be the neural basis of perceptual and cognitive alterations that occur with acute marijuana intoxication. There was no significant rCBF change in the nucleus accumbens or other reward-related brain regions, nor in basal ganglia or hippocampus, which have a high density of cannabinoid receptors.

Barriers and motivators to reducing secondhand smoke exposure in African American families of head start children: a qualitative study

PubMed Central

Hoehn, Jessica L.; Riekert, Kristin A.; Borrelli, Belinda; Rand, Cynthia S.; Eakin, Michelle N.

2016-01-01

Objective: To identify barriers and motivators for reducing secondhand smoke exposure (SHSe) for families of African-American, low-income, urban children. Method: Audiotaped intervention sessions of 52 African-American caregivers of Head Start children who reported being a smoker and/or had at least one smoker in the home were randomly sampled from a larger trial examining the effectiveness of a motivational-interviewing intervention in reducing child’s SHSe. Counseling sessions were qualitatively coded to identify barriers and motivators to implementing a home smoking ban or quitting smoking. Results: African-American families identified several themes that were either or both barriers and motivators for SHSe reduction, including: asking others not to smoke, other family living in the home, neighborhood safety, absence of childcare, cost/availability of cessation tools, physician support and prevention of health problems. Discussion: Urban, low-income African-American families face numerous barriers to reducing SHSe. Families were able to identify many motivators for reducing SHSe, suggesting an awareness of the importance for SHSe reduction but uncertainty in their confidence to change behaviors. Counseling should include tailoring to be most effective in supporting health behavior change. Greater emphasis on motivators is needed, such as low-cost/free cessation tools, engagement from physicians and greater involvement of extended family members. PMID:27329373

Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction.

PubMed

Garcia-Romeu, Albert; Griffiths, Roland R; Johnson, Matthew W

2014-01-01

Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for "complete" mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment.

Psilocybin-occasioned Mystical Experiences in the Treatment of Tobacco Addiction

PubMed Central

Garcia-Romeu, Albert; Griffiths, Roland R.; Johnson, Matthew W.

2014-01-01

Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for “complete” mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment. PMID:25563443

The Impact of a City-Wide Indoor Smoking Ban on Smoking and Drinking Behaviors Across Emerging Adulthood

PubMed Central

Talley, Anna E.; Fromme, Kim

2016-01-01

Introduction: Almost one-third of college students report recent cigarette use, primarily as “social smoking,” and often in conjunction with alcohol use. While city-wide indoor smoking bans effectively reduce the number of social opportunities to smoke (eg, bars and music clubs), little is known about how these bans may impact the smoking behaviors of college students. Furthermore, nothing is known about how indoor smoking bans may impact students’ drinking behaviors. The current study aims to determine the impact of a city-wide comprehensive indoor smoking ban on smoking and alcohol behaviors among a longitudinal sample of emerging adults. Methods: Data are from a 6-year longitudinal study (10 waves of data collection) that began the summer before college enrollment. Participants (N = 2244; 60% female) reported on their past 3-month smoking and drinking behaviors using Internet-based surveys at each wave. Piecewise linear growth modeling was used to determine how a city-wide comprehensive indoor smoking ban (implemented in the Fall of 2005 between Waves 4 and 5) impacted smoking frequency, cigarette quantity, drinking frequency, and number of binge drinking episodes. Results: Smoking and alcohol use increased from the summer before college through the semester before implementation of the city-wide smoking ban. While smoking frequency (P < .001) and cigarette quantity (P < .05) declined after the ban, drinking frequency increased (P < .001) and the number of binge drinking episodes remained stable. Conclusions: Current findings suggest that comprehensive indoor smoking bans can influence the smoking behaviors of emerging adults, whereas trajectories of drinking are relatively unchanged. PMID:25744964

Effect of Smoking Scenes in Films on Immediate Smoking

PubMed Central

Shmueli, Dikla; Prochaska, Judith J.; Glantz, Stanton A.

2010-01-01

Background The National Cancer Institute has concluded that exposure to smoking in movies causes adolescent smoking and there are similar results for young adults. Purpose This study investigated whether exposure of young adult smokers to images of smoking in films stimulated smoking behavior. Methods 100 cigarette smokers aged 18–25 years were randomly assigned to watch a movie montage composed with or without smoking scenes and paraphernalia followed by a10-minute recess. The outcome was whether or not participants smoked during the recess. Data were collected and analyzed in 2008 and 2009. Results Smokers who watched the smoking scenes were more likely to smoke during the break (OR3.06, 95% CI=1.01, 9.29). In addition to this acute effect of exposure, smokers who had seen more smoking in movies before the day of the experiment were more likely to smoke during the break (OR 6.73; 1.00–45.25 comparing the top to bottom percentiles of exposure) were more likely to smoke during the break. Level of nicotine dependence (OR 1.71; 1.27–2.32 per point on the FTND scale), “contemplation” (OR 9.07; 1.71–47.99) and “precontemplation” (OR 7.30; 1.39–38.36) stages of change, and impulsivity (OR 1.21; 1.03–1.43), were also associated with smoking during the break. Participants who watched the montage with smoking scenes and those with a higher level of nicotine dependence were also more likely to have smoked within 30 minutes after the study. Conclusions There is a direct link between viewing smoking scenes and immediate subsequent smoking behavior. This finding suggests that individuals attempting to limit or quit smoking should be advised to refrain from or reduce their exposure to movies that contain smoking. PMID:20307802

Tobacco Use and Environmental Smoke Exposure among Taiwanese Pregnant Smokers and Recent Quitters: Risk Perception, Attitude, and Avoidance Behavior

PubMed Central

Lai, Ming-Cheng; Chou, Feng-Sha; Yang, Yann-Jy; Wang, Chih-Chien; Lee, Ming-Chang

2013-01-01

In this study, we conducted an empirical survey of the avoidance behaviors and risk perceptions of active and passive smoking pregnant smokers and recent quitters. We employed an online questionnaire survey by recruiting 166 voluntary participants from an online parenting community in Taiwan. The results of the empirical survey revealed that three-fourths of smokers quit smoking during pregnancy and one-fourth continued smoking. All pregnant women who continued smoking had partners or lived with relatives who smoked. Current smokers and quitters differed significantly in their risk perceptions and attitudes toward smoking during pregnancy. Most pregnant smokers and quitters adopted passive smoking avoidance behaviors at home and in public. Nevertheless, one-fifth of pregnant women chose not to avoid passive smoking. We concluded that most women stop smoking during pregnancy; however, most women continue to be exposed to passive-smoking environments. Perceived fetal health risks and attitudes toward smoking during pregnancy are critical predictors of the anti-smoking behaviors of pregnant women. PMID:24005830

The influence of estimated retail tobacco sale price increase on smokers' smoking habit in Jiangxi province, China: a cross-sectional study.

PubMed

Wang, Ruiping; Zhu, Liping; Yan, Wei; Zeng, Guang; Michael, Engelgau

2015-01-01

China is the biggest tobacco producer and consumer in the world. Raising cigarette taxes and increasing tobacco retail prices have been prove as effective strategies to reduce tobacco consumption and the prevalence of smoking in western countries. But in China, it is uncertain how an increase of cigarette retail price will influence the tobacco consumption. From April to July, 2012, we selected 4025 residents over 15 years by a three stage random sampling in four cities, Jiangxi Province, China. We conducted interviews of their current smoking habits and how they would change their smoking behavior if tobacco retail prices increase. Overall, the prevalence of smoking is 27 % (47 % for male, 3.1 % for female). 15 % of smokers have tried to quit smoking in the past but all relapsed (168/1088), and over 50 % of current smokers do not want to quit, The average cigarette price per pack is 1.1 USD (range = 0.25-5.0). If retail cigarette prices increases by 50 %, 45 % of smokers say they will smoke fewer cigarettes, 20 % will change to cheaper brands and 5 % will attempt to quit smoking. Smokers who have intention to quit smoking are more sensitive to retail cigarette price increase. With retail cigarette price increases, more smokers will attempt to quit smoking. Chinese smokers will change their smoking habits if tobacco retail prices increase. Consequently the Chinese government should enact tobacco laws which increase the retail cigarette price. The implementation of new tobacco laws could result in lowering the prevalence of smoking. Meanwhile, price increase measures need to apply to all cigarette brands to avoid smokers switching cigarettes to cheaper brands.

Community-based participatory research to decrease smoking prevalence in a high-risk young adult population: an evaluation of the Students Against Nicotine and Tobacco Addiction (SANTA) project.

PubMed

Mendenhall, Tai J; Harper, Peter G; Henn, Lisa; Rudser, Kyle D; Schoeller, Bill P

2014-03-01

Students Against Nicotine and Tobacco Addiction is a community-based participatory research project that engages local medical and mental health providers in partnership with students, teachers, and administrators at the Minnesota-based Job Corps. This intervention contains multiple and synchronous elements designed to allay the stress that students attribute to smoking, including physical activities, nonphysical activities, purposeful modifications to the campus's environment and rules/policies, and on-site smoking cessation education and peer support. The intent of the present investigation was to evaluate (a) the types of stress most predictive of smoking behavior and/or nicotine dependence, (b) which activities students are participating in, and (c) which activities are most predictive of behavior change (or readiness to change). Quantitative data were collected through 5 campus-wide surveys. Response rates for each survey exceeded 85%. Stressors most commonly cited included struggles to find a job, financial problems, family conflict, lack of privacy or freedom, missing family or being homesick, dealing with Job Corps rules, and other-unspecified. The most popular activities in which students took part were physically active ones. However, activities most predictive of beneficent change were nonphysical. Approximately one third of respondents were nicotine dependent at baseline. Nearly half intended to quit within 1 month and 74% intended to quit within 6 months. Interventions perceived as most helpful toward reducing smoking were nonphysical in nature. Future efforts with this and comparable populations should engage youth in advancing such activities within a broader range of activity choices, alongside conventional education and support.

Translation and adaptation of smoking relapse-prevention materials for pregnant and postpartum Hispanic women.

PubMed

Simmons, Vani Nath; Cruz, Ligia M; Brandon, Thomas H; Quinn, Gwendolyn P

2011-01-01

Quitting smoking is one of the most important behavior changes a pregnant woman can make, with health benefits extending beyond pregnancy for the woman and her child. Increasing numbers of pregnant women are quitting smoking; however, the majority resume smoking later in their pregnancy or shortly after giving birth. Previous research has demonstrated the efficacy of self-help smoking relapse-prevention booklets; however, there is a dearth of materials available in Spanish for Hispanic smokers. The goal of the present study was to translate and adapt existing, theoretically based, smoking relapse-prevention materials for pregnant and postpartum Hispanic women. This article describes the transcreation approach used to ensure the Forever Free for Baby and Me booklets were linguistically and culturally relevant for the heterogeneous populations of Hispanic women. The authors conducted multistage formative research to adapt the booklets and modify vignettes and graphics. Compared with previous research conducted with pregnant non-Hispanic women, results revealed the following: (a) a lack of association or concern about smoking and weight gain, (b) the importance of family approval of behavior, and (c) stress related to difficulties surrounding the immigration experience. The authors' qualitative findings confirm and extend past research that has suggested ways to enhance the cultural relevance and acceptability of a health intervention.

Adolescent Cigarette Smoking Perceptions and Behavior: Tobacco Control Gains and Gaps Amidst the Rapidly Expanding Tobacco Products Market From 2001 to 2015.

PubMed

McKelvey, Karma; Halpern-Felsher, Bonnie

2017-02-01

The aim of the study was to determine whether adolescents' intentions to smoke, cigarette smoking behavior, and specific perceptions of cigarette smoking are different in 2015 versus 2001. Data from two California school-based studies (X age  = 14) were compared: one conducted in 2001-2002 ("2001"), N = 395; the second in 2014-2015 ("2015"); N = 282. In 2015, more participants reported it was very unlikely they would smoke (94% vs. 65%) and that they never smoked (95% vs. 74%); they reported perceiving less likelihood of looking more mature (17% vs. 28%) and greater likelihood of getting into trouble (86% vs. 77%), having a heart attack (76% vs. 69%), and contracting lung cancer (85% vs. 78%) from smoking (p < .001). Perceptions of short-term health problems and addiction were similar in 2001 and 2015. Findings suggest that adolescents in 2015 perceived greater risks compared to those in 2001 even amidst the rapidly changing tobacco product landscape. In addition to continuing messages of long-term health risks, prevention efforts should include messages about addiction and short-term health and social risks. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

A Dermatologist's Ammunition in the War Against Smoking: A Photoaging App.

PubMed

Brinker, Titus Josef; Enk, Alexander; Gatzka, Martina; Nakamura, Yasuhiro; Sondermann, Wiebke; Omlor, Albert Joachim; Petri, Maximilian Philip; Karoglan, Ante; Seeger, Werner; Klode, Joachim; von Kalle, Christof; Schadendorf, Dirk

2017-09-21

This viewpoint reviews the perspectives for dermatology as a specialty to go beyond the substantial impact of smoking on skin disease and leverage the impact of skin changes on a person's self-concept and behavior in the design of effective interventions for smoking prevention and cessation. ©Titus Josef Brinker, Alexander Enk, Martina Gatzka, Yasuhiro Nakamura, Wiebke Sondermann, Albert Joachim Omlor, Maximilian Philip Petri, Ante Karoglan, Werner Seeger, Joachim Klode, Christof von Kalle, Dirk Schadendorf. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.09.2017.

Analysis of Influential Factors Associated with the Smoking Behavior of Aboriginal Schoolchildren in Remote Taiwanese Mountainous Areas

ERIC Educational Resources Information Center

Huang, Hsiao-Ling; Hsu, Chih-Cheng; Peng, Wu-Der; Yen, Yea-Yin; Chen, Ted; Hu, Chih-Yang; Shi, Hon-Yi; Lee, Chien-Hung; Chen, Fu-Li; Lin, Pi-Li

2012-01-01

Background: A disparity in smoking behavior exists between the general and minority populations residing in Taiwan's mountainous areas. This study analyzed individual and environmental factors associated with children's smoking behavior in these areas of Taiwan. Methods: In this school-based study, data on smoking behavior and related factors for…

Cigarette smoking and military deployment: a prospective evaluation.

PubMed

Smith, Besa; Ryan, Margaret A K; Wingard, Deborah L; Patterson, Thomas L; Slymen, Donald J; Macera, Caroline A

2008-12-01

The stress of military deployment may compound occupational stress experienced in the military and manifest in maladaptive coping behaviors such as cigarette smoking. The current study describes new smoking among never-smokers, smoking recidivism among past smokers, and change in daily smoking among smokers in relation to military deployment. The Millennium Cohort is a 21-year longitudinal study. The current analysis utilized participants (N=48,304) who submitted baseline data (July 2001-June 2003) before the current conflicts in Iraq and Afghanistan and follow-up data (June 2004-January 2006) on health measures. New smoking was identified among baseline never-smokers, smoking recidivism among baseline past smokers, and increased or decreased daily smoking among baseline smokers. Analyses were conducted March 2007-April 2007. Among never-smokers, smoking initiation was identified in 1.3% of nondeployers and 2.3% of deployers. Among past smokers, smoking resumption occurred in 28.7% of nondeployers and 39.4% of those who deployed. Smoking increased 44% among nondeployers and 57% among deployers. Those who deployed and reported combat exposures were at 1.6 times greater odds of initiating smoking among baseline never-smokers (95% CI=1.2, 2.3) and at 1.3 times greater odds of resuming smoking among baseline past smokers when compared to those who did not report combat exposures. Other deployment factors independently associated with postdeployment smoking recidivism included deploying for >9 months and deploying multiple times. Among those who smoked at baseline, deployment was not associated with changes in daily amount smoked. Military deployment is associated with smoking initiation and, more strongly, with smoking recidivism, particularly among those with prolonged deployments, multiple deployments, or combat exposures. Prevention programs should focus on the prevention of smoking relapse during or after deployment.

Effect of smoking scenes in films on immediate smoking: a randomized controlled study.

PubMed

Shmueli, Dikla; Prochaska, Judith J; Glantz, Stanton A

2010-04-01

The National Cancer Institute has concluded that exposure to smoking in movies causes adolescent smoking and there are similar results for young adults. This study investigated whether exposure of young adult smokers to images of smoking in films stimulated smoking behavior. 100 cigarette smokers aged 18-25 years were randomly assigned to watch a movie montage composed with or without smoking scenes and paraphernalia followed by a 10-minute recess. The outcome was whether or not participants smoked during the recess. Data were collected and analyzed in 2008 and 2009. Smokers who watched the smoking scenes were more likely to smoke during the break (OR=3.06, 95% CI=1.01, 9.29). In addition to this acute effect of exposure, smokers who had seen more smoking in movies before the day of the experiment were more likely to smoke during the break (OR=6.73, 95% CI=1.00, 45.25, comparing the top to bottom 5th percentiles of exposure). Level of nicotine dependence (OR=1.71, 95% CI=1.27, 2.32 per point on the Fagerström Test for Nicotine Dependence scale); contemplation (OR=9.07, 95% CI=1.71, 47.99) and precontemplation (OR=7.30, 95% CI=1.39, 38.36) stages of change; and impulsivity (OR=1.21, 95% CI=1.03, 1.43) were also associated with smoking during the break. Participants who watched the montage with smoking scenes and those with a higher level of nicotine dependence were also more likely to have smoked within 30 minutes after the study. There is a direct link between viewing smoking scenes and immediate subsequent smoking behavior. This finding suggests that individuals attempting to limit or quit smoking should be advised to refrain from or reduce their exposure to movies that contain smoking. 2010 American Journal of Preventive Medicine. All rights reserved.

Longitudinal Changes in Smoking Abstinence Symptoms and Alternative Reinforcers Predict Long-term Smoking Cessation Outcomes

PubMed Central

Schnoll, Robert A.; Hitsman, Brian; Blazekovic, Sonja; Veluz-Wilkins, Anna; Wileyto, E. Paul; Leone, Frank T.; Audrain-McGovern, Janet E.

2016-01-01

Background Transdermal nicotine, with behavioral counseling, is among the most popular approaches used to quit smoking. Yet, 6-month cessation rates rarely exceed 20–25%. Identifying factors associated with cessation success may help researchers and clinicians develop enhanced interventions that can improve quit rates. This study examined longitudinal changes in withdrawal, craving, depression and anxiety symptoms, and alternative reinforcers, from a baseline assessment to a 6-month outcome, as predictors of 6-month smoking cessation outcomes following 8 weeks of nicotine patch treatment and counseling. Methods A sample of 180 smokers, who completed an effectiveness trial that provided counseling and 8 weeks of 21mg nicotine patches, was analyzed. Generalized estimating equations evaluated changes in withdrawal and craving, depression and anxiety symptoms, and alternative reinforcers over time, between participants who were smoking at 6-months and participants who were abstinent (confirmed with carbon monoxide) at 6-months. Multiple logistic regression assessed changes in these variables as predictors of relapse. Results Controlling for covariates associated with cessation (i.e., nicotine dependence, patch adherence, and rate of nicotine metabolism), participants who were abstinent at 6 months showed significantly lower craving and withdrawal and significantly higher substitute reinforcers from baseline to 6 months, vs. those who were smoking at 6 months (p < .001). An increase in craving predicted relapse to smoking (p < .05). Conclusions These results support continued efforts to strengthen interventions that reduce withdrawal and craving and the development of interventions to address alternative reinforcers in order to promote long-term smoking abstinence following nicotine patch treatment. PMID:27372219

Individual and spousal unemployment as predictors of smoking and drinking behavior.

PubMed

Arcaya, Mariana; Glymour, M Maria; Christakis, Nicholas A; Kawachi, Ichiro; Subramanian, S V

2014-06-01

The effects of unemployment on health behaviors, and substance use in particular, is still unclear despite substantial existing research. This study aimed to assess the effects of individual and spousal unemployment on smoking and alcohol consumption. The study was based on eight waves of geocoded Framingham Heart Study Offspring Cohort data (US) from 1971 to 2008 that contained social network information. We fit three series of models to assess whether lagged 1) unemployment, and 2) spousal unemployment predicted odds of being a current smoker or drinks consumed per week, adjusting for a range of socioeconomic and demographic covariates. Compared with employment, unemployment was associated with nearly twice the subsequent odds of smoking, and with increased cigarette consumption among male, but not female, smokers. In contrast, unemployment predicted a one drink reduction in weekly alcohol consumption, though effects varied according to intensity of consumption, and appeared stronger among women. While spousal unemployment had no effect on substance use behaviors among men, wives responded to husbands' unemployment by reducing their alcohol consumption. We conclude that individual, and among women, spousal unemployment predicted changes in substance use behaviors, and that the direction of the change was substance-dependent. Complex interactions among employment status, sex, and intensity and type of consumption appear to be at play and should be investigated further. Copyright © 2014 Elsevier Ltd. All rights reserved.

Unintended consequences of cigarette price changes for alcohol drinking behaviors across age groups: evidence from pooled cross sections

PubMed Central

2012-01-01

Background Raising prices through taxation on tobacco and alcohol products is a common strategy to raise revenues and reduce consumption. However, taxation policies are product specific, focusing either on alcohol or tobacco products. Several studies document interactions between the price of cigarettes and general alcohol use and it is important to know whether increased cigarette prices are associated with varying alcohol drinking patterns among different population groups. To inform policymaking, this study investigates the association of state cigarette prices with smoking, and current, binge, and heavy drinking by age group. Methods The 2001-2006 Behavioral Risk Factor Surveillance System surveys (n = 1,323,758) were pooled and analyzed using multiple regression equations to estimate changes in smoking and drinking pattern response to an increase in cigarette price, among adults aged 18 and older. For each outcome, a multiple linear probability model was estimated which incorporated terms interacting state cigarette price with age group. State and year fixed effects were included to control for potential unobserved state-level characteristics that might influence smoking and drinking. Results Increases in state cigarette prices were associated with increases in current drinking among persons aged 65 and older, and binge and heavy drinking among persons aged 21-29. Reductions in smoking were found among persons aged 30-64, drinking among those aged 18-20, and binge drinking among those aged 65 and older. Conclusions Increases in state cigarette prices may increase or decrease smoking and harmful drinking behaviors differentially by age. Adults aged 21-29 and 65 and older are more prone to increased drinking as a result of increased cigarette prices. Researchers, practitioners, advocates, and policymakers should work together to understand and prepare for these unintended consequences of tobacco taxation policy. PMID:22784412

Unintended consequences of cigarette price changes for alcohol drinking behaviors across age groups: evidence from pooled cross sections.

PubMed

McLellan, Deborah L; Hodgkin, Dominic; Fagan, Pebbles; Reif, Sharon; Horgan, Constance M

2012-07-11

Raising prices through taxation on tobacco and alcohol products is a common strategy to raise revenues and reduce consumption. However, taxation policies are product specific, focusing either on alcohol or tobacco products. Several studies document interactions between the price of cigarettes and general alcohol use and it is important to know whether increased cigarette prices are associated with varying alcohol drinking patterns among different population groups. To inform policymaking, this study investigates the association of state cigarette prices with smoking, and current, binge, and heavy drinking by age group. The 2001-2006 Behavioral Risk Factor Surveillance System surveys (n = 1,323,758) were pooled and analyzed using multiple regression equations to estimate changes in smoking and drinking pattern response to an increase in cigarette price, among adults aged 18 and older. For each outcome, a multiple linear probability model was estimated which incorporated terms interacting state cigarette price with age group. State and year fixed effects were included to control for potential unobserved state-level characteristics that might influence smoking and drinking. Increases in state cigarette prices were associated with increases in current drinking among persons aged 65 and older, and binge and heavy drinking among persons aged 21-29. Reductions in smoking were found among persons aged 30-64, drinking among those aged 18-20, and binge drinking among those aged 65 and older. Increases in state cigarette prices may increase or decrease smoking and harmful drinking behaviors differentially by age. Adults aged 21-29 and 65 and older are more prone to increased drinking as a result of increased cigarette prices. Researchers, practitioners, advocates, and policymakers should work together to understand and prepare for these unintended consequences of tobacco taxation policy.

Smoker Identity and Its Potential Role in Young Adults’ Smoking Behavior: A Meta-Ethnography

PubMed Central

2015-01-01

Objective: Identity is an important influence on behavior. To identify potential targets for smoking cessation interventions in young adults, we synthesized findings from qualitative studies on smoker identity and potential influences on smoking and smoking cessation. Methods: A systematic search of 4 electronic databases up to September 19, 2013, was conducted to identify qualitative studies on smoker identity in smokers and ex-smokers aged 16–34. Key concepts were extracted from individual studies and synthesized into higher-order interpretations by following the principles of meta-ethnography. Results: Seventeen relevant papers were identified. At the highest level of interpretation, we identified 4 types of findings: (a) contributory factors to identity, (b) identity in relation to smoking, (c) contextual and temporal patterning, and (d) behavior in relation to smoking. Contributory factors included the desire to establish aspirational individual and social identities, enact a smoker identity appropriate to the momentary social context, and alter personal nonsmoking rules when consuming alcohol. Smoker identity was multifaceted and incorporated individuals’ defensive rationalizations, and both positive and negative feelings attached to it. Smoker identities took time to develop, were subject to change, and were context dependent. Identity was found to play a role in quit attempts. Conclusions: Qualitative research into the identity of young adult smokers has established it as a multifaceted phenomenon serving important functions but also involving conflict and defensive rationalizations. It develops over time and contextual factors influence its expression. The nature of a smoker’s identity can play an important role in smoking cessation. PMID:25622078

Smoker identity and its potential role in young adults' smoking behavior: A meta-ethnography.

PubMed

Tombor, Ildiko; Shahab, Lion; Herbec, Aleksandra; Neale, Joanne; Michie, Susan; West, Robert

2015-10-01

Identity is an important influence on behavior. To identify potential targets for smoking cessation interventions in young adults, we synthesized findings from qualitative studies on smoker identity and potential influences on smoking and smoking cessation. A systematic search of 4 electronic databases up to September 19, 2013, was conducted to identify qualitative studies on smoker identity in smokers and ex-smokers aged 16-34. Key concepts were extracted from individual studies and synthesized into higher-order interpretations by following the principles of meta-ethnography. Seventeen relevant papers were identified. At the highest level of interpretation, we identified 4 types of findings: (a) contributory factors to identity, (b) identity in relation to smoking, (c) contextual and temporal patterning, and (d) behavior in relation to smoking. Contributory factors included the desire to establish aspirational individual and social identities, enact a smoker identity appropriate to the momentary social context, and alter personal nonsmoking rules when consuming alcohol. Smoker identity was multifaceted and incorporated individuals' defensive rationalizations, and both positive and negative feelings attached to it. Smoker identities took time to develop, were subject to change, and were context dependent. Identity was found to play a role in quit attempts. Qualitative research into the identity of young adult smokers has established it as a multifaceted phenomenon serving important functions but also involving conflict and defensive rationalizations. It develops over time and contextual factors influence its expression. The nature of a smoker's identity can play an important role in smoking cessation. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Adult smokers' reactions to pictorial health warning labels on cigarette packs in Thailand and moderating effects of type of cigarette smoked: findings from the international tobacco control southeast Asia survey.

PubMed

Yong, Hua-Hie; Fong, Geoffrey T; Driezen, Pete; Borland, Ron; Quah, Anne C K; Sirirassamee, Buppha; Hamann, Stephen; Omar, Maizurah

2013-08-01

In this study, we aimed to examine, in Thailand, the impact on smokers' reported awareness of and their cognitive and behavioral reactions following the change from text-only to pictorial warnings printed on cigarette packs. We also sought to explore differences by type of cigarette smoked (roll-your-own [RYO] vs. factory-made [FM] cigarettes). Data came from the International Tobacco Control Southeast Asia Survey, conducted in Thailand and Malaysia, where a representative sample of 2,000 adult smokers from each country were recruited and followed up. We analyzed data from one wave before (Wave 1) and two waves after the implementation of the new pictorial warnings (two sets introduced at Waves 2 and 3, respectively) in Thailand, with Malaysia, having text-only warnings, serving as a control. Following the warning label change in Thailand, smokers' reported awareness and their cognitive and behavioral reactions increased markedly, with the cognitive and behavioral effects sustained at the next follow-up. By contrast, no significant change was observed in Malaysia over the same period. Compared to smokers who smoke any FM cigarettes, smokers of only RYO cigarettes reported a lower salience but greater cognitive reactions to the new pictorial warnings. The new Thai pictorial health warning labels have led to a greater impact than the text-only warning labels, and refreshing the pictorial images may have helped sustain effects. This finding provides strong support for introducing pictorial warning labels in low- and middle-income countries, where the benefits may be even greater, given the lower literacy rates and generally lower levels of readily available health information on the risks of smoking.

Adult Smokers’ Reactions to Pictorial Health Warning Labels on Cigarette Packs in Thailand and Moderating Effects of Type of Cigarette Smoked: Findings From the International Tobacco Control Southeast Asia Survey

PubMed Central

2013-01-01

Introduction: In this study, we aimed to examine, in Thailand, the impact on smokers’ reported awareness of and their cognitive and behavioral reactions following the change from text-only to pictorial warnings printed on cigarette packs. We also sought to explore differences by type of cigarette smoked (roll-your-own [RYO] vs. factory-made [FM] cigarettes). Methods: Data came from the International Tobacco Control Southeast Asia Survey, conducted in Thailand and Malaysia, where a representative sample of 2,000 adult smokers from each country were recruited and followed up. We analyzed data from one wave before (Wave 1) and two waves after the implementation of the new pictorial warnings (two sets introduced at Waves 2 and 3, respectively) in Thailand, with Malaysia, having text-only warnings, serving as a control. Results: Following the warning label change in Thailand, smokers’ reported awareness and their cognitive and behavioral reactions increased markedly, with the cognitive and behavioral effects sustained at the next follow-up. By contrast, no significant change was observed in Malaysia over the same period. Compared to smokers who smoke any FM cigarettes, smokers of only RYO cigarettes reported a lower salience but greater cognitive reactions to the new pictorial warnings. Conclusions: The new Thai pictorial health warning labels have led to a greater impact than the text-only warning labels, and refreshing the pictorial images may have helped sustain effects. This finding provides strong support for introducing pictorial warning labels in low- and middle-income countries, where the benefits may be even greater, given the lower literacy rates and generally lower levels of readily available health information on the risks of smoking. PMID:23291637

Using a Marginal Structural Model to Design a Theory-Based Mass Media Campaign.

PubMed

Nishiuchi, Hiromu; Taguri, Masataka; Ishikawa, Yoshiki

2016-01-01

The essential first step in the development of mass media health campaigns is to identify specific beliefs of the target audience. The challenge is to prioritize suitable beliefs derived from behavioral theory. The purpose of this study was to identify suitable beliefs to target in a mass media campaign to change behavior using a new method to estimate the possible effect size of a small set of beliefs. Data were drawn from the 2010 Japanese Young Female Smoker Survey (n = 500), conducted by the Japanese Ministry of Health, Labor and Welfare. Survey measures included intention to quit smoking, psychological beliefs (attitude, norms, and perceived control) based on the theory of planned behavior and socioeconomic status (age, education, household income, and marital status). To identify suitable candidate beliefs for a mass media health campaign, we estimated the possible effect size required to change the intention to quit smoking among the population of young Japanese women using the population attributable fraction from a marginal structural model. Thirteen percent of study participants intended to quit smoking. The marginal structural model estimated a population attributable fraction of 47 psychological beliefs (21 attitudes, 6 norms, and 19 perceived controls) after controlling for socioeconomic status. The belief, "I could quit smoking if my husband or significant other recommended it" suggested a promising target for a mass media campaign (population attributable fraction = 0.12, 95% CI = 0.02-0.23). Messages targeting this belief could possibly improve intention rates by up to 12% among this population. The analysis also suggested the potential for regulatory action. This study proposed a method by which campaign planners can develop theory-based mass communication strategies to change health behaviors at the population level. This method might contribute to improving the quality of future mass health communication strategies and further research is needed.

