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1.
Vasc Health Risk Manag ; 15: 485-502, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31802882

RESUMO

Introduction: Smoking is a major risk factor for cardiovascular diseases (CVDs) and for many types of cancers. Despite recent policies, 1.1 billion people are active smokers and tobacco is the leading cause of mortality and illness throughout the world. The aim of this work was to identify smoking cessation interventions which could be implemented in primary care and/or at a community level. Methods: A systematic review of CVDs prevention guidelines was realized using the ADAPTE Process. These were identified on G-I-N and TRIP databases. Additionally, a purposive search for national guidelines was successfully undertaken. Guidelines focusing on non-pharmacological lifestyle interventions, published or updated after 2011, were included. Exclusion criteria were specific populations, management of acute disease and exclusive focus on pharmacological or surgical interventions. After appraisal with the AGREE II tool, high-quality guidelines were included for analysis. High-grade recommendations and the supporting bibliographic references were extracted. References had to be checked in detail where sufficient information was not available in the guidelines. Results: Nine hundred and ten guidelines were identified, 47 evaluated with AGREE II and 26 included. Guidelines recommended that patients quit smoking and that health care professionals provided advice to smokers but failed to propose precise implementation strategies for such recommendations. Only two guidelines provided specific recommendations. In the guideline bibliographic references, brief advice (BA) and multiple session strategies were identified as effective interventions. These interventions used Prochaska theory, motivational interviewing or cognitive-behavioral therapies. Self-help documentation alone was less effective than face-to-face counseling. Community-based or workplace public interventions alone did not seem effective. Discussion: Behavioral change strategies were effective in helping patients to give up smoking. BA alone was less effective than multiple session strategies although it required fewer resources. Evidence for community-based interventions effectiveness was weak, mainly due to the lack of robust studies.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Serviços de Saúde Comunitária , Aconselhamento , Atenção Primária à Saúde , Comportamento de Redução do Risco , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Proteção , Medição de Risco , Fatores de Risco , Adulto Jovem
3.
BMC Public Health ; 19(1): 1577, 2019 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-31775709

RESUMO

BACKGROUND: Smoking prevalence remains inequitably high for lower SES (socioeconomic status) populations. The psychosocial interactive model of resilience theorises that resilience might be 'switched on' in order to support and/or maintain smoking cessation for these populations. This study aimed to develop a Resilience Intervention for Smoking Cessation (RISC) through reviewing the extant literature around efficacious interventions for smoking cessation. Deliberative democracy principles were then used to understand lay perspectives regarding this potential smoking cessation program. METHODS: Public health databases were searched to find efficacious psycho-social resilience interventions in the peer-reviewed literature for smoking cessation amongst lower SES populations. Potential components for RISC were selected based on evidence within the literature for their effectiveness. We then employed the Nominal Group Technique (NGT) to create discussion and consensus on the most socially appropriate and feasible components from the perspective of smokers from low SES areas. The NGT included 16 people from a lower SES population in southern metropolitan Adelaide who indicated they were seriously contemplating quitting smoking or had recently quit. Data were collected from multiple Likert ratings and rankings of the interventions during the NGT workshop and analysed descriptively. The Wilcoxon signed-ranked test was used where appropriate. Qualitative data were collected from participant reflections and group discussion, and analysed thematically. RESULTS: Six smoking cessation interventions, likely to enhance resilience, were selected as potential constituents for RISC: mindfulness training; setting realistic goals; support groups; smoke free environments; mobile phone apps; and motivational interviewing. Consensus indicated that mindfulness training and setting realistic goals were the most acceptable resilience enhancing interventions, based on perceived usefulness and feasibility. CONCLUSIONS: This research applied principles from deliberative democracy in order to illuminate lay knowledge regarding an appropriate and acceptable smoking cessation resilience program for a lower SES population. This process of collaborative and complex knowledge-generation is critically important to confront inequities as an ongoing challenge in public health, such as smoking cessation for disadvantaged groups. Further research should involve development and trial of this resilience program.


