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Qin R, Liu Z, Cheng AQ, Zhou XM, Su Z, Cui ZY, Li JX, Wei XW, Zhao L, Chung KF, Xiao D, Wang C. Efficacy of varenicline or bupropion and its association with nicotine metabolite ratio among smokers with COPD. Respirology 2024; 29:479-488. [PMID: 38494828 DOI: 10.1111/resp.14702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND AND OBJECTIVE Nicotine metabolic ratio (NMR) has been associated with nicotine metabolism and smoking characteristics. However, there are few studies on the potential association between NMR and smoking cessation efficacy in smokers with chronic obstructive pulmonary disease (COPD) in China or elsewhere. METHODS This study was a stratified block randomized controlled trial for smoking cessation in Chinese smokers with COPD. NMR was used as a stratification factor; slow metabolizers were defined as those with NMR <0.31, and normal metabolizers as those with NMR ≥0.31. Participants were randomly assigned to the varenicline or bupropion group. Follow-up visits were conducted at 1, 2, 4, 6, 9, 12 and 24 weeks. RESULTS Two hundred twenty-four participants were recruited and analysed from February 2019 to June 2022. In normal metabolizers, the 9-12 weeks continuous abstinence rate of varenicline (43.1%) was higher than in bupropion (23.5%) (OR = 2.47, 95% CI 1.05-5.78, p = 0.038). There was no significant difference in abstinence rates between treatment groups in slow metabolizers (54.1% vs. 45.9%, OR = 1.39, 95% CI 0.68-2.83, p = 0.366). For slow metabolizers, the total score of side effects in the varenicline group was significantly higher than the bupropion group (p = 0.048), while there was no significant difference in side effects between groups for normal metabolizers (p = 0.360). CONCLUSION Varenicline showed better efficacy than bupropion in normal metabolizers, and bupropion showed equivalent efficacy in slow metabolizers with less side effects. According to our study, NMR provides a better justification for both scientific research and tailoring optimal pharmacotherapy for smoking cessation among smokers in COPD.
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Affiliation(s)
- Rui Qin
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Zhao Liu
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - An-Qi Cheng
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Xin-Mei Zhou
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Zheng Su
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Zi-Yang Cui
- Department of Geriatric Medicine, Beijing Shijitan Hospital, Beijing, China
| | - Jin-Xuan Li
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Capital Medical University, Beijing, China
| | - Xiao-Wen Wei
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
- Capital Medical University, Beijing, China
| | - Liang Zhao
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Kian Fan Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Dan Xiao
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Tobacco Control and Prevention of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
| | - Chen Wang
- China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
- National Clinical Research Center for Respiratory Diseases, Beijing, China
- Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
- National Center for Respiratory Medicine, Beijing, China
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Shadel WG, Martino SC, Setodji CM, Dunbar M, Jenson D, Wong JC, Falgoust G. Doing more with less: A proposal to advance cigarette packaging regulations in the United States. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 124:104308. [PMID: 38184903 PMCID: PMC10939880 DOI: 10.1016/j.drugpo.2023.104308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
Cigarette packages are potent marketing tools. Following guidance from the WHO Framework Convention on Tobacco Control, many countries have sought to diminish this marketing power by mandating that (1) large graphic health warnings be affixed to the packages (i.e., text warnings combined with graphic images of the health consequences of smoking) and (2) all packages be fully "plain" in their design (i.e., all packages use the same drab/bland color and font type; no brand logos, other colors, or designs are permitted). Yet, the United States lags other countries in implementing regulations designed to blunt the marketing power of cigarette packages. This is not because of a lack of effort on the part of the Food and Drug Administration, the main governmental body charged with regulating tobacco products in the United States. Rather, it is because the regulatory options that that have been advanced in the country (e.g., graphic health warnings) have not been found - yet - to be legally feasible by its courts. This commentary works through some of the conceptual, practical, and legal issues regarding packaging regulations in the United States. It considers the political and bureaucratic risks involved with issuing new regulations. The overall intent is to prompt our field to think creatively about what is realistic in this regulatory space and to offer a novel perspective that may help move the United States tobacco control community forward in its efforts to reduce the promotional power of cigarette packages.
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Affiliation(s)
- William G Shadel
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States.
| | - Steven C Martino
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
| | - Claude M Setodji
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
| | - Michael Dunbar
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
| | - Desmond Jenson
- Public Health Law Center, Mitchell Hamline School of Law, Saint Paul, MN 55105, United States
| | - Jody Cs Wong
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
| | - Grace Falgoust
- RAND Corporation, 4570 Fifth Avenue., Suite 600, Pittsburgh, PA 15213, United States
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Bernstein EY, Chang Y, Levy DE, Baggett TP, Lee SS, Tindle HA, Rigotti NA. Tobacco-Related Disease, Health Beliefs, and Post-hospital Tobacco Abstinence. Am J Prev Med 2023; 65:792-799. [PMID: 37217039 PMCID: PMC10592560 DOI: 10.1016/j.amepre.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/16/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Most hospitalized patients who smoke resume after discharge. Associations of tobacco-related disease and health beliefs with post-hospitalization abstinence were examined. METHODS This was a cohort study using data from a 2018-2020 multicenter trial of hospitalized adults who smoked and wanted to quit. Tobacco-related disease was defined using primary discharge diagnosis codes. Baseline health beliefs included (1) smoking caused hospitalization, (2) quitting speeds recovery, and (3) quitting prevents future illness. Outcomes included self-reported 7-day point prevalence abstinence 1, 3, and 6 months after discharge. Separate logistic regression models for each of the three health beliefs were constructed. Models stratified by tobacco-related disease explored effect modification. Analysis was performed in 2022-2023. RESULTS Of 1,406 participants (mean age 52 years, 56% females, 77% non-Hispanic White), 31% had tobacco-related disease, 42% believed that smoking caused hospitalization, 68% believed that quitting speeds recovery, and 82% believed that quitting prevents future illness. Tobacco-related disease was associated with higher 1-month point prevalence abstinence in each health belief model (AOR=1.55, 95% CI=1.15, 2.10; 1.53, 95% CI=1.14, 2.05; and 1.64, 95% CI=1.24, 2.19, respectively) and higher 6-month point prevalence abstinence in models including health beliefs 2 and 3. Quitting speeds recovery was the only belief associated with higher 1-month point prevalence abstinence (AOR=1.39, 95% CI=1.05, 1.85). Among patients with tobacco-related disease, the belief that quitting prevents future illness was associated with higher 1-month point prevalence abstinence (AOR=2.00, 95% CI=1.06, 3.78). CONCLUSIONS Tobacco-related disease predicts abstinence 1 and 6 months after hospitalization independent of health beliefs. Beliefs that quitting speeds recovery and prevents future illness may serve as targets for smoking-cessation interventions.