Using a Marginal Structural Model to Design a Theory-Based Mass Media Campaign

PubMed Central

Taguri, Masataka; Ishikawa, Yoshiki

2016-01-01

Background The essential first step in the development of mass media health campaigns is to identify specific beliefs of the target audience. The challenge is to prioritize suitable beliefs derived from behavioral theory. The purpose of this study was to identify suitable beliefs to target in a mass media campaign to change behavior using a new method to estimate the possible effect size of a small set of beliefs. Methods Data were drawn from the 2010 Japanese Young Female Smoker Survey (n = 500), conducted by the Japanese Ministry of Health, Labor and Welfare. Survey measures included intention to quit smoking, psychological beliefs (attitude, norms, and perceived control) based on the theory of planned behavior and socioeconomic status (age, education, household income, and marital status). To identify suitable candidate beliefs for a mass media health campaign, we estimated the possible effect size required to change the intention to quit smoking among the population of young Japanese women using the population attributable fraction from a marginal structural model. Results Thirteen percent of study participants intended to quit smoking. The marginal structural model estimated a population attributable fraction of 47 psychological beliefs (21 attitudes, 6 norms, and 19 perceived controls) after controlling for socioeconomic status. The belief, “I could quit smoking if my husband or significant other recommended it” suggested a promising target for a mass media campaign (population attributable fraction = 0.12, 95% CI = 0.02–0.23). Messages targeting this belief could possibly improve intention rates by up to 12% among this population. The analysis also suggested the potential for regulatory action. Conclusions This study proposed a method by which campaign planners can develop theory-based mass communication strategies to change health behaviors at the population level. This method might contribute to improving the quality of future mass health communication strategies and further research is needed. PMID:27441626

Model of unplanned smoking initiation of children and adolescents: an integrated stage model of smoking behavior.

PubMed

Kremers, S P J; Mudde, A N; De Vries, H

2004-05-01

Two lines of psychological research have attempted to spell out the stages of adolescent smoking initiation. The first has focused on behavioral stages of smoking initiation, while the second line emphasized motivational stages. A large international sample of European adolescents (N = 10,170, mean age = 13.3 years) was followed longitudinally. Self-reported motivational and behavioral stages of smoking initiation were integrated, leading to the development of the Model of Unplanned Smoking Initiation of Children and Adolescents (MUSICA). The MUSICA postulates that youngsters experiment with smoking while they are in an unmotivated state as regards their plans for smoking regularly in the future. More than 95% of the total population resided in one of the seven stages distinguished by MUSICA. The probability of starting to smoke regularly during the 12 months follow-up period increased with advanced stage assignment at baseline. Unique social cognitive predictors of stage progression from the various stages were identified, but effect sizes of predictors of transitions were small. The integration of motivational and behavioral dimensions improves our understanding of the process of smoking initiation. In contrast to current theories of smoking initiation, adolescent uptake of smoking behavior was found to be an unplanned action.

Do smoke-free laws in rural, distressed counties encourage cessation?

PubMed

Hahn, Ellen J; Rayens, Mary Kay; Langley, Ronald E; Adkins, Sarah M; Dignan, Mark

2010-11-01

The authors examined the association between smoke-free laws and smoking/cessation behaviors and secondhand smoke exposure among current and former smokers in rural, distressed counties. A quasi-experimental, two-group design compared outcomes between participants from a county with a longstanding smoke-free law (n = 252) and those living in four demographically similar counties without smoke-free laws ( n = 250). Participants were recruited using random digit dialing. Controlling for demographic factors, those in the treatment group reported greater nicotine dependence, were more likely to have smoke-free workplaces, and less likely to have smoke-free homes. There were no differences in smoking status, past-year quit attempts, intent to quit in 5 years, cigarettes per day, or time since last cigarette. Smokers in the treatment group were just as likely to attempt to quit, despite greater nicotine dependence. Findings showed that making nonsmoking the social norm through policy change may be more difficult in rural, distressed areas.

Does neighborhood social cohesion modify the relationship between neighborhood social norms and smoking behaviors in Mexico?

PubMed

Lozano, Paula; Fleischer, Nancy L; Moore, Spencer; Shigematsu, Luz Myriam Reynales; Santillán, Edna Arillo; Thrasher, James F

2016-07-01

The aim of this study was to examine the separate and combined relationships of neighborhood social norms and neighborhood social cohesion with smoking behavior in a cohort of adult Mexican smokers. Neighborhood anti-smoking norms were measured as the proportion of residents in each neighborhood who believed that society disapproves of smoking. Perceived social cohesion was measured using a 5-item cohesion scale and aggregated to the neighborhood level. Higher neighborhood anti-smoking norms were associated with less successful quitting. Neighborhood social cohesion modified the relationship between neighborhood social norms and two smoking behaviors: smoking intensity and quit attempts. Residents of neighborhoods with weaker anti-smoking norms and higher social cohesion had lower smoking intensity and more quit attempts than residents living in other areas. Social cohesion may help buffer smoking behavior in areas with weak social norms. Copyright © 2016 Elsevier Ltd. All rights reserved.

Social cohesion and the smoking behaviors of adults living with children.

PubMed

Alcalá, Héctor E; Sharif, Mienah Z; Albert, Stephanie L

2016-02-01

The smoking behavior of adults can negatively impact children through exposure to environmental tobacco smoke and by modeling this unhealthy behavior. Little research has examined the role of the social environment in smoking behaviors of adults living with children. The present study specifically analyzed the relationship between social cohesion and smoking behaviors of adults living with children. Data from the 2009 California Health Interview Survey, a random-digit dial cross-sectional survey of California Adults, were used. Adults living with children reported their levels of social cohesion and smoking behaviors (N=13,978). Logistic regression models were used to predict odds of being a current smoker or living in a household in which smoking was allowed, from social cohesion. Overall, 13% of the sample was current smokers and 3.74% lived in households in which smoking was allowed. Logistic regression models showed that each one-unit increase in social cohesion is associated with reduced odds of being a current smoker (AOR=0.92; 95% CI=0.85-0.99) and reduced odds of living in a household in which smoking is allowed (AOR=0.84; 95% CI=0.75-0.93), after controlling for sociodemographic characteristics. Among adults living with children, higher social cohesion is associated with a lower likelihood of both being and smoker and living in a home where smoking is allowed. Thus, future research is needed to better understand mechanisms that explain the relationship between social cohesion and smoking-related behavior in order to prevent smoking-related health consequences and smoking initiation among children and adults. Copyright © 2015 Elsevier Ltd. All rights reserved.

Social Cohesion and the Smoking Behaviors of Adults Living with Children

PubMed Central

Sharif, Mienah Z.; Albert, Stephanie L.

2015-01-01

Introduction The smoking behavior of adults can negatively impact children through exposure to environmental tobacco smoke and by modeling this unhealthy behavior. Little research has examined the role of the social environment in smoking behaviors of adults living with children. The present study specifically analyzed the relationship between social cohesion and smoking behaviors of adults living with children. Methods Data from the 2009 California Health Interview Survey, a random-digit dial cross-sectional survey of California Adults, were used. Adults living with children reported their levels of social cohesion and smoking behaviors (N=13,978). Logistic regression models were used to predict odds of being a current smoker or living in a household in which smoking was allowed, from social cohesion. Results Overall, 13% of the sample was current smokers and 3.74% lived in households in which smoking was allowed. Logistic regression models showed that each one-unit increase in social cohesion is associated with reduced odds of being a current smoker (AOR= 0.92; 95% CI= 0.85–0.99) and reduced odds of living in a household in which smoking is allowed (AOR= 0.84; 95% CI= 0.75–0.93), after controlling for sociodemographic characteristics. Conclusions Among adults living with children, higher social cohesion is associated with a lower likelihood of both being and smoker and living in a home where smoking is allowed. Thus, future research is needed to better understand mechanisms that explain the relationship between social cohesion and smoking-related behavior in order to prevent smoking-related health consequences and smoking initiation among children and adults. PMID:26562680

The Impact of a City-Wide Indoor Smoking Ban on Smoking and Drinking Behaviors Across Emerging Adulthood.

PubMed

Cance, Jessica Duncan; Talley, Anna E; Fromme, Kim

2016-02-01

Almost one-third of college students report recent cigarette use, primarily as "social smoking," and often in conjunction with alcohol use. While city-wide indoor smoking bans effectively reduce the number of social opportunities to smoke (eg, bars and music clubs), little is known about how these bans may impact the smoking behaviors of college students. Furthermore, nothing is known about how indoor smoking bans may impact students' drinking behaviors. The current study aims to determine the impact of a city-wide comprehensive indoor smoking ban on smoking and alcohol behaviors among a longitudinal sample of emerging adults. Data are from a 6-year longitudinal study (10 waves of data collection) that began the summer before college enrollment. Participants (N = 2244; 60% female) reported on their past 3-month smoking and drinking behaviors using Internet-based surveys at each wave. Piecewise linear growth modeling was used to determine how a city-wide comprehensive indoor smoking ban (implemented in the Fall of 2005 between Waves 4 and 5) impacted smoking frequency, cigarette quantity, drinking frequency, and number of binge drinking episodes. Smoking and alcohol use increased from the summer before college through the semester before implementation of the city-wide smoking ban. While smoking frequency (P < .001) and cigarette quantity (P < .05) declined after the ban, drinking frequency increased (P < .001) and the number of binge drinking episodes remained stable. Current findings suggest that comprehensive indoor smoking bans can influence the smoking behaviors of emerging adults, whereas trajectories of drinking are relatively unchanged. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Relationship transitions and change in health behavior: A four-phase, twelve-year longitudinal study.

PubMed

Josefsson, Kim; Elovainio, Marko; Stenholm, Sari; Kawachi, Ichiro; Kauppi, Maarit; Aalto, Ville; Kivimäki, Mika; Vahtera, Jussi

2018-03-19

Extensive scientific evidence shows an association between involvement in social relationships and healthy lifestyle. Prospective studies with many participants and long follow-ups are needed to study the dynamics and change in social factors within individuals over time. Our aim was to determine whether a change in relationship status (single, married, divorced, widow, cohabiting) is followed by a change in health behavior (smoking, alcohol consumption, physical activity, and body mass index). We used data from 81,925 healthy adults participating in the prospective longitudinal Finnish Public Sector Study in the period 2000-2013. We analyzed 327,700 person-observations from four data collection phases. Missing data were multiply imputed. A within-individual methodology was used to minimize the possibility of selection effects affecting the interpretation. All four health behaviors showed associations with relationship status. The effects were very similar and in the same direction in women and men, although there were gender differences in the magnitudes of the effects. The end of a relationship was followed by a decrease in body mass index, increased odds of being a smoker, increase in physical activity, and increase in alcohol consumption (widowed men). The effects were reverse when forming a new relationship. A change in relationship status is associated with a change in health behavior. The association is not explained by socioeconomic status, subjective health status, or anxiety level. People leaving or losing a relationship are at increased risk of unhealthy behavior (smoking and alcohol consumption), but at the same time they have a lower BMI and show higher physical activity compared to the time they were in a relationship. It is not clear if the cumulative health effect of these health behavior changes is positive or negative. Copyright © 2018 Elsevier Ltd. All rights reserved.

Heterogeneity in Smokers' Responses to Tobacco Control Policies.

PubMed

Nesson, Erik

2017-02-01

This paper uses unconditional quantile regression to estimate whether smokers' responses to tobacco control policies change across the distribution of smoking levels. I measure smoking behavior with the number of cigarettes smoked per day and also with serum cotinine levels, a continuous biomarker of nicotine exposure, using individual-level repeated cross-section data from the National Health and Nutrition Examination Surveys. I find that the cigarette taxes lead to reductions in both the number of cigarettes smoked per day and in smokers' cotinine levels. These reductions are most pronounced in the middle quantiles of both distributions in terms of marginal effects, but most pronounced in the lower quantiles in terms of tax elasticities. I do not find that higher cigarette taxes lead to statistically significant changes in the amount of nicotine smokers ingest from each cigarette. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Physician-based smoking intervention: a rededication to a five-step strategy to smoking research.

PubMed

Ockene, J K; Zapka, J G

1997-01-01

It is well established that physicians can have a significant effect on the smoking behavior of their patients. To do this, attention must be paid to putting in place multiple strategies or mechanisms in the organization where the physician practices, as well as in the macroenvironment (i.e., social and public policy). It has been questioned whether or not there is stagnation in the field of clinical smoking intervention requiring a rededication to basic research regarding smoking. With respect to physician-based smoking intervention, we alternatively suggest that recommitment to all phases of research is essential for moving forward physician-based smoking interventions in the rapidly changing health services and social environment. In this article, we first review the essential framework of the National Cancer Institute's research science approach to cancer prevention and control. Evidence concerning physician-based interventions is then reviewed, followed by a schematic of a comprehensive framework for thinking about the process and intervention components needed for physician-based smoking intervention to take place in the health-care setting, the impact they have, and the eventual outcome of such interventions. There is a discussion of the challenges for the delivery of smoking-cessation services presented by the rapidly changing healthy delivery system of the 1990s. Finally, we present recommendations concerning research priorities for physician-based smoking intervention and the research funding process.

An Evaluation of a Therapist-Administered Bibliotherapy and Spouse Smoking Habits on Smoking Behavior.

ERIC Educational Resources Information Center

Seibel, Barbara L.

1979-01-01

Attempted to evaluate a readily available comprehensive bibliothearpy smoking cessation program and the impact of smoking and nonsmoking behavior of a spouse on the individual to stop smoking. Results suggest that motivation is an important variable in smoking cessation. (Author)

The effect of loss and trauma on substance use behavior in individuals seeking support services after the 1995 Oklahoma City bombing.

PubMed

Pfefferbaum, Betty; Vinekar, Shreekumar S; Trautman, Richard P; Lensgraf, S Jay; Reddy, Chandrashekar; Patel, Nilam; Ford, Andria L

2002-06-01

In this study, we examined the effect of trauma exposure on substance use behaviors, specifically tobacco and alcohol use, in a group of 84 individuals who sought supportive services after the 1995 Oklahoma City bombing. A self-report instrument was used to assess demographics, sensory exposure, injury, interpersonal exposure through relationship with victims, peritraumatic reaction, grief, posttraumatic stress, worry about safety, functional impairment, and changes in smoking and drinking. Those who reported increased smoking had higher scores on peritraumatic reaction, grief, posttraumatic stress, worry about safety, and trouble functioning. Those who reported increased alcohol intake had higher scores on injury, peritraumatic reaction, grief, posttraumatic stress, worry about safety, and trouble functioning. Sensory exposure and interpersonal exposure were not significantly different between those with and without increased smoking or drinking. Although no causal relationship can be assumed, our findings indicate an association of grief and posttraumatic stress with increased substance use behaviors in disaster victims.

The Primary Results of the Treating Adult Smokers at Risk for Weight Gain with Interactive Technology (TARGIT) Study.

PubMed

Johnson, Karen C; Thomas, Fridtjof; Richey, Phyllis; Tran, Quynh T; Tylavsky, Fran; Miro, Danielle; Coday, Mace

2017-10-01

To evaluate whether a behavioral weight management program combined with a smoking cessation program delivered via interactive technology could prevent postcessation weight gain. Three hundred and thirty young adult smokers, age 18 to 35 years, were randomized to a smoking cessation program alone (comparison group), which included behavioral counseling and nicotine replacement, or to a behavioral weight management program adapted from the Look AHEAD trial plus the same smoking cessation program (intervention group). The Treating Adult Smokers at Risk for Weight Gain with Interactive Technology study randomized 164 participants to the comparison group and 166 participants to the intervention group. On average, the participants gained 0.91 kg after 24 months in the trial (comparison group + 1.45 kg and intervention group + 0.32; P = 0.157). The only variable systematically affecting weight change over time was smoking abstinence, in which those who were abstinent, on average, gained 0.14 kg more per month compared with those who continued to smoke (P < 0.001). In exploratory analyses, the intervention participants who were abstinent at 6 months had numerically smaller weight gains compared with abstinent participants in the comparison group, but these differences were not statistically significant. Providing an intensive weight gain prevention program combined with a smoking cessation program via interactive technology was not associated with greater long-term weight gain prevention. © 2017 The Obesity Society.

Introspective responses to cues and motivation to reduce cigarette smoking influence state and behavioral responses to cue exposure.

PubMed

Veilleux, Jennifer C; Skinner, Kayla D

2016-09-01

In the current study, we aimed to extend smoking cue-reactivity research by evaluating delay discounting as an outcome of cigarette cue exposure. We also separated introspection in response to cues (e.g., self-reporting craving and affect) from cue exposure alone, to determine if introspection changes behavioral responses to cigarette cues. Finally, we included measures of quit motivation and resistance to smoking to assess motivational influences on cue exposure. Smokers were invited to participate in an online cue-reactivity study. Participants were randomly assigned to view smoking images or neutral images, and were randomized to respond to cues with either craving and affect questions (e.g., introspection) or filler questions. Following cue exposure, participants completed a delay discounting task and then reported state affect, craving, and resistance to smoking, as well as an assessment of quit motivation. We found that after controlling for trait impulsivity, participants who introspected on craving and affect showed higher delay discounting, irrespective of cue type, but we found no effect of response condition on subsequent craving (e.g., craving reactivity). We also found that motivation to quit interacted with experimental conditions to predict state craving and state resistance to smoking. Although asking about craving during cue exposure did not increase later craving, it resulted in greater delaying of discounted rewards. Overall, our findings suggest the need to further assess the implications of introspection and motivation on behavioral outcomes of cue exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.

A qualitative exploration of youth in the "new" China: perspectives on tobacco use from adolescents in southwest China.

PubMed

Okamoto, Janet; Sakuma, Kari-Lyn; Yan, He; Qiu, Peiyuan; Palmer, Paula H; Johnson, C Anderson

2012-03-01

School-based prevention programs are not common in China and the attempts to modify successful Western prevention programs have largely shown little effect. Distinct cultural and social systems differences could explain why modified programs have been unsuccessful. Smoking behavior is examined from the perspective of Chinese adolescents as part of the development of a large intervention trial. A total of 16 focus groups with 128 participants were conducted in Chengdu in Sichuan province of China. Impressions of adolescent smokers were mixed, most seeing the behavior as common among boys. Smokers were seen as being overwhelmed and stressed. Girls' smoking was mostly seen as universally "bad" and reflecting poorly on a girl's character. However, a small portion of focus group participants suggested that female smoking was fashionable and trendy. With social norms changing rapidly in the "new" China, understanding what the new generation of Chinese youth thinks about smoking is critical in determining how to address and tailor prevention efforts.

Cognitive regulation of smoking behavior within a cigarette: Automatic and nonautomatic processes.

PubMed

Motschman, Courtney A; Tiffany, Stephen T

2016-06-01

There has been limited research on cognitive processes governing smoking behavior in individuals who are tobacco dependent. In a replication (Baxter & Hinson, 2001) and extension, this study examined the theory (Tiffany, 1990) that drug use may be controlled by automatic processes that develop over repeated use. Heavy and occasional cigarette smokers completed a button-press reaction time (RT) task while concurrently smoking a cigarette, pretending to smoke a lit cigarette, or not smoking. Slowed RT during the button-press task indexed the cognitive disruption associated with nonautomatic control of behavior. Occasional smokers' RTs were slowed when smoking or pretending to smoke compared with when not smoking. Heavy smokers' RTs were slowed when pretending to smoke versus not smoking; however, their RTs were similarly fast when smoking compared with not smoking. The results indicated that smoking behavior was more highly regulated by controlled, nonautomatic processes among occasional smokers and by automatic processes among heavy smokers. Patterns of RT across the interpuff interval indicated that occasional smokers were significantly slowed in anticipation of and immediately after puffing onset, whereas heavy smokers were only slowed significantly after puffing onset. These findings suggest that the entirety of the smoking sequence becomes automatized, with the behaviors leading up to puffing becoming more strongly regulated by automatic processes with experience. These results have relevance to theories on the cognitive regulation of cigarette smoking and support the importance of interventions that focus on routinized behaviors that individuals engage in during and leading up to drug use. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The influence of HIV disease events/stages on smoking attitudes and behaviors: project STATE (Study of Tobacco Attitudes and Teachable Events)

PubMed Central

2014-01-01

Background Given the increase in life expectancy among HIV-positive individuals attributable to antiretroviral therapies, cigarette smoking now represents one of the most salient health risks confronting the HIV-positive population. Despite this risk, very few efforts to date have been made to target persons living with HIV for smoking cessation treatment, and no efforts have been made to explore the role of cognitions and HIV disease events/stages on smoking outcomes. The purpose of the study, Project STATE (Study of Tobacco Attitudes and Teachable Events), is to prospectively examine the relationship between HIV events/stages, perceived impact of HIV disease, attitudes about cigarette smoking, and smoking behaviors. Methods/Design This study employs a prospective design. Patients are recruited at the time of their first physician visit at a large inner city HIV-clinic – Thomas Street Health Center (TSHC). Consenting participants then complete a baseline assessment. All participants are offered standard care smoking cessation treatment. Follow-up assessments are completed on four subsequent occasions: 3, 6, 9, and 12 months post-baseline. These follow-up assessments are scheduled to coincide with routine clinic appointments with their TSHC physicians. In addition, each participant is given a prepaid cell phone at the time of enrollment and asked to complete brief phone assessments weekly for the first three months of the study period. Discussion By evaluating events/stages of HIV disease as potential teaching moments for smoking cessation, findings from this study could be used to develop treatments tailored to an individual’s stage of HIV disease. This study design will enable us to carefully track changes in smoking behavior over time, and to link these changes to both the course of HIV disease and/or to the participant’s’ perceived impact of HIV. By identifying optimal time points for intervention, the findings from this study will have the potential to maximize the efficiency and efficacy of cessation treatments delivered in resource-limited settings. In addition, the findings will be instrumental in identifying specific constructs that should be targeted for intervention and will provide a strong foundation for the development of future cessation interventions targeting smokers living with HIV/AIDS. PMID:24517853

Social Network Behavior and Engagement Within a Smoking Cessation Facebook Page

PubMed Central

Cole-Lewis, Heather; Perotte, Adler; Galica, Kasia; Dreyer, Lindy; Griffith, Christopher; Schwarz, Mary; Yun, Christopher; Patrick, Heather; Coa, Kisha

2016-01-01

Background Social media platforms are increasingly being used to support individuals in behavior change attempts, including smoking cessation. Examining the interactions of participants in health-related social media groups can help inform our understanding of how these groups can best be leveraged to facilitate behavior change. Objective The aim of this study was to analyze patterns of participation, self-reported smoking cessation length, and interactions within the National Cancer Institutes’ Facebook community for smoking cessation support. Methods Our sample consisted of approximately 4243 individuals who interacted (eg, posted, commented) on the public Smokefree Women Facebook page during the time of data collection. In Phase 1, social network visualizations and centrality measures were used to evaluate network structure and engagement. In Phase 2, an inductive, thematic qualitative content analysis was conducted with a subsample of 500 individuals, and correlational analysis was used to determine how participant engagement was associated with self-reported session length. Results Between February 2013 and March 2014, there were 875 posts and 4088 comments from approximately 4243 participants. Social network visualizations revealed the moderator’s role in keeping the community together and distributing the most active participants. Correlation analyses suggest that engagement in the network was significantly inversely associated with cessation status (Spearman correlation coefficient = −0.14, P=.03, N=243). The content analysis of 1698 posts from 500 randomly selected participants identified the most frequent interactions in the community as providing support (43%, n=721) and announcing number of days smoke free (41%, n=689). Conclusions These findings highlight the importance of the moderator for network engagement and provide helpful insights into the patterns and types of interactions participants are engaging in. This study adds knowledge of how the social network of a smoking cessation community behaves within the confines of a Facebook group. PMID:27485315

Attitudes toward E-Cigarettes, Reasons for Initiating E-Cigarette Use, and Changes in Smoking Behavior after Initiation: A Pilot Longitudinal Study of Regular Cigarette Smokers

PubMed Central

Barr, Dana Boyd; Stratton, Erin; Escoffery, Cam; Kegler, Michelle

2015-01-01

Objectives We examined 1) changes in smoking and vaping behavior and associated cotinine levels and health status among regular smokers who were first-time e-cigarette purchasers and 2) attitudes, intentions, and restrictions regarding e-cigarettes. Methods We conducted a pilot longitudinal study with assessments of the aforementioned factors and salivary cotinine at weeks 0, 4, and 8. Eligibility criteria included being ≥18 years old, smoking ≥25 of the last 30 days, smoking ≥5 cigarettes per day (cpd), smoking regularly ≥1 year, and not having started using e-cigarettes. Of 72 individuals screened, 40 consented, 36 completed the baseline survey, and 83.3% and 72.2% were retained at weeks 4 and 8, respectively. Results Participants reduced cigarette consumption from baseline to week 4 and 8 (p’s < 0.001); 23.1% reported no cigarette use in the past month at week 8. There was no significant decrease in cotinine from baseline to week 4 or 8 (p’s = ns). At week 8, the majority reported improved health (65.4%), reduced smoker’s cough (57.7%), and improved sense of smell (53.8%) and taste (50.0%). The majority believed that e-cigarettes versus regular cigarettes have fewer health risks (97.2%) and that e-cigarettes have been shown to help smokers quit (80.6%) and reduce cigarette consumption (97.2%). In addition, the majority intended to use e-cigarettes as a complete replacement for regular cigarettes (69.4%) and reported no restriction on e-cigarette use in the home (63.9%) or car (80.6%). Conclusions Future research is needed to document the long-term impact on smoking behavior and health among cigarette smokers who initiate use of e-cigarettes. PMID:25621193

How does a culture of health change? Lessons from the war on cigarettes.

PubMed

Schudson, Michael; Baykurt, Burcu

2016-09-01

This paper focuses on one of the most dramatic changes in the culture of health in the U.S. since World War II: the reduction of adult cigarette smoking from close to half of the population to under 20 percent between the 1960s and the 1990s. What role does culture play in explaining this shift in smoking from socially accepted to socially stigmatized? After surveying how culture has been used to explain the decline in smoking in the fields of tobacco control and public health, we argue that existing concepts do not capture the complex transformation of smoking. We instead suggest a micro-sociological view which presumes that culture may change in response to spatially organized constraints, cajoling, and comradeship. By reviewing two major drivers of the transformation of smoking - the Surgeon General's Reports and the nonsmokers' rights movement - at this micro-sociological level, we show how culture works through social spaces and practices while institutionalizing collective or even legal pressures and constraints on behavior. This conclusion also seeks to explain the uneven adoption of non-smoking across classes, and to reflect on the utility of presuming that a uniform "culture" blankets a society. Copyright © 2016 Elsevier Ltd. All rights reserved.

Culture Change from Tobacco Accommodation to Intolerance: Time to Connect the Dots

ERIC Educational Resources Information Center

Livingood, William C., Jr.; Allegrante, John P.; Green, Lawrence W.

2016-01-01

Broad changes in normative health behavior are critical to overcoming many of the contemporary challenges to public health. Reduction in tobacco use during the last third of the 20th century--one of the greatest improvements in public health--illustrates such change. The culture change from accommodation to intolerance of smoking is irrefutable.…

[Interventions on the exposure of non-smoking pregnant women to passive smoking].

PubMed

Yao, Ting-ting; Chen, Xue-yun; Hu, De-wei; Mao, Zheng-zhong

2008-09-01

To investigate the extent of exposure of non-smoking pregnant women to passive smoking; to undertake interventions on the knowledge, attitudes and behaviors of those women toward passive smoking; and to evaluate the effectiveness of the interventions. A total of 128 non-smoking pregnant women participated in the survey. Their knowledge, attitudes and behaviors towards passive smoking were measured by a self-administered questionnaire. A sixteen-week intervention was undertaken. The knowledge and attitudes of the non-smoking pregnant women towards passive smoking improved significantly, as well as their attempts to avoid exposure to the passive smoking brought by their smoking husbands or other family members. Telephone counseling, booklets and doctors' advices were the most acceptable approaches of health education. The comprehensive interventions are effective for improving the knowledge, attitudes and behaviors of non-smoking women toward passive smoking.

Household and school-level influences on smoking behavior among Korean adolescents: a multilevel analysis.

PubMed

Heo, Jongho; Oh, Juhwan; Subramanian, S V; Kawachi, Ichiro

2014-01-01

Trends in adolescent smoking rates in South Korea have not shown substantial progress due to a lack of effective anti-smoking interventions and policies in school settings. We examined individual- and school-level determinants of adolescent smoking behavior (ever smoking, current smoking, and daily smoking) using the nationally representative fifth Korean Youth Risk Behavior Web-based Survey conducted in 2009. We found that students in coeducation schools or vocational high schools had greater risks of smoking for each type of smoking behavior than those in single-sex schools or general high schools, respectively even after controlling for individual-level factors. Higher family affluence and higher weekly allowances were associated with greater risks of ever smoking, current smoking and daily smoking even after controlling for parental education and other confounders. Whilst caution is required in interpreting results given the cross-sectional nature of the study, our findings suggest that in addition to raising the price of cigarettes, youth anti-smoking interventions in South Korea may benefit from focusing on coeducation schools and vocational high schools.

Psychosocial factors associated with non-smoking adolescents' intentions to smoke.

PubMed

Smith, Brian N; Bean, Melanie K; Mitchell, Karen S; Speizer, Ilene S; Fries, Elizabeth A

2007-04-01

Smoking is the most preventable cause of death in the United States. Most adult smokers began smoking during adolescence, making youth tobacco prevention an especially important public health goal. Guided by an extension of the theory of planned behavior (TPB), this study examined the role of psychosocial factors in accounting for adolescents' smoking intentions. Participants from three high schools (n = 785) were surveyed to assess smoking-related characteristics and behaviors as part of a statewide evaluation of tobacco prevention programming. Attitudes, subjective norms (and other normative factors) and perceived behavioral control were all associated with non-smokers' intentions to smoke. Having more favorable attitudes toward remaining tobacco free and perceiving that friends would not be supportive of smoking were both associated with decreased likelihood of intending to smoke. Normative influence and peer use were significant factors, such that having more friends who smoke was associated with increased odds of intent to smoke. Lastly, perceived difficulty to quit was related to smoking intentions, with higher confidence to quit significantly associated with intentions to smoke. Findings are consistent with the TPB--attitudes, normative factors and perceived behavioral control each helped account for non-smoking adolescents' intentions to smoke. Implications for theory and intervention building are discussed.

Smoking Behaviors and Intentions among Current E-Cigarette Users, Cigarette Smokers, and Dual Users: A National Survey of U.S. High School Seniors

PubMed Central

McCabe, Sean Esteban; Veliz, Phil; McCabe, Vita V.; Boyd, Carol J.

2017-01-01

E-cigarette use among adolescents has increased significantly in recent years, but it remains unclear whether cigarette smoking behaviors and intentions differ among current (i.e., 30-day) non-users, only e-cigarette users, only cigarette smokers, and dual users. A nationally representative sample of 4385 U.S. high school seniors (modal age 18 years) were surveyed during the spring of their senior year via self-administered questionnaires in 2014. An estimated 9.6% of U.S. high school seniors reported current (30-day) e-cigarette use only, 6.3% reported current cigarette smoking only, and 7.2% reported current dual use of e-cigarettes and cigarette smoking. There were no significant differences between current only cigarette smokers and dual users in the odds of early onset of cigarette smoking, daily cigarette smoking, future cigarette smoking intentions, friends’ cigarette smoking behaviors, attempts to quit cigarette smoking, or the inability to quit cigarette smoking. Adolescents who only used e-cigarettes had higher odds of cigarette smoking behaviors and intentions than current non-users, including intentions for future cigarette smoking in the next 5 years (AOR = 2.57, 95% CI: 1.21—5.24). Dual users and only cigarette smokers had higher odds of cigarette smoking behaviors and intentions than non-users or only e-cigarette users. Adolescents who engage in current dual use appear to have cigarette smoking behaviors and intentions that more closely resemble cigarette smokers than e-cigarette users. Adolescents who only use e-cigarettes have higher intentions to engage in cigarette smoking in the future relative to their peers who do not engage in e-cigarette use or cigarette smoking. PMID:28257785

Simulating demand for cigarettes among pregnant women: A Low-Risk method for studying vulnerable populations.