Assuntos
Consenso , Abandono do Hábito de Fumar/métodos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pobreza , Resiliência Psicológica , Fumantes/psicologia , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/psicologia
4.
BMC Public Health ; 19(1): 1400, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664959

RESUMO

BACKGROUND: Tobacco smoking remains one of the biggest public health threats. Smartphone apps offer new promising opportunities for supporting smoking cessation in real-time. The social context of smokers has, however, been neglected in smartphone apps promoting smoking cessation. This randomized controlled trial investigates the effectiveness of a smartphone app in which smokers quit smoking with the help of a social network member. METHODS: This protocol describes the design of a single-blind, two-arm, parallel-group, intensive longitudinal randomized controlled trial. Participants of this study are adult smokers who smoke at least one cigarette per day and intend to quit smoking at a self-set quit date. Blocking as means of group-balanced randomization is used to allocate participants to intervention or control conditions. Both intervention and control group use a smartphone-compatible device for measuring their daily smoking behavior objectively via exhaled carbon monoxide. In addition, the intervention group is instructed to use the SmokeFree Buddy app, a multicomponent app that also facilitates smoking-cessation specific social support from a buddy over a smartphone application. All participants fill out a baseline diary for three consecutive days and are invited to the lab for a background assessment. They subsequently participate in an end-of-day diary phase from 7 days before and until 20 days after a self-set quit date. Six months after the self-set quit date a follow-up diary for three consecutive days takes place. The primary outcome measures are daily self-reported and objectively-assessed smoking abstinence and secondary outcome measures are daily self-reported number of cigarettes smoked. DISCUSSION: This is the first study examining the effectiveness of a smoking cessation mobile intervention using the SmokeFree Buddy app compared to a control group in a real-life setting around a self-set quit date using a portable objective measure to assess smoking abstinence. Opportunities and challenges with running studies with smoking participants and certain design-related decisions are discussed. TRIAL REGISTRATION: This trial was prospectively registered on 04/04/2018 at ISRCTNregistry: ISRCTN11154315 .


Assuntos
Aplicativos Móveis , Smartphone , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Abandono do Hábito de Fumar/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , Método Simples-Cego , Fumantes/estatística & dados numéricos
5.
Psychol Addict Behav ; 33(8): 710-720, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31657594

RESUMO

It is unclear whether nicotine and perceived nicotine exposure can influence automatic evaluations of cigarette stimuli. In the present study, we investigated the effects of nicotine dose and instructed dose on motivational responses to smoking cues. Forty overnight nicotine-deprived smokers completed an Implicit Association Test (IAT) at each of the four laboratory sessions in a balanced-placebo design that crossed nicotine dose (Given-NIC [given nicotine] vs. Given-DENIC [given denicotinized]) with instructed dose expectancy (Told-NIC [told-nicotine] vs. Told-DENIC. [told-denicotinized]). We measured participants' behavioral performance, including reaction time (RT) and accuracy rate, and the early posterior negativity (EPN) component using the event-related potential (ERP) technique to the target pictures. During congruent trials when the categorization condition was smoking or unpleasant, smokers had greater classification accuracy, shorter RT latency, and greater EPN amplitudes compared to the incongruent trials when the categorization condition was smoking or pleasant. The Given-NIC condition was associated with increased classification accuracy, longer RT latency, and decreased EPN amplitudes compared to the Given-DENIC condition. Similarly, the Told-NIC condition was associated with increased accuracy and decreased EPN amplitudes compared to the Told-DENIC condition, but with shorter RT latency. Cigarette-related pictures produced greater EPN amplitudes than neutral pictures. Both behavioral and ERP results suggest that smokers have negative implicit attitudes toward smoking. While both nicotine dose and expected dose facilitated stimulus categorization, there was no evidence that either factor altered smokers' negative attitudes toward smoking cues. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Atenção/fisiologia , Atitude , Sinais (Psicologia) , Potenciais Evocados/efeitos dos fármacos , Nicotina/administração & dosagem , Fumantes/psicologia , Adulto , Afeto/efeitos dos fármacos , Afeto/fisiologia , Atenção/efeitos dos fármacos , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Eletroencefalografia , Emoções/efeitos dos fármacos , Emoções/fisiologia , Potenciais Evocados/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação/efeitos dos fármacos , Motivação/fisiologia , Tempo de Reação/efeitos dos fármacos , Tempo de Reação/fisiologia , Fumar/fisiopatologia , Fumar/psicologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-31614952

