Smoking Behavior In Smokers Research Articles

Impact of Pictorial Health Warnings on Cigarette Packs among Current Smokers of Sub-Metropolitan City of Nepal: A Descriptive Cross-sectional Study

Introduction: Pictorial health warning on cigarette packs is one of the strategies undertaken by Nepal Government as per the directive of World Health Organization Framework Convention on Tobacco Control to control smoking. It has been more than a decade since the introduction of pictorial health warnings on cigarette packs in Nepal. The objective of this study was to assess the impact of the pictorial warnings among current smokers of Dharan, Nepal.Methods: A descriptive cross-sectional study was conducted among current smokers visiting local shops located near ward offices of Dharan after obtaining ethical approval from Institutional Review Committee (Reference number: 204/080/01 -IRC). A structured and validated Nepali questionnaire was used to interview the smokers about the impact of the pictorial warnings based on their noticeability, behavioural and cognitive responses. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 20.0. The responses of the participants were tabulated in frequencies and percentages.Results: The pictorial warnings were noticed by 277 (98.93%) participants in past one month out of which 11 (3.93%) smokers had always read or looked closely at them. Smoking less frequently was the behaviour change reported by 70 (25%) participants and smoking less around others was reported by and 56 (20%) participants. In total, 189 (67.50%) smokers had thought about the harms of smoking and 160 (57.14%) had intention to quit smoking due to the pictorial warnings.Conclusions: The pictorial health warnings were not so effective in bringing about changes in smoking behaviour of smokers.

A qualitative study on the impact of COVID-19 on the behavior and attitudes of smokers and non-smokers in South Korea

BackgroundThe COVID-19 pandemic has affected all aspects of human society, including education, culture, and the economy, and has also introduced changes in people’s health behaviors such as drinking alcohol, nutrition intake, and practicing healthy living. This study conducted qualitative research in the Korean context to examine the changes in the smoking behavior of smokers and secondhand smoke exposure of non-smokers during the COVID-19 pandemic.MethodsFocus group interviews were conducted with 36 Korean participants (18 men and 18 women). The groups were composed of cigarette smokers, e-cigarette users, heated tobacco product users, and non-smokers.ResultsDuring the pandemic, it was found that there was an increase in the frequency of use, irrespective of the tobacco product, in users who refrained from social interaction and worked or studied from home. Users who continued to be socially active increased the amount used with each usage. Smokers showed a tendency to avoid smoking rooms and to smoke alone in places unoccupied by people. In addition, non-smokers’ exposure to secondhand smoke did not decrease, but since non-smokers used masks, they reported more relief from the risk of exposure to secondhand smoke than before.ConclusionsDespite smokers being a high-risk group for COVID-19, the risk did not result in smoking cessation among smokers. Therefore, policies and educational campaigns to raise awareness about the dangers of smoking and to encourage smoking cessation are needed in the future.

Effects of a Cigarette Price Increase on the Smoking Behavior of Smokers and Non-smokers

Objectives: The government of the Republic of Korea (ie, South Korea) drastically increased cigarette prices by 80% in 2015. The exogenous regulatory change provided us with an opportunity to examine the effects of the cigarette price increase on smoking behavior. Methods: Utilizing 2011-2016 balanced panel data from the Korea Health Panel (3693 participants each year), we divided the sample into smokers and non-smokers and traced each individual's smoking behavior. Results: Overall smoking prevalence (OR = 0.476, p < .01) and daily cigarette consumption (IRR = 0.737, p < .01) were reduced after the cigarette price increase. However, although the cigarette price increase was inversely related to smokers' cigarette consumption (OR = 0.799, p < .01), we found no statistically significant impact on smoking cessation among smokers. On the other hand, the cigarette price increase was associated with decreased smoking onset among non-smokers (OR = 0.172, p < .01) and reduced cigarette consumption after they started smoking (IRR = 0.279, p < .01). Conclusions: The reduction in smoking prevalence after the increase of the cigarette price resulted from the fact that non-smokers did not start smoking rather than from a decrease in the number of existing smokers.

Perceived Pain and Smoking Interrelations and Expectancies Are Associated With Pain and Smoking Cessation in Individuals With Mobility Impairments.