PubMed

Higgins, Stephen T; Reed, Derek D; Redner, Ryan; Skelly, Joan M; Zvorsky, Ivori A; Kurti, Allison N

2017-01-01

A substantive obstacle to experimentally studying cigarette smoking and use of other tobacco products in pregnant women is the risk of adverse effects on mother and fetus from experimenter administration of the product of interest. The purpose of this study is to investigate bypassing that obstacle by using behavioral economic simulation tasks. In the present study we used the Cigarette Purchase Task (CPT) to simulate changes in demand for hypothetical cigarettes as a function of varying cigarette prices. Participants were 95 pregnant women who completed the CPT prior to participation in a smoking-cessation trial. Aggregate and individual participant demand varied as an orderly function of price and those changes were well fitted by an exponential equation. Demand also varied in correspondence to two well-validated predictors of individual differences in smoking cessation among pregnant women (cigarettes smoked per day, pre-pregnancy quit attempts). Moreover, CPT indices were more effective than these two conventional variables in predicting individual differences in whether women made a quit attempt during the current pregnancy. Overall, these results represent a promising step in demonstrating the validity and utility of the CPT for experimentally examining demand for cigarettes, and potentially other tobacco and nicotine delivery products, among pregnant women. © 2016 Society for the Experimental Analysis of Behavior.

Influences of tobacco advertising exposure and conduct problems on smoking behaviors among adolescent males and females.

PubMed

Mays, Darren; Gilman, Stephen E; Rende, Richard; Luta, George; Tercyak, Kenneth P; Niaura, Raymond S

2014-06-01

Adolescents with conduct problems are more likely to smoke, and tobacco advertising exposure may exacerbate this risk. Males' excess risk for conduct problems and females' susceptibility to advertising suggest gender-specific pathways to smoking. We investigated the associations between gender, conduct problems, and lifetime smoking and adolescents' exposure to tobacco advertising, and we examined prospective relationships with smoking behaviors. Adolescents completed baseline (2001-2004; n = 541) and 5-year follow-up (2007-2009; n =320) interviews for a family study of smoking risk. Baseline interviews assessed conduct problems and tobacco advertising exposure; smoking behavior was assessed at both timepoints. Generalized linear models analyzed gender differences in the relationship between conduct problems, advertising exposure, and smoking behavior at baseline and longitudinally. At baseline, among males, conduct problems were associated with greater advertising exposure independent of demographics and lifetime smoking. Among females at baseline, conduct problems were associated with greater advertising exposure only among never-smokers after adjusting for demographics. In longitudinal analyses, baseline advertising exposure predicted subsequent smoking initiation (i.e., smoking their first cigarette between baseline and follow-up) for females but not for males. Baseline conduct problems predicted current (i.e., daily or weekly) smoking at follow-up for all adolescents in adjusted models. The findings of this study reinforce that conduct problems are a strong predictor of subsequent current smoking for all adolescents and reveal important differences between adolescent males and females in the relationship between conduct problems, tobacco advertising behavior, and smoking behavior. The findings suggest gender-specific preventive interventions targeting advertising exposure may be warranted.

Smoking in korean-chinese middle school students: prevalence and risk factors.

PubMed

Park, Soonbok E; Yun, Soon-Nyung; Cui, Wenying; Kim, Hyang

2013-06-01

Cigarette smoking is rising among Chinese adolescents, and adolescent smoking is a crucial public health issue. Despite the number of studies that have explored the prevalence and various aspects of adolescent smoking in China, we know of no data currently available on smoking behavior among Korean-Chinese adolescents. This article studies the prevalence of smoking and factors affecting smoking behavior among Korean-Chinese adolescents. Data were collected from six Korean-Chinese middle schools in the Yanbian region of Jilin, China. The differences in data from three groups (never-smokers, ever-smokers, and current smokers) were analyzed using χ2 tests and analysis of variance. Logistic regression was used to analyze the factors affecting smoking behavior. Among the 2,116 participants, 7.3% of the boys and 3.7% of the girls were ever-smokers, and 7.2% of the boys and 0.8% of the girls were current smokers. Differences among groups in terms of gender, number of friends currently smoking, parental smoking behavior, academic performance, alcohol consumption, and intention not to smoke were all significant (p < .001, .05). Compared with never-smoking and ever-smoking students, currently smoking students perceived a significantly less antismoking environment (p = .000). The smoking rate was 2.24 times higher in boys than girls and was 11.57 times higher in students who had three smoking friends compared with those who had no smoking friends. The findings may help develop more effective intervention approaches to prevent adolescent smoking. Preventive programs should involve smoking parents by increasing the value they place on their children's nonsmoking behavior and equipping them to help deter adolescent smoking.

Facility-level, state, and financial factors associated with changes in the provision of smoking cessation services in US substance abuse treatment facilities: Results from the National Survey of Substance Abuse Treatment Services 2006 to 2012.

PubMed

Cohn, Amy; Elmasry, Hoda; Niaura, Ray

2017-06-01

Cigarette smoking is common among patients in substance abuse treatment. Tobacco control programs have advocated for integrated tobacco dependence treatment into behavioral healthcare, including within substance abuse treatment facilities (SATFs) to reduce the public health burden of tobacco use. This study used data from seven waves (2006 to 2012) of the National Survey of Substance Abuse Treatment Services (n=94,145) to examine state and annual changes in the provision of smoking cessation services within US SATFs and whether changes over time could be explained by facility-level (private vs public ownership, receipt of earmarks, facility admissions, acceptance of government insurance) and state-level factors (cigarette tax per pack, smoke free policies, and percent of CDC recommended tobacco prevention spending). Results showed that the prevalence of SATFs offering smoking cessation services increased over time, from 13% to 65%. The amount of tax per cigarette pack, accepting government insurance, government (vs private) ownership, facility admissions, and CDC recommended tobacco prevention spending (per state) were the strongest correlates of the provision of smoking cessation programs in SATFs. Facilities that received earmarks were less likely to provide cessation services. Adult smoking prevalence and state-level smoke free policies were not significant correlates of the provision of smoking cessation services over time. Policies aimed at increasing the distribution of tax revenues to cessation services in SATFs may offset tobacco-related burden among those with substance abuse problems. Copyright © 2017. Published by Elsevier Inc.

The Influence of Social Network Characteristics on Peer Clustering in Smoking: A Two-Wave Panel Study of 19- and 23-Year-Old Swedes.

PubMed

Miething, Alexander; Rostila, Mikael; Edling, Christofer; Rydgren, Jens

2016-01-01

The present study examines how the composition of social networks and perceived relationship content influence peer clustering in smoking, and how the association changes during the transition from late adolescence to early adulthood. The analysis was based on a Swedish two-wave survey sample comprising ego-centric network data. Respondents were 19 years old in the initial wave, and 23 when the follow-up sample was conducted. 17,227 ego-alter dyads were included in the analyses, which corresponds to an average response rate of 48.7 percent. Random effects logistic regression models were performed to calculate gender-specific average marginal effects of social network characteristics on smoking. The association of egos' and alters' smoking behavior was confirmed and found to be stronger when correlated in the female sample. For females, the associations decreased between age 19 and 23. Interactions between network characteristics and peer clustering in smoking showed that intense social interactions with smokers increase egos' smoking probability. The influence of network structures on peer clustering in smoking decreased during the transition from late adolescence to early adulthood. The study confirmed peer clustering in smoking and revealed that females' smoking behavior in particular is determined by social interactions. Female smokers' propensity to interact with other smokers was found to be associated with the quality of peer relationships, frequent social interactions, and network density. The influence of social networks on peer clustering in smoking decreased during the transition from late adolescence to early adulthood.

Continued importance of family factors in youth smoking behavior.

PubMed

Mahabee-Gittens, E Melinda; Xiao, Yang; Gordon, Judith S; Khoury, Jane C

2012-12-01

Although it is known that levels of family factors (FF) such as parental monitoring and parent-adolescent connectedness vary during adolescence, it is unknown which factors remain protective, preventing smoking initiation, in youth of differing racial/ethnic groups. Using a longitudinal, nationally representative sample, we examined which FF protect against smoking initiation in White, Black, and Hispanic youth. A total of 3,473 parent-nonsmoking youth dyads from Round 1 (T1) of the National Survey of Parents and Youth were followed to Round 3 (T2). Youth smoking status at T2 was assessed as the primary outcome. We examined changes in FF (T2 - T1) and the protection afforded by these factors at T1 and T2 for smoking initiation, both by race/ethnicity and overall. There were statistically significant decreases in levels of protective FF from T1 to T2 across all racial/ethnic groups; however, FF levels were higher in never-smokers compared with smoking initiators at both T1 and T2 (p < .05). Separate models by race/ethnicity showed the protective effect of increased perceived punishment in all racial/ethnic groups and protection against initiation by increased parental monitoring in Black and Hispanic youth. Overall, higher parental monitoring at T1 was associated with decreased odds of smoking initiation (33%); decreased parental monitoring and perceived punishment from T1 to T2 were associated with increased odds of smoking initiation (55% and 17%, respectively). Smoking prevention interventions should encourage parents to both enforce consistent consequences of smoking behavior, and continue monitoring, especially in minority groups.

The Influence of Social Network Characteristics on Peer Clustering in Smoking: A Two-Wave Panel Study of 19- and 23-Year-Old Swedes

PubMed Central

Rostila, Mikael; Edling, Christofer; Rydgren, Jens

2016-01-01

Objectives The present study examines how the composition of social networks and perceived relationship content influence peer clustering in smoking, and how the association changes during the transition from late adolescence to early adulthood. Methods The analysis was based on a Swedish two-wave survey sample comprising ego-centric network data. Respondents were 19 years old in the initial wave, and 23 when the follow-up sample was conducted. 17,227 ego-alter dyads were included in the analyses, which corresponds to an average response rate of 48.7 percent. Random effects logistic regression models were performed to calculate gender-specific average marginal effects of social network characteristics on smoking. Results The association of egos’ and alters’ smoking behavior was confirmed and found to be stronger when correlated in the female sample. For females, the associations decreased between age 19 and 23. Interactions between network characteristics and peer clustering in smoking showed that intense social interactions with smokers increase egos’ smoking probability. The influence of network structures on peer clustering in smoking decreased during the transition from late adolescence to early adulthood. Conclusions The study confirmed peer clustering in smoking and revealed that females’ smoking behavior in particular is determined by social interactions. Female smokers’ propensity to interact with other smokers was found to be associated with the quality of peer relationships, frequent social interactions, and network density. The influence of social networks on peer clustering in smoking decreased during the transition from late adolescence to early adulthood. PMID:27727314

Increasing Pediatricians' Smoking Cessation Promotion and Knowledge of the Smoking Cessation Trust.

PubMed

Thomas, Katharine E H; Kisely, Steve; Urrego, Fernando

2017-05-01

The link between second hand smoke exposure (SHSe) and health issues in children has been well established. The objective of this study was to determine if a short intervention implemented among pediatricians promotes improvement in the promotion of smoking cessation to caregivers and increase pediatricians' awareness of the Smoking Cessation Trust (SCT). Pediatricians from 6 clinics were randomly assigned to the control or intervention group. All pediatricians received a survey to assess baseline knowledge, confidence and behaviors in smoking cessation promotion and utilization of the SCT. Pediatricians in intervention group received an educational lecture delivered by a physician. Two months post intervention, pediatricians in the control and intervention group received a survey to assess changes from baseline. Out of 36 general pediatricians, 27 completed the surveys for use in the analysis of this study (75%). Intervention group made more referrals to the SCT, compared to controls (p=0.048) and to baseline (p=0.0065). Pediatricians in the intervention group were more confident in recommending the use of NRT (0.040) and schedule a follow up to discuss smoking cessation (p=0.029) after the intervention. The intervention group was more likely to refer caregivers to smoking cessation programs (p=0.027), discuss a child's health risk from SHSe (0.031) and recommending the use of NRT to help quit (p=0.047) post intervention. The results from this study indicate that a short intervention can increase confidence and behavior in various parameters of smoking cessation promotion and significantly improve the rate in which pediatricians refer smoking caregivers to the SCT.

Perspectives of Mexican-origin smokers on healthy eating and physical activity.

PubMed

Strong, Larkin L; Hoover, Diana S; Heredia, Natalia I; Krasny, Sarah; Spears, Claire A; Correa-Fernández, Virmarie; Wetter, David W; Fernandez, Maria E

2016-08-01

Key modifiable risk behaviors such as smoking, poor diet and physical inactivity often cluster and may have multiplicative adverse effects on health. This study investigated barriers and facilitators to healthy eating and physical activity (PA) in overweight Mexican-origin smokers to inform the adaptation of an evidence-based smoking cessation program into a multiple health behavior change intervention. Five focus groups were conducted with overweight Mexican-origin men (n = 9) and women (n = 21) who smoked. Barriers and facilitators of healthy eating and PA were identified, and gender differences were assessed. Participants expressed some motivation to eat healthfully and identified strategies for doing so, yet many women experienced difficulties related to personal, family and work-related circumstances. Barriers to healthy eating among men were related to food preferences and lack of familiarity with fruits and vegetables. Participants performed PA primarily within the context of work and domestic responsibilities. Stress/depressed mood, lack of motivation and concern for physical well-being limited further PA engagement. Routines involving eating, PA and smoking highlight how these behaviors may be intertwined. Findings emphasize the importance of social, structural and cultural contexts and call for additional investigation into how to integrate healthy eating and PA into smoking cessation interventions for overweight Mexican-origin smokers. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Are Anti-Smoking Parenting Practices Related to Adolescent Smoking Cognitions and Behavior?

ERIC Educational Resources Information Center

Huver, Rose M. E.; Engels, Rutger C. M. E.; de Vries, Hein

2006-01-01

The aim of this study was to explain the effects of anti-smoking parenting practices on adolescent smoking cognitions and behavior by showing the mediating effects of cognitions. Data were gathered among Dutch high school students in the control condition of the European Smoking prevention Framework Approach (ESFA). Anti-smoking parenting…

Initiation of Cigarette Smoking: Is It Related to Parental Smoking Behavior?

ERIC Educational Resources Information Center

Wohlford, Paul

1970-01-01

The smoking behavior and family stability of 251 undergraduate men and women and their parents were studied. The results support the identification interpretation of the father/son smoking pattern. The variable of family intactness was a relevant moderator of the parent/son smoking pattern. The mother and daughter smoking patterns remained…

Randomized Controlled Trial of Behavioral Activation Smoking Cessation Treatment for Smokers with Elevated Depressive Symptoms

ERIC Educational Resources Information Center

MacPherson, Laura; Tull, Matthew T.; Matusiewicz, Alexis K.; Rodman, Samantha; Strong, David R.; Kahler, Christopher W.; Hopko, Derek R.; Zvolensky, Michael J.; Brown, Richard A.; Lejuez, C. W.

2010-01-01

Objective: Depressive symptoms are associated with poor smoking cessation outcomes, and there remains continued interest in behavioral interventions that simultaneously target smoking and depressive symptomatology. In this pilot study, we examined whether a behavioral activation treatment for smoking (BATS) can enhance cessation outcomes. Method:…

Choosing adolescent smokers as friends: the role of parenting and parental smoking.

PubMed

Mercken, L; Sleddens, E F C; de Vries, H; Steglich, C E G

2013-04-01

The present study examined whether parenting and parental smoking can prevent children from selecting smoking friends during adolescence. 254 Adolescents of one Belgian secondary school participated. Self-administered questionnaires were distributed among 2nd-4th graders (mean ages = 14.2-16.2 years) during spring 2006. Follow-up was conducted 12 months later. Data was analyzed conducting longitudinal social network analyses. Results showed adolescents perceiving high parental psychological control had a significant higher tendency to select smoking friends. Perceived behavioral control and perceived parental support did not affect the selection of smoking friends. Furthermore, maternal smoking behavior affected the selection of smoking friends, although no effect of paternal smoking behavior on the selection of smoking friends was found. Adolescent smoking prevention efforts should focus on the influence of parents through their smoking behavior and their psychological control to decrease adolescents' tendency to select smoking friends resulting in fewer opportunities for negative peer influences to occur. Copyright © 2013 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Original: anti-smoking media campaign messages: theory and practice.

PubMed

Cohen, Elisia L; Shumate, Michelle D; Gold, Abby

2007-01-01

This study examined televised anti-smoking advertisements that were designed to discourage adult and teen smoking. A content analysis of 399 television advertisements catalogued in the Media Campaign Resource Center (MCRC) database were evaluated to determine (a) whether the advertising content reflected core health communication theories used in the design of health campaign messages to change behavior and (b) the affective presentation of tobacco-control advertisements aimed to decrease smoking. The results revealed that anti-smoking advertising relied overwhelmingly on appeals to attitudes. Although the benefits of not smoking were mentioned in 61% of advertisements, barriers were mentioned in only 17% of advertisements. Advertisements emphasized the consequences of smoking more than the viewer's self-efficacy. Finally, advertisements were more likely to use informational and humor appeals, rather than sadness, fear, or anger appeals. The research identifies the types of advertisements that are most likely to be utilized and underutilized in national and statewide anti-smoking advertising campaigns catalogued in the MCRC database.

Detecting Smoking Events Using Accelerometer Data Collected Via Smartwatch Technology: Validation Study

PubMed Central

Cole, Casey A; Anshari, Dien; Lambert, Victoria; Thrasher, James F

2017-01-01

Background Smoking is the leading cause of preventable death in the world today. Ecological research on smoking in context currently relies on self-reported smoking behavior. Emerging smartwatch technology may more objectively measure smoking behavior by automatically detecting smoking sessions using robust machine learning models. Objective This study aimed to examine the feasibility of detecting smoking behavior using smartwatches. The second aim of this study was to compare the success of observing smoking behavior with smartwatches to that of conventional self-reporting. Methods A convenience sample of smokers was recruited for this study. Participants (N=10) recorded 12 hours of accelerometer data using a mobile phone and smartwatch. During these 12 hours, they engaged in various daily activities, including smoking, for which they logged the beginning and end of each smoking session. Raw data were classified as either smoking or nonsmoking using a machine learning model for pattern recognition. The accuracy of the model was evaluated by comparing the output with a detailed description of a modeled smoking session. Results In total, 120 hours of data were collected from participants and analyzed. The accuracy of self-reported smoking was approximately 78% (96/123). Our model was successful in detecting 100 of 123 (81%) smoking sessions recorded by participants. After eliminating sessions from the participants that did not adhere to study protocols, the true positive detection rate of the smartwatch based-detection increased to more than 90%. During the 120 hours of combined observation time, only 22 false positive smoking sessions were detected resulting in a 2.8% false positive rate. Conclusions Smartwatch technology can provide an accurate, nonintrusive means of monitoring smoking behavior in natural contexts. The use of machine learning algorithms for passively detecting smoking sessions may enrich ecological momentary assessment protocols and cessation intervention studies that often rely on self-reported behaviors and may not allow for targeted data collection and communications around smoking events. PMID:29237580

[The relationship between community resilience and adolescent smoking behavior].

PubMed

Márton, Albert-Lőrincz; Enikő, Albert-Lőrincz; Gergely, Barna; Krisztina, Bernáth; Ildikó, Gáspárik; Béla, Szabó

2016-01-01

Our study investigates the theoretical and practical relationship between community resilience and adolescent smoking behavior, based on the assumption that experiencing the supportive, protective and regulatory power of local communities and neighborhoods influences adolescent smoking behavior, it delays the early testing and it reduces the prevalence of regular smoking. The study is based on an ongoing research related to smoking prevention. Empirical, self-administered questionnaire based study, random, stratified, multistage sample, delivered in Mureş, Harghita and Covasna Counties, Romania. The community relationship showed significant association with the smoking behavior, the risk of smoking was higher among those young people who had less contact with the local community. There was a significantly lower number of regular smokers among those adolescents who perceived restrictions by their family and community in relation to smoking and those with higher social capital.

Application of the Protection Motivation Theory in Predicting Cigarette Smoking Among Adolescents in China

PubMed Central

Yan, Yaqiong; Jacques-Tiura, Angela J.; Chen, Xinguang; Xie, Nianhua; Chen, Jing; Yang, Niannian; Gong, Jie; MacDonell, Karen Kolmodin

2013-01-01

Reducing tobacco use among adolescents in China represents a significant challenge for global tobacco control. Existing behavioral theories developed in the West – such as the Protection Motivation Theory (PMT) – may be useful tools to help tackle this challenge. We examined the relationships between PMT factors and self-reported cigarette smoking behavior and intention among a random sample of vocational high school students (N = 553) in Wuhan, China. Tobacco-related perceptions were assessed using the PMT Scale for Adolescent Smoking. Among the total sample, 45% had initiated cigarette smoking, and 25% smoked in the past month. Among those who never smoked, 15% indicated being likely or very likely to smoke in a year. Multiple regression modeling analysis indicated the significance of the seven PMT constructs, the four PMT perceptions and the two PMT pathways in predicting intention to smoke and actual smoking behavior. Overall, perceived rewards of smoking, especially intrinsic rewards, were consistently positively related to smoking intentions and behavior, and self-efficacy to avoid smoking was negatively related to smoking. The current study suggests the utility of PMT for further research examining adolescent smoking. PMT-based smoking prevention and clinical smoking cessation intervention programs should focus more on adolescents’ perceived rewards from smoking and perceived efficacy of not smoking to reduce their intention to and actual use of tobacco. PMID:24157424

Application of the protection motivation theory in predicting cigarette smoking among adolescents in China.

PubMed

Yan, Yaqiong; Jacques-Tiura, Angela J; Chen, Xinguang; Xie, Nianhua; Chen, Jing; Yang, Niannian; Gong, Jie; Macdonell, Karen Kolmodin

2014-01-01

Reducing tobacco use among adolescents in China represents a significant challenge for global tobacco control. Existing behavioral theories developed in the West - such as the Protection Motivation Theory (PMT) - may be useful tools to help tackle this challenge. We examined the relationships between PMT factors and self-reported cigarette smoking behavior and intention among a random sample of vocational high school students (N=553) in Wuhan, China. Tobacco-related perceptions were assessed using the PMT Scale for Adolescent Smoking. Among the total sample, 45% had initiated cigarette smoking, and 25% smoked in the past month. Among those who never smoked, 15% indicated being likely or very likely to smoke in a year. Multiple regression modeling analysis indicated the significance of the seven PMT constructs, the four PMT perceptions and the two PMT pathways in predicting intention to smoke and actual smoking behavior. Overall, perceived rewards of smoking, especially intrinsic rewards, were consistently positively related to smoking intentions and behavior, and self-efficacy to avoid smoking was negatively related to smoking. The current study suggests the utility of PMT for further research examining adolescent smoking. PMT-based smoking prevention and clinical smoking cessation intervention programs should focus more on adolescents' perceived rewards from smoking and perceived efficacy of not smoking to reduce their intention to and actual use of tobacco. © 2013.

Not Only When Feeling Down: The Relationship Between Mood Intensity and Smoking Behavior.

PubMed

Pavlović, Maša; Zezelj, Iris

2017-03-21

There is substantial empirical evidence that negative mood triggers smoking behavior, and less support for the similar effect of positive mood. However, the relationship between the intensity of mood and smoking remains relatively under-researched. The present study explored the association between mood intensity and smoking behavior. Seventy-three ad libitum smokers recorded their mood and concurrent number of smoked cigarettes three times daily for one week using electronic diary application. Real time assessment in natural environment enabled greater reliability, validity and generalizability of the collected data. We analyzed results using within-subjects approach and obtained significant growth trend in smoking behavior that concurred with the increase of mood intensity-smokers tended to increase their consumption of cigarettes when they were feeling either happy or sad in comparison to the situation when they were in neutral mood. These findings raise implications regarding the role of mood intensity in initiating smoking behavior.

Comparative Effectiveness of Motivation Phase Intervention Components for Use with Smokers Unwilling to Quit: A Factorial Screening Experiment

PubMed Central

Cook, Jessica W.; Collins, Linda M.; Fiore, Michael C.; Smith, Stevens S.; Fraser, David; Bolt, Daniel M.; Baker, Timothy B.; Piper, Megan E.; Schlam, Tanya R.; Jorenby, Douglas; Loh, Wei-Yin; Mermelstein, Robin

2015-01-01

Aims To screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. Design A balanced, 4-factor, randomized factorial experiment. Setting Eleven primary care clinics in southern Wisconsin, USA. Participants 517 adult smokers (63% women, 91% White) recruited during primary care visits who were willing to reduce their smoking but not quit. Interventions Four factors contrasted intervention components designed to reduce smoking and promote abstinence: 1) nicotine patch vs. none; 2) nicotine gum vs. none; 3) motivational interviewing (MI) vs. none; and 4) behavioral reduction counseling (BR) vs. none. Participants could request cessation treatment at any point during the study. Measurements The primary outcome was percent change in cigarettes smoked per day at 26 weeks post-study enrollment; the secondary outcomes were percent change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment. Findings There were few main effects, but a significant 4-way interaction at 26-weeks post-study enrollment (p=.01, β = .12) revealed relatively large smoking reductions by two component combinations: nicotine gum combined with BR and BR combined with MI. Further, BR improved 12-week abstinence rates (p=.04), and nicotine gum, when used without MI, increased abstinence after a subsequent aided quit attempt (p=.01). Conclusions Motivation-phase nicotine gum and behavioral reduction counseling are promising intervention components for smokers who are initially unwilling to quit. PMID:26582140

Acute vascular effects of waterpipe smoking: Importance of physical activity and fitness status.

PubMed

Alomari, Mahmoud A; Khabour, Omar F; Alzoubi, Karem H; Shqair, Dana M; Stoner, Lee

2015-06-01

While new forms of tobacco, including waterpipe (WP) smoking, continue to gain popularity, limited literature has examined the vascular health consequences. The purpose of the current study was to examine: (i) the acute WP-induced changes in vascular function; (ii) whether acute changes in vascular function are modified by lifestyle behaviors (habitual physical activity, physical fitness). Fifty three (22.7 y, 36% F, 23.4 kg/m(2)) otherwise healthy WP smokers were recruited. Strain-gauge plethysmography was used to measure forearm blood flow, vascular resistance, venous capacitance, and venous outflow at rest and following occlusion. Habitual physical activity was determined using the Arabic version of short-form international physical activity questionnaire, while physical fitness was assessed using the 6 min walk test and handgrip strength. Partial correlations were used to examine the relationships between post-smoking vascular function and lifestyle behaviors, controlling for pre-smoking vascular measures. (i) WP had a small effect on forearm post-occlusion blood flow (d = -0.19), a moderate effect on venous outflow (d = 0.30), and a moderate effect on post-occlusion vascular resistance (d = 0.32). (ii) Total habitual physical activity strongly correlated with resting blood flow (r = 0.50) and moderately with vascular resistance (r = -0.40). Handgrip strength moderately correlated with venous capacitance (r = 0.30) and post-occlusion blood flow (r = 0.30), while 6 min walked distance moderately correlated with resting venous capacitance (r = 0.30). Waterpipe smoking is associated with immediate changes in vascular function, which are exacerbated in individuals with low habitual physical activity and physical fitness levels in young otherwise healthy individuals. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Smoking behavior in pregnant Arab Americans.

PubMed

Kulwicki, Anahid; Smiley, Karen; Devine, Susan

2007-01-01

To determine the smoking behavior in pregnant Arab American women who attended a Women, Infant and Children (WIC) program at a local county public health clinic and compare the incidence of smoking behaviors of pregnant Arab American women with pregnant women who were not Arab Americans. Data were extracted from a computer database that contained information from health history charts of pregnant Arab and non-Arab American women. The study sample was 830 women, 823 of whom were Arab American participants enrolled in the WIC program in Michigan. Approximately 6% of pregnant Arab Americans smoked during pregnancy. The prevalence of smoking behavior among pregnant Arab American women was similar to that of smoking behaviors of Hispanics and Asian Americans in the United States. Although smoking behavior is a serious problem among Arab American immigrants in general and in the Arab world in particular, cultural factors that support healthy behavior during pregnancy in the Arab culture seem to limit the use of tobacco in pregnant women. Nurses who care for Arab American pregnant women can use this information to better inform their care of these patients.

The effects of Earned Income Tax Credit payment expansion on maternal smoking.

PubMed

Averett, Susan; Wang, Yang

2013-11-01

The Earned Income Tax Credit is the largest antipoverty program in the USA. In 1993, the Earned Income Tax Credit benefit levels were changed significantly based on the number of children in the family such that families with two or more children experienced an exogenous expansion in their incomes. Using data from the National Longitudinal Survey of Youth 1979 cohort, we use a triple-difference plus fixed effects framework to examine the effect of this change on the probability of smoking among low-educated mothers. We find that the probability of smoking for White low-educated mothers of two or more children significantly decreased relative to those with only one child, and this result is robust to various specification tests. This result provides new evidence on the protective effect of income on health through changes in a health-related behavior and therefore has important policy implications. Copyright © 2012 John Wiley & Sons, Ltd.

Team-level flexibility, work–home spillover, and health behavior

PubMed Central

Moen, Phyllis; Fan, Wen; Kelly, Erin L.

2013-01-01

Drawing on two waves of survey data conducted six months apart in 2006, this study examined the impacts of a team-level flexibility initiative (ROWE – Results Only Work Environment) on changes in the work-home spillover and health behavior of employees at the Midwest headquarters of a large US corporation. Using cluster analysis, we identified three distinct baseline spillover constellations: employees with high negative spillover, high positive spillover, and low overall spillover. Within-team spillover measures were highly intercorrelated, suggesting that work teams as well as individuals have identifiable patterns of spillover. Multilevel analyses showed ROWE reduced individual- and team-level negative work-home spillover but not positive work-home spillover or spillover from home-to-work. ROWE also promoted employees’ health behaviors: increasing the odds of quitting smoking, decreasing smoking frequency, and promoting perceptions of adequate time for healthy meals. Trends suggest that ROWE also decreased the odds of excessive drinking and improved sleep adequacy and exercise frequency. Some health behavior effects were mediated via reduced individual-level negative work-home spillover (exercise frequency, adequate time for sleep) and reduced team-level negative work-home spillover (smoking frequency, exercise frequency, and adequate time for sleep). While we found no moderating effects of gender, ROWE especially improved the exercise frequency of singles and reduced the smoking frequency of employees with low overall spillover at baseline. PMID:23517706

Team-level flexibility, work-home spillover, and health behavior.

PubMed

Moen, Phyllis; Fan, Wen; Kelly, Erin L

2013-05-01

Drawing on two waves of survey data conducted six months apart in 2006, this study examined the impacts of a team-level flexibility initiative (ROWE--results only work environment) on changes in the work-home spillover and health behavior of employees at the Midwest headquarters of a large U.S. corporation. Using cluster analysis, we identified three distinct baseline spillover constellations: employees with high negative spillover, high positive spillover, and low overall spillover. Within-team spillover measures were highly intercorrelated, suggesting that work teams as well as individuals have identifiable patterns of spillover. Multilevel analyses showed ROWE reduced individual- and team-level negative work-home spillover but not positive work-home spillover or spillover from home-to-work. ROWE also promoted employees' health behaviors: increasing the odds of quitting smoking, decreasing smoking frequency, and promoting perceptions of adequate time for healthy meals. Trends suggest that ROWE also decreased the odds of excessive drinking and improved sleep adequacy and exercise frequency. Some health behavior effects were mediated via reduced individual-level negative work-home spillover (exercise frequency, adequate time for sleep) and reduced team-level negative work-home spillover (smoking frequency, exercise frequency, and adequate time for sleep). While we found no moderating effects of gender, ROWE especially improved the exercise frequency of singles and reduced the smoking frequency of employees with low overall spillover at baseline. Copyright © 2013. Published by Elsevier Ltd.

Young adult waterpipe smokers: Smoking behaviors and associated subjective and physiological effects.

