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Her W, Jung H, Sam Oh Y. Examining Predictors of Nicotine Dependence in Korean Adolescents : Comparing Ever Quitters and Never Quitters. J Psychoactive Drugs 2024; 56:264-271. [PMID: 36967576 DOI: 10.1080/02791072.2023.2184736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 01/30/2023] [Indexed: 03/29/2023]
Abstract
Despite growing research on adolescent smokers, evidence for the differences between the two smoker groups who are ever quitters and never quitters is limited. The study aimed to examine predictors of nicotine dependence (ND) in Korean adolescents by comparing ever quitters and never quitters. Data from 349 adolescents were collected through an online survey. Among respondents, most of them were male, living with families, and were enrolled at schools. Data were analyzed by dividing participants into two groups - ever quitters and never quitters. The study found that adolescents' ND was commonly predicted by smoking peers and anxiety. However, schooling status was significantly associated with ever quitters' ND only. In the total sample, never-quitters were associated with higher ND compared to ever-quitters. This study did not control for differences among ever quitters in terms of the number of attempts to quit smoking and did not significantly control age effects in the sample. Based on study results, we suggest various policy implications. Cessation intervention should be designed keeping in mind the smokers' previous quit attempts and their motivation. It is also recommended that individually tailored smoking cessation programs be used to address the heterogenous nature of the adolescents.
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Affiliation(s)
- Wonbin Her
- Department of Social Welfare, Pukyong National University, Busan, South Korea
| | - Hyejin Jung
- Department of Public Administration, Pusan National University, Busan, South Korea
| | - Young Sam Oh
- Department of Social Welfare, Pukyong National University, Busan, South Korea
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Wang L, Siau CS, Baharom N, Hairol MI, Huang L, Wee LH. Media Search Frequency, Source Credibility About e-Cigarette Health Information, and Motivation to Quit EC Among University Students in Chengdu, China. Int J Gen Med 2024; 17:895-907. [PMID: 38476623 PMCID: PMC10929557 DOI: 10.2147/ijgm.s430997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose E-cigarettes (ECs) are gaining popularity among young people. This study aimed to assess university student vapers' search frequency and source credibility of commonly used media in China, and their association with daily EC users' motivation to quit EC use. Participants and Methods This was a cross-sectional study involving an online quantitative survey in six universities in Chengdu, China. Participants answered questions on their EC use patterns, motivation to quit EC, use frequency and source credibility of media use. Hierarchical linear regression analyses were performed to determine the association between media search frequency and source credibility concerning EC health information with the motivation to quit EC. Results There were a total of 325 participants (Mean age = 20.43, SD = 1.333). Video platforms and social media were ranked frequently used by the participants and were deemed to be more trustworthy. Perceived trustworthiness of online media was the most influential predictor of motivation to quit EC. Those who reported a higher frequency of accessing video platforms and medical health applications recorded higher motivation to quit EC use. Source credibility of news portals were associated higher motivation to quit EC. The association between higher nicotine dependence and lower motivation to quit EC was attenuated when media source credibility and trustworthiness of online media were added into the fully adjusted regression models. Conclusion There is an association between media use frequency and source credibility to search for EC health information and motivation to quit vaping. More studies could be conducted to examine the effects of media use content on perceptions towards vaping and their motivation to quit vaping.
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Affiliation(s)
- Li Wang
- Ya’an Polytechnic College, Ya’an, Sichuan, 625000, People’s Republic of China
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Nizam Baharom
- Primer Healthcare Department, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, 71800, Malaysia
| | - Mohd Izzuddin Hairol
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
| | - Lixin Huang
- Chengdu Sport University, Chengdu, Sichuan, 610000, People’s Republic of China
| | - Lei Hum Wee
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, 50300, Malaysia
- School of Medicine, Faculty of Health & Medical Sciences, Taylor’s University, Subang Jaya, Selangor, 47500, Malaysia
- Non-Communicable Diseases and Public Health Research Group, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, 47500, Malaysia
- Digital Health and Innovations Impact Lab, Taylor’s University, Subang Jaya, 47500, Malaysia
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Jalli VV, Sreepradha C, Halemani S, Mutha A, Sharma R, Joshi H, Chhabra KG. Impact of nicotine dependence on self-efficacy and readiness to quit among tobacco consumers in rural areas. J Family Med Prim Care 2024; 13:1079-1084. [PMID: 38736831 PMCID: PMC11086753 DOI: 10.4103/jfmpc.jfmpc_1624_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/13/2023] [Accepted: 12/27/2023] [Indexed: 05/14/2024] Open
Abstract
Aim and Objectives The aim of the present study was to determine the impact or effect of nicotine dependence on self-efficacy and readiness to quit. Materials and Method The current study was performed using a cross-sectional descriptive questionnaire design among tobacco users visiting primary health care facilities in the rural Jaipur district. Jaipur district is divided into four directions: east, west, north, and south. From each direction, two PHCs were selected randomly based on suitable accessibility to patients. Sample size of study is 465. Out of 465 tobacco consumers, 238 were consuming a smoked form of tobacco, and 227 study participants were consuming a smokeless form of tobacco. Results It was observed that the majority of study participants (145 (31%)) need smoke/smokeless tobacco within 5 minutes of waking up. With regards to internal stimuli, the majority of study participants (179 (38%)) and (203 (44%)) were not very sure that they would refrain from smoking when they were nervous and depressed. It was determined that quitting tobacco products was not at all important for 159 (34%) study participants. In regards to confidence in tobacco product quitting, only 79 (16%) of tobacco consumers were extremely confident. Conclusion It was concluded that nicotine dependence impacts both self-efficacy and readiness to quit. It was determined that the higher the nicotine dependence, the less self-efficacy and the less would be the readiness to quit.
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Affiliation(s)
- Vishwanath V Jalli
- Department of Oral Medicine and Radiology, Government Dental College and Research Institute, Vims, Ballari, Karnataka, India
| | - C Sreepradha
- Department of Oral Medicine and Radiology, Government Dental College and Research Institute, Vims, Ballari, Karnataka, India
| | - Shweta Halemani
- Department of Periodontics, Government Dental College and Research Institute, Vims, Ballari, Karnataka, India
| | - Animesh Mutha
- Orthodontics and Dentofacial Orthopaedics, Pacific Dental College and Research Centre, Debari, Udaipur, Rajasthan, India
| | - Rituraj Sharma
- Orthodontics and Dentofacial Orthopaedics, Pacific Dental College and Research Centre, Debari, Udaipur, Rajasthan, India
| | - Himanshu Joshi
- Prosthodontics, Crown Bridge and Implantology, Daswani Dental College, Kota, Rajasthan, India
| | - Kumar Gaurav Chhabra
- Department of Public Health Dentistry, Nims Dental College and Hospital, Nims University, Rajasthan, Jaipur, India
- Adjunct Faculty, Research and Developmental Cell, Datta Meghe Institute of Higher Education and Research, Sawangi, Wardha, Maharashtra, India
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Wee LH, Galvan JAA, Patil SS, Madhavan P, Mahalingam D, Yeong CH, Wong YH, Poh HQ, Suthahar S, David SD, Tan XJ, Rosli IA, Chan CMH, Baharom N, Muhamad NA, Siau CS. Understanding Factors Associated with Motivation to Quit Vaping among Vapers in the Federal Territory of Kuala Lumpur, Malaysia. Healthcare (Basel) 2023; 11:1980. [PMID: 37510421 PMCID: PMC10379365 DOI: 10.3390/healthcare11141980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 07/30/2023] Open
Abstract
The prevalence of vaping worldwide is showing an upward trend. This study aimed to determine the factors associated with motivation to quit vaping among vapers in the Federal Territory of Kuala Lumpur, Malaysia, through a cross-sectional, purposive sampling study. Respondents were required to complete a questionnaire consisting of vapers' sociodemographic questions, habitual behavioral pattern questions, the e-Fagerström Test of Nicotine Dependence, the Glover-Nilsson Smoking Behavioral Dependence Questionnaire, perception questions, motivation to quit questions, and withdrawal symptom questions. A total of 311 vapers participated in this study. The majority of the vapers were male (84.6%), younger (18-25 years) (55.3%), and with monthly income less than RM 4000 (USD 868; 83.9%). The level of motivation to quit vaping was found to have a significant association with the perception of vaping being as satisfying as cigarette smoking (p = 0.006) and mild to very strong nicotine dependence (p = 0.001). Participants who recorded moderate and strong habitual vaping behaviors had lower odds of having high motivation to quit vaping compared to those recording slight habitual behaviors (OR = 0.279, 95%CI(0.110-0.708), p = 0.007 and OR = 0.185, 95%CI(0.052-0.654), p = 0.009, respectively). Factors associated with higher motivation to quit vaping could be explored to gain better understanding of how to increase their motivation level for future quit attempts.
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Affiliation(s)
- Lei Hum Wee
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Jo Ann Andoy Galvan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Sapna Shridhar Patil
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Priya Madhavan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Dinesh Mahalingam
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- SP Care Group, Level 3, Menara SP Care, Rawang Sentral, Rawang 48000, Malaysia
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Yin How Wong
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Non-communicable Diseases and Public Health Research Group, School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
- Medical Advancement for Better Quality of Life Impact Lab, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Hui Qi Poh
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Sanjay Suthahar
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Shamella Diya David
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Xiao Jing Tan
- School of Medicine, Faculty of Health & Medical Sciences, Taylor's University, 1 Jalan Taylors, Subang Jaya 47500, Malaysia
| | - Izzah Athirah Rosli
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Caryn Mei Hsien Chan
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
| | - Nizam Baharom
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai 71800, Malaysia
| | - Nor Asiah Muhamad
- Sector for Evidence-Based Healthcare, National Institutes of Health, Ministry of Health, Shah Alam 40170, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia
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Liao Y, Wang Y, Tang J, Wu Q, Wu Z, McNeill A. Predictors of long-term abstinence in a randomized controlled trial of smoking cessation by mobile phone text messaging (‘Happy Quit’) in China. Tob Prev Cessat 2022; 8:31. [PMID: 35991840 PMCID: PMC9354670 DOI: 10.18332/tpc/152255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION The mobile phone-based text messaging intervention (‘Happy Quit’) is a minimal and effective intervention with very wide reach; thus, it has the possibility of a population impact on quitting rates. Obtaining information on predictors of long-term quit rates is crucial for developing and implementing more effective mobile-based interventions. The study aimed to explore the predictors of long-term abstinence following the ‘Happy Quit’ intervention. METHODS This study is a secondary analysis of a randomized controlled trial (RCT) that compared 12-week text messaging intervention (‘Happy Quit’) versus control intervention with follow-up at 24 weeks, in China. Only participants who had biochemically verified continuous smoking abstinence at 24 weeks were followed up at 52 weeks after the quit date. This predictor regression analysis is for those who were biochemically verified continuous 52-week quitters (n=67) compared with the other participants (n=1302) in the RCT. RESULTS Of the 69 smokers who were continuously abstinent at 24 weeks, 97.1% (n=67) remained continuously abstinent at 52 weeks. The biochemically verified long-term (52 weeks or 1year) quit rate was 6.3% in the intervention group (60/958), 1.7% in the control group (7/411) (OR=3.677; 95% CI: 1.67–8.11, p<0.001). Multivariable regression analysis revealed that only smoked ≤10 cigarettes per day (compared with >10 cigarettes per day) was the only predictor for long-term abstinence. CONCLUSIONS This study suggests that individuals who are light smokers might get the most benefit from the text messaging intervention (‘Happy Quit’) in China.
