Implications For Smoking Cessation Programs Research Articles

Child Maltreatment and Persistent Smoking From Adolescence Into Adulthood: A Birth Cohort Study.

A prospective record-linkage analysis to examine whether notified and/or substantiated child maltreatment is associated with the prevalence and persistence of smoking in early adulthood. The sample consisted of 3758 participants enrolled in a population-based birth cohort study in Brisbane, Australia, who were followed up at both 14 and 21 years of age. Suspected experience of child maltreatment was measured by linkage with state child protection agency data. The two main outcomes were the prevalence and persistence of smoking at 21-year follow-up, as well as the 12-month prevalence of nicotine use disorder for participants who completed the Composite International Diagnostic Interview-Auto version. Of the 3758 young people at the 21-year follow-up, 7.5% (n = 282) had a history of notified maltreatment by the age of 16 years. Of these, 167 cases were substantiated. There were 1362 (35.3%) smokers at 21-year follow-up, although only 220 (5.9%) smoked more than 20 cigarettes daily. Of the 602 participants who smoked at 14 years, 289 were still smoking 7 years later. On adjusted analyses, participants who had experienced any form of notified and/or substantiated maltreatment were approximately twice as likely to be smokers at 21 years old and persistent smokers from 14 years of age. Any form of maltreatment, except sexual abuse, was also associated with an increase in the 12-month prevalence of nicotine use disorders. Child maltreatment is associated with both an increased onset and persistence of smoking from adolescence into young adulthood. This may have implications for smoking cessation programs and early interventions for individuals who have experienced maltreatment.

Gender differences in smoking behavior and cessation

Objective: Many women want to quit smoking, but have lower abstinent rates than men. The gender differences in smoking behaviors and cessation in adults were explored through qualitative analyses of individual interviews with male and female smokers. Methods: Sixty-one participants (34 men and 27 women), who reported using tobacco within the last year, completed open-ended phone interviews concerning barriers faced during smoking cessation. Participants reported smoking for an average of 23.0 ( SD = 11.3) years and making an average of 2.41 ( SD = 2.6) prior quit attempts. The interviews were transcribed and analyzed using qualitative content analysis procedures. An investigator external to the study independently analyzed qualitative interview data to increase the trustworthiness of results. Results: Barriers relating to stress-mood regulation and social factors ( e.g. , others smoking) were most commonly reported in both genders (72% & 41% respectively). However, women tended to report a greater number of distinct barriers (Cohen's d = 0.4) and a great frequency of stress-related factors and anxiety. Factors related to the sensory aspects of smoking were more common among women and only women noted the lack of social support as a barrier. Other barriers included use of alcohol and factors related to the addictive nature of tobacco use ( e.g. , cravings). Abrupt cessation, or “cold-turkey”, was most common cessation method for both genders. However, both men and women reported using a variety of smoking cessation methods including nicotine replacement, cessation medications, electronic cigarettes, and behavior strategies. Conclusions: The results showed that barriers to smoking cessation differed between the genders. Implications for smoking cessation programs include gender specific interventions.

A Single 4 mg Dose of Nicotine Decreases Heart Rate Variability in Healthy Nonsmokers: Implications for Smoking Cessation Programs

The vast majority of work on the physiological effects of nicotine in humans has been done in smokers or smokers trying to quit. Such studies can be confounded by tolerance, desensitization of receptors, or withdrawal. Because of these difficulties, there is still some dispute as to whether nicotine is proparasympathetic or prosympathetic in humans. To circumvent these difficulties, we assessed the effect of nicotine on autonomic function by measuring changes in heart rate variability (HRV) in nicotine-naive healthy subjects. Twenty males and 20 females aged between 18 and 25 years received 4 mg oral nicotine lozenge or placebo. HRV was assessed in 15-min periods before, during, and after ingestion. There were no significant changes in any measure after placebo administration. During and after nicotine ingestion, heart rate increased to 78 ± 2 beats per minute (bpm) from a baseline level of 75 ± 2 bpm (p < .01). Nicotine significantly increased low frequency (LF; normalized units) from 66 ± 2 at baseline to 70 ± 2 at 15-30 min postingestion (p < .01) and decreased high frequency (HF; normalized units) from 28 ± 2 to 24 ± 1 (p < .01). LF/HF ratio was therefore substantially increased from 2.9 ± 0.3 to 3.7 ± 0.3 (p < .01). A single dose of 4 mg oral nicotine produces a significant reduction in HRV (i.e., a proportional decrease in high-frequency variability) in healthy young nonsmokers consistent with a reduced vagal activity. This has implications for nicotine replacement treatments aimed at cessation of smoking.