PubMed

Shishani, Kawkab; Howell, Donelle; McPherson, Sterling; Roll, John

2014-06-01

The purpose of this pilot study was to investigate smoking behaviors and subjective and physiological effects of nicotine on young adult occasional waterpipe smokers. This study utilized a repeated-measures design that included one repeated factor for condition (nicotine and non-nicotine). For each participant, the sequencing of the repeated factor was assigned using random allocation. The two nicotine conditions were nicotine (0.75 g) and non-nicotine (0 g placebo) tobacco. Over the course of two weeks, twenty-two participants completed subjective (Acute Subjective Effects of Nicotine) and physiological (blood pressure, heart rate, and CO level) measures. Additional measures (QSU and MNWS-R) were used to assess for withdrawal symptoms. The participants (n=22) were young adults (23 ± 3.1years); 71% smoked waterpipe once a month in the past year and 29% smoked waterpipe 1-2 times per week. In addition, 60% reported sharing their waterpipe with friends while smoking. None of the participants reported using any other forms of tobacco products. Under the nicotine condition, participants tended to smoke longer (i.e. smoking duration, p=0.004), take more puffs (p=0.03), take shorter puffs (p=0.03), and inhale less volume with each puff (p=0.02). The repeated measures analysis of the factor headrush revealed an effect of the nicotine condition (F=9.69, p<0.001, partial η(2)=0.31) and time (F=8.17, p=0.02, partial η(2)=0.30). Heart rate increased significantly across the nicotine condition (F=7.92, p=0.01, partial η(2)=0.31) and over time (F=12.64, p=0.01, partial η(2)=0.41). This study demonstrates how differences between nicotine and non-nicotine waterpipe smoking are associated with changes in smoking behaviors, experiencing a headrush and an increase in heart rate. Copyright © 2014 Elsevier Ltd. All rights reserved.

Psychological problems and psychosocial predictors of cigarette smoking behavior among undergraduate students in Malaysia.

PubMed

Saravanan, Coumaravelou; Heidhy, Imran

2014-01-01

Cigarette smokers have their own motivation and justification to smoke. For example, smoking reduces their stress or enhances their pleasure. This study aimed to identify the (a) prevalence of cigarette smokers among undergraduates in Malaysia, (b) gender differences in nicotine dependence among current smokers, (c) differences in psychological problems (depression, anxiety and stress) based on the status of smoking cigarettes (current, former and non-smokers) and (d) extent to which precipitating factors (tension reduction, addiction, automatism, handling, social interaction, pleasure, and stimulation) predict the smoking behavior among current smokers. In this study 780 undergraduate students participated from a private university in Kuala Lumpur and Selangor state in Malaysia. The Depression, Stress and Anxiety Scale, Modified Reason for Smoking Scale and Fagerstrom Nicotine Dependence Test were used to measure psychological problems, predictors of smoking behavior and nicotine dependency among current smokers. The results showed that 14.7%(n=106) of the students were smokers. Current smokers exhibited more psychological problems (depression, anxiety and stress) compared to former and non-smokers. Addiction, tension reduction, pleasure and automatism were predictors of smoking behavior among the current smoking students. Step wise regression analysis showed that smoking behavior was highly predicted by nicotine dependency or addiction. Smoking students were motivated to smoke cigarettes as they believed that it reduced their tension and enhance pleasure. Hence, there is a need for health promotion and anti-tobacco prevention as cigarette smokers experience more psychological problems. Nicotine dependency or addition was one of the major causes for smoking behavior among the student population in Malaysia.

[Evaluation of changes in hemodynamic parameters after the use of electronic nicotine delivery systems among regular cigarette smokers].

PubMed

Czogała, Jan; Cholewiński, Mateusz; Kutek, Agnieszka; Zielińska-Danch, Wioleta

2012-01-01

A relatively new device, described by producers as a device to help smokers quit, nicotine inhaler is an electronic (e-cigarette). Its mission is to provide the body with small doses of nicotine behavior "ceremonial" burning product is not tested for efficacy and toxicity The aim of this study was to compare the effects of nicotine absorbed from cigarette conventional and electronic changes in systolic and diastolic blood pressure and heart rate. Because of the potential interaction of carbon monoxide contained in cigarette smoke and nicotine conventional to changes on the parameters is also going to examine changes in the concentration of carboxyhemoglobin after smoking cigarettes and using e-cigarettes. study group consisted of 42 people, including 21 women and 21 men aged from 18 to 62 years who declared daily cigarette smoking. In this study it was found that as a result of cigarette smoking are increasing all the analyzed conventional hemodynamic parameters, these increases probably normally associated with nicotine absorbed by the smoker with the smoke. It was also a clear increase in carboxyhemoglobin, which is associated with a high concentration of carbon monoxide in cigarette smoke. If you use the e-cigarettes tested were observed increases in diastolic blood pressure and pulse, but none of the parameters did not change significantly, indicating that either the use of e-cigarette by the respondents did not supply the body with absorbable nicotine or for the increase in haemodynamic parameters studied did not correspond only nicotine but also other smoke constituents that interact with nicotine to the smoker body as carbon monoxide.

Smoking Habits among Italian Adolescents: What Has Changed in the Last Decade?

PubMed Central

Galeone, Daniela; Spizzichino, Lorenzo; Lemma, Patrizia

2014-01-01

Tobacco use, alcohol abuse, overweight and obesity are risk factors for numerous diseases in Italy as elsewhere. However, children and adolescents are not usually included in official national surveys although it is at this stage of life when unhealthy habits are often established. Italian participation in HBSC and GYTS surveys allows our country to implement standardized surveillance systems providing reliable information on tobacco-related behaviors of this population. Data from three HBSC surveys (2002–2010) show that following the drop in the first half of the decade, prevalence of tobacco use stabilized in the second half. The decline was significant for younger age groups, while prevalence of regular tobacco use remained stable among 15-year-olds. Many adolescents reported being exposed to secondhand smoke, to have at least one parent who smokes, and having seen teachers and students smoking at school. Although the sale of tobacco products to minors is prohibited, the vast majority had no trouble in buying cigarettes. Data from GYTS and HBSC surveys provide a wealth of information about attitudes and behaviors of Italian adolescents with respect to smoking. Despite some progress, sizeable gaps remain in meeting standard recommendations for discouraging smoking initiation and motivating adolescent smokers to quit the habit. PMID:24860815

Smoking habits among italian adolescents: what has changed in the last decade?

PubMed

Charrier, Lorena; Berchialla, Paola; Galeone, Daniela; Spizzichino, Lorenzo; Borraccino, Alberto; Lemma, Patrizia; Dalmasso, Paola; Cavallo, Franco

2014-01-01

Tobacco use, alcohol abuse, overweight and obesity are risk factors for numerous diseases in Italy as elsewhere. However, children and adolescents are not usually included in official national surveys although it is at this stage of life when unhealthy habits are often established. Italian participation in HBSC and GYTS surveys allows our country to implement standardized surveillance systems providing reliable information on tobacco-related behaviors of this population. Data from three HBSC surveys (2002-2010) show that following the drop in the first half of the decade, prevalence of tobacco use stabilized in the second half. The decline was significant for younger age groups, while prevalence of regular tobacco use remained stable among 15-year-olds. Many adolescents reported being exposed to secondhand smoke, to have at least one parent who smokes, and having seen teachers and students smoking at school. Although the sale of tobacco products to minors is prohibited, the vast majority had no trouble in buying cigarettes. Data from GYTS and HBSC surveys provide a wealth of information about attitudes and behaviors of Italian adolescents with respect to smoking. Despite some progress, sizeable gaps remain in meeting standard recommendations for discouraging smoking initiation and motivating adolescent smokers to quit the habit.

Smoking behaviors and intentions among current e-cigarette users, cigarette smokers, and dual users: A national survey of U.S. high school seniors.

PubMed

McCabe, Sean Esteban; Veliz, Phil; McCabe, Vita V; Boyd, Carol J

2017-06-01

E-cigarette use among adolescents has increased significantly in recent years, but it remains unclear whether cigarette smoking behaviors and intentions for future cigarette smoking differ among current (i.e., 30-day) non-users, only e-cigarette users, only cigarette smokers, and dual users. A nationally representative sample of 4385 U.S. high school seniors were surveyed during the spring of their senior year via self-administered questionnaires in 2014. An estimated 9.6% of U.S. high school seniors reported current e-cigarette use only, 6.3% reported current cigarette smoking only, and 7.2% reported current dual use of e-cigarettes and cigarette smoking. There were no significant differences between current only cigarette smokers and dual users in the odds of early onset of cigarette smoking, daily cigarette smoking, intentions for future cigarette smoking, friends' cigarette smoking behaviors, attempts to quit cigarette smoking, or the inability to quit cigarette smoking. Adolescents who only used e-cigarettes had higher odds of intentions for future cigarette smoking in the next 5years (AOR=2.57, 95% CI: 1.21-5.24) than current non-users. Dual users and only cigarette smokers had higher odds of cigarette smoking behaviors and intentions for future cigarette smoking than non-users or only e-cigarette users. Adolescents who engage in current dual use have cigarette smoking behaviors and intentions for future cigarette smoking that more closely resemble cigarette smokers than e-cigarette users. Adolescents who only use e-cigarettes have higher intentions to engage in future cigarette smoking relative to their peers who do not engage in e-cigarette use or cigarette smoking. Copyright © 2017 Elsevier Inc. All rights reserved.

A novel training approach to activate alternative behaviors for smoking in depressed smokers.

PubMed

Kopetz, Catalina; MacPherson, Laura; Mitchell, Avery D; Houston-Ludlam, Alexandra N; Wiers, Reinout W

2017-02-01

The current research developed and tested a novel training strategy to alter the implicit associations between alternative behaviors to smoking and negative affect, and explored its effects on depressive symptoms and on smoking behavior as part of a quit attempt. Using a joystick, participants identified as smokers with depressive symptoms were trained to approach alternative behaviors to smoking in the context of negative affect. Specifically, in the experimental condition, participants were trained to avoid smoking-related targets and to approach alternative activities. In the control condition, participants pushed and pulled an equal amount of smoking and alternative activity-related targets. Compared with the participants in the control condition, those in the experimental condition showed an increase in the accessibility of the alternative activity relative to smoking and a decrease in depressive symptoms. Smoking outcomes did not differ significantly across the 2 conditions. Taken together these results indicate that the value of alternative behaviors to smoking can be modified in the lab without participants' conscious intentions with implications for depressive symptomatology. Future research is required to explore the impact of such training on smoking outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Behavioral problems and the occurrence of tobacco, cannabis, and coca paste smoking in Chile: evidence based on multivariate response models for school survey data.

PubMed

Caris, Luis; Anthony, Christopher B; Ríos-Bedoya, Carlos F; Anthony, James C

2009-09-01

In this study we estimate suspected links between youthful behavioral problems and smoking of tobacco, cannabis, and coca paste. In the Republic of Chile, school-attending youths were sampled from all 13 regions of the country, with sample size of 46,907 youths from 8th to 12th grades. A Generalized Estimating Equations (GEE) approach to multiple logistic regression was used to address three interdependent response variables, tobacco smoking, cannabis smoking, and coca paste smoking, and to estimate associations. Drug-specific adjusted slope estimates indicate that youths at the highest levels of behavioral problems are an estimated 1.1 times more likely to have started smoking tobacco, an estimated 1.6 times more likely to have started cannabis smoking, and an estimated 2.0 times more likely to have started coca paste smoking, as compared to youths at the lowest level of behavioral problems (p<0.001). In Chile, there is an association linking behavioral problems with onsets of smoking tobacco and cannabis, as well as coca paste; strength of association is modestly greater for coca paste smoking.

Transitions in Smoking Behavior During Emerging Adulthood: A Longitudinal Analysis of the Effect of Home Smoking Bans

PubMed Central

Stigler, Melissa H.; Erickson, Darin J.; Perry, Cheryl L.; Forster, Jean L.

2014-01-01

Objectives. We studied the effect of home smoking bans on transitions in smoking behavior during emerging adulthood. Methods. We used latent transition analysis to examine movement between stages of smoking from late adolescence (ages 16–18 years) to young adulthood (ages 18–20 years) and the effect of a home smoking ban on these transitions. We used data from the Minnesota Adolescent Community Cohort study collected in 2004 to 2006. Results. Overall, we identified 4 stages of smoking: (1) never smokers, (2) experimental smokers, (3) light smokers, and (4) daily smokers. Transition probabilities varied by stage. Young adults with a home ban during late adolescence were less likely to be smokers and less likely to progress to higher use later. Furthermore, the protective effect of a home smoking ban on the prevalence of smoking behavior was evident even in the presence of parental smoking. However, this effect was less clear on transitions over time. Conclusions. In addition to protecting family members from exposure to secondhand smoke, home smoking bans appear to have the additional benefit of reducing initiation and escalation of smoking behavior among young adults. PMID:24524528

Paths to tobacco abstinence: A repeated-measures latent class analysis.

PubMed

McCarthy, Danielle E; Ebssa, Lemma; Witkiewitz, Katie; Shiffman, Saul

2015-08-01

Knowledge of smoking change processes may be enhanced by identifying pathways to stable abstinence. We sought to identify latent classes of smokers based on their day-to-day smoking status in the first weeks of a cessation attempt. We examined treatment effects on class membership and compared classes on baseline individual differences and 6-month abstinence rates. In this secondary analysis of a double-blind randomized placebo-controlled clinical trial (N = 1,433) of 5 smoking cessation pharmacotherapies (nicotine patch, nicotine lozenge, bupropion SR, patch and lozenge, or bupropion SR and lozenge), we conducted repeated-measures latent class analysis of daily smoking status (any smoking vs. none) for the first 27 days of a quit attempt. Treatment and covariate relations with latent class membership were examined. Distal outcome analysis compared confirmed 6-month abstinence rates among the latent classes. A 5-class solution was selected. Three-quarters of smokers were in stable smoking or abstinent classes, but 25% were in classes with unstable abstinence probabilities over time. Active treatment (compared to placebo), and particularly the patch and lozenge combination, promoted early quitting. Latent classes differed in 6-month abstinence rates and on several baseline variables, including nicotine dependence, quitting history, self-efficacy, sleep disturbance, and minority status. Repeated-measures latent class analysis identified latent classes of smoking change patterns affected by treatment, related to known risk factors, and predictive of distal outcomes. Tracking behavior early in a change attempt may identify prognostic patterns of change and facilitate adaptive treatment planning. (c) 2015 APA, all rights reserved).

The Influence of Puff Characteristics, Nicotine Dependence, and Rate of Nicotine Metabolism on Daily Nicotine Exposure in African American Smokers.

PubMed

Ross, Kathryn C; Dempsey, Delia A; St Helen, Gideon; Delucchi, Kevin; Benowitz, Neal L

2016-06-01

African American (AA) smokers experience greater tobacco-related disease burden than Whites, despite smoking fewer cigarettes per day (CPD). Understanding factors that influence daily nicotine intake in AA smokers is an important step toward decreasing tobacco-related health disparities. One factor of interest is smoking topography, or the study of puffing behavior. (i) to create a model using puff characteristics, nicotine dependence, and nicotine metabolism to predict daily nicotine exposure, and (ii) to compare puff characteristics and nicotine intake from two cigarettes smoked at different times to ensure the reliability of the puff characteristics included in our model. Sixty AA smokers smoked their preferred brand of cigarette at two time points through a topography device. Plasma nicotine, expired CO, and changes in subjective measures were measured before and after each cigarette. Total nicotine equivalents (TNE) was measured from 24-hour urine collected during ad libitum smoking. In a model predicting daily nicotine exposure, total puff volume, CPD, sex, and menthol status were significant predictors (R(2) = 0.44, P < 0.001). Total puff volume was significantly greater and inter-puff intervals were significantly shorter after ad lib smoking compared with the first cigarette of the day, but puffing behaviors for both cigarettes were highly correlated (r range = 0.69-0.89, P < 0.001) within-subjects. This is the first study, to our knowledge, to show that puff characteristics of individual cigarettes are predictive of daily nicotine intake. These findings enhance our understanding of the relationship between smoking behavior and nicotine intake in AA smokers. Cancer Epidemiol Biomarkers Prev; 25(6); 936-43. ©2016 AACR. ©2016 American Association for Cancer Research.

Smoking Behavior, Attitudes of Second-Hand Smoke, and No-Smoking Policies on a University Campus

ERIC Educational Resources Information Center

Polacek, Georgia N. L. Johnston; Atkins, Janet L.

2008-01-01

Smoking, when condoned as socially acceptable, overtly establishes such behavior as normal and risk-free. Scientific evidence verifies that cigarette smoking pervasively damages the body, causes early death, costs billions of dollars annually in medical care for smokers, and poses serious health risks to nonsmokers exposed to secondhand smoke. Yet…

Influences of Tobacco Advertising Exposure and Conduct Problems on Smoking Behaviors Among Adolescent Males and Females

PubMed Central

2014-01-01

Introduction: Adolescents with conduct problems are more likely to smoke, and tobacco advertising exposure may exacerbate this risk. Males’ excess risk for conduct problems and females’ susceptibility to advertising suggest gender-specific pathways to smoking. We investigated the associations between gender, conduct problems, and lifetime smoking and adolescents’ exposure to tobacco advertising, and we examined prospective relationships with smoking behaviors. Methods: Adolescents completed baseline (2001–2004; n = 541) and 5-year follow-up (2007–2009; n =320) interviews for a family study of smoking risk. Baseline interviews assessed conduct problems and tobacco advertising exposure; smoking behavior was assessed at both timepoints. Generalized linear models analyzed gender differences in the relationship between conduct problems, advertising exposure, and smoking behavior at baseline and longitudinally. Results: At baseline, among males, conduct problems were associated with greater advertising exposure independent of demographics and lifetime smoking. Among females at baseline, conduct problems were associated with greater advertising exposure only among never-smokers after adjusting for demographics. In longitudinal analyses, baseline advertising exposure predicted subsequent smoking initiation (i.e., smoking their first cigarette between baseline and follow-up) for females but not for males. Baseline conduct problems predicted current (i.e., daily or weekly) smoking at follow-up for all adolescents in adjusted models. Conclusions: The findings of this study reinforce that conduct problems are a strong predictor of subsequent current smoking for all adolescents and reveal important differences between adolescent males and females in the relationship between conduct problems, tobacco advertising behavior, and smoking behavior. The findings suggest gender-specific preventive interventions targeting advertising exposure may be warranted. PMID:24590388

[The relationship between smoking behavior and self-esteem among elementary and junior high school students].

PubMed

Kawabata, T; Shimai, S; Nishioka, N

1998-01-01

This study examined the relationship between smoking behavior and self-esteem among Japanese early adolescents. The study sample comprised 1,486 fourth through ninth grade students from 10 elementary schools and six junior high schools throughout nine prefectures. Data were collected using an anonymous self-administered questionnaire which included items measuring smoking behavior, self-esteem, intention to smoke in the future, self-efficacy to refuse peer pressure to smoke, the smoking behaviors of their parents, siblings and friends. Self-esteem was measured using the Harter Perceived Competence Scale which includes four areas: cognitive, social, physical, and general. The main results were as follows: 1) Ever smokers had lower cognitive and general competence scores, but a higher physical competence score than never smokers, especially among males. 2) Ever smokers had more smoking parents, siblings and friends than never smokers. 3) Ever smokers had stronger intention to smoke in the future than never smokers. 4) Ever smokers had lower self-efficacy to refuse peer pressure to smoke than never smokers. The results of this study about the relationship between smoking behavior and self-esteem were consistent with those of some previous studies in the U.S. Therefore, it is suggested that effective smoking prevention programs for Japanese early adolescents should include strategies to enhance self-esteem.

Factors Associated With Smoking Behavior Among Operating Engineers

PubMed Central

Choi, Seung Hee; Pohl, Joanne M.; Terrell, Jeffrey E.; Redman, Richard W.

2016-01-01

Although disparities in smoking prevalence between white collar workers and blue collar workers have been documented, reasons for these disparities have not been well studied. The objective of this study was to determine variables associated with smoking among Operating Engineers, using the Health Promotion Model as a guide. With cross-sectional data from a convenience sample of 498 Operating Engineers, logistic regression was used to determine personal and health behaviors associated with smoking. Approximately 29% of Operating Engineers currently smoked cigarettes. Multivariate analyses showed that younger age, unmarried, problem drinking, physical inactivity, and a lower body mass index were associated with smoking. Operating Engineers were at high risk of smoking, and smokers were more likely to engage in other risky health behaviors, which supports bundled health behavior interventions. PMID:23957830

Effects of smoking cues in movies on immediate smoking behavior.

PubMed

Lochbuehler, Kirsten; Peters, Michiel; Scholte, Ron H J; Engels, Rutger C M E

2010-09-01

The objective of this study was to investigate the effect of smoking cues in movies on immediate smoking behavior. We tested whether smokers who are confronted with smoking characters in a movie smoke more cigarettes while watching than those confronted with non-smoking characters and whether this effect is less profound when smokers are more involved in the narrative (i.e., transportation). Using an experimental design, 60 daily smokers were assigned randomly to one of two movie conditions (smoking vs. non-smoking characters). Participants were exposed to a 72-min movie clip and were allowed to smoke while watching the movie. Transportation and smoking habits were assessed with a questionnaire afterward. The results showed a significant interaction effect between movie condition and transportation on immediate smoking behavior, indicating that smokers who were less transported smoked significantly more cigarettes when they were exposed to smoking characters compared with non-smoking characters. These results call for (a) increasing the awareness among people about the effect smoking cues in movies might have and (b) stricter control over smoking cues in movies.

The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014.

PubMed

Sim, Won Yong; Cho, Young Gyu; Kang, Jae Heon; Park, Hyun Ah; Kim, Kyoung Woo; Hur, Yang Im; Shin, Koh Eun; Byeon, Gyeong Ran

2017-01-01

Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. 'Unhealthy weight control behaviors' were subcategorized into 'extreme weight control behaviors' and 'less extreme weight control behaviors.' The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.

Cigarette tax avoidance and evasion.

PubMed

Stehr, Mark

2005-03-01

Variation in state cigarette taxes provides incentives for tax avoidance through smuggling, legal border crossing to low tax jurisdictions, or Internet purchasing. When taxes rise, tax paid sales of cigarettes will decline both because consumption will decrease and because tax avoidance will increase. The key innovation of this paper is to compare cigarette sales data to cigarette consumption data from the Behavioral Risk Factor Surveillance System (BRFSS). I show that after subtracting percent changes in consumption, residual percent changes in sales are associated with state cigarette tax changes implying the existence of tax avoidance. I estimate that the tax avoidance response to tax changes is at least twice the consumption response and that tax avoidance accounted for up to 9.6% of sales between 1985 and 2001. Because of the increase in tax avoidance, tax paid sales data understate the level of smoking and overstate the drop in smoking. I also find that the level of legal border crossing was very low relative to other forms of tax avoidance. If states have strong preferences for smoking control, they must pair high cigarette taxes with effective policies to curb smuggling and other forms of tax avoidance or employ alternative policies such as counter-advertising and smoking restrictions.

Evaluating the impact of a community-based cancer awareness roadshow on awareness, attitudes and behaviors.

PubMed

Smith, Samuel G; Osborne, Kirstie; Tring, Sophie; George, Helen; Power, Emily

2016-06-01

Improving public awareness of cancer and encouraging health behavior change are important aspects of cancer control. We investigated whether a community-based roadshow was an effective way of communicating with the public about cancer and encouraging behavior change. Data were from 1196 people who completed questionnaires at a Cancer Research UK Cancer Awareness Roadshow in 2013. Of these, 511 (43%) completed questionnaires immediately before their visit (pre-visit group) and 685 (57%) completed questionnaires immediately after their visit (post-visit group). Among the post-visit sample, 217 (32%) were retained after two months. Self-reported data were available on risk factor and symptom awareness, help-seeking barriers, use of healthcare services and health behaviors. Compared with the pre-visit sample, the post-visit group had greater awareness of cancer risk factors and was more positive about aspects of help-seeking but awareness of potential symptoms was similar. Most effects were maintained over two months. Intentions to eat more fruit and vegetables and to exercise more were comparable between the groups but more people in the post-visit sample intended to quit smoking. At 2-month follow-up, smoking prevalence had significantly reduced but fruit and vegetable consumption decreased and there was no change to physical activity. User of weight loss services and general practitioner visits were high at follow-up and largely attributed to the Roadshow. The Cancer Research UK Roadshow appears to improve risk factor awareness, promote positive attitudes towards help-seeking and increase smoking cessation. This approach could be a useful building block for additional cancer prevention and control strategies. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Executive-affective connectivity in smokers viewing anti-smoking images: an fMRI study.

PubMed

Dinh-Williams, Laurence; Mendrek, Adrianna; Dumais, Alexandre; Bourque, Josiane; Potvin, Stéphane

2014-12-30

Despite knowledge of the harmful consequences of smoking on health, tobacco users continue to smoke. Neuroimaging studies have begun to provide insight into the mechanisms underlying this response. Regions involved in executive control and affective processing/persuasion are activated when viewing the negative value of smoking, but these systems can interact in ways that promote or hinder its impact on behavior. The goal of this functional magnetic resonance imaging (fMRI) study was to examine the dynamics between these systems during the processing of images designed to elicit a negative emotional response regarding tobacco smoking in a group of current smokers. Thirty chronic smokers passively viewed aversive smoking-related, aversive nonsmoking-related and neutral images presented in a block design while being scanned. Functional connectivity analyses showed that the left inferior frontal gyrus (IFG) is negatively associated to activity in medial frontal, cingulate, limbic, subcortical and parietal regions in chronic smokers during the processing of aversive smoking-related material, a pattern that was significantly greater when stimuli were drug-related compared with when they were nondrug-related. Our results suggest that individuals with tobacco dependence present different patterns of functional connectivity depending on whether the aversive stimuli are smoking- or nonsmoking-related. Activity in the left inferior frontal gyrus may act to down-regulate corresponding activity in regions key to an affective and persuasive response during the processing of anti-smoking material. This mechanism may reduce the extent to which "feeling bad" brings about a change in behavior. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Tobacco use and asking prices of used cars: prevalence, costs, and new opportunities for changing smoking behavior

PubMed Central

Matt, Georg E; Romero, Romina; Ma, Debbie S; Quintana, Penelope JE; Hovell, Melbourne F; Donohue, Michael; Messer, Karen; Salem, Simon; Aguilar, Mauricio; Boland, Justin; Cullimore, Jennifer; Crane, Marissa; Junker, Jonathan; Tassinario, Peter; Timmermann, Vera; Wong, Kristen; Chatfield, Dale

2008-01-01

Secondhand smoke (SHS) causes premature death and disease in children and adults, and the scientific evidence indicates that there is no risk-free level of exposure to SHS. Smoking tobacco in a car can pollute the microenvironment of the car with residual SHS, leaving telltale signs to potential buyers (e.g., odor, used ash tray). This study examined (a) the proportion of used cars sold in the private party market that may be polluted with tobacco smoke and (b) whether asking prices of smoker and nonsmoker cars differed for cars of otherwise equivalent value. A random sample of 1,642 private party sellers were interviewed by telephone, and content analyses of print advertisements were conducted. Findings indicate that 22% of used cars were advertised by smokers or had been smoked in during the previous year. Among nonsmokers, 94% did not allow smoking in their car during the past year. Only 33% of smokers had the same restrictions. The smoking status of the seller and tobacco use in the car were significantly (p < .01) associated with the asking price independent of a car's Kelley Blue Book value (KBB). Used nonsmoker cars were offered at a considerable premium above their KBB value (>11%) and above comparable smoker cars (7–9%). These findings suggest that community preferences are affecting the value of smoke-free cars. New directions for research, tobacco control policies, and health education are discussed to further reduce smoking behavior, to help consumers make informed purchasing decisions, and to protect nonsmokers from SHS exposure. PMID:18822157

How are lung cancer risk perceptions and cigarette smoking related?-testing an accuracy hypothesis.

PubMed

Chen, Lei-Shih; Kaphingst, Kimberly A; Tseng, Tung-Sung; Zhao, Shixi

2016-10-01

Subjective risk perception is an important theoretical construct in the field of cancer prevention and control. Although the relationship between subjective risk perception and health behaviors has been widely studied in many health contexts, the causalities and associations between the risk perception of developing lung cancer and cigarette smoking have been inconsistently reported among studies. Such inconsistency may be from discrepancies between study designs (cross-sectional versus longitudinal designs) and the three hypotheses (i.e., the behavior motivation hypothesis, the risk reappraisals hypothesis, and the accuracy hypothesis) testing different underlying associations between risk perception and cigarette-smoking behaviors. To clarify this issue, as an initial step, we examined the association between absolute and relative risk perceptions of developing lung cancer and cigarette-smoking behaviors among a large, national representative sample of 1,680 U.S. adults by testing an accuracy hypothesis (i.e., people who smoke accurately perceived a higher risk of developing lung cancer). Data from the U.S. Health Information National Trends Survey (HINTS) were analyzed using logistic regression and multivariate linear regression to examine the associations between risk perception and cigarette-smoking behaviors among 1,680 U.S. adults. Findings from this cross-sectional survey suggest that absolute and relative risk perceptions were positively and significantly correlated with having smoked >100 cigarettes during lifetime and the frequency of cigarette smoking. Only absolute risk perception was significantly associated with the number of cigarettes smoked per day among current smokers. Because both absolute and relative risk perceptions are positively related to most cigarette-smoking behaviors, this study supports the accuracy hypothesis. Moreover, absolute risk perception might be a more sensitive measurement than relative risk perception for perceived lung cancer risk. Longitudinal research is needed in the future to investigate other types of risk perception-risk behavior hypotheses-the behavior motivation and the risk reappraisals hypotheses-among nationally representative samples to further examine the causations between risk perception of obtaining lung cancer and smoking behaviors.

Menthol smokers: metabolomic profiling and smoking behavior

PubMed Central

Hsu, Ping-Ching; Lan, Renny S.; Brasky, Theodore M.; Marian, Catalin; Cheema, Amrita K.; Ressom, Habtom W.; Loffredo, Christopher A.; Pickworth, Wallace B.; Shields, Peter G.

2016-01-01

Background The use of menthol in cigarettes and marketing is under consideration for regulation by the FDA. However, the effects of menthol on smoking behavior and carcinogen exposure have been inconclusive. We previously reported metabolomic profiling for cigarette smokers, and novelly identified a menthol-glucuronide (MG) as the most significant metabolite directly related to smoking. Here, MG is studied in relation to smoking behavior and metabolomic profiles. Methods A cross-sectional study of 105 smokers who smoked two cigarettes in the laboratory one hour apart. Blood nicotine, MG and exhaled carbon monoxide (CO) boosts were determined (the difference before and after smoking). Spearman's correlation, Chi-Square and ANCOVA adjusted for gender, race and cotinine levels for menthol smokers assessed the relationship of MG boost, smoking behavior, and metabolic profiles. Multivariate metabolite characterization using supervised Partial Least Squares-Discriminant Analysis (PLS-DA) was carried out for the classification of metabolomics profiles. Results MG boost was positively correlated with CO boost, nicotine boost, average puff volume, puff duration, and total smoke exposure. Classification using PLS-DA, MG was the top metabolite discriminating metabolome of menthol vs. non-menthol smokers. Among menthol smokers, forty-two metabolites were significantly correlated with MG boost, which linked to cellular functions such as of cell death, survival, and movement. Conclusion Plasma MG boost is a new smoking behavior biomarker that may provides novel information over self-reported use of menthol cigarettes by integrating different smoking measures for understanding smoking behavior and harm of menthol cigarettes. Impacts These results provide insight into the biological effect of menthol smoking. PMID:27628308

Beyond the statistics of adolescent smoking.

PubMed Central

Eckert, P

1983-01-01

Statistical studies can identify the demographic characteristics of the adolescent smoking population but cannot reveal how clusters of demographic categories combine in the culture of the community to form salient social categories, or how social processes link these categories to smoking and smoking-related behavior. Because smoking and smoking-related behavior function as a key social symbol, anti-smoking campaigns that are based on an inaccurate understanding of the social context in which smoking occurs can reinforce this behavior. Participant observation in a suburban high school suggests that adolescents begin smoking as part of a complex symbolic process growing out of the process of social differentiation between future members of the working class on the one hand and the middle class on the other. It points out inadequacies in two existing anti-smoking programs in the schools that result from ignoring the social dynamics of smoking. PMID:6829827

Nicotine reduction as an increase in the unit price of cigarettes: A behavioral economics approach

PubMed Central

Smith, Tracy T.; Sved, Alan F.; Hatsukami, Dorothy K.; Donny, Eric C.