RESUMO

Background: Smoking is among the most preventable causes of death globally. Tobacco cessation can lessen the number of potential deaths. The China Tobacco Cessation Guidelines encourage medical staff to perform the 5As (Ask, Advise, Assess, Assist, Arrange) when delivering tobacco dependence treatments to patients. Nursing students will develop to be nurses in the future and they have to finish 9 months of clinical practicum study in the last year at hospitals or care centers. However, the frequency of behaviors used to help smokers quit among Chinese nursing internship students is unclear. This study analyzed the rate of nurse interns' performance of the 5As and which demographic characteristics, perceptions of smoking and knowledge predicted higher performance of the 5As. Methods: The cluster sampling method was used to select 13 teaching hospitals among 29. All nursing intern students were expected to finish the questionnaire about their 5As behaviors to help patients quit smoking. Their 5As performances were scored from one to five with 5 being the best and scores were summed. A multivariate linear mixed-effect model was employed to test the differences between their 5As. Results: Participating in the survey were 1358 interns (62.4% response rate). The average scores were as follows-Ask-3.15, Advise-2.75, Assess-2.67, Assist-2.58 and Arrange-2.42. A total of 56.3% students perceived that medical staff should perform the 5As routinely to help patients quit smoking. On the other hand, 52.1% viewed clinical preceptors as role models of the 5As. School education regarding tobacco control, smoking dependence treatment, self-efficacy and positive intentions were predictors of higher performance of the 5As (p < 0.001). Conclusions: Nursing internship students seldom administered tobacco dependence treatments to patients. It is essential to improve the corresponding education, skills and self-efficacy of the 5As. Meanwhile, clinical preceptors should procure more training in the responsibilities and skills related to tobacco cessation. In this way, clinical preceptors can be role models of the 5As and impart positive influences on interns.


Assuntos
Internato e Residência , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Estudantes de Enfermagem , Tabagismo/terapia , Adulto , China , Estudos Transversais , Feminino , Humanos , Capacitação em Serviço , Masculino , Autoeficácia , Fumar , Inquéritos e Questionários , Fumar Tabaco
7.
Psychol Addict Behav ; 33(8): 721-729, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31621342

RESUMO

Cigarette craving predicts relapse to smoking, which remains the leading cause of preventable death in the United States. Understanding why individuals smoke has important clinical implications and is a research priority. Nonlaboratory studies reveal that social factors, such as the presence of other people, are associated with self-reported craving, yet laboratory smoking research has largely ignored these factors by testing participants in isolation. In this study, a shared reality framework was used to evaluate social processes that may change when smokers experience craving while in the presence of a smoking friend versus in social isolation. Sixty pairs of smoking friends (n = 120) arrived together at the laboratory following a required 5 hr of smoking abstinence. One preselected (target) participant then underwent an in vivo smoking cue-exposure craving induction with their friend either present or in another room, completing an unrelated task. Target participants who were together with their friend while craving experienced a greater sense of similarity and felt closer to their friend than did those who were alone. Furthermore, in the together condition, shared Duchenne smiles (using the Facial Action Coding System) were associated with targets' ratings of perceived similarity to their friend. Though social context did not influence affect or urge to smoke, urge was associated with targets' ratings of similarity in the together, but not the alone condition. Results highlight the potential social utility of craving (satisfying epistemic and relational goals) and highlight the need for increased laboratory research on smoking that includes a social context. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Fissura/fisiologia , Amigos/psicologia , Fumantes/psicologia , Fumar/psicologia , Meio Social , Adolescente , Adulto , Sinais (Psicologia) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Produtos do Tabaco , Adulto Jovem
8.
Aust N Z J Public Health ; 43(6): 529-531, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31617670

