Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 405
Filtrar
1.
PLoS One ; 17(1): e0263306, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35085368

RESUMO

Smoking self-efficacy, described as confidence in one's ability to abstain from smoking in high-risk situations is a key predictor in cessation outcomes; however, there is a dearth of research on factors that influence self-efficacy surrounding smoking behavior. This study examines factors associated with baseline self-efficacy among treatment seeking participants enrolled in a pilot feasibility smoking cessation study. Participants (n = 247) were daily male smokers, residents of Doha in Qatar (18-60 years) who were enrolled in a telephone-based smoking cessation study. Baseline assessments included self-efficacy, home smoking rules, socio-demographic variables, smoking history, and psychosocial characteristics. Factors associated with self-efficacy were assessed using multiple linear regression analysis. Results showed that after controlling for relevant variables, number of cigarettes smoked ([Formula: see text] = -0.22; 95% CI: -0.37, -0.06), having at least one quit attempt in the past year ([Formula: see text] = 2.30; 95% CI: 0.27, 4.35), and reporting a complete home smoking ban ([Formula: see text] = 3.13; 95% CI: 0.56, 5.70) were significantly associated with higher self-efficacy to quit smoking. These results provide data-driven indication of several key variables that can be targeted to increase smoking self-efficacy in this understudied population.


Assuntos
Fumar Cigarros/epidemiologia , Fumar Cigarros/psicologia , Autoeficácia , Fumantes/psicologia , Abandono do Hábito de Fumar/psicologia , Adolescente , Adulto , Estudos de Viabilidade , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Projetos Piloto , Catar/epidemiologia , Autorrelato , Política Antifumo , Abandono do Hábito de Fumar/métodos , Adulto Jovem
2.
Subst Use Misuse ; 57(2): 193-201, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34753379

RESUMO

BACKGROUND: In November 2016, California voters passed the Adult Use of Marijuana Act making recreational cannabis sales legal to adults aged 21and older starting January 1st, 2018. This study aims to understand the relationship of cannabis use and cigarette smoking with serious psychological distress (SPD) in California in light of the legalization of recreational cannabis sales. METHODS: This cross-sectional study included 42,313 adult participants from the 2017 to 2018 California Health Interview Surveys. We used the Kessler-6 (K6) scale to measure psychological distress in the past 30 days. Multiple logistic regression models were used to examine the association between cannabis/cigarette use and SPD. RESULTS: Cannabis use was positively associated with SPD (AOR = 2.48, 95% CI = 1.57, 3.91), but this association was not significantly different before and after recreational cannabis sales legalization in California (AOR = 0.82, 95% CI = 0.72, 2.05). Cigarette smoking was also positively associated with SPD (AOR = 2.76, 95% CI = 2.05, 3.71). Compared to those who used neither cannabis nor cigarettes, sole cannabis users (AOR = 2.51, 95% CI = 1.75, 3.60), sole cigarette smokers (AOR = 3.23, 95% CI = 2.28, 4.60), and dual users of cannabis and cigarettes (AOR = 5.65, 95% CI = 4.04, 7.89) were more likely to report SPD. Dual users were also more likely to report SPD than sole cannabis users (AOR = 2.25; 95% CI = 1.48, 3.43) and sole cigarette smokers (AOR = 1.75; 95% CI = 1.18, 2.59). CONCLUSIONS: These findings provide evidence for the need to develop effective cessation intervention strategies targeting individuals with SPD to reduce their cannabis use and dual-use of cannabis and cigarettes.


Assuntos
Cannabis , Fumar Cigarros , Fumar Maconha , Angústia Psicológica , Adulto , California/epidemiologia , Fumar Cigarros/epidemiologia , Fumar Cigarros/prevenção & controle , Fumar Cigarros/psicologia , Estudos Transversais , Sistemas Eletrônicos de Liberação de Nicotina , Humanos , Fumar Maconha/epidemiologia , Fumar Maconha/prevenção & controle , Fumar Maconha/psicologia
3.
PLoS One ; 16(11): e0259949, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34780558