Smoking and pain are highly prevalent among individuals with mobility impairments (MIs; use assistive devices to ambulate). The role of pain-related smoking motives and expectancies in smoking cessation is unknown. We examined cross-sectional and prospective associations between a novel measure of pain-related smoking motives (how smokers with pain perceive their pain and smoking to be interrelated) and pain and smoking behavior in smokers with MI. This is a secondary data analysis of a smoking cessation induction trial (N = 263; 55% female) in smokers with MI. Participants did not have to want to quit to enroll. Pain-related smoking motives and expectancies were assessed at baseline with the pain and smoking inventory (PSI) which measures perceived pain and smoking interrelations in three distinct but related domains (smoking to cope with pain, pain as a motivator of smoking and as a barrier to cessation). Other measures included pain occurrence and interference, nicotine dependence, motivation and self-efficacy to quit smoking, and number of cigarettes per day. Biochemically verified smoking abstinence was assessed at 6 months. PSI scores were significantly higher among smokers with chronic pain occurrence compared to occasional and to no occurrence (p < .002) and were associated with greater pain interference (ps < .01) and lower self-efficacy to quit smoking (ps < .01). In prospective analyses adjusted for age, treatment group, and chronic pain, only expectancies of smoking to help cope with pain predicted lower odds of abstinence. Targeting expectancies of smoking as a mechanism to cope with pain may be useful in increasing smoking cessation in pain populations. Individuals with MI have a high prevalence of smoking and pain, yet the extent to which this population perceives pain and smoking to be interrelated is unknown. This is the first article to examine prospective associations between a novel measure of perceived pain and smoking interrelations (PSI) and smoking outcomes. The PSI was associated with greater pain and lower self-efficacy for quitting. Prospectively, the PSI subscale tapping into expectancies that smoking help coping with pain predicted a lower probability of smoking abstinence. In smokers with MI, expectancies of smoking as pain-coping mechanism may be an important clinical target.

Gray matter volumes of insular subregions are not correlated with smoking cessation outcomes but negatively correlated with nicotine dependence severity in chronic smokers

The insula, a cortical region that integrates heterogeneous signals about internal states and contributes to executive functions, has been implicated as an important role in the maintenance of nicotine dependence. Previous studies have indicated that insula damage may contribute to quitting smoking successfully, but few studies have examined whether quitting successfully is related to cortical structural integrity of insular subregions before smoking cessation treatment. Moreover, although prior researches have shown group differences in insular cortex structure in chronic cigarette smokers compared to nonsmokers, less is known about how cortical structural integrity of insular subregions relate to smoking behaviors in smokers. This study, therefore, aimed to (1) further explore the association between the cortical structural integrity of insular subregions prior to the target quit date and the treatment outcomes of smoking cessation therapy; and (2) further evaluate how the cortical structural integrity of insular subregions are related to smoking behaviors. In the present study, a total of 83 smokers and 41 nonsmokers were enrolled and high-resolution structural magnetic resonance images were acquired from all participants. After a 12-week smoking cessation treatment, 28 smokers succeeded in quitting smoking, 46 failed, and 9 were unable to be contacted. Our analysis showed that gray-matter volume of bilateral anterior insula were negatively correlated with nicotine dependence scores. However, the smoking cessation outcomes showed no correlations with the gray-matter volume and seed-based structural covariance network of insular subregions prior to smoking cessation. The present study further clarified the more precise roles of the insular cortex in smoking behaviors, which might improve the understanding of the mechanism in the nicotine dependence.

Perceived effectiveness of pictorial health warnings on changes in smoking behaviour in Asia: a literature review

BackgroundSeveral Asian countries have implemented pictorial health warnings on cigarette packs as suggested by the World Health Organization with various policies based on countries’ systems. The study is aimed to analyse multiple research studies on the perceived effectiveness of Pictorial Health Warnings as a deterrent to smoking intention and as a stimulant of smoking behaviour in smokers and non-smokers in Asian countries.MethodPeer-reviewed articles were identified through multiple science databases indexed by Scopus, MEDLINE or PubMed. The review was limited to articles that reported original research findings, were conducted in Asian countries and were available for review by January 2010. A PRISMA Flow diagram was used to identify the articles through the process of data screening and extractions.ResultA total of 14 original articles which met the criteria were included in the review, consisting of 12 quantitative studies and 2 studies with both quantitative and qualitative methods from 17 jurisdictions. The reviewed studies found that pictorial health warnings were associated with a greater perception of salience (reading and noticing the warning), emotional effects, and cognitive increase. Additionally, in the reviewed studies, pictorial health warnings were perceived as more effective in deterring smoking initiation and encouraging smoking cessation than text-only warnings. Several studies also evaluated the effectiveness of a new pictorial warning compared with the old one. However, the relevance of refreshing the pictures of pictorial health warnings and the length of the effective period of the implementation of pictorial health warnings were less frequently studied.ConclusionPictorial health warnings perceived as more effective in deterring smoking initiation among non-smokers and as well as in stimulating smoking cessation among smokers. Future studies on pictorial health warnings should study the relevance of changing or refreshing pictorial health warning on cigarette packages in a period of time.