RESUMO

OBJECTIVE: Several studies have examined the characteristics of anti-smoking advertisements that are associated with quitting behaviour. Some studies use researchers or graduate students to code advertisement characteristics, while others recruit smokers or members of the general public. The aim of this study was to assist future campaign development by assessing whether anti-smoking advertisement characteristics are coded differently by smokers and 'experts' (individuals with knowledge of health promotion, public health or advertising). METHODS: A total of 49 smokers and 42 experts coded anti-smoking advertisements according to four key characteristics (emotional/cognitive approach, negative/positive tone, message frame, and main message) and the use of eight executional techniques. Chi-squared tests were used to measure differences in coding outcomes between smokers and experts. RESULTS: There were significant differences between smokers and experts in the coding of all key characteristics and four of the eight executional techniques. Compared with smokers, experts were more likely to perceive advertisements as negative in tone and as inducing fear. CONCLUSIONS: Smokers and experts perceived the characteristics of anti-smoking advertisements differently. Implications for public health: Differences between smokers and experts may need to be taken into account where studies use either of these groups to code advertisements for campaign development or evaluation purposes.


Assuntos
/estatística & dados numéricos , Promoção da Saúde/métodos , Fumantes/psicologia , Prevenção do Hábito de Fumar , Fumar/psicologia , Televisão/estatística & dados numéricos , Adolescente , Feminino , Humanos , Masculino , Saúde Pública , Abandono do Hábito de Fumar/métodos
9.
BMC Health Serv Res ; 19(1): 750, 2019 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-31653215

RESUMO

BACKGROUND: Although healthcare providers are well placed to help smokers quit, implementation of smoking cessation care is still suboptimal. The Ask-Advise-Refer tasks are important aspects of smoking cessation care. We examined to which extent a large and diverse sample of healthcare providers expressed the intention to implement smoking cessation care and which barriers they encountered. We moreover examined to which extent the Ask-Advise-Refer tasks were implemented as intended, and which determinants (in interaction) influenced intentions and the implementation of Ask-Advise-Refer. METHODS: Cross-sectional survey among addiction specialists, anaesthesiologists, cardiologists, general practitioners, internists, neurologists, paediatricians, pulmonologists, ophthalmologists, surgeons, youth specialists, dental hygienists, dentists, and midwives (N = 883). Data were analysed using multivariate linear and logistic regression analyses and regression tree analyses. RESULTS: The Ask-Advice-Refer tasks were best implemented among general practitioners, pulmonologists, midwives, and addiction specialists. Overall we found a large discrepancy between asking patients about smoking status and advising smokers to quit. Participants mentioned lack of time, lack of training, lack of motivation to quit in patients, and smoking being a sensitive subject as barriers to smoking cessation care. Regression analyses showed that the most important determinants of intentions and implementation of Ask-Advise-Refer were profession, role identity, skills, guideline familiarity and collaboration agreements for smoking cessation care with primary care. Determinants interacted in explaining outcomes. CONCLUSIONS: There is much to be gained in smoking cessation care, given that implementation of Ask-Advise-Refer is still relatively low. In order to improve smoking cessation care, changes are needed at the level of the healthcare provider (i.e., facilitate role identity and skills) and the organization (i.e., facilitate collaboration agreements and guideline familiarity). Change efforts should be directed towards the specific barriers encountered by healthcare providers, the contexts that they work in, and the patients that they work with.


Assuntos
Pessoal de Saúde/psicologia , Relações Profissional-Paciente , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Estudos Transversais , Feminino , Fidelidade a Diretrizes , Pesquisas sobre Serviços de Saúde , Pessoal de Saúde/estatística & dados numéricos , Humanos , Intenção , Masculino , Países Baixos , Guias de Prática Clínica como Assunto , Gravidez , Fumantes/estatística & dados numéricos
10.
Artigo em Inglês | MEDLINE | ID: mdl-31547229