2015-01-01

Urgent action is needed to reduce the harm caused by smoking. Product standards that reduce the addictiveness of cigarettes are now possible both in the U.S. and in countries party to the Framework Convention on Tobacco Control. Specifically, standards that required substantially reduced nicotine content in cigarettes could enable cessation in smokers and prevent future smoking among current non-smokers. Behavioral economics uses principles from the field of microeconomics to characterize how consumption of a reinforcer changes as a function of the unit price of that reinforcer (unit price = cost / reinforcer magnitude). A nicotine reduction policy might be considered an increase in the unit price of nicotine because smokers are paying more per unit of nicotine. This perspective allows principles from behavioral economics to be applied to nicotine reduction research questions, including how nicotine consumption, smoking behavior, use of other tobacco products, and use of other drugs of abuse are likely to be affected. This paper reviews the utility of this approach and evaluates the notion that a reduction in nicotine content is equivalent to a reduction in the reinforcement value of smoking—an assumption made by the unit price approach. PMID:25025523

Addiction and Other Reasons Adolescent Smokers Give to Justify Smoking.

PubMed

Borderías, Luis; Duarte, Rosa; Escario, José Julián; Molina, José Alberto

2015-01-01

The primary purpose of this paper is to examine youth addiction and other justifications for adolescent smoking, and how they affect the level of consumption. Data from the Spanish 'State Survey on Drug Use among High School Students' aged between 14 and 18 years old were used in this paper. To account for the nature of the cigarette consumption data, several count data models were estimated in order to select the one that best fits adolescent smoking consumption. Most adolescent smokers smoke because it relaxes them, and about a quarter of them recognize that they are addicted. Moreover, the latter group smoke 44% more cigarettes than the rest (IRR = 1.444), revealing the strong addictive nature of tobacco, even at early ages. Moreover, parents' smoking increases the probability of smoking and has an impact on the level of consumption. The implications of these findings offer insight for parents, researchers, educators, and cessation interventionists, as awareness of self-reported and other predictors held by smoking youth creates a vantage point to facilitate changes in smoking behavior.

Workplace smoking ban policy and smoking behavior.

PubMed

Kim, Beomsoo

2009-09-01

To evaluate the impact of the workplace smoking ban in South Korea, where the male smoking rate is high (57%), on smoking behavior and secondhand smoke exposure. A workplace smoking ban legislation implemented in April 2003 requires offices, meeting rooms, and lobbies located in larger than 3,000 square meter buildings (or 2,000 square meter multipurpose buildings) should be smoke free. A representative cross-sectional survey, the third wave (2005) of health supplements in the National Health Nutrition Survey of South Korea, was used to measure the impact of the 2003 workplace smoking ban implementation on smoking behavior. It contained 3,122 observations of adults 20 to 65 years old (excluding self-employed and non-working populations). A multivariate statistical model was used. The self-reported workplace smoking ban policy (full workplace ban, partial workplace ban, and no workplace ban) was used as the key measure. A full workplace smoking ban reduced the current smoking rate by 6.4 percentage points among all workers and also decreased the average daily consumption among smokers by 3.7 cigarettes relative to no smoking ban. Secondhand smoke showed a dramatic decrease of 86 percent (= -1.74/2.03)from the sample mean for full workplace ban. However, public anti-smoking campaign did not show any significant impact on smoking behavior. The full workplace ban policy is effective in South Korea. Male group showed bigger impact of smoking ban policy than female group. The public antismoking campaign did not show any effectiveness.

Effects of varenicline therapy in combination with advanced behavioral support on smoking cessation and quality of life in inpatients with acute exacerbation of COPD, bronchial asthma, or community-acquired pneumonia: A prospective, open-label, preference-based, 52-week, follow-up trial.

PubMed

Politis, Alexios; Ioannidis, Vasileios; Gourgoulianis, Konstantinos I; Daniil, Zoe; Hatzoglou, Chrissi

2018-05-01

Quitting smoking is the most important element in the therapeutic management of chronic respiratory diseases. Combining pharmacotherapy with behavioral support increases smoking cessation success rates. In addition, hospitalized smokers have increased motivation to quit. We investigated the efficacy on smoking cessation, of varenicline in combination with behavioral support, in smokers hospitalized due to (a) acute exacerbation of chronic obstructive pulmonary disease (COPD), or (b) bronchial asthma attack, or (c) community-acquired pneumonia (CAP). The method used is prospective, open-label, preference-based, parallel group, 52-week trial. Patients chose the smoking cessation intervention they preferred: a standard regimen of varenicline combined with post-discharge advanced behavioral support (group A) or one private consultation session during hospitalization (group B). Follow-up phone calls were scheduled in weeks 1, 2, and 4 and months 3, 6, and 9. The final hospital visit was performed in week 52. Primary outcome was success rate defined as the percentage (%) of smoking abstinence at week 52 and secondary outcomes were (a) changes in quality of life (QoL) indicated by the scores on the Short Form 36 (SF36) questionnaire and (b) predictors of smoking abstinence investigated with multiple binary logistic regression. One hundred one patients were enrolled, 44 (43.6%) in group A and 57 (56.4%) in group B. Respective abstinence rates were 54.5% and 15.8% at week 12 and 52.3% and 14.0% at week 52. Scores on SF36 were statistically significantly increased in both groups. Predictors of smoking abstinence were varenicline (odds ratio (OR) 7.29; 95% confidence interval (CI) 2.15, 24.77; p = 0.001), age (OR 1.07; 95%CI 1.00, 1.15; p = 0.042), Fagerstrom score (OR 0.37; 95%CI 0.20, 0.68; p = 0.001), SF36 domains "vitality" (OR 1.12; 95%CI 1.04, 1.21; p = 0.003), and "social functioning" (OR 0.95; 95%CI 0.90, 1.00; p = 0.041). Varenicline in combination with behavioral support resulted in high abstinence rates inpatients hospitalized for exacerbation of COPD, asthma attack, or CAP, and improved QoL.

Editorial: 2nd Special Issue on behavior change, health, and health disparities.

PubMed

Higgins, Stephen T

2015-11-01

This Special Issue of Preventive Medicine (PM) is the 2nd that we have organized on behavior change, health, and health disparities. This is a topic of fundamental importance to improving population health in the U.S. and other industrialized countries that are trying to more effectively manage chronic health conditions. There is broad scientific consensus that personal behavior patterns such as cigarette smoking, other substance abuse, and physical inactivity/obesity are among the most important modifiable causes of chronic disease and its adverse impacts on population health. As such behavior change needs to be a key component of improving population health. There is also broad agreement that while these problems extend across socioeconomic strata, they are overrepresented among more economically disadvantaged populations and contribute directly to the growing problem of health disparities. Hence, behavior change represents an essential step in curtailing that unsettling problem as well. In this 2nd Special Issue, we devote considerable space to the current U.S. prescription opioid addiction epidemic, a crisis that was not addressed in the prior Special Issue. We also continue to devote attention to the two largest contributors to preventable disease and premature death, cigarette smoking and physical inactivity/obesity as well as risks of co-occurrence of these unhealthy behavior patterns. Across each of these topics we included contributions from highly accomplished policy makers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges to effectively managing these important chronic health problems. Copyright © 2015 Elsevier Inc. All rights reserved.

Content-specific network analysis of peer-to-peer communication in an online community for smoking cessation.

PubMed

Myneni, Sahiti; Cobb, Nathan K; Cohen, Trevor

2016-01-01

Analysis of user interactions in online communities could improve our understanding of health-related behaviors and inform the design of technological solutions that support behavior change. However, to achieve this we would need methods that provide granular perspective, yet are scalable. In this paper, we present a methodology for high-throughput semantic and network analysis of large social media datasets, combining semi-automated text categorization with social network analytics. We apply this method to derive content-specific network visualizations of 16,492 user interactions in an online community for smoking cessation. Performance of the categorization system was reasonable (average F-measure of 0.74, with system-rater reliability approaching rater-rater reliability). The resulting semantically specific network analysis of user interactions reveals content- and behavior-specific network topologies. Implications for socio-behavioral health and wellness platforms are also discussed.

Factors that influence delivery of tobacco cessation support in general dental practice: a narrative review.

PubMed

Lala, Rizwana; Csikar, Julia; Douglas, Gail; Muarry, Jenni

2017-12-01

To review the literature reporting factors that are associated with the delivery of lifestyle support in general dental practice. A systematic review of the quantitative observational studies describing activities to promote the general health of adults in primary care general dental practice. Behavior change included tobacco cessation, alcohol reduction, diet, weight management, and physical activity. Tooth brushing and oral hygiene behaviors were excluded as the focus of this review was on the common risk factors that affect general health as well as oral health. Six cross sectional studies met the inclusion criteria. Five studies only reported activities to support tobacco cessation. As well as tobacco cessation one study also reported activities related to alcohol usage, physical activity, and Body Mass Index. Perceptions of time availability consistently correlated with activities and beliefs about tobacco cessation, alongside the smoking status of the dental professional. Dentists who perceive having more available time were more likely to discuss smoking with patients, prescribe smoking cessation treatments and direct patients toward (signpost to) lifestyle support services. Dental professionals who smoke were less likely to give smoking cessation advice and counselling than nonsmokers. Finally, the data showed that professional support may be relevant. Professionals who work in solo practices or those who felt a lack of support from the wider professional team (peer support) were more likely to report barriers to delivering lifestyle support. Organizational changes in dental practices to encourage more team working and professional time for lifestyle support may influence delivery. Dental professionals who are smokers may require training to develop their beliefs about the effectiveness of smoking cessation interventions. © 2016 American Association of Public Health Dentistry.

Adolescent smoking, weight changes, and binge-purge behavior: associations with secondary amenorrhea.

PubMed

Johnson, J; Whitaker, A H

1992-01-01

The association of secondary amenorrhea with extreme forms of substance use, weight control, and exercise in nonrepresentative samples raises questions as to whether adolescents in the general population who engage in these behaviors are at increased risk for secondary amenorrhea. We examined the prevalence and behavioral correlates of secondary amenorrhea in a county-wide high school population of 2544 girls aged 13 to 18. A survey questionnaire, which elicited menstrual history as well as weight history, weight control practices, level of exercise, and use of cigarettes, wine, and beer, was administered during school hours; absentees were also surveyed. The completion rate was 91%. The 1-year prevalence of secondary amenorrhea was 8.5%. Secondary amenorrhea was associated with smoking one or more packs of cigarettes per day (adjusted relative risk [RRa] = 1.96, 1.21-3.10), with multiple binge-eating behaviors in combination with laxative use or self-induced vomiting (RRa = 4.17, 2.54-6.32), and with weight fluctuation due to weight control (RRa = 2.59, 1.33-4.79). There was no association between amenorrhea and alcohol consumption or exercise level. Estimates of attributable risk are provided and indicate that bulimic behaviors and cigarette smoking may result in a considerable excess of cases of secondary amenorrhea in an adolescent population.

Theory of planned behavior and smoking: meta-analysis and SEM model

PubMed Central

Topa, Gabriela; Moriano, Juan Antonio

2010-01-01

To examine if the theory of planned behavior (TPB) predicts smoking behavior, 35 data sets (N = 267,977) have been synthesized, containing 219 effect sizes between the model variables, using a meta-analytic structural equation modeling approach (MASEM). Consistent with the TPB’s predictions, 1) smoking behavior was related to smoking intentions (weighted mean r = 0.30), 2) intentions were based on attitudes (weighted mean r = 0.16), and subjective norms (weighted mean r = 0.20). Consistent with TPB’s hypotheses, perceived behavioral control was related to smoking intentions (weighted mean r = −0.24) and behaviors (weighted mean r = −0.20) and it contributes significantly to cigarette consumption. The strength of the associations, however, was influenced by the characteristics of the studies and participants. PMID:24474850

Externalizing behavior problems and cigarette smoking as predictors of cannabis use: the TRAILS Study.

PubMed

Korhonen, Tellervo; van Leeuwen, Andrea Prince; Reijneveld, Sijmen A; Ormel, Johan; Verhulst, Frank C; Huizink, Anja C

2010-01-01

To examine externalizing behavior problems and cigarette smoking as predictors of subsequent cannabis use. Dutch adolescents (N = 1,606; 854 girls and 752 boys) from the TRacking Adolescents' Individual Lives Survey (TRAILS) ongoing longitudinal study were examined at baseline (ages 10-12 [T1]) and at two follow-up assessments (ages 12-15 [T2] and 15-18 [T3]). The analysis focused on DSM-IV externalizing behavior (conduct, attention deficit hyperactivity, and oppositional) problems at T1, assessed by the Youth Self Report and the Child Behavior Check List, on self-reported ever smoking at T2, and on cannabis use at T3. All associations of parent-rated externalizing behavior problems with cannabis were mediated by earlier smoking. Considering self-reported problems, none of these associations with cannabis were mediated by smoking, except the influence of self-reported conduct problems in girls. Interestingly, even after adjusting for externalizing problems, earlier smoking independently and consistently predicted cannabis use. The adjusted odds ratios for smoking varied in boys from 4.8 to 5.2 (ever) from 10 to 12 (daily) and from 22 to 23 (early-onset) whereas in girls from 4.9 to 5.0, 5.6 to 6.1, and 27 to 28, respectively (p <.001 for all). Our findings challenge the view that externalizing behavior problems directly predict cannabis initiation. Such associations were inconsistent across informants and sexes and were often mediated by earlier smoking. Early smoking onset is a powerful predictor of later cannabis initiation independent of preceding externalizing behavior problems. Although externalizing behavior problems are important as a starting point for substance use trajectories, early-onset smoking should be identified as an important marker of cannabis use risk.

Interpersonal communication as an indirect pathway for the effect of antismoking media content on smoking cessation.

PubMed

van den Putte, Bas; Yzer, Marco; Southwell, Brian G; de Bruijn, Gert-Jan; Willemsen, Marc C

2011-05-01

In the context of health campaigns, interpersonal communication can serve at least 2 functions: (a) to stimulate change through social interaction and (b) in a secondary diffusion process, to further disseminate message content. In a 3-wave prospective study of 1,079 smokers, the authors demonstrate that mass media messages (antismoking campaigns and news coverage relevant to smoking cessation) have an indirect effect on smoking cessation intention and behavior via interpersonal communication. Exposure to campaigns and news coverage prompts discussion about the campaigns, and, in turn, about smoking cessation. Interpersonal communication regarding smoking cessation then influences intention to quit smoking and attempts to quit smoking. The study finds evidence not only for the social interaction function of interpersonal communication, but also for the secondary diffusion function. A substantial number of smokers who are not directly exposed to the antismoking campaigns are nevertheless indirectly exposed via communication with people who have seen these campaigns. These results imply that encouragement of interpersonal communication can be an important campaign objective.

Time perspective, optimistic bias, and self-control among different statuses of university smokers in China: a cross-sectional study.

PubMed

Xu, Ying; Yang, Yang; Ma, Xiao

2018-01-09

Risk behavior often seems 'self-defeating' to the observers. Most people understand the basic health-related knowledge, but some of them still choose to continue risk behaviors, especially for the young. This study aimed to examine time perspective, optimism bias and self control correlated with smoking behavior in Chinese college students. A cross-sectional survey enrolling 3016 university students in Chengdu City, Sichuan Province, China. Influence Factors were identified using multiple logistic regression analyses. Prevalence of current smoking was 20.92% (631 smokers), including 272 daily smokers (9.02%) and 359 non-daily smokers (11.90%). Future-oriented time perspective, general capacity for self-discipline, reliability and ethnicity were protective factors of smoking behavior. Possibility of self-suffering diseases and gender were risk factors of smoking behavior. Smoking in University of Chengdu, China is a severe problem. Results in this research have suggested that irrespective of the smoking level, improving health-related knowledge, time management awareness and self-control ability may contribute to reducing the prevalence of smoking behavior.

Adolescent cigarette smoking: health-related behavior or normative transgression?

PubMed

Turbin, M S; Jessor, R; Costa, F M

2000-09-01

Relations among measures of adolescent behavior were examined to determine whether cigarette smoking fits into a structure of problem behaviors-behaviors that involve normative transgression-or a structure of health-related behaviors, or both. In an ethnically and socioeconomically diverse sample of 1782 male and female high school adolescents, four first-order problem behavior latent variables-sexual intercourse experience, alcohol abuse, illicit drug use, and delinquency-were established and together were shown to reflect a second-order latent variable of problem behavior. Four first-order latent variables of health-related behaviors-unhealthy dietary habits, sedentary behavior, unsafe behavior, and poor dental hygiene-were also established and together were shown to reflect a second-order latent variable of health-compromising behavior. The structure of relations among those latent variables was modeled. Cigarette smoking had a significant and substantial loading only on the problem-behavior latent variable; its loading on the health-compromising behavior latent variable was essentially zero. Adolescent cigarette smoking relates strongly and directly to problem behaviors and only indirectly, if at all, to health-compromising behaviors. Interventions to prevent or reduce adolescent smoking should attend more to factors that influence problem behaviors.

Attention Deficit/Hyperactivity Disorder Symptoms and Depression Symptoms as Mediators in the Intergenerational Transmission of Smoking

PubMed Central

Zoloto, Alex; Nagoshi, Craig T.; Presson, Clark; Chassin, Laurie

2012-01-01

Background Attention deficit/hyperactivity disorder and depression have been found to be comorbid with smoking behaviors, and all three behavioral syndromes have been shown to be familially transmitted. The present paper reports on the results of analyses testing whether child attention deficit/hyperactivity disorder and depression symptoms were mediators in the intergenerational transmission of cigarette smoking. Method Path analyses using bootstrapped mediation procedures were conducted on data from a community sample of 764 families (one or both parents and one adolescent offspring) from the Indiana University Smoking Survey. Parents reported on their smoking behaviors, ADHD, and depression and their child’s ADHD, while offspring reported on their smoking behaviors and depression. Results Although fathers’ and mothers’ smoking status, depression, and ADHD were not significantly correlated with boys’ smoking initiation, there was a significant mediated (indirect) pathway from mothers’ depression to boys’ smoking initiation through boys’ depression. Several parental variables were significantly correlated with smoking initiation in girls, and the pathways from mothers’ smoking status, mothers’ ADHD, and fathers’ smoking status to girls’ smoking initiation were significantly mediated by girls’ ADHD. Conclusions For adolescent girls, the intergenerational transmission of ADHD appears to be important in understanding the intergenerational transmission of cigarette smoking. Sex differences in the intergenerational transmission of psychopathology as it leads to smoking initiation were also discussed. PMID:22682659

Parental migration and smoking behavior of left-behind children: evidence from a survey in rural Anhui, China.

PubMed

Yang, Tingting; Li, Cuicui; Zhou, Chengchao; Jiang, Shan; Chu, Jie; Medina, Alexis; Rozelle, Scott

2016-08-05

Parental migration is most an important factor affecting children's behaviors. Few studies have addressed the association between parental migration and children's smoking behavior in China. This study aims to estimate the current smoking prevalence among children, evaluate the association of parental migration and the smoking behavior of children and identify factors associated with smoking behavior among left-behind children (LBC). A cross-sectional study was conducted in 6 cities in Anhui province during July and August, 2012. All participants were interviewed face-to-face using a standardized questionnaire. Only children 10 to 14 years old that live in rural villages for at least 6 months during the previous year were included in the study. A total of 1343 children met the sampling criteria and participated in the study. Of these, 56 % are LBC and 44 % live with both parents. The average rate of smoking is 3.4 %. The rate of smoking is statistically higher for LBC with both parents out (rate = 6.1 %; OR = 5.59, P < 0.001) than for children living with both parents (1.4 %). Similarly, the rate of LBC with father home only (rate = 5.0 %; OR = 5.60, P = 0.005) is also statistically higher than for children living with both parents when controlling other variables. Factors affecting the smoking behavior of LBC, include gender (i.e., boys), (perceived) school performance and primary caregiver. Parental migration is associated with a significant increase in smoking behavior among children. Intervention studies that target LBC would help to develop strategies to reduce smoking among rural children. Gender-specific strategies and anti-smoking education also appears to be needed to reduce tobacco use among rural LBC.

Continued Importance of Family Factors in Youth Smoking Behavior

PubMed Central

Xiao, Yang; Gordon, Judith S.; Khoury, Jane C.

2012-01-01

Introduction: Although it is known that levels of family factors (FF) such as parental monitoring and parent–adolescent connectedness vary during adolescence, it is unknown which factors remain protective, preventing smoking initiation, in youth of differing racial/ethnic groups. Using a longitudinal, nationally representative sample, we examined which FF protect against smoking initiation in White, Black, and Hispanic youth. Methods: A total of 3,473 parent-nonsmoking youth dyads from Round 1 (T1) of the National Survey of Parents and Youth were followed to Round 3 (T2). Youth smoking status at T2 was assessed as the primary outcome. We examined changes in FF (T2 – T1) and the protection afforded by these factors at T1 and T2 for smoking initiation, both by race/ethnicity and overall. Results: There were statistically significant decreases in levels of protective FF from T1 to T2 across all racial/ethnic groups; however, FF levels were higher in never-smokers compared with smoking initiators at both T1 and T2 (p < .05). Separate models by race/ethnicity showed the protective effect of increased perceived punishment in all racial/ethnic groups and protection against initiation by increased parental monitoring in Black and Hispanic youth. Overall, higher parental monitoring at T1 was associated with decreased odds of smoking initiation (33%); decreased parental monitoring and perceived punishment from T1 to T2 were associated with increased odds of smoking initiation (55% and 17%, respectively). Conclusions: Smoking prevention interventions should encourage parents to both enforce consistent consequences of smoking behavior, and continue monitoring, especially in minority groups. PMID:22454285

Predictors of smoking lapse in a human laboratory paradigm.

PubMed

Roche, Daniel J O; Bujarski, Spencer; Moallem, Nathasha R; Guzman, Iris; Shapiro, Jenessa R; Ray, Lara A

2014-07-01

During a smoking quit attempt, a single smoking lapse is highly predictive of future relapse. While several risk factors for a smoking lapse have been identified during clinical trials, a laboratory model of lapse was until recently unavailable and, therefore, it is unclear whether these characteristics also convey risk for lapse in a laboratory environment. The primary study goal was to examine whether real-world risk factors of lapse are also predictive of smoking behavior in a laboratory model of smoking lapse. After overnight abstinence, 77 smokers completed the McKee smoking lapse task, in which they were presented with the choice of smoking or delaying in exchange for monetary reinforcement. Primary outcome measures were the latency to initiate smoking behavior and the number of cigarettes smoked during the lapse. Several baseline measures of smoking behavior, mood, and individual traits were examined as predictive factors. Craving to relieve the discomfort of withdrawal, withdrawal severity, and tension level were negatively predictive of latency to smoke. In contrast, average number of cigarettes smoked per day, withdrawal severity, level of nicotine dependence, craving for the positive effects of smoking, and craving to relieve the discomfort of withdrawal were positively predictive of number of cigarettes smoked. The results suggest that real-world risk factors for smoking lapse are also predictive of smoking behavior in a laboratory model of lapse. Future studies using the McKee lapse task should account for between subject differences in the unique factors that independently predict each outcome measure.

A theory-based online health behavior intervention for new university students: study protocol

PubMed Central

2013-01-01

Background Too few young people engage in behaviors that reduce the risk of morbidity and premature mortality, such as eating healthily, being physically active, drinking sensibly and not smoking. The present research developed an online intervention to target these health behaviors during the significant life transition from school to university when health beliefs and behaviors may be more open to change. This paper describes the intervention and the proposed approach to its evaluation. Methods/design Potential participants (all undergraduates about to enter the University of Sheffield) will be emailed an online questionnaire two weeks before starting university. On completion of the questionnaire, respondents will be randomly assigned to receive either an online health behavior intervention (U@Uni) or a control condition. The intervention employs three behavior change techniques (self-affirmation, theory-based messages, and implementation intentions) to target four heath behaviors (alcohol consumption, physical activity, fruit and vegetable intake, and smoking). Subsequently, all participants will be emailed follow-up questionnaires approximately one and six months after starting university. The questionnaires will assess the four targeted behaviors and associated cognitions (e.g., intentions, self-efficacy) as well as socio-demographic variables, health status, Body Mass Index (BMI), health service use and recreational drug use. A sub-sample of participants will provide a sample of hair to assess changes in biochemical markers of health behavior. A health economic evaluation of the cost effectiveness of the intervention will also be conducted. Discussion The findings will provide evidence on the effectiveness of online interventions as well as the potential for intervening during significant life transitions, such as the move from school to university. If successful, the intervention could be employed at other universities to promote healthy behaviors among new undergraduates. Trial registration Current Controlled Trials, ISRCTN67684181. PMID:23384237

Characterizing Periodic Messaging Interventions Across Health Behaviors and Media: Systematic Review

PubMed Central

Fuentes, Laura W; Cohen, Joanna E

2014-01-01

Background Periodic prompts serve as tools for health behavior interventions to encourage and maintain behavior changes. Past literature reviews have examined periodic messages targeting specific behaviors (smoking, physical activity, diet, etc) or media (telephone, email, face-to-face, newsletter, etc) and have found them to be effective in impacting health behavior in the short term. Objective Our goal was to review the literature related to periodic messaging and prompts in order to explore typical characteristics, assess the role of prompt timing, identify common theoretical models used, and identify characteristics associated with the effectiveness of periodic prompts. Methods Electronic searches of PubMed, PsycINFO, CINAHL, and Web of Science were conducted in October 2012 and May 2013. Database search terms included variant terms for periods, prompts, interventions, media, and health behaviors. Results Forty-two of the 55 included research articles found that prompts resulted in significant positive behavioral outcomes for participants. Prompts were delivered via text messages, email, mailed communications, and in a few instances via phone. Generally, the provision of feedback and specific strategies to accomplish behavior change appears to be important for the success of periodic prompts. Rationale for prompt timing was rarely provided, although some studies did organize message content around days of the week or times perceived to be high risk for particular behaviors. Smoking cessation interventions tended to be organized around quit date. Among studies using theoretical models to inform their interventions, the transtheoretical model was most common. Conclusions Periodic messaging interventions yield positive results for short-term health behavior changes. Interventions including feedback and prompts that included strategies were more likely to report significantly positive outcomes. Work remains to better understand elements that make periodic prompts successful and whether they are effective in producing long-term outcomes. PMID:24667840

Detecting Smoking Events Using Accelerometer Data Collected Via Smartwatch Technology: Validation Study.

PubMed

Cole, Casey A; Anshari, Dien; Lambert, Victoria; Thrasher, James F; Valafar, Homayoun

2017-12-13

Smoking is the leading cause of preventable death in the world today. Ecological research on smoking in context currently relies on self-reported smoking behavior. Emerging smartwatch technology may more objectively measure smoking behavior by automatically detecting smoking sessions using robust machine learning models. This study aimed to examine the feasibility of detecting smoking behavior using smartwatches. The second aim of this study was to compare the success of observing smoking behavior with smartwatches to that of conventional self-reporting. A convenience sample of smokers was recruited for this study. Participants (N=10) recorded 12 hours of accelerometer data using a mobile phone and smartwatch. During these 12 hours, they engaged in various daily activities, including smoking, for which they logged the beginning and end of each smoking session. Raw data were classified as either smoking or nonsmoking using a machine learning model for pattern recognition. The accuracy of the model was evaluated by comparing the output with a detailed description of a modeled smoking session. In total, 120 hours of data were collected from participants and analyzed. The accuracy of self-reported smoking was approximately 78% (96/123). Our model was successful in detecting 100 of 123 (81%) smoking sessions recorded by participants. After eliminating sessions from the participants that did not adhere to study protocols, the true positive detection rate of the smartwatch based-detection increased to more than 90%. During the 120 hours of combined observation time, only 22 false positive smoking sessions were detected resulting in a 2.8% false positive rate. Smartwatch technology can provide an accurate, nonintrusive means of monitoring smoking behavior in natural contexts. The use of machine learning algorithms for passively detecting smoking sessions may enrich ecological momentary assessment protocols and cessation intervention studies that often rely on self-reported behaviors and may not allow for targeted data collection and communications around smoking events. ©Casey A Cole, Dien Anshari, Victoria Lambert, James F Thrasher, Homayoun Valafar. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 13.12.2017.

The Use of Behavior Change Techniques and Theory in Technologies for Cardiovascular Disease Prevention and Treatment in Adults: A Comprehensive Review

PubMed Central

Winter, Sandra J; Sheats, Jylana L; King, Abby C

2016-01-01

This review examined the use of health behavior change techniques and theory in technology-enabled interventions targeting risk factors and indicators for cardiovascular disease (CVD) prevention and treatment. Articles targeting physical activity, weight loss, smoking cessation and management of hypertension, lipids and blood glucose were sourced from PubMed (November 2010-2015) and coded for use of 1) technology, 2) health behavior change techniques (using the CALO-RE taxonomy), and 3) health behavior theories. Of the 984 articles reviewed, 304 were relevant (240=intervention, 64=review). Twenty-two different technologies were used (M=1.45, SD=+/−0.719). The most frequently used behavior change techniques were self-monitoring and feedback on performance (M=5.4, SD=+/−2.9). Half (52%) of the intervention studies named a theory/model - most frequently Social Cognitive Theory, the Trans-theoretical Model, and the Theory of Planned Behavior/Reasoned Action. To optimize technology-enabled interventions targeting CVD risk factors, integrated behavior change theories that incorporate a variety of evidence-based health behavior change techniques are needed. PMID:26902519

Smoking, food, and alcohol cues on subsequent behavior: a qualitative systematic review.

PubMed

Veilleux, Jennifer C; Skinner, Kayla D

2015-03-01

Although craving is a frequent phenomenon in addictive behaviors, and laboratory paradigms have robustly established that presentation of cues can elicit self-reported craving responses, extant work has not established whether cue exposure influences subsequent behavior. We systematically review extant literature assessing the effects of cue exposure to smoking, food, and alcohol cues on behavioral outcomes framed by three questions: (1) Is there value in distinguishing between the effects of cue exposure on behavior from the responses to cues (e.g., self-reported craving) predicting behavior?; (2) What are the effect of cues on behavior beyond lapse, such as broadly considering both target-syntonic (e.g., do cigarette cues predict smoking-related behaviors) and target-dystonic behaviors (e.g., do cigarette cues predict other outcomes besides smoking)?; (3) What are the lessons to be learned from examining cue exposure studies across smoking, food and alcohol domains? Evidence generally indicates an effect of cue exposure on both target-syntonic and target-dystonic behavior, and that self-report cue-reactivity predicts immediate target-syntonic outcomes. Effects of smoking, food and alcohol cues on behavior are compared to elucidate generalizations about the effects of cue exposure as well as methodological differences that may serve the study of craving in the future. Copyright © 2015 Elsevier Ltd. All rights reserved.

Does More Schooling Improve Health Outcomes and Health Related Behaviors? Evidence from U.K. Twins

PubMed Central

Amin, Vikesh; Behrman, Jere R.; Spector, Tim D.