RESUMO

BACKGROUND: Improving adherence to self-protective behaviours is a public health priority. We aimed to assess the potential effectiveness and ease of use of an online version of the Risk Acceptance Ladder (RAL) in promoting help-seeking for cigarette smoking, excessive alcohol consumption, insufficient physical activity, or low fruit and vegetable consumption. METHODS: 843 UK adults were recruited, of whom 602 engaged in at least one risky behaviour. Those with no immediate plans to change (n = 171) completed a behaviour specific RAL. Participants were randomised to one of two conditions; a short message congruent (on-target, n = 73) or incongruent (off-target, n = 98) with their RAL response. Performance of the RAL was assessed by participants' ability to select an applicable RAL item and reported ease of use of the RAL. Effectiveness was assessed by whether or not participants clicked a link to receive information about changing their target behaviour. RESULTS: Two thirds (68.9%, 95% CI = 61.8%-75.3%) of participants were able to select an applicable RAL item that corresponded to what they believed would need to change in order to alter their target behaviour, with 64.9% (95% CI = 57.5%-71.7%) reporting that it was easy to select one option. Compared with the off-target group, participants allocated to the on-target group had greater odds of clicking on the link to receive information (31.5% vs 19.4%; OR = 2.07, 95% CI = 1.01-4.26). CONCLUSION: The Risk Acceptance Ladder may have utility as a tool for tailoring messages to prompt initial steps to engaging in self-protective behaviours.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Fumar Cigarros/psicologia , Exercício Físico/psicologia , Comunicação em Saúde/métodos , Adulto , Feminino , Promoção da Saúde , Comportamentos de Risco à Saúde , Comportamento de Busca de Ajuda , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Projetos Piloto , Reino Unido , Adulto Jovem
4.
Asian Pac J Cancer Prev ; 22(S2): 35-44, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34780136

RESUMO

BACKGROUND: Tobacco Control Act of 2010 mandates government to implement at least 75% pictorial health warnings (PHWs) on tobacco packaging that was enforced in 2013. The purpose of the study was to assess the effectiveness of PHWs and its impact to the policy change. METHODS: A cross-sectional study was conducted in 9 cities between September 2014 and March 2015. Direct interviews were made among 2250 randomly selected individuals. The effectiveness of PHWs were measured as perceived: i) scariness; ii) quit motivation iii) convincing youth not to start smoking; iv) encouraging ex-smokers to remain as quitters; v) building public awareness. Logistic regression analysis was used to determine the factors associated with the effectiveness of PHWs. RESULTS: Of the 2250 participants, 29.8% (670) were current smokers, 8.6% (193) were ex-smokers and 97.6% believed that smoking was addictive. PHWs made 83% of the participants scared. Participants believed that PHWs would be effective in motivating smokers to quit (80.2%), in convincing youth not to start smoking (86.8%), in encouraging ex-smokers to remain as quitters (89.1%) and in building public awareness on the dangers of smoking (94%). PHWs made 58% of the current smokers intended to quit smoking and reduced their daily intake of cigarettes from 11 to 5 on average.  Current smokers preferred to purchase loose cigarettes rather than a pack. The covariates significantly associated with the effectiveness of PHWs were current smokers, ex-smokers and addiction. CONCLUSION: PHWs were found important to motivate smokers to quit smoking, to reduce consumption of cigarettes and to prevent relapse in ex-smokers. Evidence from the study had triggered policy changes which included enlargement of the size of PHW to 90% and the release of a notification to ban selling of loose cigarettes. Thus, the warning messages with pictures are required to be improved and rotated.


Assuntos
Fumar Cigarros/prevenção & controle , Política de Saúde , Promoção da Saúde/métodos , Rotulagem de Produtos/métodos , Produtos do Tabaco/legislação & jurisprudência , Adolescente , Adulto , Fumar Cigarros/psicologia , Estudos Transversais , Medo , Feminino , Promoção da Saúde/legislação & jurisprudência , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Motivação , Nepal , Rotulagem de Produtos/legislação & jurisprudência , Abandono do Hábito de Fumar/legislação & jurisprudência , Abandono do Hábito de Fumar/psicologia , Adulto Jovem
5.
Nutrients ; 13(10)2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34684357

RESUMO

OBJECTIVE: To investigate the impact of the COVID-19 pandemic on multiple lifestyle changes among adults in the United States (USA). METHODS: We conducted a survey, the Health, Ethnicity, and Pandemic (HEAP) Study, in October 2020 among USA adults. Participants were selected from the United States using 48 sampling strata, including age, race, ethnicity, education, and gender, and were asked to report five lifestyle behaviors (i.e., exercise time, screen time, fast-food meal consumption, alcohol drinking, and cigarette smoking) before and during the COVID-19 pandemic. The associations of sociodemographic factors with each lifestyle change were estimated using weighted multivariable logistic regression models. RESULTS: All 2709 HEAP participants were included in this study. Compared to pre-pandemic, the time spent on exercise decreased (32.06 vs. 38.65 min/day; p < 0.001) and screen time increased (6.79 vs. 5.06 h/day; p < 0.001) during the pandemic. The percentage of individuals who reported consuming fast-food meals ≥3 times/week decreased from 37.7% before the pandemic to 33.3% during the pandemic. The percentage of heavy drinkers (≥5 times/week) increased from 20.9% before the pandemic to 25.7% during the pandemic. Among smokers, heavy smoking (≥11 cigarettes/day) increased from 5.8% before the pandemic to 7.9% during the pandemic. We also identified subgroups who were more vulnerable to adverse influences from the pandemic, including racial/ethnic minority groups and young adults. CONCLUSIONS: The COVID-19 pandemic had negative impacts on multiple lifestyle behaviors among Americans. Mitigating such negative impacts of COVID-19 requires effective interventions, particularly for some vulnerable subgroups.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , COVID-19/psicologia , Fumar Cigarros/epidemiologia , Exercício Físico/psicologia , Fast Foods/estatística & dados numéricos , Tempo de Tela , Adolescente , Adulto , Fatores Etários , Consumo de Bebidas Alcoólicas/psicologia , Fumar Cigarros/psicologia , Estudos Transversais , /estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , /estatística & dados numéricos , SARS-CoV-2 , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Adulto Jovem
6.
Pediatrics ; 148(5)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635583