Cigarette smoking and schizophrenia: a specific clinical and therapeutic profile? Results from the FACE-Schizophrenia cohort

BackgroundTobacco use is common in patients with schizophrenia (SZ) but little is known on the role of tobacco in the physiopathology or on the course of the disease. Only few studies embrace an extensive examination of clinical and therapeutic characteristics in stabilized patients. The objective of the present study was to determine the prevalence of tobacco smoking in stabilized SZ outpatients and the clinical and treatment characteristics associated with daily tobacco use in a large community-dwelling sample of patients. MethodsThree-hundred-and-sixty-one patients were included in the network of the FondaMental Expert Centers for Schizophrenia. Current tobacco status was self-declared. Results53.7% were smokers. Mean age at tobacco onset was 17.2years old. In multivariate analyses, after adjustment for confounding factors, positive symptoms and mean daily antipsychotic dose were associated with a higher frequency of tobacco use (OR=1.06 95%IC[1.02–1.12], for positive symptoms, OR=1.1, 95%IC[1.02–1.18] for daily antipsychotic dose). Education level, negative symptoms, anticholinergic agents, clozapine or aripiprazole administration were independently associated with a lower frequency of tobacco use (respectively OR=0.87, 95%IC [0.79, 0.95], OR=0.95, 95%IC[0.91–0.98], OR=0.41, 95%IC[0.22–0.76], OR=0.56, 95%IC=[0.32, 0.99] and OR=0.49, 95%IC [0.26–0.91]). ConclusionThe prevalence of current tobacco smoking in a French community-dwelling SZ patients is higher that observed in the general population. Patients with tobacco use present clinical and therapeutic specificities that may involve interaction between cholinergic-nicotinic and dopaminergic systems. The present study suggests that some therapeutics may improve daily smoking behavior in smokers. These results should be confirmed in longitudinal studies.

Altered thalamo-cortical resting state functional connectivity in smokers

The thalamus has widespread connections with the prefrontal cortex (PFC) and modulates communication between the striatum and PFC, which is crucial to the neural mechanisms of smoking. However, relatively few studies focused on the thalamic resting state functional connectivity (RSFC) patterns and their association with smoking behaviors in smokers. 24 young male smokers and 24 non-smokers were enrolled in our study. Fagerström Test for Nicotine Dependence (FTND) was used to assess the nicotine dependence level. The bilateral thalamic RSFC patterns were compared between smokers and non-smokers. The relationship between neuroimaging findings and smoking behaviors (FTND and pack-years) were also investigated in smokers. Relative to nonsmokers, smokers showed reduced RSFC strength between the left thalamus and several brain regions, i.e. the right dorsolateral prefrontal cortex (dlPFC), the anterior cingulate cortex (ACC) and the bilateral caudate. In addition, the right thalamus showed reduced RSFC with the right dlPFC as well as the bilateral insula in smokers. Therefore, the findings in the current study revealed the reduced RSFC of the thalamus with the dlPFC, the ACC, the insula and the caudate in smokers, which provided new insights into the roles of the thalamus in nicotine addiction from a function integration perspective.

Akses Pelayanan Kesehatan terhadap Perilaku Merokok

Smoking caused 235.000 Indonesian people deaths each year and 25.000 non-smokers deaths. Not only in smokers, a disease caused by exposure to tobacco can also be suffered by farmers. That is because the tobacco farmers have the potential exposure to harmful substances from cigarettes and tobacco itself. Health services located around the site should be able to educate people to behave healthily. In this study, we examined the access of health services toward smoking behavior in smokers who lived in tobacco commodities areas. This study was an analytic research with cross sectional study design. Samples were 100 smokers in tobacco commodities areas in Weleri Kendal. Most of respondent are male (96%). They were on their final adult age (29%), worked as farmer (80%), and consumed white cigarette (79%). Most of the respondents went to health services when they sick (93%) because the distance to health service was close (69%) and had complete facilities (79%). The bivariate analysis showed there is no association between access to health sevices (p = 1) toward smoking behavior. Improving the provision and improvement of facilities should not be a priority of smoking cessation programs. Next studies is suggested to explore more about the ability of health workers to educate people to stop smoking. Keywords : Health services, facilities, access, smoking, tobacco

Quit Intentions Moderate Subjective and Physiological Responses to Acute Nicotine Replacement Therapy Administration in Dependent Smokers.

