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Haugen T. Continuing the Conversation on "The Role of the Otolaryngologist in Sexual Health". Otolaryngol Head Neck Surg 2024; 170:1479-1480. [PMID: 38415866 DOI: 10.1002/ohn.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Thorsen Haugen
- Department of Otolaryngology-Head and Neck Surgery, Geisinger Medical Center, Danville, Pennsylvania, USA
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David JC, Fonte D, Sutter-Dallay AL, Auriacombe M, Serre F, Rascle N, Loyal D. The stigma of smoking among women: A systematic review. Soc Sci Med 2024; 340:116491. [PMID: 38096599 DOI: 10.1016/j.socscimed.2023.116491] [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: 06/26/2023] [Revised: 10/04/2023] [Accepted: 12/01/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Smoking stigma has been well documented, but little is known regarding its specific features and effects on women. Notably, women face unique social, cultural, and economic challenges that may interact with smoking stigma and impact health outcomes. This review investigates the extent to which smoking women encounter and internalise stigma, while examining the various coping mechanisms they employ to manage these negative experiences. METHODS In November 2022, major databases were systematically searched with no time restrictions. After applying inclusion and exclusion criteria, 23 studies (three quantitative and 20 qualitative) met our criteria. We conducted a quality assessment and summarised the findings pertaining to public stigma, self-stigma, and coping strategies. RESULTS The stigma about smoking emerges from a variety of sources, such as family, healthcare providers, or internet forums. Women smokers are universally aware of the negative image they have in society. Yet, their experiences and management of the stigma of smoking are shaped by other variables such as cultural background, social class, or motherhood status. Smoking stigma produces ambivalent effects, such as concealment, reduced usage of support services, and to a lesser extent, smoking cessation motivation. CONCLUSIONS These results indicate that smoking stigma is an important social justice and public health issue and that further research is needed to better prevent its effects on women's well-being and health behaviours.
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Affiliation(s)
| | | | - Anne-Laure Sutter-Dallay
- Inserm U1219 Bordeaux Population Health, Bordeaux, France; Hôpital Charles Perrens, Bordeaux, France
| | - Marc Auriacombe
- Hôpital Charles Perrens, Bordeaux, France; CNRS UMR 6033, SANPSY, Bordeaux, France
| | | | - Nicole Rascle
- Inserm U1219 Bordeaux Population Health, Bordeaux, France
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Effects of psychoeducation combined with transcranial direct current stimulation on reducing cigarette craving and consumption in male smokers. Addict Behav 2023; 141:107643. [PMID: 36791642 DOI: 10.1016/j.addbeh.2023.107643] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/20/2022] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
Psychoeducation (PE) has been widely used in smoking interventions, but its long-term effects are limited. Recent studies have reported that, in some fields, a combination of transcranial direct current stimulation (tDCS) and cognitive training (e.g., working memory tasks) may improve cognitive outcomes; thus, we aimed to investigate whether such a combined intervention has a better effect than a PE intervention for reducing smoking cravings and cigarette consumption. In Exp. 1, 19 male smokers received four types of interventions at one-week intervals. In each session, participants were presented with audio PE (or control) while receiving 2-mA active (or sham) tDCS of the dorsolateral prefrontal cortex (DLPFC). In Exp. 2, 48 male smokers were randomized into four experimental groups (PE + Active, Control + Active, PE + Sham, or Control + Sham). Each participant received one type of five-day intervention (i.e., watching a five-minute PE/Control video twice while receiving 2-mA active/sham tDCS) and was followed up for one week. The results showed (a) an enhancement effect of tDCS on PE's ability to reduce cigarette consumption; (b) that repeated PE has a cumulative effect on reducing both craving and cigarette consumption during the intervention period; and (c) that, compared with PE alone, PE combined with tDCS is capable of helping participants maintain a low intake of cigarettes over one week. These findings suggest that repeated interventions of PE combined with tDCS may be effective in reducing smoking consumption and that further studies are warranted to confirm its application.