RESUMO

OBJECTIVES: In this study, we sought to identify which adolescents progress to regular electronic cigarette (e-cigarette) use (without cigarette smoking), which adolescents become dual users of both types of cigarettes, and how dual use develops across time. METHODS: Adolescents (N = 1808) from public high schools outside Philadelphia, Pennsylvania, completed in-classroom surveys at wave 1 (fall 2016, beginning of ninth grade) and at 6-month intervals for the following 36 months (fall 2019, beginning of 12th grade). RESULTS: A sequential processes growth mixture model identified 4 conjoint latent classes: later, rapid e-cigarette uptake (class 1: n = 230); no use of e-cigarettes or combustible cigarettes (class 2: n = 1141); earlier, steady e-cigarette uptake (class 3: n = 265); and dual use of e-cigarettes and combustible cigarettes (class 4: n = 204). Using a rich set of potential risk factors, multinomial logistic regression assessed the likelihood of belonging to each conjoint class compared with the comparison class (dual use). Adolescents in the dual use class were characterized by a greater number and severity of e-cigarette and combustible cigarette risk factors. Adolescents in the 2 e-cigarettes-only classes were characterized by either e-cigarette-specific risk factors (earlier onset) or no risk factors (later onset). The no use class had an absence of risk factors for e-cigarette and cigarette use. CONCLUSIONS: This study provides new prospective evidence for distinct patterns and profiles of adolescents who progress to current e-cigarette use, including adolescents who were initially cigarette smokers. The findings have implications for prevention intervention timing, tobacco product focus, content, and the adolescent subgroups to target.


Assuntos
Fumar Cigarros/epidemiologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Adolescente , Fumar Cigarros/psicologia , Métodos Epidemiológicos , Feminino , Humanos , Masculino , Philadelphia , Instituições Acadêmicas , Fatores Sexuais , Inquéritos e Questionários
7.
JAMA Netw Open ; 4(10): e2128810, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34665239

RESUMO

Importance: Although e-cigarettes are not approved as a cessation device, many who smoke believe that e-cigarettes will help them quit cigarette smoking successfully. Objective: To assess whether people who recently quit smoking and who had switched to e-cigarettes or another tobacco product were less likely to relapse to cigarette smoking compared with those who remained tobacco free. Design, Setting, and Participants: This cohort study analyzed a nationally representative sample of US households that participated in 4 waves of the Population Assessment of Tobacco and Health Study (conducted 2013 through 2017), combining 2 independent cohorts each with 3 annual surveys. Eligible participants were individuals who smoked at baseline, had recently quit at the first follow-up, and completed the second follow-up survey. Exposures: Use of e-cigarettes or alternate tobacco products at follow-up 1 after recently quitting smoking. Main Outcomes and Measures: Weighted percentage of participants with over 12 months abstinence by follow-up 2. Results: Of a total of 13 604 participants who smoked cigarettes at baseline, 9.4% (95% CI, 8.7%-10.0%) recently had quit smoking (mean age, 41.9; 95% CI, 39.7-46.6 years; 641 [43.2%] women) Of these, 22.8% (95% CI, 19.7%-26.0%) had switched to e-cigarettes, with 17.6% (95% CI, 14.8%-20.5%) using them daily. A total of 37.1% (95% CI, 33.7%-40.4%) used a noncigarette tobacco product and 62.9% (95% CI, 59.6%-66.3%) were tobacco free. Rates of switching to e-cigarettes were highest for those who were in the top tertile of tobacco dependence (31.3%; 95% CI, 25.0%-37.7%), were non-Hispanic White (26.4%; 95% CI, 22.3%-30.4%), and had higher incomes (annual income ≥$35 000, 27.5%; 95% CI, 22.5%-32.4% vs <$35 000, 19.3%; 95% CI, 16.3%-22.3%). At follow-up 2, unadjusted relapse rates were similar among those who switched to different tobacco products (for any tobacco product: successfully quit, 41.5%; 95% CI, 36.2%-46.9%; relapsed with significant requit, 17.0%; 95% CI, 12.4%-21.6%; currently smoking, 36.2%; 95% CI, 30.9%-41.4%). Controlled for potential confounders, switching to any tobacco product was associated with higher relapse rate than being tobacco free (adjusted risk difference, 8.5%; 95% CI, 0.3%-16.6%). Estimates for those who switched to e-cigarettes, whether daily or not, were not significant. While individuals who switched from cigarettes to e-cigarettes were more likely to relapse, they appeared more likely to requit and be abstinent for 3 months at follow-up 2 (17.0%; 95% CI, 12.4%-21.6% vs 10.4%; 95% CI, 8.0%-12.9%). Conclusions and Relevance: This large US nationally representative study does not support the hypothesis that switching to e-cigarettes will prevent relapse to cigarette smoking.