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Affiliation(s)
- Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- CORRESPONDENCE TO Yanhui Liao. Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, 3 East Qingchun Road, Hangzhou, 310016 Zhejiang, China. E-mail:
| | - Yunfei Wang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, the Second Xiangya Hospital of Central South University, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Qiuxia Wu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, the Second Xiangya Hospital of Central South University, China
| | - Zhenzhen Wu
- Ningbo Kangning Hospital, Zhejiang Province, Ningbo, China
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
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Chaffee BW, Halpern-Felsher B, Jacob P, St Helen G. Biomarkers of nicotine exposure correlate with the Hooked on Nicotine Checklist among adolescents in California, United States. Addict Behav 2022; 128:107235. [PMID: 35033980 PMCID: PMC8897155 DOI: 10.1016/j.addbeh.2022.107235] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/15/2021] [Accepted: 01/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Hooked on Nicotine Checklist (HONC) has been used to assess nicotine dependence (loss of autonomy over tobacco) among adolescents. Existing HONC validation studies for non-cigarette products, such as electronic cigarettes (e-cigarettes), have generally not considered biomarkers of nicotine exposure. METHODS Within a cross-sectional sample of California (USA) high school students (total N = 1396; mean age 15.2 years; 56% female; 54% Hispanic/Latinx), self-reported past 30-day users of any tobacco (including e-cigarettes) completed a modified 10-item HONC questionnaire and provided saliva samples (N = 318 samples, including N = 234 exclusive past 30-day e-cigarette users). Samples were analyzed for cotinine using liquid chromatography-tandem mass spectrometry (lower limit of quantification: 1.0 ng/mL). RESULTS Across four categories of HONC score corresponding to an increasing number of reported dependence symptoms (scores: 0, 1, 2-4, 5-10), the prevalence of quantifiable salivary cotinine increased among past 30-day tobacco users (20%, 21%, 38%, 55%, respectively, P-for-trend < 0.001) and among past 30-day exclusive e-cigarette users (15%, 22%, 31%, 42%, respectively, P-for-trend = 0.001). Among participants with quantifiable cotinine levels, HONC total score and cotinine were positively correlated among past 30-day tobacco users (n = 89; Spearman rho = 0.449; P < 0.001) and past 30-day exclusive e-cigarette users (n = 49; Spearman rho = 0.520; P < 0.001). HONC score was also associated with past 30-day frequency of tobacco product use and reported use of tobacco within 30 min of waking. CONCLUSIONS These results support the validity of HONC to assess nicotine dependence among adolescents. Dependence symptoms may be experienced at low levels of nicotine exposure.
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Liao Y, Tang J. Feasibility and Acceptability of a Cognitive Behavioral Therapy-Based Smartphone App for Smoking Cessation in China: A Single-Group Cohort Study. Front Psychiatry 2021; 12:759896. [PMID: 35309757 PMCID: PMC8928122 DOI: 10.3389/fpsyt.2021.759896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous research has suggested that mobile phone applications (apps) may potentially increase quit rates. The purpose of this single-group cohort study sought to examine the feasibility and acceptability of a novel smartphone-based smoking cessation app designed for smoking cessation in China: smoking quit rate. METHODS A total of 180 smokers from two cities of mainland China with willingness to make a quit attempt were invited to this smoking cessation app program, a cognitive behavioral theory (CBT)-based smoking cessation intervention via a smartphone app. Participants received 37- to 44-day intervention (including 7- to 14-day pre-quit preparation and 33-day intervention from quit date). Feasibility and acceptability of the program, and smoking status were assessed at baseline stage (initial installation), pre-quit stage, and post-quit stage (days 7, 15, and 33 after quit date). RESULTS A total of 163 (90.6%) participants completed the study. Among them, 76-89% of the participants logged into the app ≥1 time per day across stages (at baseline, during pre-quit stage, and on days 7, 15, and 33 of post-quit stage); approximately 90% of the participants were satisfied with the app across stages. A significant rise in self-reported overall satisfaction with the app is observed from baseline (93% at Time 1) to the end of the program (98% at Time 2, 33 days after quit date) (p = 0.021). Participants who believed/agreed this app can help them to quit smoking significantly increased from 69% at baseline to 97% at day 33 after quit date (p < 0.001). Participants were satisfied with most (80-90%) of the features, especially the information feature. Intention-to-treat analysis showed that the percentage of 33-day self-reported continuous prevalence abstinence was 63.9%, and 7-day point prevalence abstinence rate was 81.7, 87.2, and 77.8% on days 7, 15, and 33 after quit date, respectively. CONCLUSIONS This study demonstrated the feasibility and acceptability of the smartphone app intervention for smoking cessation and introduced a new digital treatment model, which is expected to overcome barriers facing accessing traditional in-person smoking cessation services and extend nationwide smoking cessation services in China.
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Affiliation(s)
- Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Medical Neurobiology of Zhejiang Province, Hangzhou, China
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Kang MJ, Lee H, Jo M. Analysis of multidimensional factors in attempts to quit using tobacco by Korean adolescents. Environ Health Prev Med 2020; 25:71. [PMID: 33218297 PMCID: PMC7679987 DOI: 10.1186/s12199-020-00913-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 11/09/2020] [Indexed: 11/17/2022] Open
Abstract
Background This study aims to understand the extent of adolescents’ attempts to quit using tobacco and the factors influencing such attempts in Korea, using a descriptive, cross-sectional design and secondary data analysis with the 2019 Youth Health Behavior Survey. Methods The participants were 4028 adolescent tobacco users who had used tobacco for 1 day or more in the past 30 days. The data analysis was performed using IBM SPSS/WIN 26.0 program, and multivariable logistic regression analysis was conducted using the complex sampling method module. Results A total of 68.2% of the participants attempted to quit using tobacco. We analyzed the factors for adolescents’ attempts to quit using tobacco by dividing them into psychological, physical, behavioral, and environmental dimensions. The factors influencing adolescents’ attempts to quit using tobacco, identified through multivariable logistic regression analysis, are as follows: participation in sports activities (OR = 1.20, 95% CI 1.01–1.41), vigorous physical activity (OR = 1.24, 95% CI 1.06–1.46), and type of tobacco product used (OR = 1.65, 95% CI 1.24–2.21) in the behavioral dimension; pictorial cigarette pack warnings (perceived smoking as unhealthy) (OR = 1.91, 95% CI 1.56–2.36), and the presence of secondhand smoking at home (OR = 1.18, 95% CI 1.01–1.38) in the environmental dimension. Conclusions Schools and public healthcare providers must consider multidimensional factors when providing support for successful tobacco cessation in adolescents and focus particularly on elements relating to physical activity and environmental factors.
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Affiliation(s)
- Mi-Jung Kang
- College of Nursing, Department of Nursing, Eulji University, Daejeon, 34824, Republic of Korea
| | - Hyunjin Lee
- College of Nursing, Department of Nursing, Eulji University, Daejeon, 34824, Republic of Korea.
| | - Mirae Jo
- College of Nursing, Department of Nursing, Eulji University, Daejeon, 34824, Republic of Korea
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Chellian R, Behnood-Rod A, Wilson R, Wilks I, Knight P, Febo M, Bruijnzeel AW. Exposure to smoke from high- but not low-nicotine cigarettes leads to signs of dependence in male rats and potentiates the effects of nicotine in female rats. Pharmacol Biochem Behav 2020; 196:172998. [PMID: 32681850 DOI: 10.1016/j.pbb.2020.172998] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 01/03/2023]
Abstract
Nicotine is only mildly rewarding, but after becoming dependent, it is difficult to quit smoking. The goal of these studies was to determine if low-nicotine cigarettes are less likely to cause dependence and enhance the reinforcing effects of nicotine than regular high-nicotine cigarettes. Male and female rats were exposed to tobacco smoke with a low or high nicotine level for 35 days. It was investigated if smoke exposure affects the development of dependence, anxiety- and depressive-like behavior, and nicotine-induced behavioral sensitization. Smoke exposure did not affect locomotor activity in a small open field or sucrose preference. Mecamylamine precipitated somatic withdrawal signs in male rats exposed to smoke with a high level of nicotine, but not in male rats exposed to smoke with a low level of nicotine or in females. After cessation of smoke exposure, there was a small decrease in sucrose preference in the male rats, which was not observed in the females. Cessation of smoke exposure did not affect anxiety-like behavior in the large open field or the elevated plus maze test. Female rats displayed less anxiety-like behavior in both these tests. Repeated treatment with nicotine increased locomotor activity, rearing, and stereotypies. Prior exposure to smoke with a high level of nicotine increased nicotine-induced rearing in the females. These findings indicate that exposure to smoke with a low level of nicotine does not lead to dependence and does not potentiate the effects of nicotine. Exposure to smoke with a high level of nicotine differently affects males and females.
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Affiliation(s)
| | - Azin Behnood-Rod
- Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA
| | - Ryann Wilson
- Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA
| | - Isaac Wilks
- Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA
| | - Parker Knight
- Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA
| | - Marcelo Febo
- Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA; Center for Addiction Research and Education, University of Florida, Gainesville, FL 32610, USA
| | - Adriaan W Bruijnzeel
- Department of Psychiatry, University of Florida, Gainesville, FL 32610, USA; Center for Addiction Research and Education, University of Florida, Gainesville, FL 32610, USA.
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The Association of Smoking Exposure at Home with Attempts to Quit Smoking and Cessation Success: A Survey of South Korean Adolescents Who Smoke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114129. [PMID: 32531888 PMCID: PMC7312504 DOI: 10.3390/ijerph17114129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 11/17/2022]
Abstract
This study aimed to examine the association of smoking exposure at home with attempts to quit smoking and the success or failure of such attempts among South Korean adolescents. We utilized the data of 28,652 South Korean adolescents who smoked from the 2015-2017 Korea Youth Risk Behavior Web-based Survey, including demographic variables (age, sex, and family structure), socioeconomic variables (allowance per week, household income level, and grade), and health-related characteristics (alcohol consumption, intensity of physical activity, stress level, self-reported health status, attendance in smoking cessation programs, and smoking onset). A multiple logistic regression analysis revealed that attempting to quit smoking was less likely among those exposed to smoking at home every day compared to those without such exposure (boys exposed to smoking every day: OR = 0.52, CI = 0.45-0.60; girls exposed to smoking every day: OR = 0.48, CI = 0.38-0.61); cessation success showed similar results (boys exposed to smoking every day: OR = 0.51, CI = 0.46-0.58; girls exposed to smoking every day: OR = 0.56, CI = 0.47-0.66). These findings highlight the impacts of smoking exposure at home and the importance of considering this exposure when supporting adolescents to quit.
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Lally J, Spaducci G, Gardner-Sood P, Atakan Z, Greenwood K, Di Forti M, Ismail K, Murphy KC, Smith S, McNeill A, Murray RM, Gaughran F. Tobacco smoking and nicotine dependence in first episode and established psychosis. Asian J Psychiatr 2019; 43:125-131. [PMID: 31132542 DOI: 10.1016/j.ajp.2019.05.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 03/28/2019] [Accepted: 05/02/2019] [Indexed: 01/08/2023]
Abstract
AIM People with psychotic disorders have increased premature mortality in comparison with the general population, with high rates of cigarette use a contributing factor. We aimed to describe the prevalence of cigarette use and nicotine dependence (ND) in first episode psychosis (FEP), and established psychosis; and to investigate associations between clinical symptoms and ND. METHODOLOGY Smoking and clinical data were collected from two cohorts: 181 people with FEP recruited as part of the Physical Health and Substance Use Measures in First Onset Psychosis (PUMP) study and from 432 people with established psychosis recruited as part of the Improving physical health and reducing substance use in psychosis randomised controlled trial (IMPaCT RCT). RESULTS The prevalence of cigarette smoking was 78% in FEP and 62% in established psychosis. Forty nine percent (n = 60) of smokers in the FEP cohort and 69% (n = 183) of smokers with established psychosis were highly nicotine dependent. Being a highly nicotine dependent smoker was significantly associated with higher PANSS positive symptom scores (F = 5.480 p = 0.004), and with decreased scores on the Rosenberg self-esteem scale (F = 3.261, p = 0.039) in established psychosis. There was no diagnostic specificity identified in relation to smoking or ND in both groups. CONCLUSION High rates of cigarette usage and nicotine dependence are problems from the early stages of psychosis. ND is higher in people with established psychosis. Smoking cessation strategies as part of comprehensive management of psychotic disorders at every stage require further development and evaluation.