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Neil JM, Senecal C, Ballini L, Chang Y, Goshe B, Flores E, Ostroff JS, Park ER. A multi-method evaluation of tobacco treatment trial recruitment messages for current smokers recently diagnosed with cancer: A pilot factorial randomized control trial (Preprint). JMIR Cancer 2022; 8:e37526. [PMID: 36001378 PMCID: PMC9453579 DOI: 10.2196/37526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/17/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background A cancer diagnosis can catalyze motivation to quit smoking. Tobacco treatment trials offer cessation resources but have low accrual rates. Digital outreach may improve accrual, but knowledge of how best to recruit smokers with recent diagnoses is limited. Objective This study aims to identify the message frames that were most effective in promoting intent to talk to a physician about participating in a tobacco treatment trial for smokers recently diagnosed with cancer. Methods From February to April 2019, current smokers diagnosed within the past 24 months were recruited from a national web-based panel for a multimethod pilot randomized trial (N=99). Participants were randomized to a 2×3 plus control factorial design that tested 3 unique message frames: proximal versus distal threats of smoking, costs of continued smoking versus benefits of quitting, and gains of participating versus losses of not participating in a tobacco treatment trial. The primary outcome was intent to talk to a physician about participating in a tobacco treatment trial. In phase 1, the main effect within each message factor level was examined using ANOVA and compared with the control condition. Other message evaluation and effectiveness measures were collected and explored in a multivariable model predicting intent to talk to a physician. In phase 2, open-text evaluations of the messages were analyzed using natural language processing software (Leximancer) to generate a thematic concept map and Linguistic Inquiry Word Count to identify and compare the prevalence of linguistic markers among message factors. Results Of the 99 participants, 76 (77%) completed the intervention. Participants who received the cost of continued smoking frame were significantly more likely to intend to talk to their physician about participating in a tobacco treatment trial than those who received the benefits of the quitting frame (mean costs 5.13, SD 1.70 vs mean benefits 4.23, SD 1.86; P=.04). Participants who received the proximal risks of continued smoking frame were significantly more likely to seek more information about participating (mean distal 4.83, SD 1.61 vs mean proximal 5.55, SD 1.15; P=.04), and those who received the losses of not participating frame reported significantly improved perceptions of smoking cessation research (mean gain 3.98, SD 0.83 vs mean loss 4.38, SD 0.78; P=.01). Male participants (P=.006) and those with greater message relevancy (P=.001) were significantly more likely to intend to talk to their physician. Participants’ perceptions of their smoking habits, as well as their motivation to quit smoking, were prevalent themes in the open-text data. Differences in the percentages of affective words across message frames were identified. Conclusions Multimethod approaches are needed to develop evidence-based recruitment messages for patients recently diagnosed with cancer. Future tobacco treatment trials should evaluate the effectiveness of different message frames on smoker enrollment rates. Trial Registration Clinicaltrials.gov NCT05471284; https://clinicaltrials.gov/ct2/show/NCT05471284
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Affiliation(s)
- Jordan M Neil
- Tobacco Settlement Endowment Trust Health Promotion Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Christian Senecal
- Department of Community Health, Tufts University, Medford, MA, United States
| | - Lauren Ballini
- Department of Community Health, Tufts University, Medford, MA, United States
| | - Yuchiao Chang
- Division of General Internal Medicine, Harvard Medical School/Massachusetts General Hospital, Boston, MA, United States
| | - Brett Goshe
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, United States
| | - Efren Flores
- Department of Radiology, Harvard Medical School/Massachusetts General Hospital, Boston, MA, United States
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Elyse R Park
- Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, United States
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Loyal D, Sutter AL, Auriacombe M, Serre F, Rascle N. The Pregnant Smoker Stigma Scale – Public Stigma (P3S-PS): development and validation in general French population. Women Health 2022; 62:157-167. [DOI: 10.1080/03630242.2022.2030449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Deborah Loyal
- INSERM U1219, Bordeaux University, Bordeaux, France
- CRPMS EA 3522, Paris University, Paris, France
| | - Anne-Laure Sutter
- INSERM U1219, Bordeaux University, Bordeaux, France
- Perinatal Psychiatry Unit, Charles Perrens Hospital, Bordeaux, France
| | - Marc Auriacombe
- CNRS USR 3413, SANPSY, Bordeaux University, Bordeaux, France
- Addictology Unit, Charles Perrens Hospital, Bordeaux, France
| | - Fuschia Serre
- CNRS USR 3413, SANPSY, Bordeaux University, Bordeaux, France