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Affiliation(s)
- Eden Y Bernstein
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Yuchiao Chang
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Tobacco Research & Treatment Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Douglas E Levy
- Harvard Medical School, Boston, Massachusetts; Tobacco Research & Treatment Center, Massachusetts General Hospital, Boston, Massachusetts; Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
| | - Travis P Baggett
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Tobacco Research & Treatment Center, Massachusetts General Hospital, Boston, Massachusetts; Institute for Research, Quality, and Policy in Homeless Health Care, Boston Health Care for the Homeless Program, Boston, Massachusetts
| | - Scott S Lee
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Hilary A Tindle
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Geriatric Research Education and Clinical Centers (GRECC), Veterans Affairs Tennessee Valley Healthcare System, Nashville, Tennessee
| | - Nancy A Rigotti
- Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Tobacco Research & Treatment Center, Massachusetts General Hospital, Boston, Massachusetts; Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts
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Köteles F, Szemerszky R, Petrie K, Nordin S. Modern health worries and annoyance from environmental factors are largely unrelated to smoking, alcohol consumption, and physical activity. J Psychosom Res 2023; 172:111417. [PMID: 37331267 DOI: 10.1016/j.jpsychores.2023.111417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Modern health worries, as well as environmental annoyance from chemical agents, noise, and electromagnetic exposure are associated with symptom reporting and marked affective-behavioural changes. As promotion and protection of health is a primary characteristic of these conditions, it can be expected that they will be related to less risk behaviour (smoking and alcohol consumption) and more health behaviour (physical activity), both cross-sectionally and longitudinally. METHODS Hypotheses were tested in a sample of 2336 individuals participating in T1 and T2 data collection (3 years apart) of the Västerbotten Environmental Health Study, Sweden. Health-related behaviours were assessed using single self-report questions. Smoking was measured on a binary (yes-or-no) scale; frequency of alcohol consumption and physical activity was measured on a 5-point and a 4-point scale, respectively. RESULTS Modern health worries showed no cross-sectional association with the three behaviours, whereas annoyance was typically inversely, very weakly, related to smoking and alcohol consumption. Physical activity was significantly positively associated only with chemical annoyance. None of the variables significantly predicted change of behaviours at T2 after controlling for the respective T1 value and demographic variables. CONCLUSIONS Individuals with high levels of modern health worries and annoyance from various environmental agents are not clearly characterized by a healthier lifestyle. Perhaps they focus on the alleviation of their existing symptoms; alternatively, somatic symptom distress decreases their cognitive-affective resources necessary for a long-term life style change.
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Affiliation(s)
- Ferenc Köteles
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Hungary.
| | - Renáta Szemerszky
- Institute of Psychology, Károli Gáspár University of the Reformed Church in Hungary, Hungary.
| | - Keith Petrie
- Department of Psychological Medicine, University of Auckland, New Zealand.
| | - Steven Nordin
- Department of Psychology, Umeå University, Umeå, Sweden.
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Halliday DM, Epperson AE, Gonzalez M, Song AV. Perceptions of COVID-related risks among people who smoke: A mediation model. Prev Med Rep 2023; 33:102205. [PMID: 37193534 PMCID: PMC10106784 DOI: 10.1016/j.pmedr.2023.102205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/06/2023] [Indexed: 05/18/2023] Open
Abstract
The COVID-19 pandemic provides both reasons to quit smoking as well as stress that may promote increased cigarette consumption. Perceptions of COVID-19 risk related to smoking may motivate cessation among smokers. At the same time, other evidence shows that affective perceptions (i.e., worry) could lead to increased smoking as a coping mechanism. Using a sample drawn from a rural region of California (N = 295), we examined the relationship between perceptions about health risks for smokers during the pandemic and both reported increases in smoking frequency and intentions to quit smoking. We also examined whether worry about health risks mediated these relationships. High perceived risk was associated both with reported increases in smoking frequency as well as greater intentions to quit smoking. Worry partially mediated both these relationships, with worry accounting for 29.11% of the variance in the relationship between high risk perceptions and increased smoking as well as 20.17% of the relationship between risk perceptions and intentions to quit smoking. These findings suggest that while smokers' awareness about their increased risk of COVID-19 can motivate intent to quit smoking in the future, smokers may require greater support to act on these intentions.