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Affiliation(s)
- John Lally
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK; Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland; Department of Psychiatry, School of Medicine and Medical Sciences, University College Dublin, St Vincent's University Hospital, Dublin, Ireland; St Vincent's Hospital Fairview, Dublin, Ireland.
| | - Gilda Spaducci
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK.
| | | | - Zerrin Atakan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK
| | - Kathryn Greenwood
- Sussex Partnership NHS Foundation Trust, School of Psychology, University of Sussex, Brighton, UK.
| | - Marta Di Forti
- MRC Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK.
| | - Khalida Ismail
- Psychological Medicine Department, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, Denmark Hill, London, UK.
| | - Kieran C Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
| | - Shubulade Smith
- Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, Denmark Hill, London, UK; Forensic Intensive Care Service, South London and Maudsley NHS Foundation Trust, London, UK.
| | - Ann McNeill
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK.
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK; Department of Psychiatry, Experimental Biomedicine and Clinical Neuroscience (BIONEC), University of Palermo, Italy.
| | - Fiona Gaughran
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London, UK; National Psychosis Service, South London and Maudsley NHS Foundation Trust, Reader, Institute of Psychiatry Psychology and Neuroscience, Kings College London, London, UK.
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Case KR, Mantey DS, Creamer MR, Harrell MB, Kelder SH, Perry CL. E-cigarette- specific symptoms of nicotine dependence among Texas adolescents. Addict Behav 2018; 84:57-61. [PMID: 29627634 DOI: 10.1016/j.addbeh.2018.03.032] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The potential of e-cigarettes to elicit symptoms of nicotine dependence has not been adequately studied, particularly in adolescent populations. The present study examined the prevalence of e-cigarette-specific symptoms of nicotine dependence ("symptoms of e-cigarette dependence") and the associations between these symptoms, e-cigarette usage group, and e-cigarette cessation-related items among Texas adolescents. METHODS This study involved a cross-sectional analysis of adolescents from Wave 4 of the Texas Adolescent Tobacco and Marketing Surveillance System (TATAMS) (n = 2891/N = 461,069). Chi-Square analyses examined differences in the prevalence of symptoms of dependence by e-cigarette usage group (exclusive versus dual users of e-cigarettes and combustible tobacco products) and demographic characteristics. Weighted multivariable logistic regression analyses examined the associations between symptoms of e-cigarette dependence, e-cigarette usage group, and e-cigarette cessation items. RESULTS Exclusive e-cigarette users experienced symptoms of e-cigarette dependence, although the prevalence of most of the symptoms was higher for dual users. Adolescents who reported more symptoms of dependence were less likely to report both wanting to quit e-cigarettes and a past-year quit attempt for e-cigarettes (adjusted odds ratio "AOR" = 0.61 (95% CI = 0.41, 0.92) and AOR = 0.52 (95% CI = 0.30, 0.92), respectively). CONCLUSIONS This study is the first to demonstrate that adolescent e-cigarette users are experiencing symptoms of dependence specific to e-cigarettes. In addition, symptoms of dependence may be barriers to e-cigarette cessation. Future research is needed to determine if characteristics of e-cigarette use (e.g. frequency and intensity) are associated with dependence.
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Horn K, Ali M, Gray T, Anesetti-Rothermel A, Branstetter S. School-level disadvantage and failed cessation treatment among adolescent smokers. Tob Prev Cessat 2018; 4:11. [PMID: 32411839 PMCID: PMC7205073 DOI: 10.18332/tpc/87074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION While understanding factors that lead to successful adolescent smoking cessation outcomes is necessary, it is also prudent to determine factors and conditions that contribute to failure to quit smoking. The present study posits that adolescents' proximal environments, such as schools, may influence cessation treatment outcomes. METHODS Using aggregated and geographically-referenced data from multi-year school-based cessation trials with 14-19 year olds seeking cessation in 5 States of the USA, the present study developed and applied a tobacco-specific socio-spatial model inclusive of Hierarchical Linear Modeling. Specifically, this novel approach spatially joined individual data files (n=8855) with measures of school (n=807) and county socio-economic factors. Once linked multi-level analyses explored the extent to which cessation treatment failure was explained by the interplay of individual, school and county-level factors. Treatment was deemed as failing to meet its primary goals if participants continued to smoke cigarettes, measured 3-months post baseline. RESULTS Ten per cent of the variation in cessation treatment failure was attributable to school-level variables. Adolescent smokers were more likely to experience failure to quit in: a) school districts with large percentages of the population having less than high-school education, and b) schools with a higher ratio of students to teachers. The strength of the relationship between cessation self-efficacy and treatment success was further weakened among adolescents attending schools with higher percentages of students eligible for free or reduced lunch programs. CONCLUSIONS Findings implicate school-level socio-economic disadvantage as a significant factor inhibiting cessation, regardless of adolescent self-efficacy to quit smoking. Understanding the interplay of proximal school environments and individual-level factors may provide insights to educators, policy makers and practitioners into the complexities that inhibit or strengthen an adolescent's smoking cessation treatment experience.
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Affiliation(s)
- Kimberly Horn
- Department of Population Health Sciences, Virginia Tech Carilion Research Institute, Virginia, United States
| | - Maliha Ali
- Milken Institute School of Public Health, Department of Prevention and Community and Health, George Washington University, Washington, United States
| | - Tiffany Gray
- Milken Institute School of Public Health, Department of Prevention and Community and Health, George Washington University, Washington, United States
| | | | - Steve Branstetter
- Department of Biobehavioral, Health Pennsylvania State University, United States
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Fanshawe TR, Halliwell W, Lindson N, Aveyard P, Livingstone‐Banks J, Hartmann‐Boyce J. Tobacco cessation interventions for young people. Cochrane Database Syst Rev 2017; 11:CD003289. [PMID: 29148565 PMCID: PMC6486118 DOI: 10.1002/14651858.cd003289.pub6] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Most tobacco control programmes for adolescents are based around prevention of uptake, but teenage smoking is still common. It is unclear if interventions that are effective for adults can also help adolescents to quit. This is the update of a Cochrane Review first published in 2006. OBJECTIVES To evaluate the effectiveness of strategies that help young people to stop smoking tobacco. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group's Specialized Register in June 2017. This includes reports for trials identified in CENTRAL, MEDLINE, Embase and PsyclNFO. SELECTION CRITERIA We included individually and cluster-randomized controlled trials recruiting young people, aged under 20 years, who were regular tobacco smokers. We included any interventions for smoking cessation; these could include pharmacotherapy, psycho-social interventions and complex programmes targeting families, schools or communities. We excluded programmes primarily aimed at prevention of uptake. The primary outcome was smoking status after at least six months' follow-up among those who smoked at baseline. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of candidate trials and extracted data. We evaluated included studies for risk of bias using standard Cochrane methodology and grouped them by intervention type and by the theoretical basis of the intervention. Where meta-analysis was appropriate, we estimated pooled risk ratios using a Mantel-Haenszel fixed-effect method, based on the quit rates at six months' follow-up. MAIN RESULTS Forty-one trials involving more than 13,000 young people met our inclusion criteria (26 individually randomized controlled trials and 15 cluster-randomized trials). We judged the majority of studies to be at high or unclear risk of bias in at least one domain. Interventions were varied, with the majority adopting forms of individual or group counselling, with or without additional self-help materials to form complex interventions. Eight studies used primarily computer or messaging interventions, and four small studies used pharmacological interventions (nicotine patch or gum, or bupropion). There was evidence of an intervention effect for group counselling (9 studies, risk ratio (RR) 1.35, 95% confidence interval (CI) 1.03 to 1.77), but not for individual counselling (7 studies, RR 1.07, 95% CI 0.83 to 1.39), mixed delivery methods (8 studies, RR 1.26, 95% CI 0.95 to 1.66) or the computer or messaging interventions (pooled RRs between 0.79 and 1.18, 9 studies in total). There was no clear evidence for the effectiveness of pharmacological interventions, although confidence intervals were wide (nicotine replacement therapy 3 studies, RR 1.11, 95% CI 0.48 to 2.58; bupropion 1 study RR 1.49, 95% CI 0.55 to 4.02). No subgroup precluded the possibility of a clinically important effect. Studies of pharmacotherapies reported some adverse events considered related to study treatment, though most were mild, whereas no adverse events were reported in studies of behavioural interventions. Our certainty in the findings for all comparisons is low or very low, mainly because of the clinical heterogeneity of the interventions, imprecision in the effect size estimates, and issues with risk of bias. AUTHORS' CONCLUSIONS There is limited evidence that either behavioural support or smoking cessation medication increases the proportion of young people that stop smoking in the long-term. Findings are most promising for group-based behavioural interventions, but evidence remains limited for all intervention types. There continues to be a need for well-designed, adequately powered, randomized controlled trials of interventions for this population of smokers.
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Affiliation(s)
- Thomas R Fanshawe
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - William Halliwell
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - Nicola Lindson
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - Paul Aveyard
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
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Lee K, Hahn EJ, Riker CA, Hoehne A, White A, Greenwell D, Thompson D. Secondhand Smoke Exposure in a Rural High School. J Sch Nurs 2016; 23:222-8. [PMID: 17676970 DOI: 10.1177/10598405070230040701] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Although federal law requires all public schools to be smoke free, lack of compliance with the smoke-free policy is commonly reported. The aims of this study were to describe the indoor fine-particle (PM2.5) air pollution in a rural high school and surrounding public venues. This cross-sectional, nonexperimental study was conducted in Monroe County, Kentucky (population of 11,756). Fine-particle concentrations were measured in the high school and 5 public venues using spectrometers. Because of illegal student smoking, PM2.5 concentrations were 19 times higher in the boys’ student restroom than the National Ambient Air Quality Standard for outdoor air (670 vs. 35 μg/m3). The staff restrooms adjacent to the student restroom where staff did not smoke also showed high PM2.5 levels. Average indoor air pollution in the public venues was 158 μg/m3. Strict enforcement of smoke-free school policy and cessation resources are needed to reduce secondhand smoke exposure. Collaborative school-community campaigns involving parents, students, mass media, and community organizations may be effective in reducing the harm caused by tobacco. Implications for school nurses are discussed.
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Affiliation(s)
- Kiyoung Lee
- Department of Preventive Medicine and Environmental Health, College of Public Health, University of Kentucky, Lexington, KY, USA
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Abstract
This technical report serves to provide the evidence base for the American Academy of Pediatrics' policy statements "Clinical Practice Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke" and "Public Policy to Protect Children From Tobacco, Nicotine, and Tobacco Smoke." Tobacco use and involuntary exposure are major preventable causes of morbidity and premature mortality in adults and children. Tobacco dependence almost always starts in childhood or adolescence. Electronic nicotine delivery systems are rapidly gaining popularity among youth, and their significant harms are being documented. In utero tobacco smoke exposure, in addition to increasing the risk of preterm birth, low birth weight, stillbirth, placental abruption, and sudden infant death, has been found to increase the risk of obesity and neurodevelopmental disorders. Actions by pediatricians can help to reduce children's risk of developing tobacco dependence and reduce children's involuntary tobacco smoke exposure. Public policy actions to protect children from tobacco are essential to reduce the toll that the tobacco epidemic takes on our children.