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Peraza N, Bello MS, Schiff SJ, Cho J, Zhang Y, Callahan C, Tackett A, Leventhal AM. Drug and alcohol dependence acute effects of pod-style e-cigarettes in vaping-naïve smokers. Drug Alcohol Depend 2021; 228:109083. [PMID: 34600262 PMCID: PMC8631487 DOI: 10.1016/j.drugalcdep.2021.109083] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/01/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study investigated the acute effects of exposure to pod-style e-cigarettes on subjective, behavioral, and physiological outcomes indicative of the potential to encourage vaping-naïve smokers to switch to e-cigarettes. METHODS In a within-subject experiment, never-vaping adult smokers interested in trying e-cigarettes (n = 24) completed 4 laboratory visits following 16-hr tobacco abstinence. Visits involved controlled puffing from preferred brand cigarettes (OwnCig) or a standardized pod-style e-cigarette with either no nicotine (NoNic), nicotine freebase (NicFreebase; 0.5% nicotine concentration), or nicotine salt (NicSalt E-Cig; 2.8% concentration) solutions. Outcomes included smoking urge, mood, user experience, plasma nicotine, and a behavioral task assessing ability to delay smoking. RESULTS NoNic, NicFreebase, and NicSalt pod-style e-cigarettes were significantly less effective than OwnCig at reducing smoking urge and increasing plasma nicotine, positive affect, satisfying user experience ratings, and ability to delay smoking on the behavioral task. Differences among pod-style e-cigarette conditions were limited to: (a) NicFreebase (vs. NoNic) preferentially suppressed participants' urge to smoke to alleviate negative mood, (b) NicFreebase (vs. NicSalt) slightly preferentially increased plasma nicotine; and (c) NicFreebase and NicSalt (vs. NoNic) produced higher aversive user experience ratings. CONCLUSIONS In tobacco deprived smokers' initial vaping experience, controlled administration of certain pod-style e-cigarettes with 0.5% NicFreebase or 2.8% NicSalt may be deficient comparators to cigarettes in terms of their capacity to acutely improve mood, deliver nicotine, suppress smoking motivation, and offer a satisfying user experience. Future research is needed to test pod-style e-cigarettes with higher nicotine doses and confirm whether NicFreebase vs. NicSalt enhances nicotine absorption.
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Affiliation(s)
- Natalia Peraza
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Mariel S Bello
- Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA
| | - Sara J Schiff
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Junhan Cho
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Yi Zhang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Carly Callahan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Alayna Tackett
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA; Department of Psychology, University of Southern California, Los Angeles, CA 90089, USA; Institute for Addiction Science, University of Southern California, Los Angeles, CA 90033, USA.
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Loyal D, Sutter AL, Auriacombe M, Serre F, Calcagni N, Rascle N. Stigma Attached to Smoking Pregnant Women: A Qualitative Insight in the General French Population. Nicotine Tob Res 2021; 24:257-264. [PMID: 34546357 DOI: 10.1093/ntr/ntab190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 09/17/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Cigarette consumption during pregnancy has major health consequences for women and unborn children. The stigma of smoking during pregnancy might hinder mothers-to-be's access to adequate healthcare and smoking cessation, especially in disadvantaged groups. This qualitative study was designed to describe extensively the public stigma associated with smoking during pregnancy. METHOD Participants were French adults recruited from the general population through social networks (N=100). They were asked to answer three pairs of open-ended questions regarding cognitions, emotions and behaviours elicited in the general population by pregnant smoking women. An inductive thematic analysis was performed and inter-judge agreement was computed on 30% of the corpus analysed deductively. Finally, independence (chi-square) between themes and gender, education, parenthood and smoking status was tested. RESULTS Themes (n=25) were defined regarding cognitions (n=9, e.g., irresponsible, thoughtless and unmindful, etc.), emotions (n=8, e.g., anger, disgust, etc.) and behaviours (n=8, e.g., inform and persuade, moralise and blame, etc.). Global inter-judge agreement was strong (κ=0.8). No difference was observed in themes according to gender, parental status or education, indicating a heterogenous awareness of stigma. However, some differences were observed according to smoking status (χ2 = 69.59, p = 0.02) (e.g., non-smokers more frequently stressed immorality). CONCLUSION The stigma associated with smoking during pregnancy includes various components that might be measured and targeted in interventions to improve access to adequate healthcare and smoking cessation in this specific population. IMPLICATIONS This qualitative study explores the stigma that the general French population attaches to pregnant women who smoke. Themes regarding cognitions (e.g., irresponsible, thoughtless and unmindful, etc.), emotions (e.g., anger, disgust, etc.) and behaviours (e.g., inform and persuade, moralise and blame, etc.) were identified. These themes could guide further research regarding scale development and anti-stigma interventions to support smoking cessation.