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Affiliation(s)
- Deanna M. Halliday
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
| | - Anna E. Epperson
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
| | - Mariaelena Gonzalez
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
- Department of Public Health, University of California, Merced, United States
| | - Anna V. Song
- Department of Psychological Sciences, University of California, Merced, United States
- Nicotine and Cannabis Policy Center, University of California, Merced, United States
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Rubenstein D, Denlinger-Apte RL, Cornacchione Ross J, Carroll DM, McClernon FJ. Older age is associated with greater misperception of the relative health risk of e-cigarettes and cigarettes among US adults who smoke. Tob Control 2023:tc-2023-057943. [PMID: 37137702 PMCID: PMC10622327 DOI: 10.1136/tc-2023-057943] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/25/2023] [Indexed: 05/05/2023]
Abstract
INTRODUCTION The prevalence of cigarette smoking among adults aged ≥55 has remained stagnant over the past decade. National data modelling suggests no reduction in cigarette smoking prevalence attributable to e-cigarette use in the USA among people aged ≥45. Misperceptions about the absolute risks (ie, cigarettes are not harmful) and relative risks (ie, e-cigarettes are more harmful than cigarettes) of tobacco products may contribute to sustained smoking prevalence and hesitancy to switch from cigarettes to e-cigarettes among older adults. METHODS Participants reported cigarette use (n=8072) at Wave 5 (2018-2019) of the Population Assessment of Tobacco and Health Study. Weighted multivariable logistic regressions included six age categories (independent variable) and cigarette and e-cigarette risk perceptions (outcomes). Additional models assessed the associations between dichotomous age (≥55 vs 18-54), risk perceptions and an interaction term (independent variables) with past 12-month quit attempts and past-month e-cigarette use (outcomes). RESULTS Adults aged ≥65 were less likely than adults aged 18-24 to rate cigarettes as very/extremely harmful (p<0.05). Odds of rating e-cigarettes as more harmful than cigarettes among adults aged 55-64 and ≥65 were 1.71 (p<0.001) and 1.43 (p=0.024) greater than for adults aged 18-24. This misperception was negatively associated with past-month e-cigarette use and was stronger among adults aged ≥55 (p<0.001) than adults aged <55 (p<0.001). DISCUSSION Adults aged ≥55 are more likely to have misperceptions about the absolute and relative risks of tobacco products, which may contribute to continued smoking. Health communications targeting this age group could modify beliefs about the perceived harms of tobacco products.
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Affiliation(s)
- Dana Rubenstein
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Clinical and Translational Science Institute, Duke University School of Medicine, Durham, North Carolina, USA
| | - Rachel L Denlinger-Apte
- Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennifer Cornacchione Ross
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Dana Mowls Carroll
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
- Clinical and Translational Science Institute, Duke University School of Medicine, Durham, North Carolina, USA
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Dugger R, Reesor-Oyer L, Beets MW, Wilson DK, Weaver RG. Parental decision-making on summer program enrollment: A mixed methods Covid-19 impact study. EVALUATION AND PROGRAM PLANNING 2023; 97:102200. [PMID: 36527887 PMCID: PMC9721268 DOI: 10.1016/j.evalprogplan.2022.102200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 05/03/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The closure of childcare organizations (e.g. schools, childcare centers, afterschool programs, summer camps) during the Covid-19 pandemic impacted the health and wellbeing of families. Despite their reopening, parents may be reluctant to enroll their children in summer programming. Knowledge of the beliefs that underlie parental concerns will inform best practices for organizations that serve children. METHODS Parents (n = 17) participated in qualitative interviews (October 2020) to discuss Covid-19 risk perceptions and summer program enrollment intentions. Based on interview responses to perceived Covid-19 risk, two groups emerged for analysis- "Elevated Risk (ER)" and "Conditional Risk (CR)". Themes were identified utilizing independent coding and constant-comparison analysis. Follow-up interviews (n = 12) in the Spring of 2021 evaluated the impact of vaccine availability on parent risk perceptions. Additionally, parents (n = 17) completed the Covid-19 Impact survey to assess perceived exposure (Range: 0-25) and household impact (Range: 2-60) of the pandemic. Scores were summed and averaged for the sample and by risk classification group. RESULTS Parents overwhelmingly supported the operation of summer programming during the pandemic due to perceived child benefits. Parent willingness to enroll their children in summer programming evolved with time and was contingent upon the successful implementation of safety precautions (e.g. outdoor activities, increased handwashing/sanitizing of surfaces). Interestingly, parents indicated low exposure (ER: Avg. 6.3 ± 3.1 Range [2-12], CR: Avg. 7.5 ± 3.6 Range [1-14]) and moderate family impact (ER: Avg. 27.1 ± 6.9 Range [20-36], CR: Avg. 33.7 ± 11.4 Range [9-48]) on the impact survey. CONCLUSION Childcare organizations should mandate and evaluate the implementation of desired Covid-19 safety precautions for their patrons.
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Affiliation(s)
- Roddrick Dugger
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, USA
| | - Layton Reesor-Oyer
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, USA
| | - Michael W Beets
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, USA
| | - Dawn K Wilson
- University of South Carolina, Department of Psychology, College of Art and Sciences, USA
| | - Robert Glenn Weaver
- University of South Carolina, Department of Exercise Science, Arnold School of Public Health, USA.