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Kleinjan M, van den Eijnden RJJM, van Leeuwe J, Brug J, van de Ven MOM, Engels RCME. Adolescents' movement towards cessation of smoking: role and relative value of the processes of change and nicotine dependence. Psychol Health 2014; 23:729-43. [PMID: 25160813 DOI: 10.1080/08870440701757344] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The present study addresses the applicability of the Transtheoretical Model's processes of change in explaining adolescents' readiness to quit smoking. Furthermore, the association between nicotine dependence and readiness to quit was assessed both directly, as well as indirectly through the processes of change. A cross-sectional survey was conducted, identifying 1547 weekly smokers aged 14-18 years. Structural equation modelling showed that the processes of change were only marginally associated with readiness to quit. Adding nicotine dependence to the model showed a direct association between nicotine dependence and readiness to quit. Only one process of change, self-liberation (i.e. choice/commitment to change and belief in the ability to change), was found to mediate this association. Nicotine dependence appeared to be highly important in adolescents' readiness to quit.
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Affiliation(s)
- Marloes Kleinjan
- a Addiction Research Institute (IVO) , Rotterdam , The Netherlands
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Nicotine dependence matters: examining longitudinal association between smoking and physical activity among Canadian adults. Prev Med 2013; 57:652-7. [PMID: 23994713 DOI: 10.1016/j.ypmed.2013.08.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 08/14/2013] [Accepted: 08/19/2013] [Indexed: 11/22/2022]
Abstract
OBJECTIVE A number of studies point to the inverse relationship between physical activity and smoking; however, none has examined the role of nicotine dependence in physical activity participation among smokers. This study examined whether levels of nicotine dependence modify the association between leisure time physical activity and smoking status. METHODS The study used longitudinal data on 6795 adults from the Canadian National Population Health Survey (2004-2010). Generalized estimating equations were used to examine the association between physical activity, smoking, and nicotine dependence. RESULTS We found that nicotine dependent smokers were significantly less likely to be physically active compared to non-smokers. Specifically, using the Fagerstrom Test for Nicotine Dependence, nicotine dependent smokers (OR 0.65, 95% CI 0.55-0.76) were less likely to be physically active while no significant difference was found for non-dependent smokers (OR 0.90, 95% CI 0.80-1.02) compared to non-smokers. CONCLUSIONS Nicotine dependence matters in shaping engagement in physical activity among daily smokers. Efforts directed at promoting smoking cessation through nicotine dependence treatment intervention may provide additional benefits to health and well-being through an increased participation in physical activity.
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Abstract
BACKGROUND Most tobacco control programmes for adolescents are based around prevention of uptake, but teenage smoking is still common. It is unclear if interventions that are effective for adults can also help adolescents to quit. This is the second update of a Cochrane review first published in 2006. OBJECTIVES To evaluate the effectiveness of strategies that help young people to stop smoking tobacco. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group's Specialized Register in February 2013. This includes reports for trials identified in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and PsyclNFO. SELECTION CRITERIA We included randomized controlled trials, cluster-randomized controlled trials and other controlled trials recruiting young people, aged less than 20, who were regular tobacco smokers. We included any interventions; these could include pharmacotherapy, psycho-social interventions and complex programmes targeting families, schools or communities. We excluded programmes primarily aimed at prevention of uptake. The primary outcome was smoking status after at least six months follow-up among those who smoked at baseline. DATA COLLECTION AND ANALYSIS Both authors independently assessed the eligibility of candidate trials and extracted data. Included studies were evaluated for risk of bias using standard Cochrane methodology. Where meta-analysis was appropriate, we estimated pooled risk ratios using a Mantel-Haenszel fixed-effect method, based on the quit rates at longest follow-up. MAIN RESULTS Twenty-eight trials involving approximately 6000 young people met our inclusion criteria (12 cluster-randomized controlled trials, 14 randomized controlled trials and 2 controlled trials). The majority of studies were judged to be at high or unclear risk of bias in at least one domain. Many studies combined components from various theoretical backgrounds to form complex interventions.The majority used some form of motivational enhancement combined with psychological support such as cognitive behavioural therapy (CBT) and some were tailored to stage of change using the transtheoretical model (TTM). Three trials based mainly on TTM interventions achieved moderate long-term success, with a pooled risk ratio (RR) of 1.56 at one year (95% confidence interval (CI) 1.21 to 2.01). The 12 trials that included some form of motivational enhancement gave an estimated RR of 1.60 (95% CI 1.28 to 2.01). None of the 13 individual trials of complex interventions that included cognitive behavioural therapy achieved statistically significant results, and results were not pooled due to clinical heterogeneity. There was a marginally significant effect of pooling six studies of the Not on Tobacco programme (RR of 1.31, 95% CI 1.01 to 1.71), although three of the trials used abstinence for as little as 24 hours at six months as the cessation outcome. A small trial testing nicotine replacement therapy did not detect a statistically significant effect. Two trials of bupropion, one testing two doses and one testing it as an adjunct to NRT, did not detect significant effects. Studies of pharmacotherapies reported some adverse events considered related to study treatment, though most were mild, whereas no adverse events were reported in studies of behavioural interventions. AUTHORS' CONCLUSIONS Complex approaches show promise, with some persistence of abstinence (30 days point prevalence abstinence or continuous abstinence at six months), especially those incorporating elements sensitive to stage of change and using motivational enhancement and CBT. Given the episodic nature of adolescent smoking, more data is needed on sustained quitting. There were few trials with evidence about pharmacological interventions (nicotine replacement and bupropion), and none demonstrated effectiveness for adolescent smokers. There is not yet sufficient evidence to recommend widespread implementation of any one model. There continues to be a need for well-designed adequately powered randomized controlled trials of interventions for this population of smokers.
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Affiliation(s)
- Alan Stanton
- Heart of England Foundation Trust, 3, The Green, Shirley, UK, B90 4LA
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Carrasco MC, Vidal J, Redolat R. Bupropion induced changes in exploratory and anxiety-like behaviour in NMRI male mice depends on the age. Behav Processes 2013; 98:117-24. [PMID: 23727544 DOI: 10.1016/j.beproc.2013.05.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 03/08/2013] [Accepted: 05/09/2013] [Indexed: 12/15/2022]
Abstract
The aim of this study was to assess the effects of the antidepressant bupropion on anxiety and novelty-seeking in adolescent mice of different ages and adults. Behavioural differences between early adolescent, late adolescent and adult NMRI mice were measured both in the elevated plus-maze and the hole-board tasks following acute administration of bupropion (5, 10, 15, 20mg/kg) or saline. In the plus maze test, early and late adolescent mice treated with bupropion (10, 15mg/kg, respectively) had lower percentages of entries in the open-arms compared to their vehicle controls. Adult mice treated with bupropion did not differ from their vehicle controls. These results suggest that the effect of this drug on anxiety-like behaviour in mice depends on the age, showing adolescents an anxiogenic-like profile. In the hole-board, adolescents showed more elevated levels of novelty-seeking than adults, exhibiting shorter latency to the first head-dip (HD) and a higher number of HD's. Bupropion increases the latency to the first HD and decreases the number of HD's in all age-groups, indicating a decline in exploratory tendency. Findings reveal that the age can modulate the behaviour displayed by mice in both animal models, and that adolescents are more sensitive to bupropion's anxiogenic effects.
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Affiliation(s)
- M Carmen Carrasco
- Departamento Psicobiología, Facultad de Psicología, Universitat de València, Blasco Ibañez, 21, Valencia 46010, Spain.
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Goodwin RD, Zvolensky MJ, Keyes KM, Hasin DS. Mental disorders and cigarette use among adults in the United States. Am J Addict 2013; 21:416-23. [PMID: 22882392 DOI: 10.1111/j.1521-0391.2012.00263.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The goal of this study was to determine the association between mental disorders and cigarette consumption and nicotine dependence. METHODS Data were drawn from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative survey of adults (N = 43,093) aged 18 and older. Relationships between specific anxiety disorders, mood disorders, nondependent cigarette use, nicotine dependence among the whole sample, and nicotine dependence among cigarette users were examined. RESULTS After adjusting for demographics and comorbid mental disorders, generalized anxiety disorder (OR = 1.16 (1.29-1.51)), specific phobia (OR = 1.35 (1.21-1.51)), panic disorder (PD) (OR = 1.90 (1.62-2.23)), major depression (MDD) (OR = 1.31 (1.16-1.48)), and bipolar disorder (OR = 1.30 (1.09-1.54)) were associated with increased likelihood of nondependent cigarette use. Specific phobia (OR = 1.69 (1.49-1.91)), PD (OR = 1.82 (1.50-2.21)), MDD (OR = 1.59 (1.38-1.84)), and bipolar disorder (OR = 1.71 (1.39-2.09)) were associated with increased odds of nicotine dependence among the whole sample; social phobia (OR = 1.69 (1.19-2.40)), specific phobia (OR = 1.69 (1.43-2.01)), MDD (OR = 1.65 (1.34-2.02)), and bipolar disorder (OR = 2.38 (1.74-3.24)) were associated with increased risk of nicotine dependence among cigarette users. CONCLUSIONS Specific anxiety disorders and mood disorders were uniquely associated with nondependent cigarette use, nicotine dependence among the whole sample, and the risk of nicotine dependence among cigarette users in the United States. Findings suggest that demographic differences, comorbid mood, anxiety, substance, and personality disorders all contributed to previously observed associations between mental disorders and nicotine dependence, explaining these links in some but not all cases.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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22
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Park S, Lee JY, Song TM, Cho SI. Age-associated changes in nicotine dependence. Public Health 2012; 126:482-9. [DOI: 10.1016/j.puhe.2012.02.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 11/02/2011] [Accepted: 02/10/2012] [Indexed: 11/16/2022]
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Saunders C, Geletko K. Adolescent cigarette smokers' and non-cigarette smokers' use of alternative tobacco products. Nicotine Tob Res 2012; 14:977-85. [PMID: 22318693 DOI: 10.1093/ntr/ntr323] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION This study uses the most recent data from the nationally representative National Youth Tobacco Survey (NYTS) to examine the use of alternative tobacco products among U.S. cigarette smokers and non-cigarette smokers aged 14-17. Alternative tobacco product use is defined as use of one or more of the following products: smokeless tobacco, cigars, pipes, bidis, or kreteks. METHODS Using the results from the 2004, 2006, and 2009 NYTS, multivariate logistic regressions were used to investigate separately the extent of alternative tobacco product use in current cigarette smokers and in those who reported not smoking cigarettes controlling for demographic and other independent influences. RESULTS The results indicate that for adolescent smokers and nonsmokers, the use of one type of alternative tobacco product made it much more likely the individual would use one or more of the other alternative tobacco products. Non-cigarette smokers using these tobacco products appeared to exhibit symptoms of nicotine dependence comparable to those of cigarette smokers. CONCLUSIONS More information on adolescent use of alternative tobacco products is needed. Current cigarette use declined 3.4% annually over 2004-2009 for the NYTS 14- to 17-year-old population, but this cohort's use of alternative tobacco products was unchanged. The number of adolescents aged 14-17 who did not smoke cigarettes but used alternative tobacco products increased 5.9% per year over the same period. Current surveillance measures need to be expanded in order to gain a more comprehensive understanding of adolescent alternative tobacco use.
