Peer-Facilitated Tobacco Cessation in a Prison Setting: A Proof of Concept Study.

Background: Despite the vast human and economic costs associated with tobacco use among U.S. inmates, smoking remains a largely ignored public health epidemic. Incarcerated individuals smoke at 3 to 4 times the rate of the general population and face tobacco-related health disparities. Purpose: This paper reports results from a single arm, pre/post pilot study designed to test the feasibility and initial effectiveness of an inmate-administered group tobacco cessation intervention within a men's pre-release program run by the Arizona Department of Corrections. Methods: Corrections staff and inmate peer mentors were trained in the DIMENSIONS: Tobacco Free Program, a manualized 6-session tobacco cessation group curriculum. Group sessions used evidence-based interventions for assisting inmates develop skills to live tobacco and nicotine free. In 2019-2020, 39 men who reported tobacco use voluntarily participated in one of three cessation groups. Wilcoxen signed-rank tests evaluated changes across group sessions in frequency of tobacco use and attitudes about nicotine-free living post release. Results: Most participants attended all six group sessions (79%) and made one or more quit attempts (78%). Overall, 24% of the sample reported quitting tobacco, and significant reductions in tobacco use were reported after only two sessions. Participants further reported significant positive changes in knowledge, plans, support, and confidence to live tobacco-free lives post-release. Conclusions: To our knowledge, this is the first study to demonstrate that, with minimal investment, implementation of an evidence-based, peer-led tobacco free program is feasible and effective within an incarcerated population uniquely vulnerable to the burden of tobacco.

Results of a Peer Navigator Program to Address Chronic Illness Among Persons Experiencing Homelessness.

People who are homeless disproportionately experience the burdens of chronic disease, have limited access to preventive care, and may be less trusting of healthcare agencies. The Collective Impact Project created and evaluated an innovative model designed to increase chronic disease screening and referral to healthcare and public health services. Trained Peer Navigators (PNs), who were paid staff with lived experiences similar to the clients served, were embedded in five agencies serving people experiencing homelessness or at risk for homelessness. Over two years, PNs engaged 1071 individuals. Of those, 823 were screened for chronic diseases and 429 were referred to healthcare services. Alongside screening and referrals, the project demonstrated the value of convening a coalition of community stakeholders, experts, and resources to identify service gaps and how PN functions might complement existing staffing roles. Project findings add to a growing literature documenting unique PN roles that potentially reduce health inequities.

Nicotine and Opioids: a Call for Co-treatment as the Standard of Care.

The U.S. is in the midst of an opioid epidemic. At the same time, tobacco use remains the leading cause of preventable death and disability. While the shared biological underpinnings of nicotine and opioid addiction are well established, clinical implications for co-treatment of these two substance use disorders has not been emphasized in the literature, nor have researchers, clinicians, and policy makers adequately outlined pathways for incorporating co-treatment into existing clinical workflows. The current brief review characterizes the metabolic and neural mechanisms which mediate co-use of nicotine and opioids, and then outlines clinical and policy implications for concurrently addressing these two deadly epidemics. Screening, assessment, medication-assisted treatment (MAT), and tobacco-free policy are discussed. The evidence suggests that clinical care and policies that facilitate co-treatment are an expedient means of delivering healthcare to individuals that result in better health for the population while also meeting patients' substance abuse disorder recovery goals.

Effects of a Statewide Tobacco Cessation Program Among Individuals Involved With Arkansas Community Correction.

In response to a critical need for tobacco cessation services among justice-involved populations, Arkansas Community Correction (ACC) partnered with the University of Colorado's Behavioral Health & Wellness Program in 2013 to implement the DIMENSIONS: Tobacco Free Program within all probation, parole, and drug court units. In the first 2 years of this statewide, evidence-based program, more than 1,100 individuals from 33 ACC area office locations attended tobacco-free group sessions and provided data on tobacco use and readiness to quit. Results demonstrated a significant reduction in tobacco use among participants as well as increased knowledge, confidence, and intent to quit. This study provides some of the first evidence that members of this vulnerable population will attend tobacco-free group sessions with regularity and make progress toward tobacco cessation.

Tobacco-Free Policy Outcomes for an Inpatient Substance Abuse Treatment Center.

We assessed changes in patient census, smoking prevalence, and intention to remain abstinent associated with the voluntary enactment of a campus-wide tobacco-free policy in a for-profit residential addictions treatment center. Employing nationally recognized tobacco-free policy strategies, steps toward implementation were tailored to addictions treatment settings. Census data and survey of client tobacco use data were collected for 1 year before the policy began and for 1 year following the policy. Average daily census increased for both the inpatient and extended residential treatment programs after enactment of the tobacco-free policy. Number of tobacco users admitted to treatment increased significantly, while the number of tobacco users who left treatment early did not significantly change. In addition to reducing smoking, the policy was associated with a significant increase of patients reporting the intention to remain abstinent after discharge. Contrary to common concern, a tobacco-free policy implemented in an inpatient residential addictions treatment setting did not negatively affect census rates. This study suggests potential clinical and organizational benefits for campus-wide tobacco-free policies.

Estimating the sex-specific effects of genes on facial attractiveness and sexual dimorphism.