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Affiliation(s)
- Deborah Loyal
- INSERM U1219, Bordeaux University, F-33000 Bordeaux France.,CRPMS, EA 3522, Paris University, F-75000 Paris France
| | - Anne-Laure Sutter
- INSERM U1219, Bordeaux University, F-33000 Bordeaux France.,Charles Perrens Hospital, F-33000 Bordeaux France
| | - Marc Auriacombe
- Charles Perrens Hospital, F-33000 Bordeaux France.,CNRS USR 3413, SANPSY, Bordeaux University, F-33000 Bordeaux France
| | - Fuschia Serre
- CNRS USR 3413, SANPSY, Bordeaux University, F-33000 Bordeaux France
| | | | - Nicole Rascle
- INSERM U1219, Bordeaux University, F-33000 Bordeaux France
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Bello MS, Liautaud MM, De La Cerda JT, Pang RD, Ray LA, Ahluwalia JA, Leventhal AM. Association of frequency of perceived exposure to discrimination with tobacco withdrawal symptoms and smoking lapse behavior in African Americans. Addiction 2021; 116:914-925. [PMID: 32860477 PMCID: PMC7914272 DOI: 10.1111/add.15238] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/23/2020] [Accepted: 08/24/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND AND AIMS Frequent experiences of discrimination could increase vulnerability to tobacco withdrawal and smoking lapse in populations subject to tobacco-related health disparities. This laboratory study (2013-17) examined whether individual differences in perceived exposure to discrimination in one's daily life predicted tobacco withdrawal symptoms and smoking lapse behavior following acute tobacco deprivation in African American smokers. DESIGN Mixed design with the between-subjects continuous variable of perceived discrimination crossed with the within-subject variable of tobacco deprivation status (deprived versus non-deprived). SETTING Academic medical center in Los Angeles, CA, USA. PARTICIPANTS African American non-treatment seeking daily cigarette smokers (n = 607, ≥ 10 cig/day). MEASUREMENTS At a baseline visit, self-reported frequency of perceived exposure to discrimination in one's daily life was measured [everyday discrimination scale (EDDS)]. At two subsequent counterbalanced experimental visits (16-hour tobacco deprivation versus ad-libitum smoking), self-report assessments of various tobacco withdrawal symptom domains [Brief Questionnaire of Smoking Urges), Wisconsin Smoking Withdrawal Scale (WSWS), Profile of Mood States (POMS), Snaith-Hamilton Pleasure Scale (SHAPS) and Current Impulsivity Scale (CIS)) and a behavioral smoking lapse analogue task were measured. FINDINGS Adjusted models demonstrated that greater frequency of perceived exposure to discrimination was associated with larger deprivation-induced increases in acute urges to smoke to alleviate negative mood, several negative mood states and subjective cognitive functioning-effect sizes were small in magnitude (βs = 0.09-0.13; Ps < 0.02). Data were inconclusive for associations between perceived exposure to discrimination and deprivation-induced changes in cravings, urges to smoke for pleasure, positive mood reduction, other symptoms or smoking reinstatement behavior. CONCLUSIONS Frequency of perceived exposure to discrimination appears to be modestly associated with increased severity of some deprivation-induced tobacco withdrawal symptoms in African American smokers.
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Affiliation(s)
- Mariel S. Bello
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Madalyn M. Liautaud
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Julianne T. De La Cerda
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Raina D. Pang
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lara A. Ray
- University of California Los Angeles, Department of Psychology, Los Angeles, CA, USA
| | - Jasjit A. Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Adam M. Leventhal
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Helweg-Larsen M, Pyakuryal M, Pisinger C. Reminders of a Stigmatized Status Might Help Smokers Quit. STIGMA AND HEALTH 2020; 5:273-283. [PMID: 34027059 PMCID: PMC8132603 DOI: 10.1037/sah0000197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
As members of a devalued group, it is not surprising that smokers experience stigmatization and discrimination. But it is not clear if smokers react to these experiences by moving toward or away from their group membership and identity as smokers. Guided by the identity threat model of stigma (Major and O'Brien, 2005) we examined the process of stigmatization and its emotional, cognitive, attitudinal, and behavioral consequences. We experimentally examined how reading a stigmatizing newspaper article or a control article (Experiment 1) and recalling one's experience with smoking discrimination or a control prompt (Experiment 2) affected smokers' responses. We also examined the role of cultural contexts (U.S. vs. Denmark; only in Experiment 1) and smoking identity. In Experiment 1, we used a community sample of smokers from the U.S. (N = 111) and Denmark (N = 111). We found that reading the stigmatizing article (compared to the control) caused more rejection sensitivity (U.S. participants only) and more intentions to quit smoking (both U.S. and Danish participants) for smokers low in smoking identity. In Experiment 2, we used an online sample of 194 U.S. smokers and found that recalling instances of mistreatment made smokers more stressed, rejection sensitive, and interested in smoking cessation, when smokers appraised the stigma cue as threatening. Thus, we generally found that identity threat moved smokers toward leaving their stigmatized group (e.g., quitting smoking) rather than away from it. Our studies highlight the importance of understanding psychological process by which smokers distance themselves from their spoiled identity.
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