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Affiliation(s)
- Charles Saunders
- Division of Health Affairs, College of Medicine, Florida State University, 1115 W. Call Street, Tallahassee, FL 32306, USA.
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Bailey SR, Jeffery CJ, Hammer SA, Bryson SW, Killen DT, Ammerman S, Robinson TN, Killen JD. Assessing teen smoking patterns: the weekend phenomenon. Drug Alcohol Depend 2012; 120:242-5. [PMID: 21885211 PMCID: PMC3245765 DOI: 10.1016/j.drugalcdep.2011.07.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 07/15/2011] [Accepted: 07/17/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND Adolescent cigarette smokers may have more daily variability in their smoking patterns than adults. A better understanding of teen smoking patterns can inform the development of more effective adolescent smoking cessation interventions. METHODS Teen smokers seeking cessation treatment (N=366) reported the number of cigarettes smoked on each day of a typical week. A paired t-test was used to examine differences between weekday (Sunday-Thursday) and weekend (Friday-Saturday) smoking. Main effects and interactions for race/ethnicity and gender were assessed using a 2-way ANOVA for the following variables: typical weekly smoking, average weekday smoking, average weekend smoking, and difference between weekday and weekend smoking. Scheffé post hoc tests were used to analyze any statistically significant differences. RESULTS There was significantly more weekend smoking compared to weekday smoking, p<0.001. The difference in weekday versus weekend smoking levels was larger for females than for males, p<0.05. Hispanics reported less typical weekly smoking, p<0.001, less weekday smoking, p<0.001, and less weekend day smoking, p<0.01, compared to Caucasians and multi-racial teens. There was no difference in weekend day versus weekday smoking by race/ethnic background. CONCLUSIONS Using a more detailed assessment of smoking quantity captures patterns of adolescent smoking that may lead to more effective smoking cessation interventions.
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Affiliation(s)
- Steffani R. Bailey
- Stanford University School of Medicine, Stanford Prevention Research Center, 1070 Arastradero Road, Suite 300, Palo Alto, CA, USA, 94304-1334,Corresponding Author: Telephone: (408) 451-7303, FAX: (650) 723-6450,
| | - Christina J. Jeffery
- Stanford University School of Medicine, Stanford Prevention Research Center, 1070 Arastradero Road, Suite 300, Palo Alto, CA, USA, 94304-1334
| | - Sarah A. Hammer
- Stanford University School of Medicine, Stanford Prevention Research Center, 1070 Arastradero Road, Suite 300, Palo Alto, CA, USA, 94304-1334
| | - Susan W. Bryson
- Stanford University School of Medicine, Stanford Prevention Research Center, 1070 Arastradero Road, Suite 300, Palo Alto, CA, USA, 94304-1334
| | - Diana T. Killen
- Stanford University School of Medicine, Stanford Prevention Research Center, 1070 Arastradero Road, Suite 300, Palo Alto, CA, USA, 94304-1334
| | - Seth Ammerman
- Stanford University School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, 1174 Castro Street, Suite 250-A, Mountain View, CA, USA, 94040
| | - Thomas N. Robinson
- Stanford University School of Medicine, Stanford Prevention Research Center, 1070 Arastradero Road, Suite 300, Palo Alto, CA, USA, 94304-1334,Stanford University School of Medicine, Department of Pediatrics, Division of General Pediatrics, Stanford, CA, USA, 94305
| | - Joel D. Killen
- Stanford University School of Medicine, Stanford Prevention Research Center, 1070 Arastradero Road, Suite 300, Palo Alto, CA, USA, 94304-1334
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Do YK, Farooqui MA. Differential Subjective Responsiveness to a Future Cigarette Price Increase Among South Korean Youth Smokers. Nicotine Tob Res 2011; 14:209-16. [DOI: 10.1093/ntr/ntr187] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Horn K, Dino G, Branstetter SA, Zhang J, Noerachmanto N, Jarrett T, Taylor M. Effects of physical activity on teen smoking cessation. Pediatrics 2011; 128:e801-11. [PMID: 21930544 DOI: 10.1542/peds.2010-2599] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To understand the influence of physical activity on teen smoking-cessation outcomes. METHODS Teens (N = 233; 14-19 years of age) from West Virginia high schools who smoked >1 cigarette in the previous 30 days were included. High schools with >300 students were selected randomly and assigned to brief intervention (BI), Not on Tobacco (N-O-T) (a proven teen cessation program), or N-O-T plus a physical activity module (N-O-T+FIT). Quit rates were determined 3 and 6 months after baseline by using self-classified and 7-day point prevalence quit rates, and carbon monoxide validation was obtained at the 3-month follow-up evaluation. RESULTS Trends for observed and imputed self-classified and 7-day point prevalence rates indicated that teens in the N-O-T+FIT group had significantly higher cessation rates compared with those in the N-O-T and BI groups. Effect sizes were large. Overall, girls quit more successfully with N-O-T compared with BI (relative risk [RR]: >∞) 3 months after baseline, and boys responded better to N-O-T+FIT than to BI (RR: 2-3) or to N-O-T (RR: 1-2). Youths in the N-O-T+FIT group, compared with those in the N-O-T group, had greater likelihood of cessation (RR: 1.48) at 6 months. The control group included an unusually large proportion of participants in the precontemplation stage at enrollment, but there were no significant differences in outcomes between BI and N-O-T (z = 0.94; P = .17) or N-O-T+FIT (z = 1.12; P = .13) participants in the precontemplation stage. CONCLUSIONS Adding physical activity to N-O-T may enhance cessation success, particularly among boys.
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Affiliation(s)
- Kimberly Horn
- West Virginia Prevention Research Center and Mary Babb Randolph Cancer Center, and Department of Community Health, School of Medicine, West Virginia University, Morgantown, West Virginia 26505, USA.
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Schuck K, Otten R, Engels RCME, Kleinjan M. The relative role of nicotine dependence and smoking-related cognitions in adolescents' process of smoking cessation. Psychol Health 2011; 26:1310-26. [PMID: 21598190 DOI: 10.1080/08870446.2010.520715] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present study evaluates the role of distinct components of nicotine dependence (craving, withdrawal, behavioural dependence) in comparison to smoking-related cognitions (attitudes, perceived social approval, self-efficacy) in adolescent smoking cessation. In the process towards smoking cessation, we distinguish between distinct behavioural transitions, respectively, short-term abstinence, reduction in smoking behaviour and prolonged cessation, to evaluate differences in cessation-related antecedents as a function of varying behavioural outcomes. A total of 850 adolescent smokers (age 14-16) participated in the present study. Smoking behaviour was assessed 1 year after baseline. Results showed that all dependence components had a distinct role in the prediction of behavioural change towards cessation. Furthermore, each behavioural transition was predicted by a distinct set of variables, indicating that contributions of cessation-related factors vary across the course towards cessation. Overall, our findings suggest that smoking-related cognitions are particularly relevant in the initiation of behavioural change, such as short-term abstinence, whereas nicotine dependence, craving in particular, becomes increasingly important in the prediction of maintained behavioural change, such as prolonged cessation. Implications encompass enhanced attention to the multidimensional nature of nicotine dependence and the value of comparing different behavioural outcomes in a comprehensive understanding of cessation-related factors.
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Affiliation(s)
- Kathrin Schuck
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
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Anesetti-Rothermel A, Noerachmanto N, Horn K, Dino G. Beyond reach and effectiveness: evaluating the not-on-tobacco (N-o-T) program in West Virginia from 2000 to 2005. Health Promot Pract 2011; 13:506-14. [PMID: 21441206 DOI: 10.1177/1524839910386183] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite most teenage smokers wanting to quit, their likelihood of success resembles that of flipping a coin. Evidence-based cessation programs, like the American Lung Association's Not-On-Tobacco (N-O-T) program, are effective. Evaluation of program dissemination is critical. This study uses the RE-AIM framework to evaluate the N-O-T program in West Virginia from 2000 to 2005. RE-AIM components consisted of four measures. Regional dissemination was measured using comparative differences between Regional Educational Service Agency regions (RESAs). Significant associations were found between RESAs for numerous characteristics. Among the RE-AIM components, two measures of Implementation were significantly different between RESAs. Variability between RESAs provided valuable descriptive evidence of N-O-T program dissemination in West Virginia. Therefore, geographical tailoring grounded in community-based participatory research could increase the N-O-T program's overall dissemination.
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Hamilton KR, Perry ME, Berger SS, Grunberg NE. Behavioral effects of nicotine withdrawal differ by genetic strain in male and female adolescent rats. Nicotine Tob Res 2010; 12:1236-45. [PMID: 21071625 DOI: 10.1093/ntr/ntq179] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Gender and ethnicity are powerful predictors of initiation and maintenance of cigarette smoking in adults but less is known about their role in smoking in adolescents. Consistent with human studies, rat models also reveal sex and strain differences in response to nicotine administration. METHODS This research examined nicotine withdrawal behaviors in 96 adolescent, male and female, Sprague Dawley (SD) and Long Evans (LE) rats. Rats received seven days continuous subcutaneous infusion of saline or 3.16 mg/kg nicotine via Alzet osmotic minipumps. Behavioral observations were made before, during, and after saline or nicotine administration. Occurrences of six specific behaviors were quantified: abnormal posture or movement, abnormal grooming, whole-body shakes, ptosis, empty-mouth chewing/teeth chattering, and diarrhea. RESULTS SD male and female rats that received nicotine displayed significantly more withdrawal behaviors 1 and 2 days after cessation of nicotine administration compared with rats that had received saline. LE male rats that received nicotine displayed significantly more withdrawal behaviors 1 day but not 2 days after cessation of nicotine administration compared with males that received saline. LE females showed no significant withdrawal behaviors after cessation of nicotine administration. CONCLUSION Results indicate that nicotine withdrawal in adolescent rats depends on sex and strain.
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Affiliation(s)
- Kristen R Hamilton
- Department of Medical and Clinical Psychology, Uniformed Services University, Bethesda, Maryland 20814, USA.
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Mickens L, Ameringer K, Brightman M, Leventhal AM. Epidemiology, determinants, and consequences of cigarette smoking in African American women: an integrative review. Addict Behav 2010; 35:383-91. [PMID: 20061090 DOI: 10.1016/j.addbeh.2009.12.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 12/11/2009] [Indexed: 10/20/2022]
Abstract
Tobacco smoking is a national public health problem that has been associated with numerous adverse health effects, including increased disease and cancer rates. Previous review articles on smoking in specific demographic populations have focused on smoking in women and on smoking in African Americans, but have not considered the dual roles of ethnicity and gender in smoking behavior. African American women (AAW) are an important subgroup to study because they are distinct from non-AAW and their male African American counterparts on biopsychosocial factors that are relevant to smoking behavior. The purpose of the present review paper is to integrate and summarize the current literature on the epidemiology, determinants, and consequences of cigarette smoking among AAW, by contrasting them to relevant comparison groups (non-AAW and African American men). Evidence suggests that AAW are generally more likely to be light smokers and initiate smoking later. The prevalence rates of AAW smokers have decreased over the past 25years, yet AAW are disproportionately affected by several smoking-related illnesses when compared to their ethnic and gender comparison groups. AAW smokers are distinct from relevant comparison groups in metabolic sensitivity to nicotine, aspects of smoking topography, and several psychosocial factors that influence smoking. Although a small literature on smoking in AAW is emerging, further empirical research of AAW smokers could inform the development of tailored interventions for AAW.