This study assessed the impact of expectancy and administration components of acute nicotine inhaler use on craving, heart rate, and smoking behavior in smokers with varying intentions to quit. 47 dependent smokers that differed in self-reported intention to quit (no intention to quit during the next month N = 26 vs. intention to initiate a quit attempt within 2 weeks N = 21) were randomly administered a 4 mg nicotine or nicotine-free inhaler across two sessions. Instructions regarding the inhaler's nicotine content (expect nicotine vs. expect nicotine-free; nicotine expectancy) and flavor (mint vs. citrus) varied across sessions. Craving and heart rate were assessed before and after inhaler administration (two-second inhalations every 10 seconds over 20 minutes). Next, participants were offered an opportunity to self-administer puffs of their preferred tobacco brand during an hour-long progressive ratio task. Across participants, nicotine expectancy independently reduced withdrawal related craving (p = .018), but no comparable effects of nicotine administration were evident. In quitting motivated smokers, nicotine expectancy and administration interacted to reduce intention to smoke (p = .040), while nicotine expectancy (p = .047) and administration (p = .025) independently reduced intention to smoke in quitting unmotivated smokers. Blunted heart rate reactivity to nicotine administration was observed in quitting motivated relative to unmotivated smokers (p = .042); however, neither expectancy nor administration impacted smoking behavior in either group (p values > .25). Findings indicate that participant quitting intentions moderate acute nicotine replacement therapy responses. In quitting motivated smokers, a combination of pharmacological and psychological factors may be necessary for nicotine replacement therapy to impact craving. Findings from this study demonstrate that motivations to quit smoking moderate subjective and physiological responses to acute nicotine administration and expectancy in dependent cigarette smokers. Quitting motivated smokers showed blunted heart rate reactivity to nicotine administration, suggesting that they may be less sensitive to the rewarding aspects of nicotine consumption. Nicotine administration and expectancy were found to interact to reduce craving in quitting motivated but not in unmotivated smokers, suggesting that pharmacological and psychological factors may be necessary for nicotine replacement therapy to impact craving in smokers who plan to quit.

Effects of the opioid receptor antagonist naltrexone on smoking and related behaviors in smokers preparing to quit: a randomized controlled trial

To determine if naltrexone affects smoking behaviors in smokers preparing to quit, and whether or not such pre-quit responses predict post-quit date outcomes. Double-blind, placebo-controlled, randomized study. The current study focused on smoking-related outcomes in the pre-quit phase, which was 1 week prior to the quit date, and these findings were linked with reductions in the same outcomes demonstrated in the post-quit phase published previously for this randomized controlled trial (RCT) in mediation analyses. Community sample of adult smokers desiring to quit in Chicago, Illinois, USA. Participants were 315 smokers randomized to naltrexone (n = 161; mean age = 42.58 years; 60% Caucasian) or placebo (n = 154; mean age = 41.32 years; 55% Caucasian). The difference from baseline in the number of cigarettes smoked during the pre-quit phase interval was the primary outcome. Secondary pre-quit outcomes were assessed using Likert scales of subjective responses and consumption of cigarettes, alcohol and food. Number of cigarettes smoked, alcoholic drinks consumed and the Brief Questionnaire of Smoking Urges were assessed in the post-quit phase. Relative to placebo, naltrexone decreased the number of cigarettes smoked (-4.21 versus -2.93, P < 0.05), smoking urge (P = 0.02) and number of alcoholic drinks consumed (P = 0.04). Exploratory mediation analyses linking outcomes of the pre-quit and post-quit phases found that naltrexone's effects on reducing smoking urge, cigarettes smoked and alcoholic drinks consumed in the pre-quit phase demonstrated full mediation of their respective effects during the post-quit phase. Naltrexone taken in the week before a quit attempt reduces cigarette consumption, urges to smoke and alcohol consumption relative to placebo. The size of the effect mediates statistically the size of similar effects after the quit date.

Changes in smoking habits of smokers under bombing by rockets

Stress is known to impact smoking. This survey assessed changes in smoking behaviour of smokers in Southern Israel during a military operation (December 2008-January 2009) that exposed several civilian communities to intensive rocket bombing and acute stress. Households with an active land telephone line in Jewish Gaza vicinity communities were sampled. Inclusion criteria were age (18+ years) and being a daily or an occasional smoker. A telephone interview was carried out, focusing on socio-demographic characteristics and change in smoking behaviour during the military operation. Personal, demographic and circumstantial correlates of smoking behaviour were assessed using univariate and multivariate analyses. A total of 425 smokers took part in the survey. Most (85%) reported being daily smokers, and smoked, on average, 10-20 cigarettes/day before the operation. During the operation, 38% of the smokers changed their smoking habits and most (88%) reported higher than usual smoking rates. Correlates significantly associated with higher smoking during the operation were sex (female), education (lower) and not working due to the operation. Exposure to acute stress has an impact on smoking rates, especially in certain subgroups of smokers. Relevant smoking cessation interventions should address the special needs of smokers exposed to stressful circumstances.