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Land SR, Baker L, Bachand J, Twesten J, Kaufman AR, Reyes-Guzman CM. Associations of Daily Versus Nondaily Smoking, Tobacco-Related Risk Perception, and Cancer Diagnosis Among Adults in the Population Assessment of Tobacco and Health (PATH) Study. Nicotine Tob Res 2022; 24:1540-1547. [PMID: 35245943 PMCID: PMC9575975 DOI: 10.1093/ntr/ntac059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 02/02/2022] [Accepted: 03/01/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Nondaily smoking has become increasingly common among cigarette smokers. Our objective was to determine whether current daily versus nondaily smoking differed by tobacco-related risk perceptions (TRRPs), demographic factors, and cancer history. METHODS Participants were all adults in Waves 1-3 of the longitudinal cohort Population Assessment of Tobacco and Health Study who were current smokers at Wave 3 (N = 8307). The primary analysis was weighted logistic regression of daily versus nondaily smoking at Wave 3. TRRP measures were cigarette harm perception, worry that tobacco products will damage one's health, belief that smoking cigarettes causes [lung/bladder/mouth/liver] cancer, and nondaily cigarette harm perception (Likert-type scale). Other measures included demographic factors, other tobacco product use, minor at time of first cigarette, and cancer survivor status (yes/no). RESULTS Among current smokers, daily versus nondaily smoking was significantly associated with being a minor at time of first cigarette (OR = 1.54, p < .001), TRRPs (OR = 0.83, p < .001; OR = 1.40, p < .001; and OR = 1.17, p = .009 [harm perception, worry, and nondaily cigarette harm perception, respectively]), and interaction between cancer survivor status and belief that smoking causes cancer (p < .001). TRRPs among current smokers did not differ significantly between cancer survivors and respondents without a cancer history. CONCLUSIONS Respondents with lower harm perception, higher worry, and higher nondaily cigarette harm perception were more likely to be daily versus nondaily smokers. Respondents with higher belief that smoking causes cancer or who were cancer survivors were less likely to be daily (versus nondaily) smokers compared to respondents with low belief and no cancer history. IMPLICATIONS This study is unique in that it examined associations of smoking cigarettes daily versus nondaily with tobacco-related risk perceptions and cancer survivorship-comparing cancer survivors to those without a cancer history. Given the increasing prevalence of nondaily smoking as compared with daily smoking in the general population, and the prognostic significance of smoking after cancer diagnosis, these findings fill a clinically important gap in the literature and provide a foundation for further research.
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Affiliation(s)
- Stephanie R Land
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Laura Baker
- The Bizzell Group, LLC, New Carrollton, MD, USA
| | - Jacqueline Bachand
- U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Washington, DC, USA
| | | | - Annette R Kaufman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Carolyn M Reyes-Guzman
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Everson NS, Klein WMP, Lee SS, Selove R, Sanderson M, Blot WJ, Tyndale RF, King S, Gilliam K, Kundu S, Steinwandel M, Sternlieb SJ, Andersen SW, Friedman DL, Connors E, Fadden MK, Freiberg MS, Wells QS, Canedo J, Young RP, Scott RJ, Umeukeje EM, Griffith DM, Tindle HA. Dispositional optimism and optimistic bias: Associations with cessation motivation, confidence, and attitudes. Health Psychol 2022; 41:621-629. [PMID: 35901400 PMCID: PMC9830640 DOI: 10.1037/hea0001184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To test whether 2 conceptually overlapping constructs, dispositional optimism (generalized positive expectations) and optimistic bias (inaccurately low risk perceptions), may have different implications for smoking treatment engagement. METHOD Predominantly Black, low-income Southern Community Cohort study smokers (n = 880) self-reported dispositional optimism and pessimism (Life Orientation Test-Revised subscales: 0 = neutral, 12 = high optimism/pessimism), comparative lung cancer risk (Low/Average/High), and information to calculate objective lung cancer risk (Low/Med/High). Perceived risk was categorized as accurate (perceived = objective), optimistically-biased (perceived < objective), or pessimistically-biased (perceived > objective). One-way ANOVAs tested associations between dispositional optimism/pessimism and perceived risk accuracy. Multivariable logistic regressions tested independent associations of optimism/pessimism and perceived risk accuracy with cessation motivation (Low/High), confidence (Low/High), and precision treatment attitudes (Favorable/Unfavorable), controlling for sociodemographics and nicotine dependence. RESULTS Mean dispositional optimism/pessimism scores were 8.41 (SD = 2.59) and 5.65 (SD = 3.02), respectively. Perceived lung cancer risk was 38% accurate, 27% optimistically-biased, and 35% pessimistically-biased. Accuracy was unrelated to dispositional optimism (F(2, 641) = 1.23, p = .29), though optimistically-biased (vs. pessimistically-biased) smokers had higher dispositional pessimism (F(2, 628) = 3.17, p = .043). Dispositional optimism was associated with higher confidence (Adjusted odds ratio [AOR] = 1.71, 95% CI [1.42, 2.06], p < .001) and favorable precision treatment attitudes (AOR = 1.66, 95% CI [1.37, 2.01], p < .001). Optimistically-biased (vs. accurate) risk perception was associated with lower motivation (AOR = .64, 95% CI [.42, .98], p = .041) and less favorable precision treatment attitudes (AOR = .59, 95% CI [.38, .94], p = .029). CONCLUSIONS Dispositional optimism and lung cancer risk perception accuracy were unrelated. Dispositional optimism was associated with favorable engagement-related outcomes and optimistically-biased risk perception with unfavorable outcomes, reinforcing the distinctiveness of these constructs and their implications for smoking treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Nicole Senft Everson