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Schepis TS, Rao U. Smoking cessation for adolescents: a review of pharmacological and psychosocial treatments. ACTA ACUST UNITED AC 2009; 1:142-55. [PMID: 19630713 DOI: 10.2174/1874473710801020142] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Unlike the vast literature on smoking cessation in adults, research in adolescents has gained significant attention only within the last decade. Even with this increase in focus, research into pharmacological aids for smoking cessation in adolescents (e.g., nicotine replacement therapy, bupropion) is a more recent phenomenon and has produced only modest results. While more extensive, much of the research on behaviorally- or psychosocially-based adolescent smoking cessation interventions has been limited by a lack of control for contact time, biochemical verification of self-reported abstinence, and/or a theoretical focus for the interventions. The MEDLINE, PubMed, PSYCInfo, EMBASE, ERIC, CINHAL, Cochrane CENTRAL and Systematic Review databases were searched for articles relevant to adolescent smoking cessation treatment. After briefly examining the adolescent smoking cessation research prior to 2000, more recent developments in pharmacological aids and psychological treatment will be reviewed. Investigations have made progress in elucidating efficacious treatments for adolescent smokers, but much work remains to be done in both pharmacological and non-pharmacological areas of treatment. With the current state of the literature as a guide, future directions for research into smoking cessation for adolescents will be proposed.
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Affiliation(s)
- Ty S Schepis
- Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9101, USA
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Horn K, Noerachmanto N, Dino G, Manzo K, Brayboy M. Who wants to quit? Characteristics of American Indian youth who seek smoking cessation intervention. J Community Health 2009; 34:153-63. [PMID: 18975061 DOI: 10.1007/s10900-008-9131-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
No group is more at-risk for tobacco-related health disparities than are American Indian youth. Little is known about their readiness to quit smoking and the extent to which cessation programs may require cultural tailoring related to recruitment, implementation, or content. This study identifies unique characteristics of American Indian teen smokers who enrolled in a school-based smoking cessation program, Not On Tobacco (called N-O-T). Using data from N-O-T intervention trials conducted in North Carolina between 2001 and 2004, the present study (a) describes the characteristics of American Indian participants (n = 91); (b) determines if basic demographics and smoking history affect intervention readiness; and (c) compares findings with non-Native participants (n = 138) enrolled in N-O-T within the same state. Upon enrollment, 80% of the sample reported that they planned to quit smoking in the next 1-6 months. We found significant differences between American Indian and non-Native youth on smoking history, with non-Natives smoking with greater intensity and frequency. Contrary to previous reports, American Indian youth in this study smoked with less intensity and were more ready to quit smoking than non-Native youth. Results reveal previously unreported characteristics of American Indian teen smokers. Study findings may advance the development of effective marketing, recruitment, and programming among American Indian teen smokers into cessation programs, particularly N-O-T, which is the only teen smoking cessation program which includes an adaptation specifically for American Indians.
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Affiliation(s)
- Kimberly Horn
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, Morgantown, WV 26506-8110, USA.
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Adolescents' rationalizations to continue smoking: the role of disengagement beliefs and nicotine dependence in smoking cessation. Addict Behav 2009; 34:440-5. [PMID: 19185429 DOI: 10.1016/j.addbeh.2008.12.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2008] [Revised: 12/16/2008] [Accepted: 12/31/2008] [Indexed: 11/20/2022]
Abstract
Adult smokers were found to reduce cognitive dissonance regarding their smoking behaviour by adhering to rationalizations or justifications to continue smoking, also known as disengagement beliefs. These beliefs were found to be an important barrier with regard to smoking cessation practices. Neither the occurrence of disengagement beliefs, nor its effect on motivation to quit and actual smoking cessation have been studied among adolescent smokers. Therefore, this prospective study among a sample of 363 adolescents examined the extent to which adolescents adhere to disengagement beliefs, and the relations between disengagement beliefs and adolescents' motivation to quit smoking, motivation change and smoking cessation. The association and interplay between disengagement beliefs and level of nicotine dependence was also assessed. Results showed that the degree to which adolescent smokers adhere to disengagement beliefs was similar to that of adults, if not stronger. Higher levels of dependence coincided with stronger adherence to disengagement beliefs. Further, when controlling for nicotine dependence, disengagement beliefs were strongly negatively associated with motivation to quit, but only marginally inversely associated with smoking cessation one year later. Nicotine dependence was the strongest barrier for smoking cessation at follow-up.
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Van Zundert RMP, Nijhof LM, Engels RCME. Testing Social Cognitive Theory as a theoretical framework to predict smoking relapse among daily smoking adolescents. Addict Behav 2009; 34:281-6. [PMID: 19059732 DOI: 10.1016/j.addbeh.2008.11.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Revised: 10/06/2008] [Accepted: 11/14/2008] [Indexed: 11/30/2022]
Abstract
Predictors of adolescent smoking relapse are largely unknown, since studies either focus on relapse among adults, or address (long-term) smoking cessation but not relapse. In the present study, Social Cognitive Theory (SCT) was used as a theoretical framework to examine the first and second lapses, as well as mild and heavy relapse into smoking among 135 daily smoking adolescents who embarked on a serious quit attempt. Baseline predictors were pros of smoking, pros of quitting, self-efficacy, and intensity of smoking. Using an ecological momentary assessment (EMA) study design, participants were monitored three times a day during 4 weeks. A follow-up was administered 2 months after the monitoring period. Perceiving many pros of smoking, reporting a low self-efficacy to quit, and high levels of baseline smoking significantly predicted relapse within 3 weeks after quitting. The effects of pros of smoking and self-efficacy on relapse, however, appeared to be accounted for by differences in intensity of smoking. Besides that pros of quitting showed a marginal effect on abstinence at the 2-month follow-up, no long-term effects were detected.
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Branstetter SA, Horn K, Dino G, Zhang J. Beyond quitting: predictors of teen smoking cessation, reduction and acceleration following a school-based intervention. Drug Alcohol Depend 2009; 99:160-8. [PMID: 18804924 PMCID: PMC2683731 DOI: 10.1016/j.drugalcdep.2008.07.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Accepted: 07/21/2008] [Indexed: 10/21/2022]
Abstract
There remains a great need for effective, cost-efficient, and acceptable youth smoking cessation interventions. Unfortunately, only a few interventions have been demonstrated to increase quit rates among youth smokers, and little is known about how elements of cessation interventions and participants' psychosocial characteristics and smoking histories interact to influence program outcomes. Additionally, few studies have examined how these variables lead to complete smoking abstinence, reduction or acceleration over the course of a structured cessation intervention. Data for the present investigation were drawn from a sample of teen smokers (n=5892) who voluntarily participated in either a controlled study or field study (i.e., no control group) of the American Lung Association's Not On Tobacco (N-O-T) program between 1998 and 2006 in five states. Results suggest that those who reduce smoking (but do not achieve full abstinence) are similar to those who quit on most measures except stage of change. Furthermore, it was found that those who increased smoking were heavier smokers at baseline, more addicted, were more likely to have parents, siblings, and significant others who smoked and reported less confidence in and less motivation for quitting than did those who quit or reduced smoking. Finally, a path model demonstrated how peers, siblings and romantic partners affected tobacco use and cessation outcomes differently for males and females. Implications for interventions are discussed.
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Affiliation(s)
- Steven A. Branstetter
- Department of Psychology & Translational Tobacco Reduction Research Program (T2R2), Mary Babb Randolph Cancer Center at Robert C. Byrd Health Sciences Center, West Virginia University, 53 Campus Drive/1124 LSB, Morgantown, WV 26506, United States, Corresponding author. Tel.: +1 304 293 2001x31672. E-mail address: (S.A. Branstetter)
| | - Kimberly Horn
- Department of Community Medicine & Translational Tobacco Reduction Research Program (T2R2), Mary Babb Randolph Cancer Center at Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9190, Morgantown, WV 26506−9190, United States
| | - Geri Dino
- Department of Community Medicine & Translational Tobacco Reduction Research Program (T2R2), Mary Babb Randolph Cancer Center at Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9190, Morgantown, WV 26506−9190, United States
| | - Jianjun Zhang
- Department of Community Medicine & Translational Tobacco Reduction Research Program (T2R2), Mary Babb Randolph Cancer Center at Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9190, Morgantown, WV 26506−9190, United States
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Mechanisms of adolescent smoking cessation: roles of readiness to quit, nicotine dependence, and smoking of parents and peers. Drug Alcohol Depend 2009; 99:204-14. [PMID: 18848408 DOI: 10.1016/j.drugalcdep.2008.08.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Revised: 07/25/2008] [Accepted: 08/06/2008] [Indexed: 11/20/2022]
Abstract
Multiple levels of influence should be considered in interventions aimed at the adolescent smoker, including psychological, addiction, peer and parental influences. However, the mechanism by which these variables influence the process of smoking cessation in adolescents is not well elucidated. Therefore, this prospective study tested two models among 850 adolescent smokers, specifying the direct and indirect relations between adolescents' readiness to quit smoking, levels of nicotine dependence, and smoking behavior of their parents and friends. One year later smoking cessation was assessed. Results showed that, among adolescent smokers, readiness to quit was positively associated with quit attempts, while nicotine dependence was inversely associated with successful cessation. Instead of a direct relation, parental and peers' smoking were inversely related to smoking cessation through nicotine dependence. The findings emphasize that interventions should be developed and tested within and outside the school setting, as well as within the family situation. In addition, the strong impact of nicotine dependence on successful cessation indicates that a more direct approach is needed to lower nicotine dependence among adolescents.
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Rubinstein ML, Benowitz NL, Auerback GM, Moscicki AB. A randomized trial of nicotine nasal spray in adolescent smokers. Pediatrics 2008; 122:e595-600. [PMID: 18762494 PMCID: PMC2744418 DOI: 10.1542/peds.2008-0501] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Nicotine nasal spray has been 1 of the most successful forms of nicotine-replacement therapy in adult populations. The nasal sprayer has not been studied in adolescent smokers. The objective of this pilot study was to determine the feasibility and utility of using nicotine nasal spray for adolescent smokers who wanted to quit smoking. METHODS Forty adolescent smokers who were between 15 and 18 years of age and smoked >/=5 cigarettes daily for at least 6 months were recruited from several San Francisco Bay area schools from 2005 to 2007. Using a randomized, open-label, 12-week trial, adolescent smokers were assigned to receive either weekly counseling alone (control) for 8 weeks or 8 weeks of counseling along with 6 weeks of nicotine nasal spray. Self-reported smoking abstinence was verified by both expired-air carbon monoxide and salivary cotinine. RESULTS There was no difference in cessation rates, the numbers of cigarettes smoked per day, or cotinine levels at 12 weeks. Fifty-seven percent of participants stopped using their spray after only 1 week. The most commonly reported adverse effect was nasal irritation and burning (34.8%) followed by complaints about the taste and smell (13%). CONCLUSIONS The unpleasant adverse effects, poor adherence, and consequent lack of efficacy observed in our pilot study do not support the use of nicotine nasal spray as an adjunct to counseling for adolescent smokers who wish to quit.
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Affiliation(s)
- Mark L Rubinstein
- University of California, Division of Adolescent Medicine, 3333 California St, Suite 245, San Francisco, CA 94118, USA.