Assuntos
Fumar Cigarros/psicologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Recidiva , Abandono do Hábito de Fumar/métodos , Fumar Cigarros/epidemiologia , Fumar Cigarros/prevenção & controle , Estudos de Coortes , Sistemas Eletrônicos de Liberação de Nicotina/normas , Feminino , Humanos , Incidência , Estudos Longitudinais , Masculino , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Uso de Tabaco/epidemiologia , Uso de Tabaco/prevenção & controle , Uso de Tabaco/psicologia , Dispositivos para o Abandono do Uso de Tabaco/normas , Dispositivos para o Abandono do Uso de Tabaco/estatística & dados numéricos
8.
PLoS One ; 16(9): e0256829, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34473786

RESUMO

Tobacco smoking might be impacted by various influences, including psychological, socio-cultural, and economic factors. A community-based cross-sectional survey was conducted in Syrian Arab Republic from March to April 2019 using a web-based questionnaire. The survey aimed at assessing tobacco use (shisha and cigarettes) as well as examining the association between current tobacco use and various sociodemographic and war-related factors. The sample comprised 978 participants (251 males: 727 females) and had a mean age of 24.7 years (SD: 7.60). Most participants were single (n = 825, 84.4%), reside in Damascus and Rif-Dimashq (n = 579, 59.2%), and had a college/university education (n = 911, 93.1%). Concerning smoking, a total of 371 participants (37.9%) were identified to be current tobacco smokers, of whom 211, 84, 76 were exclusive shisha smokers, exclusive cigarette smokers, and dual smokers, respectively. The prevalence of cigarette smoking (exclusive and dual) among males and females was found to be 34.7%, and 10.0%, respectively. On the other hand, the prevalence of shisha smoking (exclusive and dual) among males and females was around 34.3% and 27.6%, respectively. Additionally, various factors have predicted a higher likelihood of cigarette smoking including male gender (AOR = 4.152; 95% CI: 2.842-6.064; p<0.001), and losing someone due to the war (AOR = 1.487; 95% CI: 1.028-2.151; p = 0.035), while unemployed individuals were found to have lower odds of being cigarette smokers (AOR = 0.634; 95% CI: 0.429-0.937; p = 0.022). Concerning shisha smoking, married (AOR = 0.622; 95% CI: 0.402-0.963; p = 0.033), and unemployed individuals (AOR = 0.679; 95% CI: 0.503-0.916; p = 0.011) were found to have lower odds of shisha smoking. Amid the tobacco epidemic in the region, rates of tobacco use in Syria are still worrying. The Syrian armed conflicts may possess a double-edged effect on smoking, and tobacco users who adopt smoking to cope with various stressors should be targeted with well-structured health education, along with appropriate psychological services.


Assuntos
Conflitos Armados/psicologia , Fumar Cigarros/epidemiologia , Fumar Cigarros/psicologia , Fumantes/psicologia , Cachimbos de Água , Estresse Psicológico , Tabaco para Cachimbos de Água , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários , Síria/epidemiologia , Adulto Jovem
9.
Neuropharmacology ; 198: 108756, 2021 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-34416269

RESUMO

Women have more difficulty maintaining smoking cessation than men, and experience greater withdrawal symptomatology as well as higher prevalence of relapse. Further, currently available treatments for smoking cessation, such as the nicotine patch and varenicline, have been shown to be less effective in women. Fluctuations in ovarian hormones across the menstrual cycle can affect craving and smoking relapse propensity. In addition, many women who smoke use some form of oral contraceptives, which most often contain ethinyl estradiol (EE), a synthetic, orally bio-available estrogen that is currently prescribed to women chronically and has been shown to alter smoking reward in women. The current study examined the impact of 17ß-estradiol (E2), the prominent endogenous form of the steroid hormone estrogen, as well as EE, on nicotine self-administration, demand, and reinstatement following ovariectomy (OVX) or sham surgery. OVX vehicle-treated female rats consumed less nicotine, had lower intensity of demand, and reinstated less compared to sham vehicle-treated female rats. OVX-E2 and OVX-EE treatment groups showed a rebound of nicotine intake later in training, and Q0 levels of consumption were partially rescued in both groups. Further, E2 but not EE reversed the abolishment of reinstated nicotine seeking induced by OVX. Taken together, these results demonstrate that natural and synthetic estrogens play a critical role in mediating the neurobehavioral effects of nicotine, and future studies are essential for our understanding of how synthetic hormones contained within oral contraceptives interact with smoking.