- Vanderbilt University Medical Center, Nashville, TN, USA
- Behavioral Research Program, National Cancer Institute, Bethesda, MD, USA
| | | | - Scott S. Lee
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Departments of Pharmacology and Toxicology, and Psychiatry, University of Toronto, ON, CA
| | - Stephen King
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Karen Gilliam
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Suman Kundu
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Shaneda Warren Andersen
- Vanderbilt University Medical Center, Nashville, TN, USA
- University of Wisconsin-Madison; Carbone Cancer Center, Madison, WI, USA
| | | | - Erin Connors
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Matthew S. Freiberg
- Vanderbilt University Medical Center, Nashville, TN, USA
- Geriatric Research Education and Clinical Centers (GRECC), Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Quinn S. Wells
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Juan Canedo
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | | | - Derek M. Griffith
- Georgetown University, Departments of Health Services Administration and Oncology, Washington, DC, USA
| | - Hilary A. Tindle
- Vanderbilt University Medical Center, Nashville, TN, USA
- Geriatric Research Education and Clinical Centers (GRECC), Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN, USA
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10
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Lee E, Moore SP, Trapl E, Fryer CS, Gunzler D, Sterling KL. Changes in Little Cigar and Cigarillo Use during the COVID-19 Pandemic: A Cross-Sectional Analysis of a Nationally Representative Sample of Young Adult Users. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158933. [PMID: 35897303 PMCID: PMC9331994 DOI: 10.3390/ijerph19158933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 02/01/2023]
Abstract
We examined the smoking behaviors of U.S. young adults ages 18-36 regarding little cigars and cigarillos (LCCs) during the COVID-19 pandemic. Survey data were collected from a nationally representative sample of young adults between October and November 2020. Respondents who reported using LCCs with tobacco (CAI) and/or with marijuana (CAB) within the past 6 months prior to the survey (n = 399) were included in the study. Logistic regression analyses assessed the association between their perceived risk of having COVID when smoking LCCs and pandemic-related behavioral changes in CAI and CAB use (e.g., worrying, quit attempts, smoking more, smoking less). Findings showed that users with a higher perceived risk of getting COVID-19 when smoking LCCs were more likely to endorse trying to quit CAI and CAB during the pandemic. Compared to the non-Hispanic White population, the non-Hispanic Black population were less likely to endorse smoking less CAI and trying to quit CAB during the pandemic. Dual users of CAI and CAB and females were more likely to endorse smoking more CAB compared to CAB-only users and males, respectively. Tailored cessation strategies are needed for dual users, non-Hispanic Black young adults, and young women. Raising awareness about the risks of LCC use can be an effective strategy for LCC smoking cessation.
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Affiliation(s)
- Eugenia Lee
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Dallas Regional Campus, Dallas, TX 75207, USA;
- Correspondence:
| | - Stephanie Pike Moore
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA; (S.P.M.); (E.T.); (D.G.)
| | - Erika Trapl
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA; (S.P.M.); (E.T.); (D.G.)
| | - Craig S. Fryer
- Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD 20742, USA;
| | - Douglas Gunzler
- Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA; (S.P.M.); (E.T.); (D.G.)
| | - Kymberle L. Sterling
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston, Dallas Regional Campus, Dallas, TX 75207, USA;
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11
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Pagano A, McCuistian C, Le T, Campbell BK, Delucchi K, Woodward-Lopez G, Guydish J. Smoking Behavior and Wellness among Individuals in Substance Use Disorder Treatment. J Psychoactive Drugs 2022:1-12. [PMID: 35815722 PMCID: PMC9826798 DOI: 10.1080/02791072.2022.2095942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Tobacco-related morbidity and mortality disproportionately affect people with substance use disorders (SUD). Encouraging overall wellness may support tobacco use cessation. We investigated relationships between wellness (health status, physical activity, sugar-sweetened beverage (SSB) consumption), cigarette smoking, and smoking cessation among SUD treatment patients to inform clinical care. Cross-sectional surveys were conducted with 395 patients in 20 California residential SUD programs. Using multivariate regression, we examined associations between smoking status and wellness. Among smokers, we examined associations between lifetime smoking exposure, cessation behaviors and attitudes, and wellness. Compared to nonsmokers (n = 121), smokers (n = 274) reported more SSB consumption, poorer physical health, and more respiratory symptoms. Among smokers, SSB consumption and respiratory symptoms increased per ten pack-years of smoking. Smokers with respiratory symptoms reported higher motivation to quit and more use of nicotine replacement therapy (NRT). Smokers with more days of poor mental health reported lower motivation to quit. Overall, cigarette smoking was associated with other health-risk behaviors among SUD treatment patients. Respiratory symptoms may increase, and poor mental health may decrease, SUD patients' intent to quit smoking. To reduce chronic disease risk among SUD patients, treatment programs should consider promoting overall wellness concurrently with smoking cessation.