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Horn K, Dino G, Branstetter SA, Zhang J, Kelley G, Noerachmanto N, Tworek C. A profile of teen smokers who volunteered to participate in school-based smoking intervention. Tob Induc Dis 2008; 4:6. [PMID: 18822165 PMCID: PMC2556032 DOI: 10.1186/1617-9625-4-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Accepted: 08/05/2008] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES Although a number of population-based studies have examined the characteristics of teens who attempt to quit smoking, few have identified the characteristics of youth who participate in structured cessation interventions, particularly those with demonstrated effectiveness. The purpose of the present study is to describe the sociodemographic and smoking-related characteristics of teen smokers who participated in the American Lung Association's Not On Tobacco (N-O-T) program, spanning eight years. N-O-T is the most widely used teen smoking cessation program in the nation. METHODS Drawn from multiple statewide N-O-T studies, this investigation examined data from 5,892 teen smokers ages 14-19 who enrolled in N-O-T between 1998-2006. We demonstrate similarities and differences between N-O-T findings and existing data from representative samples of US teen smokers where available and relevant. RESULTS N-O-T teens started smoking earlier, were more likely to be poly-tobacco users, were more dependent on nicotine, had made more previous attempts to quit, and were more deeply embedded in smoking contexts than comparative samples of teen smokers. Additionally, N-O-T teens were moderately ready to quit smoking, believed important people in their lives would support their quit efforts, yet had deficits in their confidence with quitting. CONCLUSION This profile of N-O-T teens can guide efforts for targeted recruitment strategies to enhance intervention reach for teen smoking cessation. Findings provide guidance for marketing and recruitment efforts of intensive, school-based cessation interventions among established teen smokers, particularly those who want to quit. Study results may shed light upon who is and is not enrolling in N-O-T.
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Affiliation(s)
- Kimberly Horn
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 8110, Morgantown, WV 26506-8110, USA
- Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, V 26506-9190, USA
| | - Geri Dino
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 8110, Morgantown, WV 26506-8110, USA
- Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, V 26506-9190, USA
| | - Steven A Branstetter
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 8110, Morgantown, WV 26506-8110, USA
- Department of Psychology, West Virginia University, PO Box 6040, Morgantown, WV 26506-6040, USA
| | - Jianjun Zhang
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 8110, Morgantown, WV 26506-8110, USA
- Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, V 26506-9190, USA
| | - George Kelley
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 8110, Morgantown, WV 26506-8110, USA
- Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, V 26506-9190, USA
| | - N Noerachmanto
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 8110, Morgantown, WV 26506-8110, USA
- Department of Community Medicine, West Virginia University, PO Box 9190, Morgantown, V 26506-9190, USA
| | - Cindy Tworek
- Translational Tobacco Reduction Research Program, Mary Babb Randolph Cancer Center and Prevention Research Center, West Virginia University, PO Box 8110, Morgantown, WV 26506-8110, USA
- Department of Pharmaceutical Systems and Policy, West Virginia University, PO Box 9510, Morgantown, WV 26506-9510, USA
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Eisenberg M. Integrating a school-based health intervention in times of high-stakes testing: lessons learned from full court press. Health Promot Pract 2008; 10:284-92. [PMID: 18340084 DOI: 10.1177/1524839907301405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Because of the growing focus on the production of favorable academic standardized test scores, schools have become increasingly resistant to sponsoring nonacademic programming, such as tobacco cessation services for students. Nevertheless, the need for such programs has not diminished. The purpose of this article is to provide descriptive information about the logistics of establishing and delivering a health intervention in schools that are resistant to nonacademic programming. The data were collected as part of a qualitative retrospective process evaluation of Full Court Press, a 5-year youth tobacco demonstration project funded by the Robert Woods Johnson Foundation and implemented in Tucson, Arizona. Lessons learned about recruiting schools, integrating programs, and managing facilitators are presented.
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Affiliation(s)
- Merrill Eisenberg
- The Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona 85719, USA.
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van Zundert RMP, Engels RCME, Kleinjan M, van den Eijnden RJJM. An integration of parents' and best friends' smoking, smoking-specific cognitions, and nicotine dependence in relation to readiness to quit smoking: a comparison between adolescents with and without asthma. J Pediatr Psychol 2008; 33:821-32. [PMID: 18287108 DOI: 10.1093/jpepsy/jsn010] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To study the impact of parents' and best friends' smoking, nicotine dependence, and craving on smoking-specific cognitions, and readiness to quit in adolescents with and without asthma. METHODS Structural equation analyses were applied to data from a sample of 1,120 daily smoking adolescents, 83 of whom had asthma. RESULTS Adolescents with asthma felt more ready to quit, and cognitions were more strongly related to readiness to quit among adolescents with asthma than among adolescents without asthma. Moreover, best friends' smoking seemed more relevant to the cognitions of adolescents with asthma. Nicotine dependence and craving were strongly related to cognitions, and to readiness to quit in both groups. The relation between craving and readiness to quit, however, was stronger among participants with asthma. CONCLUSIONS Reduction of nicotine dependence and craving is essential for both groups. Youth with asthma may benefit even more from cognitive-based cessation services than healthy youth. The finding that adolescents with asthma are relatively more ready to quit, and that their cognitions are more easily affected can be turned into advantages in asthma-specific cessation services.
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Affiliation(s)
- Rinka M P van Zundert
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500 HE Nijmegen, the Netherlands.
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Kleinjan M, Brug J, van den Eijnden RJJM, Vermulst AA, van Zundert RMP, Engels RCME. Associations between the transtheoretical processes of change, nicotine dependence and adolescent smokers' transition through the stages of change. Addiction 2008; 103:331-8. [PMID: 18199313 DOI: 10.1111/j.1360-0443.2007.02068.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To examine the significance of the transtheoretical processes of change in predicting transition through the stages of change in adolescent smokers, as well as the relative role of nicotine dependence in predicting stage transitions. DESIGN In grades 9 and 10, adolescents' stage of change, the use of processes of change and nicotine dependence were assessed (T1). Stage transitions were assessed 1 year later (T2). Response rate was 73.2%. SETTING Twenty-five secondary schools throughout the Netherlands participated in the present study. PARTICIPANTS Respondents were 721 adolescents who were classified as smokers at T1 and consequently completed the paper-and-pencil questionnaire at T2. MEASUREMENTS Stages of change and processes of change were assessed according to the original transtheoretical measures. Nicotine dependence was measured using a newly developed multi-dimensional scale consisting of 11 items. FINDINGS Few associations were found between the processes of change and stage transitions. Nicotine dependence contributed significantly to the explanation of adolescents' transition from preparation to action, after adjustment for processes of change. No evidence for a moderating effect of nicotine dependence in the relation between the processes of change and stage transitions was found. CONCLUSIONS Processes of change do not seem significant in explaining adolescents' stage transitions. As an alternative for promoting the use of the processes of change for intervention purposes in adolescents, it might be more useful to focus on treating nicotine dependence.
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Panday S, Reddy SP, Ruiter RAC, Bergström E, de Vries H. Nicotine dependence and withdrawal symptoms among occasional smokers. J Adolesc Health 2007; 40:144-50. [PMID: 17259054 DOI: 10.1016/j.jadohealth.2006.09.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2006] [Revised: 08/28/2006] [Accepted: 09/05/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE This study describes the levels of nicotine dependence, withdrawal symptoms, depressive mood, and risk behavior reported by male and female weekly and monthly adolescent smokers in South Africa. METHODS A cross-sectional survey was conducted among 554 grade 9-11 weekly and monthly smokers in the Southern Cape-Karoo Region. Differences between the gender groups and smoking status were analyzed while controlling for demographic characteristics. RESULTS Weekly and monthly smokers were classified as light smokers having smoked 6-10 cigarettes and 0-1 cigarettes a week, respectively. However, they displayed substantial levels of dependence, with 11.6% of weekly smokers classified as highly dependent. Furthermore, 55.9% of weekly smokers and 47.1% of the overall sample experienced more than two withdrawal symptoms. Although dependency levels and withdrawal symptoms were higher among weekly smokers, the levels were not negligible among monthly smokers. Weekly smokers reported higher levels of depressive mood and risk behavior than monthly smokers. Females reported higher levels of dependence, withdrawal symptoms, depressive mood, and lower levels of risk behavior than males. Gender differences were not found on the number of cigarettes smoked in a week. CONCLUSIONS This study demonstrates multiple symptoms of dependence among a large sample of adolescent occasional smokers in a multi-ethnic cultural setting. Smoking cessation programs may, therefore, be required to help adolescents quit smoking and possibly consider pharmacotherapy for highly dependent smokers. Prevention programs should also consider providing occasional smokers skills to identify and cope with withdrawal symptoms.
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Affiliation(s)
- Saadhna Panday
- Department of Health Education and Health Promotion, Maastricht University, Maastricht, The Netherlands.
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Abstract
BACKGROUND Teenage smoking prevalence is around 15% in developing countries (with wide variation from country to country), and around 26% in the UK and USA. Although most tobacco control programmes for adolescents are based around prevention of uptake, there are also a number of initiatives to help those who want to quit. Since those who do not smoke before the age of 20 are significantly less likely to start as adults, there is a strong case for programmes for young people that address both prevention and treatment. OBJECTIVES To evaluate the effectiveness of strategies that help young people to stop smoking tobacco. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Tobacco Addiction Group's Specialized Register, MEDLINE, EMBASE, PsyclNFO, ERIC, CINAHL, and the bibliographies of identified trials. We also searched the 'grey' literature (unpublished materials), and contacted authors and experts in the field where necessary. SELECTION CRITERIA Types of studies: Randomized controlled trials, cluster-randomized controlled trials and controlled trials. TYPES OF PARTICIPANTS Young people, aged less than 20, who are regular tobacco smokers. Types of interventions: The interventions ranged from simple ones such as pharmacotherapy, targeting individual young people, through complex programmes targeting people or organizations associated with young people (for example, their families or schools), or the community in which young people live. We included cessation programmes but excluded programmes primarily aimed at prevention of uptake. Types of outcome measures: The primary outcome was smoking status at six months follow up, among those who smoked at baseline. We report the definition of cessation used in each trial (e.g seven- or thirty-day point prevalence abstinence, or sustained or prolonged abstinence), and we preferred biochemically verified cessation when that measure was available. DATA COLLECTION AND ANALYSIS Both authors independently assessed the eligibility of candidate trials identified by the searches, and extracted data from them. We categorized included trials as being at low, medium or high risk of bias, based on concealment of allocation, blinding (where applicable) and the handling of attrition and losses to follow up. We conducted limited meta-analyses of some of the trials, provided that it was appropriate to group them and provided that there was minimal heterogeneity between them. We estimated pooled odds ratios using the Mantel-Haenszel method, based on the quit rates at longest follow up for trials with at least six months follow up from the start of the intervention. MAIN RESULTS We found 15 trials, covering 3605 young people, which met our inclusion criteria (seven cluster-randomized controlled trials, six randomized controlled trials and two controlled trials). Three trials used or tested the transtheoretical model (stages of change) approach, two tested pharmacological aids to quitting (nicotine replacement and bupropion), and the remaining trials used various psycho-social interventions, such as motivational enhancement or behavioural management. The trials evaluating TTM interventions achieved moderate long-term success, with a pooled odds ratio (OR) at one year of 1.70 ( 95% confidence interval (CI) 1.25 to 2.33) persisting at two-year follow up with an OR of 1.38 (95% CI 0.99 to 1.92). Neither of the pharmacological intervention trials achieved statistically significant results (data not pooled), but both were small-scale, with low power to detect an effect. The three interventions (5 trials) which used cognitive behavioural therapy interventions did not individually achieve statistically significant results, although when the three Not on Tobacco trials were pooled the OR 1.87; (95% CI 1.00 to 3.50) suggested some measure of effectiveness. Although the three trials that incorporated motivational interviewing as a component of the intervention achieved a pooled OR of 2.05 (95% CI 1.10 to 3.80), the impossibility of isolating the effect of the motivational interviewing in these trials meant that we could not draw meaningful inferences from that analysis. AUTHORS' CONCLUSIONS Complex approaches show promise, with some persistence of abstinence (30 days point prevalence abstinence at six months), especially those incorporating elements sensitive to stage of change. There were few trials with evidence about pharmacological interventions (nicotine replacement and bupropion), and none demonstrated effectiveness for adolescent smokers. Psycho-social interventions have not so far demonstrated effectiveness, although pooled results for the Not on Tobacco trials suggest that that this approach may yet prove to be effective; however, their definition of cessation (one or more smoke-free days) may not adequately account for the episodic nature of much adolescent smoking. There is a need for well-designed adequately powered randomized controlled trials for this population of smokers, with a minimum of six months follow up and rigorous definitions of cessation (sustained and biochemically verified). Attrition and losses to follow up are particularly problematic in trials for young smokers, and need to be kept to a minimum, so that management and interpretation of missing data need not compromise the findings.