Assuntos
Comportamento de Procura de Droga/efeitos dos fármacos , Congêneres do Estradiol/farmacologia , Estradiol/farmacologia , Estrogênios/farmacologia , Tabagismo/psicologia , Animais , Fumar Cigarros/psicologia , Sinais (Psicologia) , Etinilestradiol/farmacologia , Feminino , Ovariectomia , Ratos , Ratos Long-Evans , Recidiva , Recompensa , Autoadministração
11.
PLoS One ; 16(6): e0253061, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34129631

RESUMO

AIMS: Electronic Nicotine Delivery System (ENDS) use is increasing among US adults. While existing research has demonstrated higher cigarette smoking rates among people with mental health conditions, there is sparse information on the association between ENDS use and mental health such as internalizing and externalizing problems. The aim of this study was to evaluate associations between internalizing and externalizing problems for cigarette only, ENDS only, and dual users, as well as changes in mental health among those groups. METHOD: We used the U.S. Population Assessment of Tobacco and Health (PATH) Study Wave 3 adult data. Internalizing and externalizing problems were self-reported and assessed via the Global Appraisal of Individual Needs-Short Screener; response options were dichotomized to reflect past 12 months and any lifetime problems. Self-reported changes in mental health over the past 12 months were also assessed. Participants' tobacco use status was categorized as ENDS only use (n = 618), cigarette only use (n = 6,779), dual use (cigarettes and ENDS) (n = 681), and non-current use (n = 16,515). RESULTS: Lifetime and past 12 month internalizing problems were reported by 63.8% (n = 18,706) and 50.4% (n = 15,326), respectively, while lifetime and past 12 months externalizing problems were reported by 63.3% (n = 18,835) and 52.7% (n = 16,005), respectively. Six percent of participants reported worse mental health over the past 12 months. Compared to non-current use of any tobacco product, and adjusting for age, sex, race, education, and household income, those reporting ENDS use only had higher odds of ever (aOR = 1.52; 95%CI: 1.22-1.89) and past 12 months (aOR = 1.49; 95%CI: 1.22-1.84) internalizing, and externalizing problems (aOR = 1.32; 95%CI: 1.04-1.66 and aOR = 1.34; 95%CI: 1.07-1.67, respectively), and higher odds of reporting worse mental health over the past 12 months (aOR = 1.50; 95%CI: 1.05-2.12). CONCLUSION: Health care providers should be aware that internalizing and externalizing problems, and worsening mental health, are more common among adults who use ENDS, cigarettes, or both of these tobacco products.


Assuntos
Fumar Cigarros/psicologia , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Autoavaliação (Psicologia) , Estudos de Casos e Controles , Fumar Cigarros/epidemiologia , Feminino , Humanos , Masculino , Autorrelato , Estados Unidos/epidemiologia , Adulto Jovem
12.
JAMA Intern Med ; 181(8): 1081-1089, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34125135

RESUMO

Importance: Pregnancy presents an opportunity to engage expectant fathers in smoking cessation, but evidence from randomized clinical trials is scarce. Objective: To evaluate the effectiveness of a proactive, combined intervention for smoking cessation in expectant fathers. Design, Setting, and Participants: This pragmatic randomized clinical trial in prenatal clinics in 7 public hospitals in Hong Kong proactively recruited and enrolled 1053 participants from October 10, 2018, to February 8, 2020. Included male adults were 18 years or older, smoked cigarettes daily in the past 3 months, had partners who were pregnant and nonsmoking in the past 30 days, and had a landline or mobile telephone number for follow-up. These participants were randomized to either the intervention group or the control group. The primary analyses used an intention-to-treat approach. Interventions: The intervention group received brief cessation advice, a 1-week free sample of nicotine replacement therapy (NRT), and active referral to a community-based smoking cessation service. The control group received only brief cessation advice with a leaflet on the hazards of perinatal exposure to tobacco smoke and the toll-free quitline telephone number. Main Outcomes and Measures: The primary outcome was biochemically validated tobacco abstinence at 6 months after intervention initiation defined by an exhaled carbon monoxide level of 3 parts per million or lower. The secondary outcomes included self-reported 24-week continuous abstinence at 6 months after intervention initiation as well as 7-day point prevalence abstinence, use of any NRT, and use of a smoking cessation service at 3 and 6 months after intervention initiation. Results: All 1053 randomized participants were male adults with a mean (SD) age of 33.8 (6.9) years. The retention rate at 6-month follow-up was 80.7%. The primary outcome of biochemically validated tobacco abstinence at 6 months after intervention initiation was significantly higher in the intervention group than in the control group (6.8% [36 of 527 participants] vs 3.6% [19 of 526]; odds ratio [OR], 1.96; 95% CI, 1.11-3.46; P = .02). The main secondary outcomes of self-reported 24-week continuous abstinence at 6 months (OR, 1.87; 95% CI, 1.08-3.23; P = .03) and 7-day point prevalence abstinence at 3 months (OR, 1.48; 95% CI, 1.05-2.09; P = .03) and 6 months (OR, 1.74; 95% CI, 1.29-2.34; P < .001) were also significantly higher in the intervention group. The intervention group had a significantly higher increase in perceived family harmony (score range, 0-10, with a higher score indicating a higher level of harmony) from baseline to 6 months (B = 0.28; 95% CI, 0.063-0.50; P = .01). Conclusions and Relevance: This trial found that combining brief advice with a 1-week sample of NRT and referral to smoking cessation programs nearly doubled the odds that expectant fathers who smoked would achieve validated abstinence compared with providing brief advice alone. The intervention was also effective in promoting family harmony. Trial Registration: ClinicalTrials.gov Identifier: NCT03671707.