2013-01-01

Several recent studies using instrumental variables based on changes in compulsory schoolleaving age laws have estimated the causal effect of schooling on health outcomes and health-related behaviors in the U.K. Despite using the same identification strategy and similar datasets, no consensus has been reached. We contribute to the literature by providing results for the U.K. using a different research design and a different dataset. Specifically, we estimate the effect of schooling on health outcomes (obesity and physical health) and health-related behaviors (smoking, alcohol consumption and exercise) for women through within-MZ twins estimates using the TwinsUK database. For physical health, alcohol consumption and exercise, the within-MZ twins estimates are uninformative about whether there is a causal effect. However, we find (1) that the significant association between schooling and smoking status is due to unobserved endowments that are correlated with schooling and smoking (2) there is some indication that more schooling reduces the body mass index for women, even once these unobserved endowments have been controlled for. PMID:24415826

The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014

PubMed Central

Sim, Won Yong; Kang, Jae Heon; Park, Hyun Ah; Kim, Kyoung Woo; Hur, Yang Im; Shin, Koh Eun; Byeon, Gyeong Ran

2017-01-01

Background Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents. Methods This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’ Results The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls. Conclusion Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors. PMID:28197330

Predictors of Smoking among the Secondary High School Boy Students Based on the Health Belief Model

PubMed Central

Mohammadi, Samira; Ghajari, Haydeh; Valizade, Rohollah; Ghaderi, Naseh; Yousefi, Fayegh; Taymoori, Parvaneh; Nouri, Bejan

2017-01-01

Background: Smoking is one of the most important risk factors for health and also health problems, such as heart diseases, especially for young people. This study aimed to investigate the effect of factors related to smoking among the secondary high school students in the city of Marivan (Kurdistan-Iran), in 2015, based on the constructs of health belief model (HBM). Methods: This cross-sectional study was conducted in 470 secondary high school students in Marivan in 2015. The samples were selected by random cluster sampling. A question with four sections was used to collect data (demographic questions, knowledge section, attitude section, and questions related to e constructs of HBM). Results: According to the results, the correlation of smoking was stronger with attitude (r = 0.269 and odds ratio = 0.89) but weaker with perceived barriers (r = 0.101). There was not a significant correlation between smoking behavior and knowledge of the harms of smoking (r = −0.005). Moreover, Cues to action was effective predictor of smoking behavior (r = 0.259). Conclusions: The findings of this study show that the prevalence of smoking in the studied sample is somewhat lower than other regions of Iran, but it should be noted that if no interventions are done to prevent smoking in this age group. The findings of the study also showed that the structure of attitudes, self-efficacy, and Cues to action are the strongest predictors of smoking among students. Albeit, attitude was strongest predictor of smoking that shows the prevalence of smoking can be reduced by focusing in this part. Considering the mean age of participants (16/2 ± 0.25 years), that shows the riskiest period for smoking is 16 years and authorities can make change in policies of cigarette selling only for over 18 years. PMID:28479966

Tobacco consumption among pediatric residents in Argentina. Current prevalence and trend over the past 10 years.

PubMed

Gigliotti, Emiliano; Ferrero, Fernando; Castaños, Claudio; Blengini, María Teresa; Durán, Pablo; Moreno, Laura

2013-01-01

Pediatricians are in a strategic position to prevent smoking. To estimate the prevalence of smoking among pediatric residents, analyze associated factors, describe preventive actions, and assess the differences observed over the past decade. Cross-sectional study with a self-administered, anonymous survey conducted among pediatric residents from eight Argentine hospitals. Smoking habit, associated factors, and attitude towards patients' or their parents' smoking were evaluated; results were compared to those obtained in 2002. Out of 448 surveyed physicians, 20.1% smoked. There were no significant differences between smokers and non-smokers in terms of gender, having children, number of on-call shifts, and having a supervisor who smokes. Having a parent who smoked was a risk factor for tobacco use only among women (OR: 1.98; 95% CI: 1.09-3.61; p = 0.01). Surveyed residents living with a couple had a lower smoking rate (OR: 0.57; 95% CI: 0.34-0.96; p = 0.03). Only 18.1% referred having an active behavior towards smoking patients, no differences were observed between smokers and non-smokers. In addition, there were no differences in smoking prevalence from 2002, but there was a higher rate of residents who advised their patients (32.4% versus 26.1%; p < 0.01) and warned them against smoking (37.7% versus 18.6%; p < 0.01), and of those who received information on this topic during their training (63.6% versus 39.8%; p < 0.01). Among resident pediatricians, 20.1% were smokers, with a higher prevalence among women with a father or mother who is a smoker. The rate of active behavior regarding patients or parents who smoke was very low. In spite of official policies, tobacco use in this group has not changed over the past decade, but there was an increase in the rate of those who received information during their training and of those who advised their patients of smoking risks.

A primary health-care intervention on pre- and postnatal risk factor behavior to prevent childhood allergy. The Prevention of Allergy among Children in Trondheim (PACT) study.

PubMed

Storrø, Ola; Oien, Torbjørn; Dotterud, Christian K; Jenssen, Jon A; Johnsen, Roar

2010-07-28

This study aimed to evaluate the impact of a primary prevention intervention program on risk behavior for allergic diseases among children up to 2 years of age. The setting was in ordinary pre- and postnatal primary health care in Trondheim, Norway. The Prevention of Allergy among Children in Trondheim, Norway (PACT) study invited all pregnant women and parents to children up to 2 years of age in the community to participate in a non-randomized, controlled, multiple life-style intervention study. Interventional topics was increased dietary intake of cod liver oil and oily fish for women during pregnancy and for infants during the first 2 years of life, reduced parental smoking and reduced indoor dampness. A control cohort was established prior to the intervention cohort with "follow up as usual". Questionnaires were completed in pregnancy, 6 weeks after birth and at 1 and 2 years of age. Trends in exposure and behavior are described. Intake of oily fish and cod liver oil increased statistically significantly among women and infants in the intervention cohort compared to the control cohort. There was a low postnatal smoking prevalence in both cohorts, with a trend towards a decreasing smoking prevalence in the control cohort. There was no change in indoor dampness or in behavior related to non- intervened life-style factors. The dietary intervention seemed to be successful. The observed reduced smoking behavior could not be attributed to the intervention program, and the latter had no effect on indoor dampness. (Current Controlled Trials registration number: ISRCTN28090297).

Relations among affect, abstinence motivation and confidence, and daily smoking lapse risk.

PubMed

Minami, Haruka; Yeh, Vivian M; Bold, Krysten W; Chapman, Gretchen B; McCarthy, Danielle E

2014-06-01

This study tested the hypothesis that changes in momentary affect, abstinence motivation, and confidence would predict lapse risk over the next 12-24 hr using Ecological Momentary Assessment (EMA) data from smokers attempting to quit smoking. One hundred and three adult, daily, treatment-seeking smokers recorded their momentary affect, motivation to quit, abstinence confidence, and smoking behaviors in near real time with multiple EMA reports per day using electronic diaries postquit. Multilevel models indicated that initial levels of negative affect were associated with smoking, even after controlling for earlier smoking status, and that short-term increases in negative affect predicted lapses up to 12, but not 24, hr later. Positive affect had significant effects on subsequent abstinence confidence, but not motivation to quit. High levels of motivation appeared to reduce increases in lapse risk that occur over hours although momentary changes in confidence did not predict lapse risk over 12 hr. Negative affect had short-lived effects on lapse risk, whereas higher levels of motivation protected against the risk of lapsing that accumulates over hours. An increase in positive affect was associated with greater confidence to quit, but such changes in confidence did not reduce short-term lapse risk, contrary to expectations. Relations observed among affect, cognitions, and lapse seem to depend critically on the timing of assessments.

Racial/Ethnic Differences in Cigarette Smoking Initiation and Progression to Daily Smoking: A Multilevel Analysis

PubMed Central

Kandel, Denise B.; Kiros, Gebre-Egziabher; Schaffran, Christine; Hu, Mei-Chen

2004-01-01

Objectives. We sought to identify individual and contextual predictors of adolescent smoking initiation and progression to daily smoking by race/ethnicity. Methods. We used data from the National Longitudinal Study of Adolescent Health to estimate the effects of individual (adolescent, family, peer) and contextual (school and state) factors on smoking onset among nonsmokers (n = 5374) and progression to daily smoking among smokers (n = 4474) with multilevel regression models. Results. Individual factors were more important predictors of smoking behaviors than were contextual factors. Predictors of smoking behaviors were mostly common across racial/ethnic groups. Conclusions. The few identified racial/ethnic differences in predictors of smoking behavior suggest that universal prevention and intervention efforts could reach most adolescents regardless of race/ethnicity. With 2 exceptions, important contextual factors remain to be identified. PMID:14713710

Re-training Automatic Action Tendencies to Approach Cigarettes among Adolescent Smokers: A Pilot Study

PubMed Central

Kong, Grace; Larsen, Helle; Cavallo, Dana; Becker, Daniela; Cousijn, Janna; Salemink, Elske; D'Escury-Koenigs, Annemat L. Collot; Morean, Meghan; Wiers, Reinout; Krishnan-Sarin, Suchitra

2015-01-01

Background This pilot study conducted a preliminary examination of whether Cognitive Bias Modification (CBM), a computerized task to retrain cognitive-approach biases towards smoking stimuli, (1) changed approach bias for cigarettes, and (2) improved smoking cessation outcomes in adolescent smokers. Methods Sixty adolescent smokers received four weeks of Cognitive Behavioral Therapy (CBT) for smoking cessation, with CBM (90% avoidance/10% approach for smoking stimuli and 10% avoidance/90% approach for neutral stimuli) or sham (50% avoidance/50% approach for smoking and neutral stimuli) training in the Netherlands (n = 42) and the United States (n = 18). Results While we did not observe changes in action tendencies related to CBM, adolescents with higher smoking approach biases at baseline had greater decreases in approach biases at follow up, compared to adolescents with smoking avoidance biases, regardless of treatment condition (p = 0.01). Intent-to-treat (ITT) analyses showed that CBM, when compared with sham trended toward higher end-of-treatment, biochemically-confirmed, seven-day point prevalence abstinence, (17.2% vs. 3.2%, p = 0.071). ITT analysis also showed that regardless of treatment condition, cotinine level (p = 0.045) and average number of cigarette smoked (p ≤ 0.001) significantly decreased over the course of treatment. Conclusions The findings from this pilot study suggests that re-training approach biases toward cigarettes shows promise for smoking cessation among adolescent smokers. Future research should utilize larger samples and increased distinction between CBM and sham conditions, and examine mechanisms underlying the CBM approach. PMID:26186485

Assessing motivation to smoking cessation in hospitalized patients.

PubMed

Sepúlveda-Sánchez, Juana María; Canca-Sánchez, José Carlos; Rivas-Ruiz, Francisco; Martín-García, Mónica; Lorente Márquez, Celia; Timonet-Andreu, Eva María

To assess motivation to quit smoking in patients admitted to an acute care hospital, determine predictors of readiness to change, and identify a risk group that requires targeted motivational interviewing. A cross-sectional descriptive study. A retrospective study was performed on the medical records of 248 patients aged >18 years with smoking habits admitted to the medical and surgery units of a district hospital between May 2014 and April 2015. The data collected included sociodemographic data, data on respiratory function, number of cigarettes smoked per day, motivation to quit smoking, patient-reported readiness to quit, history of respiratory diseases and previous admissions. The Richmond test revealed that 54% of patients (n=134) were poorly motivated to quit smoking vs. 11.74% (n=29) who reported to be highly motivated. The group of patients who reported to be willing to receive support (n=77) was prevailingly composed of men (p=.009) admitted to a medical care unit (p=.026) -mainly the Unit of Cardiology (51%)- who smoked 11/29 cigarettes/day (p=.015). Dyspnoea at admission, a history of respiratory disease and previous admissions for respiratory problems were not predictors of readiness to quit. This study identifies a risk group of patients with respiratory disease, low motivation to quit smoking and poor readiness to receive smoke cessation support, that should be the target of motivational approaches to behavior change. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Perinatal Smoking and Depression in Women with Concurrent Substance Use

PubMed Central

Forray, Ariadna; Gotman, Nathan; Kershaw, Trace; Yonkers, Kimberly A.

2014-01-01

Objective The purpose of this report was to examine the course of smoking among pregnant women with concurrent substance use, and to assess the impact of depression on smoking. Methods Data were gathered as part of a randomized controlled trial assessing the efficacy of substance abuse treatment in pregnant women. Women (n=176) were recruited before 28 completed weeks of pregnancy, and followed until 3 months postpartum. Depression was assessed using the Inventory of Depressive Symptomatology and the MINI Neuropsychiatric Interview. Our outcome was the average number of cigarettes smoked per day. Linear mixed effects regression was used to measure differential changes in smoking. Results 66% of women smoked in the three months before pregnancy, 42% of pre-pregnancy smokers achieved abstinence before delivery and 60% of the baseline cohort smoked postpartum. Smoking did not differ significantly between depressed and non-depressed groups. After delivery both groups increased smoking at similar rates. Conclusion Smoking was common among our cohort of pregnant women with a history of substance use. Women were able to discontinue or decrease smoking during pregnancy, but were likely to resume or increase smoking postpartum. Having clinically significant depressive symptoms or a diagnosis of depression did not have an obvious effect on smoking behaviors. PMID:24447885

Using drama to prevent teen smoking: development, implementation, and evaluation of crossroads in Hawai'i.

PubMed

Mitschke, Diane B; Loebl, Karen; Tatafu, Elitei; Matsunaga, Doris Segal; Cassel, Kevin

2010-03-01

The use of drama as a preventive education measure has demonstrated success in various health promotion venues and offers promise in promoting positive youth attitudes and behavior change related to tobacco use. Especially important is a need to implement culturally relevant methods to reach youth. This article describes the development and implementation of a tobacco prevention drama for Asian and Pacific Islander youth. The resulting play, Crossroads, features a soap opera-style drama interspersed with humorous vignettes and multimedia effects and incorporates cultural cues, mannerisms, dress, and values consistent with Asian and Pacific Islander youth culture. Evaluation data indicate that the drama has an effect on audience knowledge, attitudes, and intended behavior, including a change in future intent to smoke cigarettes and the ability of audience members to develop connections with the characters in the play and apply concepts that are presented in the play to their own lives.

Agreement between proband and parental self-report of smoking behavior and nicotine dependence.

PubMed

Marks, Judith L; Swan, Gary E; Pomerleau, Cynthia S; Pomerleau, Ovide F

2003-08-01

Although investigators have used family history methods to investigate familial clustering of disorders such as depressive disorder, alcoholism, coronary heart disease, and cancer, research of this type is relatively new to the field of smoking. We examined agreement between proband report of parental smoking behavior and parent's self-reported smoking behavior in 126 proband-parent pairs. Probands were either never, current, or exsmokers; parents were either current or exsmokers. Agreement between proband and parent was better for smoking behaviors when the parent was a current smoker. We found good proband-parent agreement for some smoking behaviors when the parent was a current smoker (e.g., age started smoking [mean (SD) difference between proband and parental report, 1.36 years (9.07 years)], and cigarettes per day and brand smoked [kappa=.49 and.56, respectively]) but poor agreement for items that may represent more complex or less observable indicators of nicotine dependence, regardless of parental smoking status. Reliability was excellent for probands of either current- or exsmoker parents for smoking status (kappa=.92). As a result of probands' difficulty in reliably answering several items that comprise the Fagerström Tolerance Questionnaire (FTQ) (e.g., number of minutes to parent's first cigarette of the day, whether parent smoked more in the morning than during the rest of the day) and the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) diagnosis (e.g., sleep difficulties and difficulty concentrating during nicotine withdrawal), reliability for an FTQ score >/=7 (kappa=.067) and the DSM-IV nicotine dependence diagnosis (kappa=.28) was poor. Our findings should aid investigators in defining the limits of proband reports of parental smoking behavior and identify opportunities for the development of better approaches for the assessment of familial nicotine dependence.

Personality, perceived environment, and behavior systems related to future smoking intentions among youths: an application of problem-behavior theory in Shanghai, China.

PubMed

Cai, Yong; Li, Rui; Zhu, Jingfen; Na, Li; He, Yaping; Redmon, Pam; Qiao, Yun; Ma, Jin

2015-01-01

Smoking among youths is a worldwide problem, particularly in China. Many endogenous and environmental factors influence smokers' intentions to smoke; therefore, a comprehensive model is needed to understand the significance and relationship of predictors. This study aimed to develop a prediction model based on problem-behavior theory (PBT) to interpret intentions to smoke among Chinese youths. We conducted a cross-sectional study of 26,675 adolescents from junior, senior, and vocational high schools in Shanghai, China. Data on smoking status, smoking knowledge, attitude toward smoking, parents' and peers' smoking, and media exposure to smoking were collected from students. A structural equation model was used to assess the developed prediction model. The experimental smoking rate and current smoking rate among the students were 11.0% and 3%, respectively. Our constructed model showed an acceptable fit to the data (comparative fit index = 0.987, root-mean-square error of approximation = 0.034). Intention to smoke was predicted by perceived environment (β = 0.455, P < 0.001) system consisting of peer smoking (β = 0.599, P < 0.001), parent smoking (β = 0.152, P < 0.001), and media exposure to smoking (β = 0.226, P < 0.001), and behavior system (β = 0.487, P < 0.001) consisting of tobacco experimentation (β = 0.663, P < 0.001) and current smoking (β = 0.755, P < 0.001). Smoking intention was irrelevant for personality system in students (β = -0.113, P>0.05) which consisted of acceptance of tobacco use (β = 0.668, P < 0.001) and academic performance (β = 0.171, P < 0.001). The PBT-based model we developed provides a good understanding of the predictors of intentions to smoke and it suggests future interventions among youths should focus on components in perceived environment and behavior systems, and take into account the moderating effects of personality system.

Differences of smoking knowledge, attitudes, and behaviors between medical and non-medical students.

PubMed

Han, Min-Yan; Chen, Wei-Qing; Wen, Xiao-Zhong; Liang, Cai-Hua; Ling, Wen-Hua

2012-03-01

Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education.

Knowledge and Perceptions of Overweight Employees about Lifestyle-Related Health Benefit Changes

PubMed Central

Li, Jiang; Linnan, Laura; Finkelstein, Eric A.; Tate, Deborah; Naseer, Carolyn; Evenson, Kelly R.

2016-01-01

Background We investigated overweight state employees’ perceptions about health insurance benefit changes designed to reduce the scope of health benefits for employees who were obese or smoked. Methods Prior to implementation of health benefit plan changes, 658 overweight [body mass index (BMI) ≥25 kg/m2] state employees enrolled in a weight loss intervention study were asked about their attitudes and beliefs of the new benefit plan changes. Results Thirty-one percent of employees with a BMI≥40 kg/ m2 were unaware that their current BMI would place them in a higher risk benefit plan. More than half reported that the new benefit change would motivate them to make behavioral changes, but less than half felt confident in making changes. Respondents with a BMI≥40 kg/m2 were more likely to oppose the new changes focused on BMI categories compared to respondents in lower BMI categories (P<0.0001). Current smokers were more likely to oppose the new benefit change focused on tobacco use than former smokers and non-smokers (P<0.01). Limitations Participants represented a sample of employees enrolled in a weight loss study, limiting generalizability to the larger population of state employees. Conclusions Benefit plan changes that require employees who are obese or smoke to pay more for health care may motivate some, but not all, individuals to change their behaviors. Since confidence to lose weight was lowest among those in the highest weight categories, health plan benefit modifications may be required to achieve desired health behavior changes. PMID:21901911

Mobile Phone Apps for Preventing Cancer Through Educational and Behavioral Interventions: State of the Art and Remaining Challenges.

PubMed

Coughlin, Steven; Thind, Herpreet; Liu, Benyuan; Champagne, Nicole; Jacobs, Molly; Massey, Rachael I

2016-05-30

Rapid developments in technology have encouraged the use of mobile phones in smoking cessation, promoting healthy diet, nutrition, and physical activity, sun safety, and cancer screening. Although many apps relating to the prevention of cancer and other chronic diseases are available from major mobile phone platforms, relatively few have been tested in research studies to determine their efficacy. In this paper, we discuss issues related to the development and testing of new apps for preventing cancer through smoking cessation, sun safety, and other healthy behaviors, including key methodologic issues and outstanding challenges. An exploratory literature review was conducted using bibliographic searches in PubMed and CINAHL with relevant search terms (eg, smartphones, smoking cessation, cancer prevention, cancer screening, and carcinogens) to identify papers published in English through October 2015. Only 4 randomized controlled trials of the use of mobile phone apps for smoking cessation and 2 trials of apps for sun safety were identified, indicating that it is premature to conduct a systematic search and meta-analysis of the published literature on this topic. Future studies should utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better establish the cancer prevention and control capabilities of mobile phone apps. In developing new and refined apps for cancer prevention and control, both health literacy and eHealth literacy should be taken into account. There is a need for culturally appropriate, tailored health messages to increase knowledge and awareness of health behaviors such as smoking cessation, cancer screening, and sun safety. Mobile phone apps are likely to be a useful and low-cost intervention for preventing cancer through behavioral changes.

Mobile Phone Apps for Preventing Cancer Through Educational and Behavioral Interventions: State of the Art and Remaining Challenges

PubMed Central

Champagne, Nicole; Jacobs, Molly; Massey, Rachael I

2016-01-01

Background Rapid developments in technology have encouraged the use of mobile phones in smoking cessation, promoting healthy diet, nutrition, and physical activity, sun safety, and cancer screening. Although many apps relating to the prevention of cancer and other chronic diseases are available from major mobile phone platforms, relatively few have been tested in research studies to determine their efficacy. Objective In this paper, we discuss issues related to the development and testing of new apps for preventing cancer through smoking cessation, sun safety, and other healthy behaviors, including key methodologic issues and outstanding challenges. Methods An exploratory literature review was conducted using bibliographic searches in PubMed and CINAHL with relevant search terms (eg, smartphones, smoking cessation, cancer prevention, cancer screening, and carcinogens) to identify papers published in English through October 2015. Results Only 4 randomized controlled trials of the use of mobile phone apps for smoking cessation and 2 trials of apps for sun safety were identified, indicating that it is premature to conduct a systematic search and meta-analysis of the published literature on this topic. Conclusions Future studies should utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better establish the cancer prevention and control capabilities of mobile phone apps. In developing new and refined apps for cancer prevention and control, both health literacy and eHealth literacy should be taken into account. There is a need for culturally appropriate, tailored health messages to increase knowledge and awareness of health behaviors such as smoking cessation, cancer screening, and sun safety. Mobile phone apps are likely to be a useful and low-cost intervention for preventing cancer through behavioral changes. PMID:27242162

Exploring Organizational Smoking Policies and Employee Vaping Behavior.

PubMed

Song, Xiaochuan; English, Master Thomas M; Whitman, Marilyn V

2017-04-01

Cigarette consumption has become global threat to both smokers and organizations. However, little is known about organizational smoking and vaping policies, and their influence to employees' smoking and vaping behavior. We collected data from 456 employed smokers, vapers, and/or dual users. Smoking and/or vaping behavior, along with perceived organizational smoking/vaping policies were examined. Vapers reported perceiving more stringent smoking policy, while vapers who reported having workplace vaping policies perceived having generally more stringent vaping policy. Most smokers and vapers are well informed about smoking policy; however, a considerable portion of them do not have a good understanding about organizational vaping policy. Organizations should not consider smoking and vaping to be the same when setting policy. Employers should ensure that organizational vaping policies are present and clear to all employees.

Does education confer a culture of healthy behavior? Smoking and drinking patterns in Danish twins.

PubMed

Johnson, Wendy; Kyvik, Kirsten Ohm; Mortensen, Erik L; Skytthe, Axel; Batty, G David; Deary, Ian J

2011-01-01

More education is associated with healthier smoking and drinking behaviors. Most analyses of effects of education focus on mean levels. Few studies have compared variance in health-related behaviors at different levels of education or analyzed how education impacts underlying genetic and environmental sources of health-related behaviors. This study explored these influences. In a 2002 postal questionnaire, 21,522 members of the Danish Twin Registry, born during 1931-1982, reported smoking and drinking habits. The authors used quantitative genetic models to examine how these behaviors' genetic and environmental variances differed with level of education, adjusting for birth-year effects. As expected, more education was associated with less smoking, and average drinking levels were highest among the most educated. At 2 standard deviations above the mean educational level, variance in smoking and drinking was about one-third that among those at 2 standard deviations below, because fewer highly educated people reported high levels of smoking or drinking. Because shared environmental variance was particularly restricted, one explanation is that education created a culture that discouraged smoking and heavy drinking. Correlations between shared environmental influences on education and the health behaviors were substantial among the well-educated for smoking in both sexes and drinking in males, reinforcing this notion.

The Behavioral Aspects of Smoking.

ERIC Educational Resources Information Center

Krasnegor, Norman A., Ed.

These five papers present a compact summary of current biological, behavioral and psychosocial research on cigarette smoking behavior. They focus especially on the addictive and dependence processes related to smoking and its effects on health. While much is known, recommendations for further research are suggested on topics including: nicotine,…

Epidemiology of smoking in Ukraine, 2000.

PubMed

Gilmore, A B; McKee, M; Telishevska, M; Rose, R

2001-11-01

A clear, up-to-date picture of smoking prevalence and its determinants is needed to inform the development of an effective tobacco control policy in Ukraine, particularly given the way in which the tobacco industry has targeted post-Soviet countries since transition. A nationally representative household survey was undertaken in Ukraine in February 2000. Data were available on 1,590 individuals (response rate 72%). Fifty-seven percent of men and 10% of women were current smokers and an additional 21 and 7%, respectively, were ex-smokers. Smoking behavior has changed considerably over successive generations, with an increase in the proportion of women smoking and a reduction in the mean age at first smoking. Factors associated with smoking include young age, urban residence (among women), and material hardship, particularly unemployment. Involvement in social networks appears to reduce the probability of smoking. Smoking commonly occurs in public places and smokers differ from nonsmokers in their health beliefs about smoking. Levels of smoking among men are already high and among young women are increasing rapidly. Unless an effective tobacco policy response is developed to address the issues identified, tobacco will continue to make an increasingly large contribution to premature morbidity and mortality in Ukraine. Copyright 2001 American Health Foundation and Academic Press.

The Recruitment Experience of a Randomized Clinical Trial to Aid Young Adult Smokers to Stop Smoking without Weight Gain with Interactive Technology.

PubMed

Coday, Mace; Richey, Phyllis; Thomas, Fridtjof; Tran, Quynh T; Terrell, Sarah B; Tylavsky, Fran; Miro, Danielle; Caufield, Margaret; Johnson, Karen C

2016-04-15

Multiple recruitment strategies are often needed to recruit an adequate number of participants, especially hard to reach groups. Technology-based recruitment methods hold promise as a more robust form of reaching and enrolling historically hard to reach young adults. The TARGIT study is a randomized two-arm clinical trial in young adults using interactive technology testing an efficacious proactive telephone Quitline versus the Quitline plus a behavioral weight management intervention focusing on smoking cessation and weight change. All randomized participants in the TARGIT study were required to be a young adult smoker (18-35 years), who reported smoking at least 10 cigarettes per day, had a BMI < 40 kg/m 2, and were willing to stop smoking and not gain weight. Traditional recruitment methods were compared to technology-based strategies using standard descriptive statistics based on counts and proportions to describe the recruitment process from initial pre-screening (PS) to randomization into TARGIT. Participants at PS were majority Black (59.80%), female (52.66%), normal or over weight (combined 62.42%), 29.5 years old, and smoked 18.4 cigarettes per day. There were differences in men and women with respect to reasons for ineligibility during PS (p < 0.001; ignoring gender specific pregnancy-related ineligibility). TARGIT experienced a disproportionate loss of minorities during recruitment as well as a prolonged recruitment period due to either study ineligibility or not completing screening activities. Recruitment into longer term behavioral change intervention trials can be challenging and multiple methods are often required to recruit hard to reach groups.

Comparative effectiveness of motivation phase intervention components for use with smokers unwilling to quit: a factorial screening experiment.

PubMed

Cook, Jessica W; Collins, Linda M; Fiore, Michael C; Smith, Stevens S; Fraser, David; Bolt, Daniel M; Baker, Timothy B; Piper, Megan E; Schlam, Tanya R; Jorenby, Douglas; Loh, Wei-Yin; Mermelstein, Robin

2016-01-01

To screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. A balanced, four-factor, randomized factorial experiment. Eleven primary care clinics in southern Wisconsin, USA. A total of 517 adult smokers (63.4% women, 91.1% white) recruited during primary care visits who were willing to reduce their smoking but not quit. Four factors contrasted intervention components designed to reduce smoking and promote abstinence: (1) nicotine patch versus none; (2) nicotine gum versus none; (3) motivational interviewing (MI) versus none; and (4) behavioral reduction counseling (BR) versus none. Participants could request cessation treatment at any point during the study. The primary outcome was percentage change in cigarettes smoked per day at 26 weeks post-study enrollment; the secondary outcomes were percentage change at 12 weeks and point-prevalence abstinence at 12 and 26 weeks post-study enrollment. There were few main effects, but a significant four-way interaction at 26 weeks post-study enrollment (P = 0.01, β = 0.12) revealed relatively large smoking reductions by two component combinations: nicotine gum combined with BR and BR combined with MI. Further, BR improved 12-week abstinence rates (P = 0.04), and nicotine gum, when used without MI, increased 26-week abstinence after a subsequent aided quit attempt (P = 0.01). Motivation-phase nicotine gum and behavioral reduction counseling are promising intervention components for smokers who are initially unwilling to quit. © 2015 Society for the Study of Addiction.

Smoking control: challenges and achievements

PubMed Central

da Silva, Luiz Carlos Corrêa; de Araújo, Alberto José; de Queiroz, Ângela Maria Dias; Sales, Maria da Penha Uchoa; Castellano, Maria Vera Cruz de Oliveira

2016-01-01

ABSTRACT Smoking is the most preventable and controllable health risk. Therefore, all health care professionals should give their utmost attention to and be more focused on the problem of smoking. Tobacco is a highly profitable product, because of its large-scale production and great number of consumers. Smoking control policies and treatment resources for smoking cessation have advanced in recent years, showing highly satisfactory results, particularly in Brazil. However, there is yet a long way to go before smoking can be considered a controlled disease from a public health standpoint. We can already perceive that the behavior of our society regarding smoking is changing, albeit slowly. Therefore, pulmonologists have a very promising area in which to work with their patients and the general population. We must act with greater impetus in support of health care policies and social living standards that directly contribute to improving health and quality of life. In this respect, pulmonologists can play a greater role as they get more involved in treating smokers, strengthening anti-smoking laws, and demanding health care policies related to lung diseases. PMID:27832238

Help Preferences Among Employees Who Wish to Change Health Behaviors.

PubMed

Persson, Roger; Cleal, Bryan; Jakobsen, Mette Øllgaard; Villadsen, Ebbe; Andersen, Lars L

2014-08-01

To examine the help preferences of employees in the Danish police who had acknowledged that they wished to change health behaviors. In addition, we explored whether preferences varied with age, gender, chronic health concerns, positive expectations of good health, and past experiences of in-house health promotion services (i.e., wellness service). Respondents to an electronic questionnaire who acknowledged wishing to change health behaviors in relation to smoking (n = 845), alcohol (n = 684), eating (n = 4,431), and physical activity (n = 5,179) were asked to choose up to three help alternatives on a predefined list. In descending order, smokers preferred help from nicotine gum, no help, and help and support from family and friends. Alcohol consumers preferred no help or help and support from family and friends or "other" forms. Employees who wanted to change eating habits preferred a free fruit bowl, free nutritional guidance, and healthy food at work. Employees who wanted to change physical activity patterns preferred exercise at work, offers of free exercise, and exercise in a social/collegial context. Wishing to change health behaviors is not always accompanied by perceiving a need for assistance. The no-help option was selected fairly frequently and mostly in relation to alcohol and smoking. A fruit bowl was the most preferred option for help, followed by exercise at work and free exercise. Help from traditional health services was ranked low, possibly reflecting that they are primarily viewed as a solution for stopping disease rather than promoting health. © 2013 Society for Public Health Education.

Social Network Assessments and Interventions for Health Behavior Change: A Critical Review.

PubMed

Latkin, Carl A; Knowlton, Amy R

2015-01-01

Social networks provide a powerful approach for health behavior change. This article documents how social network interventions have been successfully used for a range of health behaviors, including HIV risk practices, smoking, exercise, dieting, family planning, bullying, and mental health. We review the literature that suggests the relationship between health behaviors and social network attributes demonstrates a high degree of specificity. The article then examines hypothesized social influence mechanisms including social norms, modeling, and social rewards and the factors of social identity and social rewards that can be employed to sustain social network interventions. Areas of future research avenues are highlighted, including the need to examine and to adjust analytically for contamination and social diffusion, social influence versus differential affiliation, and network change. Use and integration of mhealth and face-to-face networks for promoting health behavior change are also critical research areas.

[Prevention of atherosclerosis by enforcing non-smoking behavior].