Smoking It All Away: Influences of Stress, Negative Emotions, and Stigma on Lesbian Tobacco Use

This study explored the reported processes, conditions, and consequences of lesbian and heterosexual female smoking and relapse to understand the reasons for elevated lesbian smoking rates. Using grounded theory techniques, we conducted semistructured, face-to-face interviews with an ethnically diverse sample of 35 lesbian and 35 heterosexual female participants in Northern California. We found minority stress/sexual stigma to be an additional, unique cause of negative emotions and stress reported by 75% of lesbian participants, leading to smoking and relapse. Implications for smoking cessation programs tailored to lesbians are discussed.

Resisting Gendered Smoking Pressures: Critical Consciousness as a Correlate of Women's Smoking Status

Gender is one of the social structures, along with social class and ethnicity, that shapes women's smoking behaviors. We examined how different responses to gender pressures (internalization and resistance) relate to smoking. We analyzed data from a national random digit dial survey of 945 women and found that never smokers scored high on resistance to gender pressure (indicated by high scores on feminist consciousness) and on education and Body Mass Index; current smokers had the reverse pattern. Ex-smokers scored high on one measure of resistance (advertising skepticism) and on two measures of internalization (embodied femininity and weight concern); they were also likely to have high household income and to be European American. Results are discussed in terms of their implications for smoking cessation programs and antismoking campaigns.

The opioid antagonist naltrexone inhibits activity and alters expression of α7 and α4β2 nicotinic receptors in hippocampal neurons: implications for smoking cessation programs

This study was designed to investigate whether naltrexone, an opioid antagonist that has been evaluated clinically as a co-adjuvant in smoking cessation programs, affects function and expression of neuronal nicotinic receptors (nAChRs). Whole-cell current recordings from rat hippocampal neurons in culture and in slices demonstrated that α7 nAChRs can be inhibited non-competitively by naltrexone (IC 50∼25 μM). The voltage dependence of the effect suggested that naltrexone acts as an open-channel blocker of α7 nAChRs. Naltrexone also inhibited activation of α4β2 nAChRs in hippocampal neurons; however its IC 50 was higher (∼141 μM). At a concentration as high as 300 μM (which is sufficient to block by 100% and 70% the activity of α7 and α4β2 nAChRs, respectively), naltrexone had no effect on kainate and AMPA receptors, blocked by no more than 20% the activity of NMDA and glycine receptors, and reduced by 35% the activity of GABA A receptors. A 3-day exposure of cultured hippocampal neurons to naltrexone (30 μM) or nicotine (10 μM, a concentration that fully desensitized α7 nAChRs) resulted in a 2-fold increase in the average amplitude of α7 nAChR-subserved currents. Naltrexone did not augment the maximal up-regulation of α7 nAChRs induced by nicotine, indicating that both drugs act via a common mechanism. In addition to increasing α7 nAChRs-mediated responses per neuron, nicotine increased the number of neurons expressing functional non-α7 nAChRs (probably α4β2 nAChRs); this effect was blocked by naltrexone (0.3 and 30 μM). Therefore, naltrexone may affect dependence on cigarette smoking by differentially altering function and expression of α7 and α4β2 nAChRs in the central nervous system.

Self-efficacy as a predictor for the cessation of smoking: Methodological issues and implications for smoking cessation programs

Abstract A prospective study focused on self-efficacy as a predictor for smoking cessation. Subjects were 123 Dutch participants in a 3-week smoking cessation group program. Before and after treatment perceived self-efficacy was measured by questionnaire. Three measures related to self-efficacy were used: a 17-item perceived ability scale (PAS), a 10-item perceived difficulty scale (PDS), and a 1-item perceived ability measure (1-item PAM). Smoking behavior was assessed through self-report at pre- and post-treatment, and after 6-weeks and 1-year follow-up periods. Pre-treatment perceived difficulty was a predictor for short-term cessation, while post-treatment perceived ability predicted long-term abstinence for post-treatment successes. The 1-item PAM was the strongest predictor, which may indicate that asking respondents to include every possible situation in their answer to a 1-item PAM is an effective conceptualization of the dimension 'generality' of self-efficacy. The results of factor analyses on t...

Effect of smoking characteristics on cognitive dissonance in current and former smokers.

The effect of smoking characteristics on the development of cognitive dissonance in current and former smokers is examined. Smoking characteristics (number of cigarettes per day, number of years smoked, and years since quitting) and health beliefs were obtained from over 9,000 respondents to the 1986 Adult Use of Tobacco Survey. Overall, current smokers exhibited more cognitive dissonance involving smoking-related beliefs than did former smokers. Logistic regression analysis indicated that heavier current smokers (those smoking > or = 20 cigarettes per day) were more likely to exhibit cognitive dissonance over smoking-related health beliefs than were lighter smokers. In contrast, number of cigarettes consumed per day had only minor effects on former smokers' beliefs; former smokers who had smoked for more years (> or = 17), or who had quite recently (within the last 8 years), were more likely to showed greater dissonance than former smokers without these characteristics. The factors underlying these results and their implications for smoking cessation programs are discussed.

Smoking and Health Implications for Smoking Cessation Programs

Smoking and Health Implications for Smoking Cessation Programs