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Affiliation(s)
- Anna Pagano
- Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois Street, Floor 7, San Francisco, CA 94158,Corresponding author: Anna Pagano, PhD,
| | - Caravella McCuistian
- Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois Street, Floor 7, San Francisco, CA 94158
| | - Thao Le
- Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois Street, Floor 7, San Francisco, CA 94158
| | - Barbara K. Campbell
- Division of General & Internal Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098
| | - Kevin Delucchi
- Department of Psychiatry & Behavioral Sciences, 401 Parnassus Ave, University of California, San Francisco, San Francisco, CA 94143
| | - Gail Woodward-Lopez
- University of California Nutrition Policy Institute, 1111 Franklin St, Fifth Floor, Oakland, CA 94607
| | - Joseph Guydish
- Institute for Health Policy Studies, University of California, San Francisco, 490 Illinois Street, Floor 7, San Francisco, CA 94158
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12
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Zhai Q, Sher A, Li Q. The Impact of Health Risk Perception on Blockchain Traceable Fresh Fruits Purchase Intention in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137917. [PMID: 35805573 PMCID: PMC9266064 DOI: 10.3390/ijerph19137917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022]
Abstract
This paper systematically investigates the impact of consumers’ health risk perceptions on the purchase intention of blockchain traceable fresh fruits in China. It uses online-survey data collected from four pilot cities that are part of the food traceability system in China. The ordinary least squares (OLS) and the ordered probit model was applied to examine the posited relationships. The results show that consumers’ health risk perception has a significant positive effect on the purchase intention of blockchain traceable fresh fruits. The stronger consumers’ health risk perception, the stronger their purchase intention of blockchain traceable fresh fruits. Likewise, heterogeneity exists among gender, age, income, and education in their corresponding effect of consumers’ health risk perception on blockchain traceable fresh fruit purchase intention. This suggests that male, high-aged, high-income and high-educated groups have a higher health risk perception, and therefore a higher purchase perception for blockchain traceable fresh fruits than female, low-aged, low-income and low-educated, respectively. Furthermore, family structure, consumers’ traceability cognition and purchase experience of traceable products affect the purchase intention of blockchain traceable fresh fruits. The study has several insights on the broader promotion, acceptance and development of the food traceability system and provides practical cues for policy and practice.
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Affiliation(s)
- Qianqian Zhai
- College of Economics and Management, Nanjing Agricultural University, Nanjing 210095, China;
| | - Ali Sher
- Business School, Nanjing University of Information Science & Technology, Nanjing 210044, China;
| | - Qian Li
- College of Economics, Beijing Technology and Business University, Beijing 100048, China
- Correspondence:
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13
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Perski O, Jambharunkar T, Brown J, Kale D. A pilot randomised trial of a brief virtual reality scenario in smokers unmotivated to quit: Assessing the feasibility of recruitment. PLOS DIGITAL HEALTH 2022; 1:e0000060. [PMID: 36812542 PMCID: PMC9931367 DOI: 10.1371/journal.pdig.0000060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/07/2022] [Indexed: 11/19/2022]
Abstract
Individual-level interventions for smokers unmotivated to quit remain scarce and have had limited success. Little is known about the potential of virtual reality (VR) for delivering messaging to smokers unmotivated to quit. This pilot trial aimed to assess the feasibility of recruitment and acceptability of a brief, theory-informed VR scenario and estimate proximal quitting outcomes. Unmotivated smokers (recruited between February-August 2021) aged 18+ years who had access to, or were willing to receive via post, a VR headset were randomly assigned (1:1) using block randomisation to view the intervention (i.e., a hospital-based scenario with motivational stop smoking messaging) or a 'sham' VR scenario (i.e., a scenario about the human body without any smoking-specific messaging) with a researcher present via teleconferencing software. The primary outcome was feasibility of recruitment (i.e., achieving the target sample size of 60 participants within 3 months of recruitment). Secondary outcomes included acceptability (i.e., positive affective and cognitive attitudes), quitting self-efficacy and intention to stop smoking (i.e., clicking on a weblink with additional stop smoking information). We report point estimates and 95% confidence intervals (CIs). The study protocol was pre-registered (osf.io/95tus). A total of 60 participants were randomised within 6 months (intervention: n = 30; control: n = 30), 37 of whom were recruited within a 2-month period of active recruitment following an amendment to gift inexpensive (£7) cardboard VR headsets via post. The mean (SD) age of participants was 34.4 (12.1) years, with 46.7% identifying as female. The mean (SD) cigarettes smoked per day was 9.8 (7.2). The intervention (86.7%, 95% CI = 69.3%-96.2%) and control (93.3%, 95% CI = 77.9%-99.2%) scenarios were rated as acceptable. Quitting self-efficacy and intention to stop smoking in the intervention (13.3%, 95% CI = 3.7%-30.7%; 3.3%, 95% CI = 0.1%-17.2%) and control (26.7%, 95% CI = 12.3%-45.9%; 0%, 95% CI = 0%-11.6%) arm were comparable. The target sample size was not achieved within the feasibility window; however, an amendment to gift inexpensive headsets via post appeared feasible. The brief VR scenario appeared acceptable to smokers unmotivated to quit.
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Affiliation(s)
- Olga Perski
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, London, United Kingdom
- * E-mail:
| | - Trupti Jambharunkar
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, London, United Kingdom
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, London, United Kingdom
| | - Dimitra Kale
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- SPECTRUM Consortium, London, United Kingdom
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14
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Chun HR, Cheon E, Hwang JE. Systematic review of changed smoking behaviour, smoking cessation and psychological states of smokers according to cigarette type during the COVID-19 pandemic. BMJ Open 2022; 12:e055179. [PMID: 35701057 PMCID: PMC9198387 DOI: 10.1136/bmjopen-2021-055179] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Although the global COVID-19 pandemic has increased interest in research involving high-risk smokers, studies examining changed smoking behaviours, cessation intentions and associated psychological states among smokers are still scarce. This study aimed to systematically review the literature related to this subject. DESIGN A systematic review of published articles on cigarettes and COVID-19-related topics DATA SOURCES: Our search was conducted in January 2021. We used the keywords COVID-19, cigarettes, electronic cigarettes (e-cigarettes) and psychological factors in PubMed and ScienceDirect and found papers published between January and December 2020. DATA SELECTION We included articles in full text, written in English, and that surveyed adults. The topics included smoking behaviour, smoking cessation, psychological state of smokers and COVID-19-related topics. DATA EXTRACTION AND SYNTHESIS Papers of low quality, based on quality assessment, were excluded. Thirteen papers were related to smoking behaviour, nine papers were related to smoking cessation and four papers were related to psychological states of smokers. RESULTS Owing to the COVID-19 lockdown, cigarette users were habituated to purchasing large quantities of cigarettes in advance. Additionally, cigarette-only users increased their attempts and willingness to quit smoking, compared with e-cigarette-only users. CONCLUSIONS Owing to the COVID-19 outbreak, the intention to quit smoking was different among smokers, according to cigarette type (cigarette-only users, e-cigarette-only users and dual users). With the ongoing COVID-19 pandemic, policies and campaigns to increase smoking cessation intentions and attempts to quit smoking among smokers at high risk of COVID-19 should be implemented. Additionally, e-cigarette-only users with poor health-seeking behaviour require interventions to increase the intention to quit smoking.