PubMed

Gohlke, H

1991-01-01

Cigarette smoking is the single most important cause for avoidable diseases. Malignancies, pulmonary diseases, and the different manifestations of coronary artery disease (CAD) are either caused or developed significantly earlier with cigarette smoking. Even in the young-adult-age, smokers have more raised lesions in the abdominal aorta or in the coronary arteries. The analysis of more than 800 patients with myocardial infarction at young age showed that cigarette smoking is the dominant risk factor up until myocardial infarction. In male patients with CAD myocardial infarction is the first clinical manifestation. Therefore, the potential for primary prevention is small in traditional medical practice. Based on these experiences, we tried to support nonsmoking behavior in the 7th grade in school. Knowledge about the cardiovascular system and the acute effects of cigarette smoking were taught. In addition, role plays were performed by the children to practice rejecting an offered cigarette. With this intervention, new onset of smoking could be reduced by 50% over 2 years with a limited (8h) educational intervention. Reasons for the onset of cigarette smoking are different for boys and girls. The percentage of pupils smoking decreases with the increasing social status of the parents. The tobacco industry has recognized that children are an important target group as future consumers, and it uses that fact in its public relations and advertising strategy. However, the government undertakes virtually no efforts to control illegal sales of cigarettes to minors. Tax incomes from illegal sales of cigarettes to minors by far exceed the expenses for preventive efforts of state agencies. A change of this permissive attitude appears warranted.

The pediatric residency training on tobacco project: four-year parent outcome findings.

PubMed

Hymowitz, Norman; Pyle, Sara A; Haddock, C Keith; Schwab, Joseph V

2008-08-01

To assess parent behavioral change and perception of resident intervention on tobacco. In a long-term study of the efficacy of training pediatric residents to address tobacco conducted at the New Jersey Medical School, sixteen pediatric training programs were assigned randomly to either special or standard training conditions. Parent surveys were administered in the fall of 2001 and 2005 in order to assess the effects of resident intervention on parent behavior, as well as parent perceptions of resident intervention. The percent of parents who smoke at sites associated with the special training condition, but not of those at sites associated with standard training, who reported that residents advised them to stop smoking, offered to help them quit, and provided quit smoking materials increased significantly from baseline to year 4. The percent of parents in the special training condition who reported quitting smoking in the past year also increased, although the increase was not statistically significant. A majority of the parents associated with each training condition reported receiving intervention for second hand smoke (SHS). For each training condition, the level of intervention to prevent exposure of infants and children to SHS exposure was similar at baseline and year 4, as was the percent of parents who reported having a smoke-free household. The results support the efficacy of the special training program and underscore the importance of preparing pediatric residents to address tobacco.

Self-esteem differences in the effects of hypocrisy induction on behavioral intentions in the health domain.

PubMed

Peterson, Alexandra A; Haynes, Graeme A; Olson, James M

2008-04-01

Two studies investigated whether individuals with varying levels of self-esteem respond differently in the hypocrisy paradigm. In the first study, all participants were regular smokers. Those in the hypocrisy condition delivered a speech in front of a camera on the dangers of smoking. The principal dependent measure was the intention to stop smoking. In the second study, participants in the hypocrisy condition wrote a public (personally identifiable) passage about the importance of a healthy lifestyle. The principal dependent measure was the intention to improve one's health behaviors. In both studies, self-esteem scores were positively related to intentions to change behavior in the hypocrisy condition but not in a control condition. The implications of these findings for conceptions of self-esteem and for dissonance theory are discussed.

How do price minimizing behaviors impact smoking cessation? Findings from the International Tobacco Control (ITC) Four Country Survey.

PubMed

Licht, Andrea S; Hyland, Andrew J; O'Connor, Richard J; Chaloupka, Frank J; Borland, Ron; Fong, Geoffrey T; Nargis, Nigar; Cummings, K Michael

2011-05-01

This paper examines how price minimizing behaviors impact efforts to stop smoking. Data on 4,988 participants from the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey who were smokers at baseline (wave 5) and interviewed at a 1 year follow-up were used. We examined whether price minimizing behaviors at baseline predicted: (1) cessation, (2) quit attempts, and (3) successful quit attempts at one year follow up using multivariate logistic regression modeling. A subset analysis included 3,387 participants who were current smokers at waves 5 and 6 and were followed through wave 7 to explore effects of changing purchase patterns on cessation. Statistical tests for interaction were performed to examine the joint effect of SES and price/tax avoidance behaviors on cessation outcomes. Smokers who engaged in any price/tax avoidance behaviors were 28% less likely to report cessation. Persons using low/untaxed sources were less likely to quit at follow up, those purchasing cartons were less likely to make quit attempts and quit, and those using discount cigarettes were less likely to succeed, conditional on making attempts. Respondents who utilized multiple behaviors simultaneously were less likely to make quit attempts and to succeed. SES did not modify the effects of price minimizing behaviors on cessation outcomes. The data from this paper indicate that the availability of lower priced cigarette alternatives may attenuate public health efforts aimed at to reduce reducing smoking prevalence through price and tax increases among all SES groups.

Smoking cessation: barriers to success and readiness to change.

PubMed

Guirguis, Alexander B; Ray, Shaunta M; Zingone, Michelle M; Airee, Anita; Franks, Andrea S; Keenum, Amy J

2010-10-01

Smoking cessation interventions should be individualized based on patient history and readiness for change. The objective of this study was to assess stages of change and key components of smoking and cessation history among a sample of primary care patients. A telephone survey of current or recent smokers identified smoking status, stage of change, motivation, concerns, relapse history, pharmacotherapy, and social support. Of 150 participants, most were within precontemplation (22.7 percent) or contemplation (44.0 percent) stages of change; 14.0 percent were in preparation, 4.7 percent in action, and 14.7 percent in maintenance. The primary motivation for quitting was to improve general health (42.3 percent). The most common cessation-related concerns were: breaking the habit, stress, and weight gain. Pharmacotherapy was discontinued due to adverse events in 31.5 percent of users. Intratreatment social support was reported by 17.5 percent. The most common reasons for relapse were falling back into the habit (36 percent), stressful situations (27 percent), and being around other smokers (25 percent). Targeted interventions are needed for patients in either precontemplation or contemplation stages. Counseling should focus on helping patients resolve barriers to cessation and reasons for relapse, particularly stress and weight management. Pharmacotherapy should be utilized when patients are ready to quit. Increased intratreatment social support and counseling appear warranted to support behavior change and appropriate medication use.

Sensation seeking and smoking behaviors among adolescents in the Republic of Korea.

PubMed

Hwang, Heejin; Park, Sunhee

2015-06-01

This study aimed to explore the relationship between the four components of sensation seeking (i.e., disinhibition, thrill and adventure seeking, experience seeking, and boredom susceptibility) and three types of smoking behavior (i.e., non-smoking, experimental smoking, and current smoking) among high school students in the Republic of Korea. Multivariate multinomial logistic regression analysis was performed using two models. In Model 1, the four subscales of sensation seeking were used as covariates, and in Model 2, other control factors (i.e., characteristics related to demographics, individuals, family, school, and friends) were added to Model 1 in order to adjust for their effects. In Model 1, the impact of disinhibition on experimental smoking and current smoking was statistically significant. In Model 2, the influence of disinhibition on both of these smoking behaviors remained statistically significant after controlling for all the other covariates. Also, the effect of thrill and adventure seeking on experimental smoking was statistically significant. The two statistically significant subscales of sensation seeking were positively associated with the risk of smoking behaviors. According to extant literature and current research, sensation seeking, particularly disinhibition, is strongly associated with smoking among youth. Therefore, sensation seeking should be measured among adolescents to identify those who are at greater risk of smoking and to develop more effective intervention strategies in order to curb the smoking epidemic among youth. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exposure to parental smoking and child growth and development: a cohort study.

PubMed

Yang, Seungmi; Decker, Adriana; Kramer, Michael S

2013-07-10

Studies on adverse childhood health and development outcomes associated with parental smoking have shown inconsistent results. Using a cohort of Belarusian children, we examined differences in cognition, behaviors, growth, adiposity, and blood pressure at 6.5 years according to prenatal and postnatal exposure to parental smoking. Using cluster-adjusted multivariable regression, effects of exposure to prenatal smoking were examined by comparing (1) children whose mothers smoked during pregnancy with those of mothers who smoked neither during nor after pregnancy and (2) children whose mothers smoked during and after pregnancy with those whose mothers smoked after pregnancy only; effects of postnatal smoking were examined by comparing (1) children whose mothers smoked after pregnancy only with those of mothers who smoked neither during nor after pregnancy and (2) children whose fathers smoked with those whose fathers did not smoke among children of non-smoking mothers after adjusting for a wide range of socioeconomic and family characteristics. After adjusting for confounders, children exposed vs unexposed to prenatal maternal smoking had no differences in mean IQ, teacher-rated behavioral problems, adiposity, or blood pressure. Children exposed to maternal postnatal smoking had slightly increased behavioral problems [0.9, 95% CI: 0.6, 1.2 for total difficulties], higher body mass index [0.2, 95% CI: 0.1, 0.3], greater total skinfold thickness [0.4, 95% CI: 0.04, 0.71], and higher odds of overweight or obesity [1.4, 95% CI; 1.1, 1.7]. Similar magnitudes of association were observed with postnatal paternal smoking. No adverse cognitive, behavioral and developmental outcomes were associated with exposure to maternal prenatal smoking. Observed associations with postnatal smoking of both parents may reflect residual confounding by genetic and family environmental factors.

Improving cancer prevention at the worksite: how are Belgian companies dealing with smoking regulations?

PubMed

Razavi, D; Vandecasteele, H; Primo, C; Bodo, M; Debrier, F; Verbist, H; Paesmans, M

1997-09-01

Little is known about the impact of smoking policy on companies' policies related to smoking in Belgium. The study was designed in order to compare the companies' policies related to smoking (CPRS) in 1990 and in 1993. During this 3 year period, numerous information and regulation inputs (media, brochures) were aimed at companies to regulate smoking behavior in the workplace, so as to reduce the risks of passive smoking. A short questionnaire was mailed to 3543 Belgian companies in October 1990 and in June 1993 to assess: designation of smoke free areas (SFA); willingness to offer a worksite information program (WIP); willingness to offer a worksite smoking cessation program (WSCP); willingness to subsidize a WSCP; willingness to offer a WSCP during working hours; willingness to offer a meeting room for a WSCP and actual organization of a WSCP. In 1990, 773 companies (22%) and in 1993, 890 companies (25%) responded to the questionnaire. The results showed that small companies and companies with a high blue/white collar ratio were less able to implement health policy recommendations. A total of 325 (9%) companies responded to the 1990 and 1993 questionnaires. Comparison of 1990 and 1993 dataset showed that during this 3 year period, no major changes occurred for a majority of companies. Amongst the small positive changes, only the designation of smoke free areas and the organization of a small number of WSCP was observed. The conclusion is that despite inputs, little impact on smoking policies is noticeable. Strategies designed to intensify inputs and to promote implementation of regulation of WSCP should therefore further be studied.

Application of Behavior Change Techniques in a Personalized Nutrition Electronic Health Intervention Study: Protocol for the Web-Based Food4Me Randomized Controlled Trial

PubMed Central

Macready, Anna L; Fallaize, Rosalind; Butler, Laurie T; Ellis, Judi A; Kuznesof, Sharron; Frewer, Lynn J; Celis-Morales, Carlos; Livingstone, Katherine M; Araújo-Soares, Vera; Fischer, Arnout RH; Stewart-Knox, Barbara J; Mathers, John C

2018-01-01

Background To determine the efficacy of behavior change techniques applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques that have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development, and most are not adapted for Web-based delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized Web-based techniques employed in a large-scale, internet-based intervention to change dietary behavior and physical activity. Objective The aims of this study were (1) to describe techniques embedded in the Food4Me study design and explain the selection rationale and (2) to demonstrate the use of behavior change technique taxonomies, develop standard operating procedures for training, and identify strengths and limitations of the Food4Me framework that will inform its use in future studies. Methods The 6-month randomized controlled trial took place simultaneously in seven European countries, with participants receiving one of four levels of personalized advice (generalized, intake-based, intake+phenotype–based, and intake+phenotype+gene–based). A three-phase approach was taken: (1) existing taxonomies were reviewed and techniques were identified a priori for possible inclusion in the Food4Me study, (2) a standard operating procedure was developed to maintain consistency in the use of methods and techniques across research centers, and (3) the Food4Me behavior change technique framework was reviewed and updated post intervention. An analysis of excluded techniques was also conducted. Results Of 46 techniques identified a priori as being applicable to Food4Me, 17 were embedded in the intervention design; 11 were from a dietary taxonomy, and 6 from a smoking cessation taxonomy. In addition, the four-category smoking cessation framework structure was adopted for clarity of communication. Smoking cessation texts were adapted for dietary use where necessary. A posteriori, a further 9 techniques were included. Examination of excluded items highlighted the distinction between techniques considered appropriate for face-to-face versus internet-based delivery. Conclusions The use of existing taxonomies facilitated the description and standardization of techniques used in Food4Me. We recommend that for complex studies of this nature, technique analysis should be conducted a priori to develop standardized procedures and training and reviewed a posteriori to audit the techniques actually adopted. The present framework description makes a valuable contribution to future systematic reviews and meta-analyses that explore technique efficacy and underlying psychological constructs. This was a novel application of the behavior change taxonomies and was the first internet-based personalized nutrition intervention to use such a framework remotely. Trial Registration ClinicalTrials.gov NCT01530139; https://clinicaltrials.gov/ct2/show/NCT01530139 (Archived by WebCite at http://www.webcitation.org/6y8XYUft1) PMID:29631993

Smoking-related knowledge, attitudes, and behaviors among Alaska Native people: a population-based study.

PubMed

Rohde, Kristen; Boles, Myde; Bushore, Chris J; Pizacani, Barbara A; Maher, Julie E; Peterson, Erin

2013-01-01

Several studies have shown that Alaska Native people have higher smoking prevalence than non-Natives. However, no population-based studies have explored whether smoking-related knowledge, attitudes, and behaviors also differ among Alaska Native people and non-Natives. We compared current smoking prevalence and smoking-related knowledge, attitudes, and behavior of Alaska Native adults living in the state of Alaska with non-Natives. We used Alaska Behavioral Risk Factor Surveillance System data for 1996 to 2010 to compare smoking prevalence, consumption, and cessation- and second-hand smoke-related knowledge, attitudes, and behaviors among self-identified Alaska Native people and non-Natives. Current smoking prevalence was 41% (95% CI: 37.9%-44.4%) among Alaska Native people compared with 17.1% (95% CI: 15.9%-18.4%) among non-Natives. Among current every day smokers, Alaska Natives were much more likely to smoke less than 10 cigarettes per day (OR = 5.0, 95% CI: 2.6-9.6) than non-Natives. Compared with non-Native smokers, Alaska Native smokers were as likely to have made a past year quit attempt (OR = 1.4, 95% CI: 0.9-2.1), but the attempt was less likely to be successful (OR = 0.5, 95% CI: 0.2-0.9). Among current smokers, Alaska Natives were more likely to believe second-hand smoke (SHS) was very harmful (OR = 4.5, 95% CI: 2.8-7.2), to believe that smoking should not be allowed in indoor work areas (OR = 1.9, 95% CI: 1.1-3.1) or in restaurants (OR = 4.2, 95% CI: 2.5-6.9), to have a home smoking ban (OR = 2.5, 95% CI: 1.6-3.9), and to have no home exposure to SHS in the past 30 days (OR = 2.3, 95% CI: 1.5-3.6) than non-Natives. Although a disparity in current smoking exists, Alaska Native people have smoking-related knowledge, attitudes, and behaviors that are encouraging for reducing the burden of smoking in this population. Programs should support efforts to promote cessation, prevent relapse, and establish smoke-free environments.

Caught in a dilemma: why do non-smoking women in China support the smoking behaviors of men in their families?

PubMed

Mao, Aimei; Bristow, Katie; Robinson, Jude

2013-02-01

Intimate relationships influence family members' health practices. Although cigarette smoking in China is predominantly a male behavior, (non-smoking) women's roles should be taken into account for the development of home-smoking interventions. Drawing on ethnographic interviews with 22 families in a rural area of China, this article explores non-smoking women's attitudes towards male smoking. The findings suggest that women's ability to influence male behavior is largely determined by culturally defined gender roles, underpinned by ideologies of familism and collectivism. Despite concerns about the adverse results of smoking to their family members and households, non-smoking women ultimately maintain the (male) smokers' argument that smoking plays an important role in construction and maintenance of intra- and extra-family relationships. By accepting male smoking and men's engagement in the social practice of smoking and cigarette exchanges, women maintain their identities as supportive wives, filial daughters/in-law and responsible family members who pursue family collective interests at the expense of their own personal beliefs. Future smoking control initiatives that target non-smoking women to influence male smoking should take into account the women's overarching need to maintain the status and harmony of their families.

The gap between behavioral risk status and willingness to change behavior among healthcare professionals.

PubMed

Kasila, K; Hallman, M; Kautiainen, H; Vanhala, M; Kettunen, T

2018-01-01

This study explored behavioral health risk factors among healthcare professionals and investigated the at-risk persons' satisfaction with their health habits and ongoing change attempts. The study was based on a cross-sectional web-based survey directed at the nurses and physicians ( N = 1233) in Finnish healthcare. Obesity, low physical activity, smoking, and risky alcohol drinking were used as behavioral health risk factors. In all, 70% of the participants had at least one behavioral risk factor, and a significant number of at-risk persons were satisfied with their health habits and had no ongoing change process. Good self-rated health and good self-rated work ability were significantly associated with whether a participant had a behavioral health risk factor. Overall, unhealthy behaviors and a lack of ongoing change attempts were commonly observed among healthcare professionals. Work in healthcare is demanding, and healthy lifestyles can support coping. Thus, healthy lifestyle programs should also be targeted to healthcare professionals.

The role of prepartum motivation in the maintenance of postpartum smoking abstinence

PubMed Central

Heppner, Whitney L.; Ji, Lingyun; Reitzel, Lorraine R.; Castro, Yessenia; Correa-Fernandez, Virmarie; Vidrine, Jennifer Irvin; Li, Yisheng; Dolan-Mullen, Patricia; Velasquez, Mary M.; Cinciripini, Paul M.; Cofta-Woerpel, Ludmila; Greisinger, Anthony; Wetter, David W.

2011-01-01

Objective Motivation plays an important role in a variety of behaviors, including smoking cessation, and is integral to theory and treatment of smoking. For many women, pregnancy offers a motivational shift that helps them stop smoking and maintain abstinence during pregnancy. However, women's motivation to maintain smoking abstinence postpartum is not well-understood and may play a role in high postpartum relapse rates. The current study utilized multiple measures of prepartum motivation to maintain smoking abstinence to predict postpartum smoking abstinence. Design As part of a randomized clinical trial on postpartum smoking relapse prevention, pregnant women who quit smoking during pregnancy reported their motivation to continue smoking abstinence at a prepartum baseline session. Continued smoking abstinence was assessed at 8 and 26 weeks postpartum. Main Outcome Measure Biochemically verified continuous abstinence from smoking. Results Direct relationships among multiple measures of motivation were significant, and ranged in strength from weak to moderate. All motivation measures individually predicted continuous smoking abstinence, after controlling for treatment group, demographics, and pre-quit tobacco use. When tested simultaneously, a global motivation measure and parenthood motives for quitting remained significant predictors of abstinence. Backward selection modeling procedures resulted in a reduced model of prepartum predictors of postpartum abstinence including global motivation, parenthood motives, and stage of change. Conclusion Global motivation for smoking abstinence and parenthood motives for quitting are particularly important motivational constructs for pregnant women's continued smoking abstinence. PMID:21859215

Depression, anxiety, stress, and motivation over the course of smoking cessation treatment

PubMed Central

Pawlina, Maritza Muzzi Cardozo; Rondina, Regina de Cássia; Espinosa, Mariano Martinez; Botelho, Clóvis

2015-01-01

Objective: To evaluate changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Methods: This cohort study involved patients enrolled in a smoking cessation program in Cuiabá, Brazil. We selected patients who completed the program in six months or less (n = 142). Patient evaluations were conducted at enrollment (evaluation 1 [E1]); after 45 days of treatment with medication and cognitive-behavioral therapy (E2); and at the end of the six-month study period (E3). Patients were evaluated with a standardized questionnaire (to collect sociodemographic data and determine smoking status), as well as with the University of Rhode Island Change Assessment scale, Beck Anxiety Inventory, Beck Depression Inventory, and Lipp Inventory of Stress Symptoms for Adults. The data were analyzed with the nonparametric Wilcoxon test for paired comparisons. To compare treatment success (smoking cessation) with treatment failure, the test for two proportions was used. Results: Among the 142 patients evaluated, there were improvements, in terms of the levels of anxiety, depression, motivation, and stress, between E1 and E2, as well as between E1 and E3. In addition, treatment success correlated significantly with the levels of motivation and anxiety throughout the study period, whereas it correlated significantly with the level of depression only at E2 and E3. Conclusions: We conclude that there are in fact changes in the levels of patient anxiety, depression, motivation, and stress over the course of smoking cessation treatment. Those changes appear to be more pronounced in patients in whom the treatment succeeded. PMID:26578135

Exploration of Incarcerated Men’s and Women’s Attitudes of Smoking in the Presence of Children and Pregnant Women: Is There a Disparity Between Smoking Attitudes and Smoking Behavior?

PubMed Central

Roberts, Mary B.; van den Berg, Jacob J.; Bock, Beth; Stein, Lyn A. R.; Martin, Rosemarie A.; Clarke, Jennifer G.

2016-01-01

Abstract Introduction: A major health challenge facing persons who are incarcerated is tobacco smoking. Upon reentry to the community, concerns regarding smoking cessation may be less likely to receive needed attention. Many individuals have partners who are pregnant and/or reside in households where children and pregnant women live. We explored incarcerated adults’ attitudes of smoking in the presence of children and pregnant women and how post-release smoking behaviors are influenced by their attitudes. Methods: Two hundred forty-seven incarcerated adults participated in a smoking cessation randomized clinical trial in a tobacco-free prison. An instrument was developed to examine smoking attitudes and behaviors around children and pregnant women. Moderating effects of smoking factors on post-release abstinence were examined by evaluating interactions between smoking factors and treatment group. Results: Four factors were defined using factor analysis: smoking around children; impact of smoking on child’s health; awareness of environmental tobacco smoke (ETS) risk for pregnant women; and importance of smoking avoidance during pregnancy. We found moderation effects of smoking factors on smoking outcomes which included: treatment group by smoking behavior around children (β = 0.8085; standard error [ SE ] = 0.4002; P = .04); treatment group by impact of smoking on child’s health (β = 1.2390; SE = 0.5632; P = .03) and for those smoking 50% fewer cigarettes post-release, treatment group by smoking impact on child’s health (β = 1.2356; SE = 0.4436; P < .01). Conclusions: Concern for smoking around children and pregnant women and awareness of ETS risk for pregnant women was not found to be significantly associated with smoking outcomes and requires additional investigation. Among individuals who continue to smoke post-release, effective ETS interventions are needed aimed at protecting children and pregnant women with whom they live. PMID:26014453

Predictors of smoking cessation in Taiwan: using the theory of planned behavior.

PubMed

Tseng, Yu-Fang; Wang, Kuei-Lan; Lin, Ching-Yun; Lin, Yi-Ting; Pan, Hui-Chen; Chang, Chai-Jan

2018-03-01

This study aimed to explore the factors predicting the intention to quit smoking and the subsequent behavior 6 months later using the theory of planned behavior (TPB). Data were obtained from 145 smokers who attended a smoking cessation clinic in a community hospital. All participants completed a questionnaire which included demographic information, TPB-based items, perceived susceptibility and previous attempts to quit. The actual quitting behavior was obtained by follow-up phone calls 6 months later. The TPB constructs explained 34% of the variance in intention to quit smoking. By adding perceived susceptibility, the explained variance was significantly improved to 40%. The most important predictors were perceived behavior control and perceived susceptibility, followed by attitude. Subjective norm did not contribute to the prediction of intention. Attitude and perceived behavior control contributed to the prediction of actual quitting behavior, but intention, subjective norm and perceived susceptibility did not. Our findings support that the TPB is generally a useful framework to predict the intention to quit smoking in Taiwan. The inclusion of perceived susceptibility improved the prediction of intention. With regards to successfully quitting, attitude and perceived behavior control played more crucial roles than other TPB constructs. Smoking cessation promotion initiatives focusing on reinforcing cessation belief, enhancing a smoker's perception of their capability to quit smoking, and persuading smokers that they can overcome cessation barriers to cessation could make subsequent interventions more effective.

Are diet and physical activity patterns related to cigarette smoking in adolescents? Findings from Project EAT.

PubMed

Larson, Nicole I; Story, Mary; Perry, Cheryl L; Neumark-Sztainer, Dianne; Hannan, Peter J

2007-07-01

An inadequate diet and physical inactivity may compound the many deleterious effects of smoking on health. Some research indicates that smoking behavior is related to other health behaviors, but little research has examined how smoking may be related to dietary intake of key nutrients, consumption of fast food, sedentary lifestyle, or weight status. The purpose of this study was to describe smoking frequency among adolescents and its relationship to physical activity and dietary patterns. The research study employed a cross-sectional, population-based design. Adolescents self-reported cigarette smoking, physical activity, and eating behaviors on the Project EAT (Eating Among Teens) survey and reported dietary intake on a food frequency questionnaire completed in school classrooms. The sample included 4746 middle school and high school students from Minneapolis-St. Paul public schools. Mixed-model regression, which was controlled for sex, race and ethnicity, socioeconomic status, grade level (middle school or high school), and school, was used to examine the association of smoking with diet and physical activity patterns. Overall, reported smoking frequency was inversely related to participating in team sports, eating regular meals, and consuming healthful foods and nutrients. Smoking frequency was directly related to frequency of fast-food and soft drink consumption. Adolescents who smoke cigarettes may be less likely to engage in health-promoting lifestyle behaviors. Interventions are needed to prevent smoking and the unhealthy dietary practices and physical activity behaviors that may be associated with it.

Predictors of change on the smoking uptake continuum among adolescents.

PubMed

Kaufman, Nancy J; Castrucci, Brian C; Mowery, Paul D; Gerlach, Karen K; Emont, Seth; Orleans, C Tracy

2002-06-01

Understanding how advertising and other risk and demographic factors affect adolescent susceptibility to smoking would allow for the development of more effective youth-targeted tobacco prevention and cessation programs and policies. To examine the effect of various demographic and risk factors on different stages of smoking among adolescents. A nationally representative cross-sectional survey, The Robert Wood Johnson Foundation's Survey of Tobacco Price Sensitivity, Behavior, and Attitudes Among Teenagers and Young Adults. The Robert Wood Johnson Foundation's Survey of Tobacco Price Sensitivity, Behavior, and Attitudes Among Teenagers and Young Adults included 17,287 adolescent respondents (aged, 13-19 years) in 1996. Stage of susceptibility and correlates of progression toward regular smoking. Of all never [corrected] smoking adolescents, 32% were susceptible smokers (have never smoked, but might) with younger adolescents almost 3 times more likely than older adolescents to be susceptible. Female subjects were 50% [corrected] more likely than male subjects to be susceptible. In addition to exposure to others' smoking, owning or willingness to own tobacco promotional items, having a favorite cigarette advertisement, skipping school, poor school performance, and lack of attendance in religious activities were associated with progression along the uptake continuum. Improved understanding of the tobacco use trajectories of adolescents and the risk factors associated with progression will help clinicians and tobacco control advocates create effective youth-targeted interventions and policies. Findings suggest that physicians and other health care providers should redouble their efforts to ask preadolescents and young adults about smoking or the likelihood of their smoking. Nonsmokers should also be advised about the addictive nature of tobacco products and the resulting loss of control that accompanies addiction.

Relationship of nicotine deprivation and indices of alcohol use behavior to implicit alcohol and cigarette approach cognitions in smokers.

PubMed

Cohn, Amy; Ehlke, Sarah; Cobb, Caroline O

2017-04-01

Alcohol and smoking frequently co-occur and alcohol is a primary trigger for smoking behavior and relapse back to smoking. This study examined whether several indices of alcohol use behavior and consequences of use would be associated with changes in implicit alcohol-approach versus implicit cigarette-approach cognitions under cigarette deprived and non-deprived cognitions in 109 smokers who drank at risky or non-risky levels. An Implicit Association Task (IAT) measured how quickly respondents paired alcohol and cigarette pictures with approach and avoid words. Regression analyses examined the associations of quantity/frequency, proportion heavy drinking days, number of DSM-IV alcohol use disorder (AUD) symptoms, and risky drinking status to IAT scores under deprived conditions, controlling for IAT order effects, non-deprived IAT score, and deprived cigarette craving and withdrawal. Interactions with craving and withdrawal intensity were also examined. Results showed a significant positive association between proportion of heavy drinking days and stronger alcohol-approach than cigarette-approach motivations when deprived. There was also a conditional association of AUD symptoms to alcohol-approach motivations among respondents reporting more intense withdrawal when deprived. Alcohol quantity and frequency, as well as risky drinking status were unrelated to change in IAT scores. Findings suggest that cigarette deprivation may magnify motivation to drink, rather than smoke, among smokers who engage in more frequent bouts of heavy drinking and who report more alcohol-related problems. Results also show relative momentary and unconscious "preference" or choice for alcohol over cigarettes in some high-risk smokers, when cigarette craving and withdrawal are high. Copyright © 2016 Elsevier Ltd. All rights reserved.

The impact of prenatal education on behavioral changes toward breast feeding and smoking cessation in a healthy start population.

PubMed

Caine, Virginia A; Smith, Mark; Beasley, Yvonne; Brown, Haywood L

2012-01-01

To evaluate the impact of prenatal education by case managers on 2 social determinants of health behaviors-breast feeding and smoking cessation-among participants enrolled in Indianapolis Healthy Start (IHS). Birth and death data up to 1 year for IHS clients were collected from Marion County vital records for births 20 weeks or greater. Case managers provide education on the health benefits for mothers and infants on breast feeding and smoking cessation to all clients. Data were analyzed for differences between the IHS participants and other Marion County births. Most participants (63%) were non-Hispanic blacks aged less than 25 years (56%), without a high school diploma or general education development (53%), and enrolled in Medicaid (91%). Program participants were more likely to initiate breast feeding than nonparticipants (OR, 1.33; 95% CI, 1.10-1.61), and 22% continued to breast feed for 6 months. Hispanic women were more likely to breast feed for at least 6 months (OR, 4.71; 95% CI, 2.32-9.58). Women with advanced education were more likely to have quit smoking, as were women who were breast feeding at hospital discharge. After controlling for education, IHS clients tended to be less likely to continue to smoke during the third trimester (OR, 0.76, 95% CI, 0.49-1.16), as were those with a first pregnancy (OR, 0.32; 95% CI, 0.10, 0.98) and no other smokers in the home (OR, 0.25; 95% CI, 0.08, 0.74). Breast feeding and smoking cessation are modifiable risk factors that were impacted by behavioral interventions through case management education.

Association Between Distance From Home to Tobacco Outlet and Smoking Cessation and Relapse.