Human facial attractiveness and facial sexual dimorphism (masculinity-femininity) are important facets of mate choice and are hypothesized to honestly advertise genetic quality. However, it is unclear whether genes influencing facial attractiveness and masculinity-femininity have similar, opposing, or independent effects across sex, and the heritability of these phenotypes is poorly characterized. To investigate these issues, we assessed facial attractiveness and facial masculinity-femininity in the largest genetically informative sample (n = 1,580 same- and opposite-sex twin pairs and siblings) to assess these questions to date. The heritability was ~0.50-0.70 for attractiveness and ~0.40-0.50 for facial masculinity-femininity, indicating that, despite ostensible selection on genes influencing these traits, substantial genetic variation persists in both. Importantly, we found evidence for intralocus sexual conflict, whereby alleles that increase masculinity in males have the same effect in females. Additionally, genetic influences on attractiveness were shared across the sexes, suggesting that attractive fathers tend to have attractive daughters and attractive mothers tend to have attractive sons.

Women's luteal-phase sexual proceptivity and the functions of extended sexuality.

Women's sexuality, unlike that of most mammals, is not solely defined by sexual receptivity during the short window of fertility. Women demonstrate extended sexuality (in which they initiate and accept sexual advances outside of the fertile phase) more than any other mammalian female. In this light, surprisingly little research has addressed the functions of women's luteal-phase sexuality. On the basis of theory and comparative evidence, we propose that women's initiation of sex during nonfertile phases evolved in part to garner investment from male partners. If so, women should be particularly prone to initiate luteal-phase sex when the potential marginal gains are greatest. Results from a study of 50 heterosexual couples showed that women increasingly initiate sex in the luteal phase (but not the fertile phase) when they perceive their partners' investment to lag behind their own. These findings provide evidence for the distinct nature of women's extended sexuality and may contribute to a more comprehensive understanding of women's sexuality.

The genetic correlation between height and IQ: shared genes or assortative mating?

Traits that are attractive to the opposite sex are often positively correlated when scaled such that scores increase with attractiveness, and this correlation typically has a genetic component. Such traits can be genetically correlated due to genes that affect both traits ("pleiotropy") and/or because assortative mating causes statistical correlations to develop between selected alleles across the traits ("gametic phase disequilibrium"). In this study, we modeled the covariation between monozygotic and dizygotic twins, their siblings, and their parents (total N = 7,905) to elucidate the nature of the correlation between two potentially sexually selected traits in humans: height and IQ. Unlike previous designs used to investigate the nature of the height-IQ correlation, the present design accounts for the effects of assortative mating and provides much less biased estimates of additive genetic, non-additive genetic, and shared environmental influences. Both traits were highly heritable, although there was greater evidence for non-additive genetic effects in males. After accounting for assortative mating, the correlation between height and IQ was found to be almost entirely genetic in nature. Model fits indicate that both pleiotropy and assortative mating contribute significantly and about equally to this genetic correlation.

Changes in women's mate preferences across the ovulatory cycle.

Previous research has shown that women's mate preferences change across the ovulatory cycle in a number of ways. The leading explanation for these changes--the good genes hypothesis--predicts that women should prefer presumed markers of genetic benefits ("good genes") most strongly when they are fertile and evaluating men as possible short-term mates. Research testing this hypothesis has almost exclusively examined preferences for purported markers of good genes. Little is known about how preferences for men who display traits valued in long-term, investing mates (e.g., warmth and faithfulness) change across the cycle. The authors had women at different points in their ovulatory cycle rate videotapes of men in terms of how attractive they found each man as a short-term and long-term mate. The authors then examined how women's preferences for traits typically valued in long-term and/or short-term mates varied according to women's fertility status. The results supported the good genes hypothesis. Implications of these findings for models of human mating are discussed.

Major histocompatibility complex alleles, sexual responsivity, and unfaithfulness in romantic couples.

Preferences for mates that possess genes dissimilar to one's own at the major histocompatibility complex (MHC), a polymorphic group of loci associated with the immune system, have been found in mice, birds, fish, and humans. These preferences may help individuals choose genetically compatible mates and may adaptively function to prevent inbreeding or to increase heterozygosity and thereby immunocompetence of offspring. MHC-dissimilar mate preferences may influence the psychology of sexual attraction. We investigated whether MHC similarity among romantically involved couples (N= 48) predicted aspects of their sexual relationship. All women in our sample normally ovulated, and alleles at three MHC loci were typed for each person. As the proportion of MHC alleles couples shared increased, women's sexual responsivity to their partners decreased, their number of extrapair sexual partners increased, and their attraction to men other than their primary partners increased, particularly during the fertile phase of their cycles.

Women's sexual interests across the ovulatory cycle depend on primary partner developmental instability.

Normally ovulating women have been found to report greater sexual attraction to men other than their own partners when near ovulation relative to the luteal phase. One interpretation is that women possess adaptations to be attracted to men possessing (ancestral) markers of genetic fitness when near ovulation, which implies that women's interests should depend on qualities of her partner. In a sample of 54 couples, we found that women whose partners had high developmental instability (high fluctuating asymmetry) had greater attraction to men other than their partners, and less attraction to their own partners, when fertile.

Women's preferences for male behavioral displays change across the menstrual cycle.

Women prefer both the scent of symmetrical men and masculine male faces more during the fertile (late follicular and ovulatory) phases of their menstrual cycles than during their infertile (e.g., luteal) phases. Men's behavioral displays in social settings may convey signals that affect women's attraction to men even more strongly. This study examined shifts in women's preferences for these behavioral displays. A sample of 237 normally ovulating women viewed 36 or 40 videotaped men who were competing for a potential lunch date and then rated each man's attractiveness as a short-term and a long-term mate. As predicted, women's preference for men who displayed social presence and direct intrasexual competitiveness increased on high-fertility days relative to low-fertility days, but only in a short-term, not a long-term, mating context. These findings add to the growing literature indicating that women's mate preferences systematically vary across the reproductive cycle.