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Affiliation(s)
- Hae-Ryoung Chun
- Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, Republic of Korea
| | - Eunsil Cheon
- Graduate School of Public Health, Seoul National University, Gwanak-gu, Seoul, Republic of Korea
| | - Ji-Eun Hwang
- College of health science, Dankook University, Chungnam, Republic of Korea
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15
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Bjurlin MA, Basak R, Zambrano I, Schatz D, El Shahawy O, Sherman S, Matulewicz RS. Patterns and associations of smoking and electronic cigarette use among survivors of tobacco related and non-tobacco related cancers: A nationally representative cross-sectional analysis. Cancer Epidemiol 2022; 78:101913. [PMID: 33674247 DOI: 10.1016/j.canep.2021.101913] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Tobacco-use among cancer survivors leads to preventable morbidity, mortality, and increased healthcare costs. We sought to explore the prevalence of smoking and e-cigarette use among survivors of tobacco and non-tobacco related cancers. METHODS A cross-sectional analysis was conducted using the 2015-2018 National Health Interview Survey. Our primary outcome was the prevalence of current cigarette smoking or e-cigarette use among adults with self-reported history of tobacco related or non-tobacco related cancer. Logistic regression analysis was to assess the association of reported cancer type with cigarette smoking or e-cigarette use. Secondary outcomes included yearly trends and dual use. RESULTS A total of 12,984 respondents reported a history of cancer, representing a weighted estimate of 5,060,059 individuals with a history of tobacco-related malignancy and 17,583,788 with a history of a tobacco and non-tobacco related cancer, respectively. Survivors of tobacco-related cancers had a significantly higher prevalence of current cigarette use (18.2 % vs 9.7 %, P < 0.0001), e-cigarette use (2.7 % vs 1.6 %, P < 0.0001) and similar rates of dual use. The prevalence of cigarette smoking among all survivors increased as time increased from the year of diagnosis up to 2 years post-diagnosis (P = 0.047). Odds of reporting current cigarette smoking use was higher for survivors of tobacco-related cancers, adjusted for sociodemographic factors (OR1.69, 95 % CI 1.44-1.99). CONCLUSIONS Survivors of tobacco-related cancers have a higher prevalence of current cigarette smoking and e-cigarette use compared to survivors of non-tobacco related cancers. There was a sequential increase in the prevalence of cigarette use during each subsequent year from the time of a new cancer diagnosis, underscoring the need for long term tobacco cessation support among newly diagnosed adults with cancer.
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Affiliation(s)
- Marc A Bjurlin
- Department of Urology, University of North Carolina, Chapel Hill, NC, United States; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States.
| | - Ramsankar Basak
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, United States
| | - Ibardo Zambrano
- Department of Urology, University of North Carolina, Chapel Hill, NC, United States
| | - Daniel Schatz
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, New York University School of Medicine, New York, NY, United States; Office of Behavioral Health, Health + Hospitals, New York, NY, United States
| | - Omar El Shahawy
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Scott Sherman
- Section on Tobacco, Alcohol and Drug Use, Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Richard S Matulewicz
- Department of Urology, New York University, New York, NY, United States; Department of Population Health, New York University School of Medicine, New York, NY, United States
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16
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DeAtley T, Sokolovsky AW, Snell ML, Tidey J. Mediational pathways of tobacco use among adult daily smokers with psychiatric symptoms in the Population Assessment of Tobacco and Health (PATH) survey. Addict Behav 2022; 129:107249. [PMID: 35104739 PMCID: PMC8969557 DOI: 10.1016/j.addbeh.2022.107249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Individuals with psychiatric conditions suffer disproportionately from tobacco-related morbidity and mortality, but the factors driving this relationship remain unclear. We used data from the Population Assessment of Tobacco and Health (PATH) to investigate whether associations between internalizing psychiatric symptoms and change in smoking heaviness (as measured by cigarettes per day (CPD) were mediated by self-reported respiratory symptoms, smoking risk perceptions, and cigarette dependence. METHODS This study used data from PATH Waves 1 through 4 (2013-2017, n = 4,152). Psychiatric symptoms were indexed with the internalizing sub-scale of the Global Appraisal of Individual Needs-Short Screener (GAIN-SS) among daily smokers. We fit auto-regressive structural equation models (SEM) to data from Wave 1-3 and 2-4 to determine the direct and indirect associations between internalizing symptom scores and CPD through each mediator. RESULTS The association between internalizing symptoms and CPD was mediated by cigarette dependence (indirect: B = 0.004, SE = 0.041, p = 0.023) and respiratory symptom severity (indirect: B = 0.018, SE = 0.097, p < 0.001). Internalizing symptoms predicted higher harm perceptions (B = 0.056, SE = 0.035, p < 0.001) but the indirect relationship with CPD was non-significant. Findings from Waves 2-4 replicated these results. CONCLUSION Our results indicate that cigarette dependence and respiratory symptom severity partially mediate the relationship between internalizing symptoms and CPD but risk perceptions were not significant predictors in our models. This suggests that efforts to reduce smoking among people with internalizing disorders should focus on decreasing nicotine dependence and increasing awareness of respiratory symptoms to encourage a quit attempt or switch to a less harmful source of nicotine.