PubMed

Pulakka, Anna; Halonen, Jaana I; Kawachi, Ichiro; Pentti, Jaana; Stenholm, Sari; Jokela, Markus; Kaate, Ilkka; Koskenvuo, Markku; Vahtera, Jussi; Kivimäki, Mika

2016-10-01

Reduced availability of tobacco outlets is hypothesized to reduce smoking, but longitudinal evidence on this issue is scarce. To examine whether changes in distance from home to tobacco outlet are associated with changes in smoking behaviors. The data from 2 prospective cohort studies included geocoded residential addresses, addresses of tobacco outlets, and responses to smoking surveys in 2008 and 2012 (the Finnish Public Sector [FPS] study, n = 53 755) or 2003 and 2012 (the Health and Social Support [HeSSup] study, n = 11 924). All participants were smokers or ex-smokers at baseline. We used logistic regression in between-individual analyses and conditional logistic regression in case-crossover design analyses to examine change in walking distance from home to the nearest tobacco outlet as a predictor of quitting smoking in smokers and smoking relapse in ex-smokers. Study-specific estimates were pooled using fixed-effect meta-analysis. Walking distance from home to the nearest tobacco outlet. Quitting smoking and smoking relapse as indicated by self-reported current and previous smoking at baseline and follow-up. Overall, 20 729 men and women (age range 18-75 years) were recruited. Of the 6259 and 2090 baseline current smokers, 1744 (28%) and 818 (39%) quit, and of the 8959 and 3421 baseline ex-smokers, 617 (7%) and 205 (6%) relapsed in the FPS and HeSSup studies, respectively. Among the baseline smokers, a 500-m increase in distance from home to the nearest tobacco outlet was associated with a 16% increase in odds of quitting smoking in the between-individual analysis (pooled odds ratio, 1.16; 95% CI, 1.05-1.28) and 57% increase in within-individual analysis (pooled odds ratio, 1.57; 95% CI, 1.32-1.86), after adjusting for changes in self-reported marital and working status, substantial worsening of financial situation, illness in the family, and own health status. Increase in distance to the nearest tobacco outlet was not associated with smoking relapse among the ex-smokers. These data suggest that increase in distance from home to the nearest tobacco outlet may increase quitting among smokers. No effect of change in distance on relapse in ex-smokers was observed.

Socioeconomic Determinants of Inequality in Smoking Stages: A Distributive Analysis on a Sample of Male High School Students.

PubMed

Ayubi, Erfan; Sani, Mohadeseh; Safiri, Saeid; Khedmati Morasae, Esmaeil; Almasi-Hashiani, Amir; Nazarzadeh, Milad

2017-07-01

The effect of socioeconomic status on adolescent smoking behaviors is unclear, and sparse studies are available about the potential association. The present study aimed to measure and explain socioeconomic inequality in smoking behavior among a sample of Iranian adolescents. In a cross-sectional survey, a multistage sample of adolescents ( n = 1,064) was recruited from high school students in Zanjan city, northwest of Iran. Principal component analysis was used to measure economic status of adolescents. Concentration index was used to measure socioeconomic inequality in smoking behavior, and then it was decomposed to reveal inequality contributors. Concentration index and its 95% confidence interval for never, experimental, and regular smoking behaviors were 0.004 [-0.03, 0.04], 0.05 [0.02, 0.11], and -0.10 [-0.04, -0.19], respectively. The contribution of economic status to measured inequality in experimental and regular smoking was 80.0% and 68.8%, respectively. Household economic status could be targeted as one of the relevant factors in the unequal distribution of smoking behavior among adolescents.

Teachable moments for health behavior change and intermediate patient outcomes.

PubMed

Flocke, Susan A; Clark, Elizabeth; Antognoli, Elizabeth; Mason, Mary Jane; Lawson, Peter J; Smith, Samantha; Cohen, Deborah J

2014-07-01

Teachable moments (TM) are opportunities created through physician-patient interaction and used to encourage patients to change unhealthy behaviors. We examine the effectiveness of TMs to increase patients' recall of advice, motivation to modify behavior, and behavior change. A mixed-method observational study of 811 patient visits to 28 primary care clinicians used audio-recordings of visits to identify TMs and other types of advice in health behavior change talk. Patient surveys assessed smoking, exercise, fruit/vegetable consumption, height, weight, and readiness for change prior to the observed visit and 6-weeks post-visit. Compared to other identified categories of advice (i.e. missed opportunities or teachable moment attempts), recall was greatest after TMs occurred (83% vs. 49-74%). TMs had the greatest proportion of patients change in importance and confidence and increase readiness to change; however differences were small. TMs had greater positive behavior change scores than other categories of advice; however, this pattern was statistically non-significant and was not observed for BMI change. TMs have a greater positive influence on several intermediate markers of patient behavior change compared to other categories of advice. TMs show promise as an approach for clinicians to discuss behavior change with patients efficiently and effectively. Copyright © 2014. Published by Elsevier Ireland Ltd.

Parental Practices and Attitudes Related to Smoke-Free Rules in Homes, Cars, and Outdoor Playgrounds in US Households With Underage Children and Smokers, 2010-2011.

PubMed

Zhang, Xiao; Martinez-Donate, Ana; Rhoads, Natalie

2015-06-18

A smoke-free environment protects children from exposure to involuntary smoke and also can reduce or prevent future smoking behavior. The purpose of this study was to examine levels and correlates of parental behavior and attitudes related to voluntary smoke-free rules in homes, cars, and outdoor children's play areas among US households with underage children and 1 or more smoking parents. We used data from the 2010-2011 Tobacco Use Supplement to the Current Population Survey and logistic regressions to model behavior and attitudes related to voluntary smoke-free rules in 3 settings. Overall, 60.1% of households with children and at least 1 smoking parent had voluntary smoke-free home rules. Approximately 84.6% and 71.5% of parents thought that smoking should not be allowed inside cars with children present and in outdoor play areas, respectively. Positive parental behavior and attitudes related to voluntary smoke-free rules were more likely among households with 2 parents, parents of higher education and household income, Hispanic parents, and parents of infants (P < .05). Tobacco control and prevention efforts are needed to promote the voluntary adoption of smoke-free rules in homes, private cars, and outdoor children's play areas. Most parents from smoker households with underage children were supportive of smoke-free laws for cars and outdoor children's play areas, providing evidence and encouragement to policy makers to take action to restrict smoking in these locations.

Associations between Poor Sleep Quality and Stages of Change of Multiple Health Behaviors among Participants of Employee Wellness Program.

PubMed

Hui, Siu-Kuen Azor; Grandner, Michael A

2015-01-01

Using the Transtheoretical Model of behavioral change, this study evaluates the relationship between sleep quality and the motivation and maintenance processes of healthy behavior change. The current study is an analysis of data collected in 2008 from an online health risk assessment (HRA) survey completed by participants of the Kansas State employee wellness program (N=13,322). Using multinomial logistic regression, associations between self-reported sleep quality and stages of change (i.e. precontemplation, contemplation, preparation, action, maintenance) in five health behaviors (stress management, weight management, physical activities, alcohol use, and smoking) were analyzed. Adjusted for covariates, poor sleep quality was associated with an increased likelihood of contemplation, preparation, and in some cases action stage when engaging in the health behavior change process, but generally a lower likelihood of maintenance of the healthy behavior. The present study demonstrated that poor sleep quality was associated with an elevated likelihood of contemplating or initiating behavior change, but a decreased likelihood of maintaining healthy behavior change. It is important to include sleep improvement as one of the lifestyle management interventions offered in EWP to comprehensively reduce health risks and promote the health of a large employee population.

Neural Correlates of Graphic Cigarette Warning Labels Predict Smoking Cessation Relapse

PubMed Central

Owens, Max M.; MacKillop, James; Gray, Joshua C.; Hawkshead, Brittany E.; Murphy, Cara M.; Sweet, Lawrence H.

2017-01-01

Exposure to graphic warning labels (GWLs) on cigarette packaging has been found to produce heightened activity in brain regions central to emotional processing and higher-order cognitive processes. The current study extends this literature by using functional magnetic resonance imaging (fMRI) to investigate neural activation in response to GWLs and use it to predict relapse in an evidence-based smoking cessation treatment program. Participants were 48 treatment-seeking nicotine-dependent smokers who completed an fMRI paradigm in which they were exposed to GWLs, text-only warning labels (TOLs), and matched control stimuli. Subsequently, they enrolled in smoking cessation treatment and their smoking behavior was monitored. Activation in bilateral amygdala, right dorsolateral prefrontal cortex, right inferior frontal gyrus, left medial temporal gyrus, bilateral occipital lobe, and bilateral fusiform gyrus was greater during GWLs than TOLs. Neural response in the ventromedial prefrontal cortex (vmPFC) during exposure to GWLs (relative to a visual control image) predicted relapse during treatment beyond baseline demographic and dependence severity, but response in the amygdala to GWLs did not. These findings suggest that neurocognitive processes in the vmPFC may be critical to understanding how GWL’s induce behavior change and may be useful as a predictor of smoking cessation treatment prognosis. PMID:28236714

The Effect of Computer Usage in Internet Café on Cigarette Smoking and Alcohol Use among Chinese Adolescents and Youth: A Longitudinal Study

PubMed Central

Wu, Liyun; Delva, Jorge

2012-01-01

We used longitudinal data to investigate the relationship between computer use in internet cafés and smoking/drinking behavior among Chinese adolescents and young adults. Data are from two waves of the China Health and Nutrition Survey (2004 and 2006). Fixed effects models were used to examine if changes in internet café use were associated with changes in cigarette smoking and drinking of alcohol. Male café users spent on average 17.3 hours in front of the computer/week. This was associated with an increase in the probability of being a current smoker by 13.3% and with smoking 1.7 more cigarettes. Female café users spent on average 11 hours on the computer/week. This was associated with an increase in the probability of drinking wine and/or liquor by 14.74% and was not associated with smoking. Internet cafés are an important venue by which adolescent and young adults in China are exposed to smoking and drinking. Multi-component interventions are needed ranging from policies regulating cigarette and alcohol availability in these venues to anti-tobacco campaigns aimed at the general population but also at individuals who frequent these establishments. PMID:22470305

The effect of computer usage in internet café on cigarette smoking and alcohol use among chinese adolescents and youth: a longitudinal study.

PubMed

Wu, Liyun; Delva, Jorge

2012-02-01

We used longitudinal data to investigate the relationship between computer use in internet cafés and smoking/drinking behavior among Chinese adolescents and young adults. Data are from two waves of the China Health and Nutrition Survey (2004 and 2006). Fixed effects models were used to examine if changes in internet café use were associated with changes in cigarette smoking and drinking of alcohol. Male café users spent on average 17.3 hours in front of the computer/week. This was associated with an increase in the probability of being a current smoker by 13.3% and with smoking 1.7 more cigarettes. Female café users spent on average 11 hours on the computer/week. This was associated with an increase in the probability of drinking wine and/or liquor by 14.74% and was not associated with smoking. Internet cafés are an important venue by which adolescent and young adults in China are exposed to smoking and drinking. Multi-component interventions are needed ranging from policies regulating cigarette and alcohol availability in these venues to anti-tobacco campaigns aimed at the general population but also at individuals who frequent these establishments.

Smoking Behaviors Among Adolescents in Foster Care: A Gender-Based Analysis.

PubMed

Shpiegel, Svetlana; Sussman, Steve; Sherman, Scott E; El Shahawy, Omar

2017-09-19

Adolescents in foster care are at high risk for cigarette smoking. However, it is not clear how their smoking behaviors vary by gender. The present study examined lifetime and current smoking among males and females, and explored gender-specific risk factors for engagement in smoking behaviors. Data from the Multi Site Evaluation of Foster Youth Programs was used to evaluate patterns of smoking among adolescents aged 12-18 years (N = 1121; 489 males, 632 females). Males and females did not differ significantly in rates of lifetime and current smoking, or in the age of smoking initiation and number of cigarettes smoked on a typical day. Gender-based analyses revealed that older age and placement in group homes or residential treatment facilities were associated with heightened risk of smoking among males. In contrast, sexual minority status (i.e., nonheterosexual orientation) and increased childhood victimization were associated with heightened risk of smoking among females. A history of running away was linked to smoking in both genders. Gender should be considered when designing intervention programs to address cigarette smoking among foster youth, as the stressors associated with smoking may differ for males and females.

Comparison of Smoking History Patterns Among African American and White Cohorts in the United States Born 1890 to 1990.

PubMed

Holford, Theodore R; Levy, David T; Meza, Rafael

2016-04-01

Characterizing smoking history patterns summarizes life course exposure for birth cohorts, essential for evaluating the impact of tobacco control on health. Limited attention has been given to patterns among African Americans. Life course smoking histories of African Americans and whites were estimated beginning with the 1890 birth cohort. Estimates of smoking initiation and cessation probabilities, and intensity can be used as a baseline for studying smoking intervention strategies that target smoking exposure. US National Health Interview Surveys conducted from 1965 to 2012 yielded cross-sectional information on current smoking behavior among African Americans and whites. Additional detail for smokers including age at initiation, age at cessation and smoking intensity were available in some surveys and these were used to construct smoking histories for participants up to the date that they were interviewed. Age-period-cohort models with constrained natural splines provided estimates of current, former and never-smoker prevalence in cohorts beginning in 1890. This approach yielded yearly estimates of initiation, cessation and smoking intensity by age for each birth cohort. Smoking initiation probabilities tend to be lower among African Americans compared to whites, and cessation probabilities also were generally lower. Higher initiation leads to higher smoking prevalence among whites in younger ages, but lower cessation leads to higher prevalence at older ages in blacks, when adverse health effects of smoking become most apparent. These estimates provide a summary that can be used to better understand the effects of changes in smoking behavior following publication of the Surgeon General's Report in 1964. A novel method of estimating smoking histories was applied to data from the National Health Interview Surveys, which provided an extensive summary of the smoking history in this population following publication of the Surgeon General's Report in 1964. The results suggest that some of the existing disparities in smoking-related disease may be due to the lower cessation rates in African Americans compared to whites. However, the number of cigarettes smoked is also lower among African Americans. Further work is needed to determine mechanisms by which smoking duration and intensity can account for racial disparities in smoking-related diseases. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Developing a smoke free homes initiative in Kerala, India.

PubMed

Nichter, Mimi; Padmajam, Sreedevi; Nichter, Mark; Sairu, P; Aswathy, S; Mini, G K; Bindu, V C; Pradeepkumar, A S; Thankappan, K R

2015-05-10

Results of the Global Adult Tobacco Survey in Kerala, India found that 42 % of adults were exposed to second hand smoke (SHS) inside the home. Formative research carried out in rural Kerala suggests that exposure may be much higher. Numerous studies have called for research and intervention on SHS exposure among women and children as an important component of maternal and child health activities. Community-based participatory research was carried out in Kerala. First, a survey was conducted to assess prevalence of SHS exposure in households. Next, a proof of concept study was conducted to develop and test the feasibility of a community-wide smoke free homes initiative. Educational materials were developed and pretested in focus groups. After feasibility was established, pilot studies were implemented in two other communities. Post intervention, surveys were conducted as a means of assessing changes in community support. At baseline, between 70 and 80 % of male smokers regularly smoked inside the home. Over 80 % of women had asked their husband not to do so. Most women felt powerless to change their husband's behavior. When women were asked about supporting a smoke free homes intervention, 88 % expressed support for the idea, but many expressed doubt that their husbands would comply. Educational meetings were held to discuss the harms of second hand smoke. Community leaders signed a declaration that their community was part of the smoke free homes initiative. Six months post intervention a survey was conducted in these communities; between 34 and 59 % of men who smoked no longer smoked in their home. The smoke free homes initiative is based on the principle of collective efficacy. Recognizing the difficulty for individual women to effect change in their household, the movement establishes a smoke free community mandate. Based on evaluation data from two pilot studies, we can project that between a 30 and 60 % reduction of smoking in the home may be achieved, the effect size determined by how well the smoke free home steps are implemented, the characteristics of the community, and the motivation of community level facilitators.

Implementation of Workplace-Based Smoking Cessation Support Activities and Smoking Cessation Among Employees: The Finnish Public Sector Study

PubMed Central

Kivimäki, Mika; Oksanen, Tuula; Pentti, Jaana; Heponiemi, Tarja; Väänänen, Ari; Virtanen, Marianna; Vahtera, Jussi

2012-01-01

Objectives. We investigated the relationship between implementation of workplace smoking cessation support activities and employee smoking cessation. Methods. In 2 cohort studies, participants were 6179 Finnish public-sector employees who self-reported as smokers at baseline in 2004 (study 1) or 2008 (study 2) and responded to follow-up surveys in 2008 (study 1; n = 3298; response rate = 71%) or 2010 (study 2; n = 2881; response rate = 83%). Supervisors’ reports were used to assess workplace smoking cessation support activities. We conducted multilevel logistic regression analyses to examine changes in smoking status. Results. After adjustment for sociodemographic characteristics, number of cigarettes smoked per day, work unit size, shift work, type of job contract, health status, and health behaviors, baseline smokers whose supervisors reported that the employing agency had offered pharmacological treatments or financial incentives were more likely than those in workplaces that did not offer such support to have quit smoking. In general, associations were stronger among moderate or heavy smokers (≥ 10 cigarettes/day) than among light smokers (< 10 cigarettes/day). Conclusions. Cessation activities offered by employers may encourage smokers, particularly moderate or heavy smokers, to quit smoking. PMID:22594722

Babies Living Safe & Smokefree: randomized controlled trial of a multilevel multimodal behavioral intervention to reduce low-income children's tobacco smoke exposure.

PubMed

Collins, Bradley N; Lepore, Stephen J

2017-03-14

Addressing children's tobacco smoke exposure (TSE) remains a public health priority. However, there is low uptake and ineffectiveness of treatment, particularly in low-income populations that face numerous challenges to smoking behavior change. A multilevel intervention combining system-level health messaging and advice about TSE delivered at community clinics that disseminate the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), combined with nicotine replacement and intensive multimodal, individual-level behavioral intervention may improve TSE control efforts in such high-risk populations. This trial uses a randomized two-group design with three measurement points: baseline, 3-month and 12-month follow-up. The primary outcome is bioverified child TSE; the secondary outcome is bioverified maternal quit status. Smoking mothers of children less than 6 years old are recruited from WIC clinics. All participants receive WIC system-level intervention based on the "Ask, Advise, Refer (AAR)" best practices guidelines for pediatrics clinics. It includes training all WIC staff about the importance of maternal tobacco control; and detailing clinics with AAR intervention prompts in routine work flow to remind WIC nutrition counselors to ask all mothers about child TSE, advise about TSE harms and benefits of protection, and refer smokers to cessation services. After receiving the system intervention, mothers are randomized to receive 3 months of additional treatment or an attention control intervention: (1) The multimodal behavioral intervention (MBI) treatment includes telephone counseling sessions about child TSE reduction and smoking cessation, provision of nicotine replacement therapy, a mobile app to support cessation efforts, and multimedia text messages about TSE and smoking cessation; (2) The attention control intervention offers equivalent contact as the MBI and includes nutrition-focused telephone counseling, mobile app, and multimedia text messages about improving nutrition. The control condition also receives a referral to the state smoking cessation quitline. This study tests an innovative community-based, multilevel and integrated multimodal approach to reducing child TSE in a vulnerable, low-income population. The approach is sustainable and has potential for wide reach because WIC can integrate the tobacco intervention prompts into routine workflow and refer smokers to free evidence-based behavioral counseling interventions, such as state quitlines. Clinicaltrials.gov NCT02602288 . Registered 9 November 2015.

Smoking, health knowledge, and anti-smoking campaigns: an empirical study in Taiwan.

PubMed

Hsieh, C R; Yen, L L; Liu, J T; Lin, C J

1996-02-01

This paper uses a measure of health knowledge of smoking hazards to investigate the determinants of health knowledge and its effect on smoking behavior. In our analysis, two equations are estimated: smoking participation and health knowledge. The simultaneity problem in estimating smoking behavior and health knowledge is also considered. Overall, the estimated results suggest that anti-smoking campaigns have a significantly positive effect on the public's health knowledge, and this health knowledge in turn, has a significantly negative effect on smoking participation. The health knowledge elasticities of smoking participation are -0.48 and -0.56 for all adults and adult males, respectively.

Smoking ban policies and their influence on smoking behaviors among current California smokers: a population-based study.

PubMed

Zablocki, Rong W; Edland, Steven D; Myers, Mark G; Strong, David R; Hofstetter, C Richard; Al-Delaimy, Wael K

2014-02-01

To assess whether smoking ban policies are associated with smoking reduction and quit attempts among California smokers. Data were examined for 1718 current smokers from follow-up telephone interviews conducted in 2011 of persons previously identified as smokers in a representative sample of the adult population of California. Population weighted logistic regressions controlling for demographic and other variables were used to evaluate the association between smoking ban policies (home, work, and town) and changes in tobacco use (past year quit attempt or reduction in smoking rate). Living in a home with a total ban was significantly associated with smoking reduction (adjusted odds ratio, AOR: 2.4, 95% CI: 1.4-4.2) and making a quit attempt (AOR: 2.3, 95% CI: 1.3-3.9) compared to living in a home with no home ban. Self-reported perception of an outdoor ban in one's city/town was associated with smoking reduction (AOR: 1.7, 95% CI: 1.02-2.7) and making a quit attempt (AOR: 1.8, 95% CI: 1.05-2.9). These results indicate that smoking bans not only protect nonsmokers from the harms of secondhand smoke, but are also associated with smoking reduction and cessation. Copyright © 2013 Elsevier Inc. All rights reserved.

Smoking addiction in chronic obstructive pulmonary disease: Integrating neurobiology and phenomenology through a review of the literature.

PubMed

Klinke, Marianne E; Jónsdóttir, Helga

2014-11-01

The aim of this review is to extend professional understanding of the various mechanisms that make smoking cessation difficult for patients with chronic obstructive pulmonary disease (COPD). Smoking in people with COPD is a major challenge for health care today. In spite of significant advances in knowledge about the processes of nicotine addiction, current interventions to support smoking cessation in patients with COPD are less successful than hoped for. A wealth of literature has confirmed that nicotine addiction is a powerful force and that smoking is not simply an unhealthy lifestyle or destructive behavior. However, research based on this realization is still in its infancy. To increase understanding and to develop ways of enhancing smoking cessation in patients with COPD, we review and synthesize knowledge found in neurobiology and phenomenology. We use neurobiology to explain the neurochemical changes that take place in addiction in order to substantiate phenomenological perspectives of smoking in patients with COPD. We relate the smoking experience to the concept of "affordances"-in this context "smoking affordances"-to analyze how smoking affects action possibilities in individuals with COPD. Combining these perspectives helps to illuminate the manifold and unique issues related to smoking addiction in patients with COPD. © The Author(s) 2014.

Losing jobs and lighting up: Employment experiences and smoking in the Great Recession

PubMed Central

Golden, Shelley D.; Perreira, Krista M.

2015-01-01

The Great Recession produced the highest rates of unemployment observed in decades, in part due to particularly high rates of people losing work involuntarily. The impact of these job losses on health is unknown, due to the length of time required for most disease development, concerns about reverse causation, and limited data that covers this time period. We examine associations between job loss, employment status and smoking, the leading preventable cause of death, among 13,571 individuals participating in the 2001-2011 waves of the U.S.-based Panel Study of Income Dynamics. Results indicate that recent involuntary job loss is associated with an average 1.1 percentage point increase in smoking probability. This risk is strongest when people have returned to work, and appears reversed when they leave the labor market altogether. Although some job loss is associated with changes in household income and psychological distress levels, we find no evidence that these changes explain smoking behavior modifications. Smoking prevention programs and policies targeted at displaced workers or the newly employed may alleviate some negative health effects produced by joblessness during the Great Recession. PMID:26079992

Factors associated with smoking among operating engineers.

PubMed

Choi, Seung Hee; Pohl, Joanne M; Terrell, Jeffrey E; Redman, Richard W; Duffy, Sonia A

2013-09-01

Although disparities in smoking prevalence between white collar workers and blue collar workers have been documented, reasons for these disparities have not been well studied. The objective of this study was to determine variables associated with smoking among Operating Engineers, using the Health Promotion Model as a guide. With cross-sectional data from a convenience sample of 498 Operating Engineers, logistic regression was used to determine personal and health behaviors associated with smoking. Approximately 29% of Operating Engineers currently smoked cigarettes. Multivariate analyses showed that younger age, unmarried, problem drinking, physical inactivity, and a lower body mass index were associated with smoking. Operating Engineers were at high risk of smoking, and smokers were more likely to engage in other risky health behaviors, which supports bundled health behavior interventions. Copyright 2013, SLACK Incorporated.

Adolescent smoking, weight changes, and binge-purge behavior: associations with secondary amenorrhea.

PubMed Central

Johnson, J; Whitaker, A H

1992-01-01

BACKGROUND. The association of secondary amenorrhea with extreme forms of substance use, weight control, and exercise in nonrepresentative samples raises questions as to whether adolescents in the general population who engage in these behaviors are at increased risk for secondary amenorrhea. We examined the prevalence and behavioral correlates of secondary amenorrhea in a county-wide high school population of 2544 girls aged 13 to 18. METHODS. A survey questionnaire, which elicited menstrual history as well as weight history, weight control practices, level of exercise, and use of cigarettes, wine, and beer, was administered during school hours; absentees were also surveyed. The completion rate was 91%. RESULTS. The 1-year prevalence of secondary amenorrhea was 8.5%. Secondary amenorrhea was associated with smoking one or more packs of cigarettes per day (adjusted relative risk [RRa] = 1.96, 1.21-3.10), with multiple binge-eating behaviors in combination with laxative use or self-induced vomiting (RRa = 4.17, 2.54-6.32), and with weight fluctuation due to weight control (RRa = 2.59, 1.33-4.79). There was no association between amenorrhea and alcohol consumption or exercise level. CONCLUSIONS. Estimates of attributable risk are provided and indicate that bulimic behaviors and cigarette smoking may result in a considerable excess of cases of secondary amenorrhea in an adolescent population. PMID:1536334

A tailored Internet-delivered intervention for smoking cessation designed to encourage social support and treatment seeking: usability testing and user tracing.

PubMed

Houston, Tom K; Ford, Daniel E

2008-03-01

While Internet technologies show promise for changing behavior, new methods for engaging individuals are needed to maximize effectiveness. The aim of this study is to design and evaluate an Internet-delivered intervention for smoking cessation that encouraged seeking support from family and treatment from doctors. To evaluate different introductions to the Internet site. We conducted usability testing and analyzed server logs to trace user participation in the website. Two groups of users (current smokers) were recruited using Google advertisements. In Phase 1, 58% (75/126) of users accessed the self-management strategies, but few users accessed the social support (28%) and treatment-seeking modules (33%). Then, a brief motivational introduction was added, stating the proven effectiveness of content in the unused modules, low use of these modules, and recommendations by two doctors to use all modules. Compared with Phase 1, in Phase 2 the mean time spent on the website per session increased (8 to 18 min, p = 0.01) and use of the social support (50%) and treatment seeking modules (56%) increased (both p < 0.01). At 1-month follow-up, reports of talking to family about smoking cessation also increased from 84% to 100% (p = 0.038). Changing the rationale and context of Web-based health information using a motivational introduction can change user behavior.

Cigarette Smoking by Adolescent Females: Implications for Health and Behavior.

ERIC Educational Resources Information Center

Gritz, Ellen R.

Cigarette smoking is a behavior with profound biomedical and psychosocial consequences across the life span. Although it is advertised in terms of youth, beauty, sexual appeal, success and independence, smoking is intimately linked with addiction, disease and death. Smoking has been shown to be a leading contributer to several kinds of cancer,…

Social Contexts of Regular Smoking in Adolescence: Towards a Multidimensional Ecological Model

ERIC Educational Resources Information Center

Wen, Ming; Van Duker, Heather; Olson, Lenora M.

2009-01-01

Using data from the Add Health, this study examined multilevel factors of adolescent smoking after controlling for the baseline smoking behavior and individual characteristics. Results showed that peer, family and school were all important life domains contextually influencing subsequent smoking behavior among adolescents. Time spent with peers,…

Health Educators: Role Modeling and Smoking Behavior.

ERIC Educational Resources Information Center

Brennan, Andrew J. J.; Galli, Nicholas

1985-01-01

Examined cigarette smoking among health educators, their views about the effects of this behavior upon their audiences and beliefs about smoking in light of their professional role. Smokers and nonsmokers were significantly less included than former smokers to feel the role of health education is to convince people not to smoke. (Author/ABL)

Smoking behavior, attitudes, and cessation counseling among healthcare professionals in Armenia.

PubMed

Movsisyan, Narine K; Varduhi, Petrosyan; Arusyak, Harutyunyan; Diana, Petrosyan; Armen, Muradyan; Frances, Stillman A

2012-11-24

Smoking cessation counseling by health professionals has been effective in increasing cessation rates. However, little is known about smoking cessation training and practices in transition countries with high smoking prevalence such as Armenia. This study identified smoking-related attitudes and behavior of physicians and nurses in a 500-bed hospital in Yerevan, Armenia, the largest cancer hospital in the country, and explored barriers to their effective participation in smoking cessation interventions. This study used mixed quantitative and qualitative methods. Trained interviewers conducted a survey with physicians and nurses using a 42-item self-administered questionnaire that assessed their smoking-related attitudes and behavior and smoking cessation counseling training. Four focus group discussions with hospital physicians and nurses explored barriers to effective smoking cessation interventions. The focus group sessions were audio-taped, transcribed, and analyzed. The survey response rate was 58.5% (93/159) for physicians and 72.2% (122/169) for nurses. Smoking prevalence was almost five times higher in physicians compared to nurses (31.2% vs. 6.6%, p < 0.001). Non-smokers and ex-smokers had more positive attitudes toward the hospital's smoke-free policy compared to smokers (90.1% and 88.2% vs. 73.0%). About 42.6% of nurses and 26.9% of physicians reported having had formal training on smoking cessation methods. While both groups showed high support for routinely assisting patients to quit smoking, nurses more often than physicians considered health professionals as role models for patients. This study was the first to explore differences in smoking-related attitudes and behavior among hospital physicians and nurses in Yerevan, Armenia. The study found substantial behavioral and attitudinal differences in these two groups. The study revealed a critical need for integrating cessation counseling training into Armenia's medical education. As nurses had more positive attitudes toward cessation counseling compared to physicians, and more often reported having cessation training, they are an untapped resource that could be more actively engaged in smoking cessation interventions in healthcare settings.

[Changes in behaviors and indicators of mental health between 2006 and 2010 in the French working population].

PubMed

Malard, L; Chastang, J-F; Niedhammer, I

2017-08-01

The 2008 economic crisis may have had an impact on mental health but the studies on this topic are sparse, in particular among the working population. However, mental health at work is a crucial issue involving substantial costs and consequences. The aim of the study was to assess changes in behaviors and indicators of mental health in the French working population between 2006 and 2010, and to explore the differential changes according to age, origin, occupation, activity sector, public/private sector, self-employed/employee status and work contract. The data came from the prospective national representative Santé et itinéraire professionnel (SIP) survey, including a sample of 5600 French workers interviewed in 2006 and 2010. The behaviors and indicators of mental health studied were excessive alcohol consumption, smoking, sleep problems (sleep disorders and/or insufficient sleep duration), psychotropic drug use (antidepressants, anxiolytics and/or hypnotics), and poor self-reported health. Generalized estimating equations were used to analyze changes in behaviors and indicators of mental health, and the analyses were adjusted for age. Covariates (age, origin, occupation, activity sector, public/private sector, self-employed/employee status and type of contract) were added separately to assess differential changes. Increases in excessive alcohol consumption among women, sleep problems among men, and smoking, insufficient sleep duration and poor self-reported health for both genders were observed in the French working population between 2006 and 2010. Some differential changes were observed, negative changes being more likely to affect young workers and workers with a permanent contract. Prevention policies should consider that behavior and indicators of mental health may deteriorate in times of economic crisis, especially among some sub-groups of the working population, such as young workers and workers with a permanent contract. These changes might foreshadow a forthcoming increase in mental disorders. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

The effects of message framing within the stages of change on smoking cessation intentions and behaviors.

PubMed

Cornacchione, Jennifer; Smith, Sandi W

2012-01-01

This study examines two commonly used and accepted theoretical models in health communication-the stages of change and message framing-to determine whether gain- or loss-framed messages are more effective at getting people to intend to quit smoking depending on their current stage of change (precontemplation, contemplation, or preparation). One hundred forty-eight current smokers were exposed to one of four gain- or loss-framed messages that emphasized the benefits of cessation or the costs of smoking. Message believability, message processing, and stage movement were measured to see if any differences existed as a function of the individual's base stage of change and message frame exposure. Overall, results indicated that all participants, regardless of stage and frame, engaged in more central than peripheral message processing. However, those in the precontemplation/loss frame and preparation/gain frame conditions engaged in significantly less cognitive processing than those in all other conditions. Additionally, gain-framed messages were most influential at getting individuals to progress from the contemplation to the preparation stage. Implications and future directions for research are also discussed.