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Affiliation(s)
- G M Grimshaw
- Warwick Medical School, Medical Teaching Centre, University of Warwick, Coventry, UK.
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Hakko H, Lintunen J, Lappalainen J, Mäkikyrö T, Räsänen P, Timonen M. Nicotine use and dependence and their association to psychiatric disorders in a large sample of adolescent psychiatric inpatients. Addict Behav 2006; 31:1873-80. [PMID: 16466862 DOI: 10.1016/j.addbeh.2006.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2005] [Revised: 12/20/2005] [Accepted: 01/09/2006] [Indexed: 11/17/2022]
Abstract
The purpose of this research was to evaluate the level of nicotine dependence (ND) and to examine its association to psychiatric disorders in a representative clinical sample of adolescent psychiatric inpatients. The modified Fagerstrom Tolerance Questionnaire (mFTQ) was used to assess the level of ND. Psychiatric DSM-IV diagnoses were obtained by using the Schedule for affective disorder and schizophrenia for school-age children (K-SADS-PL). Of the total of 342 inpatients in the study sample, 259 (75.7%) reported to be current smokers. A sum score 6 or higher in the mFTQ, indicating a high level of ND, was found in 37.9% of all smokers. An increased likelihood for high level of ND was associated with substance related disorders (OR 5.1, 95% CI 2.8-9.3), conduct disorder and oppositional defiant disorders (OR 2.4, 95% CI 1.4-4.4). The usefulness of mFTQ in measuring ND among adolescent inpatients is apparent. Therefore, it can be recommended to be used as a routine screening instrument for ND among adolescents hospitalized due to psychiatric disorders.
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Affiliation(s)
- Helinä Hakko
- Oulu University Hospital, Department of Psychiatry, P.O. Box 26, 90029 OYS, Finland.
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Karp I, O'Loughlin J, Hanley J, Tyndale RF, Paradis G. Risk factors for tobacco dependence in adolescent smokers. Tob Control 2006; 15:199-204. [PMID: 16728750 PMCID: PMC2564659 DOI: 10.1136/tc.2005.014118] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2005] [Accepted: 02/08/2006] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To study the incidence of conversion to tobacco dependence (TD) and the prevalence of the TD state in relation to several potential determinants in a sample of adolescent smokers. METHODS Questionnaires were administered every 3-4 months to document TD symptoms, amount of cigarette consumption, and depression symptoms in a prospective cohort of 1293 grade 7 students in a convenience sample of 10 schools. RESULTS Over 54 months of follow-up, 113 of 344 novice smokers converted to TD. The referent series for the analysis of incidence comprised 823 person-surveys. The prevalence series included 1673 person-surveys, contributed by 429 smokers. Conversion to TD and TD status were associated with the intensity of recent (that is, past 3-month) cigarette consumption (adjusted incidence rate ratio (aIRR) 1.63 (95% confidence interval (CI) 1.36 to 1.97) and adjusted prevalence odds ratio (aPOR) 1.35 (95% CI 1.23 to 2.48) per 100 cigarettes per month), slowest CYP2A6 activity (aIRR 4.19 (95% CI 1.38 to 12.76) and aPOR 2.30 (95% CI 1.29 to 4.09)), depression score (aIRR 1.61 (95% CI 1.17 to 2.21) and aPOR 1.47 (95% CI 1.22, 1.75) per 1-unit change). Additional determinants included, for conversion to TD, time since onset of cigarette use (aIRR 0.76 (95% CI 0.58 to 1.00) per year) and, for the TD state, positive TD status six months ago (aPOR 3.53 (95% CI 2.41 to 5.19)). CONCLUSIONS TD risk in adolescents is associated with intensity of recent cigarette consumption, while the role of more distant cigarette consumption appears small; subjects with slow nicotine metabolism and those with more depression symptoms are at increased risk of becoming tobacco dependent. The risk of being tobacco dependent is considerably higher in subjects who had previously developed the TD state.
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Affiliation(s)
- I Karp
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada
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Tercyak KP, Beville KW, Walker LR, Prahlad S, Cogen FR, Sobel DO, Streisand R. Health Attitudes, Beliefs, and Risk Behaviors Among Adolescents and Young Adults With Type 1 Diabetes. CHILDRENS HEALTH CARE 2005. [DOI: 10.1207/s15326888chc3403_1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Hahn EJ, Rayens MK, Rasnake R, York N, Okoli CTC, Riker CA. School tobacco policies in a tobacco-growing state. THE JOURNAL OF SCHOOL HEALTH 2005; 75:219-25. [PMID: 16014128 DOI: 10.1111/j.1746-1561.2005.00027.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study examined factors associated with tobacco-free policies and tobacco cessation in schools serving children in grades 6 to 12 in a tobacco-growing state using a cross-sectional telephone survey of school administrators from public and private middle and high schools (N = 691), representing 117 of the 120 Kentucky counties. Trained health department staff contacted 1028 schools; 691 (67%) participated in a phone survey, which lasted an average of 19 minutes. Variables of interest were indoor and outdoor smoking policies, fund-raising in Bingo halls, provision of cessation and prevention programs, owning or leasing a tobacco base, if the school received money from tobacco companies, type of school (public vs private), and school setting (urban vs rural). Only 20% of Kentucky schools reported comprehensive tobacco-free policies. Urban area schools were nearly twice as likely to have a tobacco-free campus than rural schools. Schools that did fund-raising in smoky Bingo halls were 30% less likely to have tobacco-free school policies. While few schools had a tobacco affiliation, those that received money from tobacco companies or grew tobacco were nearly 3 times as likely to provide cessation resources, compared to schools without tobacco affiliation. Rural schools were less likely to be tobacco free and provide cessation services. School-related, off-campus, extracurricular events might be considered as an element of tobacco-free school policy. Schools with tobacco affiliation may provide more cessation resources due to the increased prevalence of tobacco use in these areas.
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Affiliation(s)
- Ellen J Hahn
- University of Kentucky College of Nursing and College of Public Health, 40536, USA
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Soresi S, Catalano F, Spatafora M, Bonsignore MR, Bellia V. “Light” smoking and dependence symptoms in high-school students. Respir Med 2005; 99:996-1003. [PMID: 15950140 DOI: 10.1016/j.rmed.2005.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2004] [Indexed: 10/25/2022]
Abstract
In high-school students, prevalence of smoking is high but few studies analyzed smoking in the student population according to nicotine content of smoked cigarettes and gender. We analyzed the responses to a questionnaire, including the modified Fagerström Tolerance Questionnaire (FTQ), administered to 555 students (382 males, 173 females) of a professional high school in Palermo, Italy, to assess the prevalence in both genders of: (1) smoking "light" and high nicotine (HN) cigarettes; (2) signs of nicotine dependence and (3) respiratory symptoms. Nicotine content of habitually smoked cigarettes was considered as "light" if 0.8 mg; as high if >0.8 mg. Forty-four percent of students smoked, without differences between genders. Two-thirds of the total sample reported "light" cigarette smoking (76.7% of females vs. 62.0% of males, P<0.05). On average, "light" cigarette smoking was associated with lower pack/year and FTQ global score compared to HN smoking. However, when FTQ global score was analyzed by taking into account pack/year, no major difference was found between "light" and HN cigarette smokers. Cough with phlegm and breathlessness were more frequently reported by smoking than non-smoking students, without differences between "light" and HN cigarette smokers. About 50% of smoking students reported having tried to quit, while only 3.4% of students were ex-smokers. "Light" smoking was common in high school students, especially among females. Dependence appeared more influenced by the smoking history than by nicotine content. Respiratory symptoms were similar in "light" and HN cigarette smokers.
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Affiliation(s)
- Simona Soresi
- Istituto di Medicina Generale e Pneumologia, Università di Palermo, Via Trabucco, 180, 90146 Palermo, Italy
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Ladwig KH, Baumert J, Löwel H, Döring A, Wichmann HE. Contemplating to quit current smoking status: differences in behavioural and psychosocial patterns in a population-based cohort of current smokers. Prev Med 2005; 41:134-40. [PMID: 15917004 DOI: 10.1016/j.ypmed.2004.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2004] [Revised: 09/30/2004] [Accepted: 10/19/2004] [Indexed: 11/25/2022]
Abstract
BACKGROUND Smokers actively considering to quit smoking were compared with hard-core smokers completely unwilling to change smoking habits with respect to psychosocial variables. METHODS A total of 3,229 current regular smokers aged 25-74 years were drawn from three population-based MONICA/KORA Augsburg surveys conducted between 1984 and 1995. Among them, 592 (8.4%) subjects were defined as active contemplators (AC) and 776 (22.6%) as immotives (IM). Multivariate logistic regression analysis stratified by sex was used to identify active contemplators. RESULTS No differences between ACs and IMs were observed for sex and age. Active contemplating in females was strongly mediated by impaired self-rated health [Odds ratio (OR) 2.29; 95% CI 1.42-3.69] and somatic complaints (OR 2.10; 95% CI 1.29-3.48). For men, depression (OR 2.49; 95% CI 1.64-3.79) and not living alone (OR 2.20, 95% CI 1.51-3.20) promoted being AC. Long-term survival was impaired for IM compared to AC. The odds ratio for smoking cessation of ACs compared to IMs was 1.77 (95% CI 1.25-2.50). CONCLUSIONS Sex-specific differences in factors associated with the intention to quit smoking were observed and may lead to sex-specific targets in prevention strategy. IMs may be victims of a conceited healthy smoker effect triggered by the absence of disabling body or affective symptoms.
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Affiliation(s)
- Karl-Heinz Ladwig
- GSF-National Research Center for Environment and Health, Institute of Epidemiology, Ingolstädter Landstr. 1, Neuherberg 85764, Germany.
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Vink JM, Willemsen G, Beem AL, Boomsma DI. The Fagerström Test for Nicotine Dependence in a Dutch sample of daily smokers and ex-smokers. Addict Behav 2005; 30:575-9. [PMID: 15718074 DOI: 10.1016/j.addbeh.2004.05.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We explored the performance of the Fagerström Test for Nicotine Dependence (FTND) in a sample of 1378 daily smokers and 1058 ex-smokers who participated in a survey study of the Netherlands Twin Register. FTND scores were higher for smokers than for ex-smokers. Nicotine dependence level was not associated with age. FTND score was highly correlated with the maximum number of cigarettes smoked (even after excluding the item 'number of cigarettes per day' from FTND), but the FTND score showed a low correlation with age of first cigarette and total number of years smoked. In a subsample of smokers (n = 143) and ex-smokers (n = 181) the test-retest correlations for the FTND were high. In general, the performance of the FTND in ex-smokers was comparable with that in smokers. These findings suggest the FTND to be a valuable tool for studies of nicotine dependence in large epidemiological samples.
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Affiliation(s)
- Jacqueline M Vink
- Department of Biological Psychology, Vrije Universiteit Amsterdam, van der Boechortstraat 1, 1081 BT Amsterdam, The Netherlands.
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