Subjective and physiological responses to smoking cues in smokers with schizophrenia

The prevalence of smoking is high among people with schizophrenia. Although several research groups are developing smoking treatments for these smokers, abstinence rates to date have been modest. Methodological tools such as cue exposure are useful in clinical research with smokers in general, but the value of these paradigms with smokers with schizophrenia has yet to be established. The aim of the present study was to determine the subjective and physiological effects of exposure to in vivo smoking cues in smokers with schizophrenia. A total of 25 heavy smokers with schizophrenia or schizoaffective disorder were assessed while nonabstinent and after 2-hr smoking abstinence. Urge to smoke, mood, nicotine withdrawal symptoms, heart rate, and blood pressure were measured during a precue relaxation period, after exposure to neutral cues, and after exposure to smoking cues. Results indicate that both exposure to smoking cues and brief abstinence increased urge levels, nicotine withdrawal symptom levels, and negative affect. Abstinence did not amplify the effects of cues on urges or other cue reactivity measures. These results indicate that smoking cue reactivity laboratory models may be useful for investigating potential smoking treatments for, or neurobiological contributions to, smoking behavior in smokers with schizophrenia.

Psychological interventions: state of the art.

The usefulness of psychological interventions in smoking cessation is well established. Ongoing efforts are aimed at establishing interventions for specific diagnostic groups, developing interventions that are targeted at smokers who do not seek treatment, and combining psychological and pharmacological treatment. There is emerging evidence that useful treatments have been developed for smokers with a depression history, and that expert system interventions based upon a stage model can be useful in changing the smoking behavior of smokers who are not yet ready to quit. Psychological interventions add to the efficacy of nicotine replacement therapy, but whether they add to the efficacy of other pharmacotherapies is not known. There is a need to determine whether psychological interventions are useful for diagnostic groups other than depressive disorder, and if so, whether they need be specific for that group. Additional research is needed on interventions for smokers who are not ready to quit, both in developing new techniques, and determining the need and usefulness of adaptations of those in existence to specific populations.

Nicotine preference in smokers as a function of smoking abstinence

Overnight smoking abstinence increases desire to smoke and intensity of smoking behavior in smokers, but it is not completely clear that this reflects an increase in reinforcement from the psychoactive effects of nicotine per se. We examined choice of nicotine vs. placebo via nasal spray (Study 1) and nicotine vs. nonnicotine cigarette puffs (Study 2) in separate groups of smokers during each of two sessions, following overnight abstinence vs. no abstinence. In each study, subjects followed a forced choice procedure in which they were instructed to self-administer six sprays/puffs from between the two nasal sprays/cigarettes every 15 min for 2 h following initial exposure to each. In Study 1, choice of nicotine spray (1.5 μg/kg per spray) increased significantly following abstinence vs. no abstinence (47 ± 6% vs. 34 ± 5%, respectively, p < 0.05). This shift in choice was more pronounced in the subset of smokers (choosers, n = 9 out of 24) who selected nicotine on more than 50% of choices on the abstinent day. Choosers exhibited greater responses to initial nicotine exposure on positive (e.g., pleasant, vigor) but not aversive (e.g., jittery, uneasy) subjective measures, suggesting that greater positive reinforcement from nicotine per se predicted subsequent choice. In Study 2, abstinence similarly increased choice of nicotine vs. nonnicotine cigarette puffs (82 ± 6% vs. 64 ± 8%, p < 0.05), although nearly all subjects (12 of 13) preferred the nicotine cigarette following abstinence. These results indicate that choice of nicotine per se, isolated from tobacco smoke, increases significantly after overnight tobacco abstinence.

Increased desire to smoke during acute stress.

Conditions which promote smoking urges, or desire to smoke, are believed to be important in maintaining smoking behaviour, yet little controlled research has examined acute situational factors which increase desire to smoke. In this study, 16 male and 16 female smokers either smoked or sham-smoked with an unlit cigarette after brief abstinence during two sessions, one involving a stressful computer task and the other a non-stress task. Desire to smoke was greater during the stress vs. non-stress task for sham-smokers (p less than 0.01). Furthermore, although smoking desire decreased markedly after smoking in the smoking smokers (p less than 0.001), even this group tended to report greater desire to smoke during stress (p less than 0.10). There were no differences between males and females. These findings indicate that exposure to stressors increases desire to smoke, and suggest that such situations may be influential in maintaining smoking behaviour in smokers not attempting to quit.