RESUMO

There were high smoking rates among young male college students in Korea. We aimed to investigate the prevalence of and factors affecting abstinence from smoking following smoking cessation service attendance in this population. Data were collected between 1 August 2015 and 20 August 2018. Participants were administered more than nine face-to-face and telephone counseling sessions by trained tobacco cessation specialists for six months. Follow-up assessments were conducted at 4, 6, and 12 weeks, and 6 months after the quit date. A total of 3978 male college student smokers were enrolled; their mean age was 23.17 (±3.45) years. Almost one-third of the participants (64.9%) reported that they had attempted to quit during the past year. The number of cigarettes smoked per day, CO ppm, and Fagerström Test of Nicotine Dependence score at the baseline were negatively associated with abstinence, while motivational variables-importance, confidence, and readiness-were positively associated with abstinence. Our results suggest that provision of visiting smoking cessation services can be an active intervention platform for college student smokers who need professional assistance or support. Active and accessible support should be provided to such people. Visiting a smoking cessation service may result in increased long-term abstinence rates in such students.


Assuntos
Fumantes/psicologia , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/psicologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Fumar Tabaco/psicologia , Tabagismo/psicologia , Adulto , Humanos , Masculino , República da Coreia , Estudos Retrospectivos , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-31547255

RESUMO

Smoking cessation remains a health promotion target. Applying the Transtheoretical Model to Australian Burden of Obstructive Lung Diseases (BOLD) data, we examined differences in stages of change (SoC) and readiness to quit decisional behaviours. Factors were identified likely to influence readiness of smokers, ≥40 years old, to quit. Analysis was restricted to current smokers classified to one of three stages: pre-contemplation (PC), contemplation (C) or preparation (P) to quit. Their ability to balance positive and negative consequences was measured using decisional balance. Among 314 smokers, 43.0% females and 60.8% overweight/obese, the distribution of SoC was: 38.1% PC, 38.3% C and 23.5% P. Overweight/obesity was associated with readiness to quit in stages C and P and there were more negative than positive attitudes towards smoking in those stages. Males were significantly heavier smokers in PC and C stages. Females used smoking cessation medication more frequently in PC stage, were more embarrassed about smoking and had greater negative reinforcements from smoking. Age started smoking and factors related to smoking history were associated with readiness to quit and increased the odds of being in stage C or P. An overweight/obese smoker was likely to be contemplating or preparing to quit. In these stages, smokers have more negative attitudes toward smoking. Starting smoking later, taking advice on cessation from health providers and using quit medications indicate increased readiness to quit. Evaluating these factors in smokers and developing cessation gain-framed messages may prove useful to healthcare providers.


Assuntos
Comportamentos Relacionados com a Saúde , Pneumopatias Obstrutivas/induzido quimicamente , Motivação , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Fumar Tabaco/efeitos adversos , Fumar Tabaco/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos
12.
Artigo em Inglês | MEDLINE | ID: mdl-31547374

RESUMO

Cigarette pack graphic warning labels (GWLs) are associated with increased knowledge of tobacco-related harms; scant research has evaluated their effects on behavior among vulnerable populations. We used a behavioral economic approach to measure the effects of GWLs and price on hypothetical cigarette purchasing behavior among HIV-positive smokers. Participants (n = 222) completed a cigarette valuation task by making hypothetical choices between GWL cigarette packs at a fixed price ($7.00) and text-only warning label cigarette packs at increasing prices ($3.50 to $14.00; $0.25 increments). More than one-quarter (28.8%) of participants paid more to avoid GWLs. The remaining participants' purchasing decisions appear to have been driven by price: 69.8% of participants chose the cheaper pack. Across all participants, overall monetary choice value observed for GWL cigarette packs (mean = $7.75) was greater than if choice was driven exclusively by price ($7.00). Most (87.4%) preferred the text-only warning label when GWL and text-only cigarette packs were equally priced. Correlation analysis indicated GWL pack preference was associated with agreement with statements that GWLs would stop individuals from having a cigarette or facilitate thoughts about quitting. These data suggest that GWLs may influence some HIV-positive smokers in such a way that they are willing to pay more to avoid seeing GWLs.