Assuntos
Terapia Comportamental/métodos , Fumar Cigarros , Pai/psicologia , Relações Interpessoais , Intervenção Psicossocial/métodos , Abandono do Uso de Tabaco/métodos , Adulto , Testes Respiratórios/métodos , Monóxido de Carbono/análise , Fumar Cigarros/psicologia , Fumar Cigarros/terapia , Saúde da Família , Feminino , Humanos , Masculino , Avaliação de Resultados em Cuidados de Saúde/métodos , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Abandono do Hábito de Fumar/psicologia , Dispositivos para o Abandono do Uso de Tabaco
13.
PLoS One ; 16(5): e0251099, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33983989

RESUMO

OBJECTIVE: To examine the relationship between current cigarette smoking patterns and three established risk factors for suicide using nationally representative data of high school students in the United States. METHODS: We analyzed cross-sectional data from the national Youth Risk Behavior Surveillance Survey (YRBSS)-United States, 2017. Multivariable, logistic regressions examined the association between 3 cigarette smoking behaviors [i.e., past 30-day cigarette (n = 13,731), frequent (n = 1,093) and heavy (n = 880) smoking] and 3 risk factors for suicidal outcomes [feeling sad or hopeless, suicidal ideation, suicide plan] assessed over the previous year. RESULTS: Among high school cigarette smokers, smoking 11 or more cigarettes per day (i.e., heavy smoking) was associated with 3.43 (95% CI: 1.69, 6.94) greater odds of reporting feeling sad or hopeless, 2.97 (95% CI: 1.60, 5.51) greater odds of reporting suicidal ideations, and 2.11 (95% CI: 1.34, 3.32) greater odds of reporting having ever planned a suicide attempt, controlling for covariates. CONCLUSIONS: Our study shows that it is not simply cigarette smoking, but heavy cigarette smoking that is a risk factor for suicidal outcomes among adolescents. PUBLIC HEALTH IMPLICATIONS: A comprehensive plan is needed to accommodate heavy adolescent smokers who are at increased suicidal risk.


Assuntos
Fumar Cigarros/psicologia , Estudantes/psicologia , Suicídio/psicologia , Adolescente , Comportamento do Adolescente , Fumar Cigarros/efeitos adversos , Fumar Cigarros/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Risco , Assunção de Riscos , Instituições Acadêmicas , Autoimagem , Autorrelato , Fumar/epidemiologia , Ideação Suicida , Suicídio/prevenção & controle , Tentativa de Suicídio/estatística & dados numéricos , Produtos do Tabaco/estatística & dados numéricos , Fumar Tabaco/efeitos adversos , Estados Unidos
14.
Sci Rep ; 11(1): 10248, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33986309

RESUMO

Vascular contributions to cognitive impairment and dementia (VCID) include structural and functional blood vessel injuries linked to poor neurocognitive outcomes. Smoking might indirectly increase the likelihood of cognitive impairment by exacerbating vascular disease risks. Sex disparities in VCID have been reported, however, few studies have assessed the sex-specific relationships between smoking and memory performance and with contradictory results. We investigated the associations between sex, smoking, and cardiovascular disease with verbal learning and memory function. Using MindCrowd, an observational web-based cohort of ~ 70,000 people aged 18-85, we investigated whether sex modifies the relationship between smoking and cardiovascular disease with verbal memory performance. We found significant interactions in that smoking is associated with verbal learning performance more in women and cardiovascular disease more in men across a wide age range. These results suggest that smoking and cardiovascular disease may impact verbal learning and memory throughout adulthood differently for men and women.


Assuntos
Fumar Cigarros/efeitos adversos , Memória/efeitos dos fármacos , Aprendizagem Verbal/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Fumar Cigarros/psicologia , Cognição/efeitos dos fármacos , Cognição/fisiologia , Disfunção Cognitiva/fisiopatologia , Estudos de Coortes , Demência Vascular/etiologia , Feminino , Humanos , Masculino , Memória/fisiologia , Pessoa de Meia-Idade , Fatores Sexuais , Aprendizagem Verbal/fisiologia
16.
Addict Biol ; 26(3): e12948, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33860602

RESUMO

Chronic cigarette smoking is associated with regional metabolite abnormalities in choline-containing compounds, creatine-containing compounds, glutamate, and N-acetylaspartate. The effects of cigarette smoking on anterior frontal cortical gamma-aminobutyric acid (GABA) concentration are unknown. This study compared chronic smokers (n = 33) and nonsmokers (n = 31) on anterior cingulate cortex (ACC) and right dorsolateral prefrontal cortex (DLPFC) GABA+ (the sum of GABA and coedited macromolecules) concentrations and associations of GABA+ levels in these regions with seven neurocognitive domains of functioning, decision making, and impulsivity measures. Smokers had significantly lower right DLPFC GABA+ concentration than nonsmokers, but groups were equivalent on ACC GABA+ level. Across groups, greater number of days since end of menstrual cycle was related to higher GABA+ level in the ACC but not right DLPFC GABA+ concentration. In exploratory correlation analyses, higher ACC and right DLPFC GABA+ levels were associated with faster processing speed and better auditory-verbal memory, respectively, in the combined group of smokers and nonsmokers; in smokers only, higher ACC GABA+ was related to better decision making and auditory-verbal learning. This study contributes additional novel data on the adverse effects of chronic cigarette smoking on the adult human brain and demonstrated ACC and DLPFC GABA+ concentrations were associated with neurocognition and decision making/impulsivity in active cigarette smokers. Longitudinal studies on the effects of smoking cessation on regional brain GABA levels, with a greater number of female participants, are required to determine if the observed metabolite abnormalities are persistent or normalize with smoking cessation.


Assuntos
Fumar Cigarros/metabolismo , Fumar Cigarros/psicologia , Cognição/fisiologia , Giro do Cíngulo/metabolismo , Córtex Pré-Frontal/metabolismo , Ácido gama-Aminobutírico/metabolismo , Adulto , Estudos de Casos e Controles , Tomada de Decisões/fisiologia , Feminino , Humanos , Comportamento Impulsivo/fisiologia , Imageamento por Ressonância Magnética , Masculino , Memória , Pessoa de Meia-Idade
17.
Neuroreport ; 32(9): 762-770, 2021 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-33901056

RESUMO

BACKGROUND: Modulation of cigarette craving and neuronal activations from nicotine-dependent cigarette smokers using real-time functional MRI (rtfMRI)-based neurofeedback (rtfMRI-NF) has been previously reported. OBJECTIVES: The aim of this study was to evaluate the efficacy of rtfMRI-NF training in reducing cigarette cravings using fMRI data acquired before and after training. METHODS: Treatment-seeking male heavy cigarette smokers (N = 14) were enrolled and randomly assigned to two conditions related to rtfMRI-NF training aiming at resisting the urge to smoke. In one condition, subjects underwent conventional rtfMRI-NF training using neuronal activity as the neurofeedback signal (activity-based) within regions-of-interest (ROIs) implicated in cigarette craving. In another condition, subjects underwent rtfMRI-NF training with additional functional connectivity information included in the neurofeedback signal (functional connectivity-added). Before and after rtfMRI-NF training at each of two visits, participants underwent two fMRI runs with cigarette smoking stimuli and were asked to crave or resist the urge to smoke without neurofeedback. Cigarette craving-related or resistance-related regions were identified using a general linear model followed by paired t-tests and were evaluated using regression analysis on the basis of neuronal activation and subjective craving scores (CRSs). RESULTS: Visual areas were mainly implicated in craving, whereas the superior frontal areas were associated with resistance. The degree of (a) CRS reduction and (b) the correlation between neuronal activation and CRSs were statistically significant (P < 0.05) in the functional connectivity-added neurofeedback group for craving-related ROIs. CONCLUSION: Our study demonstrated the feasibility of altering cigarette craving in craving-related ROIs but not in resistance-related ROIs via rtfMRI-NF training.


Assuntos
Encéfalo/diagnóstico por imagem , Fumar Cigarros/terapia , Fissura/fisiologia , Fumantes/psicologia , Abandono do Hábito de Fumar/métodos , Adulto , Mapeamento Encefálico , Fumar Cigarros/psicologia , Neuroimagem Funcional , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Neurorretroalimentação
18.
Psychopharmacology (Berl) ; 238(8): 2083-2090, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33796907