Assuntos
Infecções por HIV/psicologia , Rotulagem de Produtos/estatística & dados numéricos , Fumantes/psicologia , Produtos do Tabaco/economia , Populações Vulneráveis/estatística & dados numéricos , Adulto , Comportamento do Consumidor/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Mensagem de Texto/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Estados Unidos , Populações Vulneráveis/psicologia , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-31547517

RESUMO

This research examined the influence of natural cigarette advertising on tobacco control policy support, and the potential for misbeliefs arising from exposure to cigarette marketing to affect such support. Ample research indicates that natural cigarettes such as Natural American Spirit (NAS) are widely and erroneously perceived as safer than their traditional counterparts because of their marketed "natural" composition. Yet regulatory action regarding natural cigarette marketing has been limited in scope, and little research has examined whether misleading product advertising affects support for related policy, an important component of the policy process. Here, we administered a large-scale randomized experiment (n = 1128), assigning current and former smokers in the United States to an NAS advertising condition or a control group and assessing their support for tobacco industry regulation. Results show that exposure to NAS advertising reduces support for policies to ban potentially misleading terminology from cigarette advertising, and these effects are stronger for daily smokers. Further, misinformed beliefs about the healthy composition of NAS partially mediate effects on policy support. Yet interestingly, exposure to NAS marketing does not reduce support for policies to establish standards for when certain terms are permissible in cigarette advertising. The results of this analysis indicate potential spillover effects from exposure to NAS advertising in the realm of support for regulatory action pertaining to tobacco industry marketing.


Assuntos
/legislação & jurisprudência , Regulamentação Governamental , Fumantes/psicologia , Indústria do Tabaco/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Adulto , Comunicação , Feminino , Política de Saúde , Humanos , Masculino , Estados Unidos
14.
BMC Res Notes ; 12(1): 473, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31370907

RESUMO

OBJECTIVE: Current literature suggests there may be a relationship between sex hormones, which dramatically increase during pregnancy, and nicotine use behaviors. We hypothesized that higher progesterone and progesterone:estradiol ratio (P/E2) would be associated with less smoking-related symptomatology (SRS), better mood and fewer cigarettes smoked per day (CPD) during ad libitum smoking and following overnight abstinence in pregnant women. Associations between SRS, mood, smoking behavior and sex hormones were estimated using multiple linear regression with adjustment for CPD and pregnancy trimester. RESULTS: There were 35 second trimester and 42 third trimester participants. Participants mean age was 26.2 (SD: 4.1), they smoked 11.3 CPD (SD: 4.4) and the mean nicotine dependence score was 4.94 (SD: 1.98). There were no statistically significant associations between progesterone levels, estradiol levels, or the P/E2 ratio and SRS or mood measures during ad libitum smoking or following overnight abstinence in this sample of pregnant women. Similarly, there were no associations between sex hormone levels and number of CPD smoked during the ad libitum period. Contrary to our hypothesis, we found no significant associations between sex hormones and SRS, mood or smoking behavior in this sample of pregnant women. Trial registration ClinicalTrials.gov (NCT01811225), December 6, 2012.


Assuntos
Fumantes/psicologia , Fumar/psicologia , Tabagismo/psicologia , Adulto , Afeto/fisiologia , Estudos Transversais , Estradiol/sangue , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Modelos Lineares , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Progesterona/sangue , Fumar/sangue , Tabagismo/sangue
15.
Artigo em Inglês | MEDLINE | ID: mdl-31398854

RESUMO

The current study investigated whether quit success among employees who participated in a smoking cessation intervention at the workplace was associated with social support from, and the smoking behavior of, people in their environment. Tobacco-smoking employees (n = 604) from 61 companies participated in a workplace group smoking cessation program. Participants completed questionnaires assessing social support from, and the smoking behavior of, people in their social environment. They were also tested for biochemically validated continuous abstinence directly after finishing the training and after 12 months. The data were analyzed using mixed-effects logistic regression analyses. Social support from colleagues was positively associated with 12-month quit success (odds ratio (OR) = 1.85, 95% confidence interval (CI) = 1.14-3.00, p = 0.013). Support from a partner was positively associated with short-term quit success (OR = 2.01, 95% CI = 1.23-3.30, p = 0.006). Having a higher proportion of smokers in the social environment was negatively associated with long-term abstinence (OR = 0.81, 95% CI = 0.71-0.92, p = 0.002). Compared to having a non-smoking partner, long-term quit success was negatively associated with having no partner (OR = 0.48, 95% CI = 0.26-0.88, p < 0.019), with having a partner who smokes (OR = 0.40, 95% CI = 0.24-0.66, p < 0.001), and with having a partner who used to smoke (OR = 0.47, 95% CI = 0.26-0.86, p = 0.014). In conclusion, people in a smoker's social environment, particularly colleagues, were strongly associated with quit success. The workplace may, therefore, be a favorable setting for smoking cessation interventions.


Assuntos
Terapia Comportamental/métodos , Infuência dos Pares , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Meio Social , Apoio Social , Local de Trabalho/psicologia , Adulto , Terapia Comportamental/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fumantes/estatística & dados numéricos , Abandono do Hábito de Fumar/estatística & dados numéricos , Inquéritos e Questionários , Local de Trabalho/estatística & dados numéricos
16.
BMC Public Health ; 19(1): 1083, 2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31399047

RESUMO

BACKGROUND: The recent development of smoking cessation interventions for smokers with chronic diseases has focused heavily on brief interventions. However, these interventions are too brief to make an impact on these smokers, especially when most of them are without any intention to quit. Previous studies showed that smokers who did not want to quit might be interested in changing other health behaviours. Also, once people engage in a health behaviour, they are found more likely to change other unhealthy habits. Hence, a general health promotion approach could be a feasible approach to motivate smokers who do not want to quit to first engage in any desirable health behaviour, and later quit smoking when they intend to do so. This study aims to determine the potential efficacy and effect size of such intervention approach in promoting smoking cessation for smokers with chronic diseases. METHODS: This is a randomized controlled trial. A convenience sample of 60 smokers with chronic diseases will be randomly assigned into either experimental (n = 30) or control group (n = 30). Smokers in the experimental group will receive an individual face-to-face brief motivational interviewing (MI) with generic advice on selected health behaviour. More brief MI messages will be delivered to them via WhatsApp/WeChat for 6 months. For subject in the control group, they will be asked to indicate their desirable health-related practice. However, no MI and booster interventions will be given. All subjects will complete a questionnaire at 1, 3, 6 and 12 months. Subjects abstinent from cigarettes at 12 months will perform a biochemical validation. The primary outcome is biochemically validated smoking abstinence at 12 months. Effect size of the intervention will be estimated by the odd ratios using intention-to-treat. DISCUSSION: This is the first study to determine the potential efficacy for the use of a personalized general health promotion approach in promoting smoking cessation for smokers with chronic diseases. If our proposed intervention is effective, we will able to assist smokers with chronic disease to quit smoking and change their health behaviour simultaneously. TRIAL REGISTRATION: CinicalTrials.gov NCT03983330 (Prospectively registered), registered on June 12, 2019.


Assuntos
Doença Crônica/epidemiologia , Comunicação , Tecnologia da Informação , Aplicativos Móveis , Entrevista Motivacional/métodos , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Adulto , Feminino , Humanos , Masculino , Projetos de Pesquisa , Fumantes/estatística & dados numéricos
17.
Artigo em Inglês | MEDLINE | ID: mdl-31416256

RESUMO

This study examined to what extent e-cigarette users noticed the European Union's new legislation regarding e-cigarettes, and whether this may have influenced perceptions regarding addictiveness and toxicity. Data were obtained from yearly surveys (2015-2017) of the International Tobacco Control (ITC) Netherlands Survey. Descriptive statistics and Generalized Estimating Equations were applied. About a third of the e-cigarette users noticed the text warning (28%) and the leaflet (32%). When compared to tobacco-only smokers, e-cigarette users showed greater increases in perceptions regarding addictiveness (ß = 0.457, p = 0.045 vs. ß = 0.135, p < 0.001) and toxicity (ß = 0.246, p = 0.055 vs. ß = 0.071, p = 0.010). In conclusion, the new legislation's noticeability should be increased.