RESUMO

RATIONALE: Reducing nicotine content of inhaled tobacco products may prevent nicotine addiction, but the threshold for nicotine reinforcement has not been systematically evaluated in controlled human laboratory studies. OBJECTIVES: The current study uses a novel double-blind placebo-controlled intravenous (IV) nicotine self-administration (NSA) model to determine threshold for subjective effects of nicotine and nicotine reinforcement using a forced choice self-administration procedure. METHODS: Young adults (n = 34) had 5 laboratory sessions after overnight nicotine abstinence. In each session, participants sampled and rated the subjective effects of an IV dose of nicotine (0.0125, 0.025, 0.05, 0.1, or 0.2 mg nicotine/70 kg bodyweight) versus saline (placebo), then were given a total of 10 opportunities to self-administer either the IV dose of nicotine or placebo. RESULTS: Mixed effect models revealed a significant effect of nicotine dose for positive (i.e., "stimulatory" and "pleasurable"; p < .0001) effects, but not "aversive" effects during sampling period. Post hoc comparisons showed that higher doses (i.e., 0.1 and 0.2 mg) were associated with greater stimulatory, pleasurable, and physiological effects than placebo and lower doses. Mixed effect models revealed that only the highest dose (i.e., 0.2 mg) was consistently preferred over placebo. Sex differences were generally weak (p = .03-.05). CONCLUSIONS: Using our IV nicotine NSA model, the threshold for detecting positive effects of nicotine in young adult smokers is about 0.1 mg, but a higher dose of nicotine, 0.2 mg, is required to produce a consistent nicotine reinforcement. Regarding the regulatory impact, our findings further support the value of nicotine reinforcement threshold as a tobacco regulatory target.


Assuntos
Fumar Cigarros/psicologia , Nicotina/administração & dosagem , Reforço Psicológico , Fumantes/psicologia , Administração Intravenosa , Adolescente , Adulto , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Estudos Cross-Over , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Humanos , Masculino , Agonistas Nicotínicos/administração & dosagem , Autoadministração/métodos , Autoadministração/psicologia , Adulto Jovem
19.
Behav Pharmacol ; 32(2&3): 212-219, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33660663

RESUMO

Relapse is common amongst smokers attempting to quit and tobacco cue-induced craving is an important relapse mechanism. Preclinical studies commonly use cue-induced reinstatement of nicotine seeking to investigate relapse neurobiology. Previous research suggests dependence severity and nicotine intake history affect smoking resumption and cue-induced reinstatement of nicotine seeking. However, behavioural data may be interpreted in terms of nicotine reinforcement. This translational study investigated if individual differences in objectively assessed nicotine reinforcement strength were associated with cue-reactivity in both rats and human smokers, which to our knowledge has not been investigated before. Rats (n = 16) were trained to self-administer nicotine and were tested on a progressive ratio schedule of nicotine reinforcement, to assess reinforcer strength, and on a test of cue-induced reinstatement of nicotine seeking. Nicotine reinforcement strength was assessed in human smokers (n = 104) using a forced choice task (nicotine containing vs. denicotinised cigarettes) and self-reported cue-induced craving was assessed following exposure to smoking and neutral cues. Responding for nicotine under progressive ratio was strongly positively correlated with cue-induced reinstatement of nicotine seeking in rats. Nicotine choices in human smokers were significantly associated with cue-induced craving controlling for dependence severity, years of smoking, and urge to smoke following neutral cues. Findings suggest nicotine reinforcement strength is associated with both types of cue-induced behaviour, implying some translational commonality between cue-induced craving in human smokers and cue-induced reinstatement of nicotine seeking in rats. Findings are discussed in relation to clinical implications and whether these laboratory tasks assess drug 'wanting'.


Assuntos
Fumar Cigarros/psicologia , Sinais (Psicologia) , Nicotina/farmacologia , Reforço Psicológico , Adulto , Animais , Comportamento Animal/efeitos dos fármacos , Fissura , Feminino , Humanos , Masculino , Ratos , Ratos Long-Evans , Esquema de Reforço , Autoadministração , Fumantes/psicologia , Especificidade da Espécie
20.
Addict Biol ; 26(5): e13029, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33663023

RESUMO

An extensive epidemiological literature indicates that increased exposure to tobacco retail outlets (TROs) places never smokers at greater risk for smoking uptake and current smokers at greater risk for increased consumption and smoking relapse. Yet research into the mechanisms underlying this effect has been limited. This preliminary study represents the first effort to examine the neurobiological consequences of exposure to personally relevant TROs among both smokers (n = 17) and nonsmokers (n = 17). Individuals carried a global positioning system (GPS) tracker for 2 weeks. Traces were used to identify TROs and control outlets that fell inside and outside their ideographically defined activity space. Participants underwent functional MRI (fMRI) scanning during which they were presented with images of these storefronts, along with similar store images from a different county and rated their familiarity with these stores. The main effect of activity space was additive with a Smoking status × Store type interaction, resulting in smokers exhibiting greater neural activation to TROs falling inside activity space within the parahippocampus, precuneus, medial prefrontal cortex, and dorsal anterior insula. A similar pattern was observed for familiarity ratings. Together, these preliminary findings suggest that the otherwise distinct neural systems involved in self-orientation/self-relevance and smoking motivation may act in concert and underlie TRO influence on smoking behavior. This study also offers a novel methodological framework for evaluating the influence of community features on neural activity that can be readily adapted to study other health behaviors.


Assuntos
Fumar Cigarros/psicologia , Marketing , Fumantes/psicologia , Produtos do Tabaco , Tabagismo/diagnóstico por imagem , Adolescente , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Motivação , Fumar , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...