Assuntos
Comportamento Aditivo/psicologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Rotulagem de Produtos/legislação & jurisprudência , Fumantes/psicologia , Abandono do Hábito de Fumar/legislação & jurisprudência , Fumar/legislação & jurisprudência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , União Europeia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos , Medição de Risco , Inquéritos e Questionários , Adulto Jovem
19.
Artigo em Inglês | MEDLINE | ID: mdl-31434229

RESUMO

The United States (U.S.) Food and Drug Administration has expressed concern about flavored e-cigarettes (e.g., JUUL brand) because they are appealing to youth who may be unaware that the product is addictive. The Population Assessment of Tobacco and Health Study Wave 3 provided data on flavor categories, type of e-cigarette product, and smoking status among past 30-day youth and adult e-cigarette users in the US. Most past 30-day youth and adult users reported using only one flavor category, with fruit (53% youth, 31% adult) being the most commonly reported category. Adults were far more likely to report using tobacco flavor alone, compared to any other individual flavor category or flavor category combinations (OR: 21.08, 95%CI: 5.92, 75.12). Whereas, youth were more likely to report using multiple flavor categories (OR: 2.03, 95%CI: 1.55, 2.65), with the most reported pairing being fruit and candy (36%). The variety of flavors on the market appeals to consumers of all ages. Although most past 30-day e-cigarette users reported only one flavor category, non-tobacco flavors were far more common among youth. Differences in flavor preferences among adult versus youth vapers may have implications for the role of flavors in both the initiation of youth vaping and adult vaping for smoking cessation.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Aromatizantes , Fumantes/estatística & dados numéricos , Vaping/epidemiologia , Adolescente , Adulto , Fatores Etários , Comportamento Aditivo , Criança , Feminino , Humanos , Masculino , Fumantes/psicologia , Paladar , Estados Unidos/epidemiologia , Adulto Jovem
20.
Artigo em Inglês | MEDLINE | ID: mdl-31450707

RESUMO

Stress is robustly associated with tobacco smoking and relapse. African Americans experience greater difficulty quitting compared to whites, yet no studies have examined race differences in physiological stress biomarkers during a quit attempt. This pilot study compared cortisol levels among treatment-seeking African American and white smokers, and relapse rates. Adult smokers (N = 115; n = 72 African American, n = 43 White) received eight sessions of group cognitive behavioral therapy plus transdermal nicotine patches. Assessments included demographics, salivary cortisol (collected at session 1, the end-of-therapy [EOT], and one-month post-therapy), and carbon monoxide-verified smoking relapse. Overall, cortisol levels declined over the course of the day at baseline, the EOT, and the one-month follow-up. African Americans exhibited lower cortisol levels compared to Whites at baseline and the EOT, but not at the one-month follow-up. In addition, African American smokers exhibited flatter slopes compared to Whites at each time point. Relapse rates were greater among African Americans at the EOT and one-month follow-up. The attenuated cortisol pattern observed in African Americans may indicate hypothalamic-pituitary-adrenal axis (HPA) exhaustion and aid our understanding of tobacco-related disparities. There is a need to focus on stress mechanisms and specific intervention approaches in order to eliminate racial/ethnic differences.


Assuntos
Fumantes/psicologia , Abandono do Hábito de Fumar , Estresse Fisiológico , Fumar Tabaco , Tabagismo , Adulto , Terapia Cognitivo-Comportamental , Grupos de Populações Continentais , Grupos Étnicos , Feminino , Humanos , Hidrocortisona/sangue , Masculino , Pessoa de Meia-Idade , Recidiva , Abandono do Hábito de Fumar/etnologia , Abandono do Hábito de Fumar/psicologia , Fumar Tabaco/sangue , Fumar Tabaco/etnologia , Fumar Tabaco/psicologia , Fumar Tabaco/terapia , Dispositivos para o Abandono do Uso de Tabaco , Tabagismo/sangue , Tabagismo/etnologia , Tabagismo/psicologia , Tabagismo/terapia
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