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Affiliation(s)
- Teresa DeAtley
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA.
| | - Alexander W Sokolovsky
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | - Morgan L Snell
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
| | - Jennifer Tidey
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI 02912, USA
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17
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Bennett B, Romm KF, Berg CJ. Changes in cigarette and e-cigarette use among US young adults from before to during the COVID-19 pandemic: News exposure and risk perceptions as potential predictors. Tob Prev Cessat 2022; 8:18. [PMID: 35601562 PMCID: PMC9074834 DOI: 10.18332/tpc/148245] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/09/2022] [Accepted: 04/12/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION COVID-19 impacted cigarette and e-cigarette use behaviors among some individuals. This study examined COVID-19 factors and prior substance use as predictors of cigarette and e-cigarette cessation and initiation among US young adults from before to during the COVID-19 pandemic. METHODS We analyzed data from Wave 3 (Sept-Dec 2019) and Wave 5 (Sept-Dec 2020) of a 2-year, 5-wave longitudinal study of young adults across six US metropolitan areas. We examined COVID-19 news exposure, perceived smoking and e-cigarette use risk, and prior substance use, as predictors of cigarette and e-cigarette cessation and initiation, respectively. RESULTS Of W3 cigarette users (n=516), 37.8% (n=195) quit cigarettes at W5; predictors of cessation included younger age, fewer days of W3 past-month cigarette use, and no W3 e-cigarette use. Of W3 e-cigarette users (n=687), 38.7% (n=266) quit e-cigarettes at W5; predictors included greater COVID-19 news exposure, fewer days of W3 past-month e-cigarette use, and no W3 cigarette use. Of W3 cigarette non-users (n=1693), 5.0% (n=85) initiated cigarettes at W5; predictors of initiation included younger age, lower perceived smoking risk, lifetime cigarette and e-cigarette use, and W3 e-cigarette use. Of W3 e-cigarette non-users (n=1522), 6.3% (n=96) initiated e-cigarettes at W5; predictors included younger age, less news exposure, lifetime cigarette and e-cigarette use, and W3 cigarette use. CONCLUSIONS These findings underscore the need to address cigarette and e-cigarette co-use and related risk perceptions in prevention and cessation interventions.
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Affiliation(s)
- Breesa Bennett
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Katelyn F. Romm
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
| | - Carla J. Berg
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, United States
- George Washington Cancer Center, George Washington University, Washington, United States
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18
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Pastor Esplá E, Castelló Faus C, Jordá Baldó A, Boira Enrique I, Chiner Vives E. COVID-19 and smoking: An opportunity to quit. Arch Bronconeumol 2021; 57:784-785. [PMID: 34703073 PMCID: PMC8531400 DOI: 10.1016/j.arbr.2021.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Esther Pastor Esplá
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Carmen Castelló Faus
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
| | - Ariana Jordá Baldó
- Medicina Familiar y Comunitaria, Hospital Universitario Virgen del Puerto Plasencia, Plasencia, Cáceres, Spain
| | | | - Eusebi Chiner Vives
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Alicante, Spain
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19
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Gadhave S, Nagarkar A, Saraf A. Five decades of risk perception measurements of tobacco use: a review of literature. CARDIOMETRY 2021. [DOI: 10.18137/cardiometry.2021.20.8899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Perceptions of risk are beliefs about the likelihood of damage orloss. People make subjective judgments regarding the intensityand features of a danger. Smoking start and continuation areinfluenced by risk perception. Risk perception of tobacco useor smoking has always been controversial. Few studies foundthat risk perception is overestimated by smokers and tobaccousers, while other studies found that smokers underestimatethe risk of smoking. It has been observed that different authorshave been using different approaches to measure the risk perceptionof tobacco use. The present literature review is an ontologicalexploration of the process of calculating this constructand determining which method gives more holistic and robustinformation. A literature survey was carried out to understanddifferent ways in which risk perception can be measured. Fifty-seven studies were identified from 1970 to 2020 in which riskperception was calculated for any form of tobacco use. Theliterature review found that the researchers used two practicalapproaches to measure risk perception. In the first approach,the researchers tried to measure only the health risks of tobaccouse, and in the second, multiple dimensions of tobaccouse were measured. Most commonly perceived addictionand then the social risk of tobacco use was accessed. Thoughrecent literature is dominated by an approach where a singledimension, i.e., perceived health risk of tobacco use, is mostcommonly access, it is inferring from the available literature thattools that access multiple sizes of the perceived risk of tobaccouse give more comprehensive and robust information aboutthat construct which can be used further to create tobacco useprevention intervention.
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20
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High Perceived Susceptibility to and Severity of COVID-19 in Smokers Are Associated with Quitting-Related Behaviors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010894. [PMID: 34682641 PMCID: PMC8535969 DOI: 10.3390/ijerph182010894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 12/19/2022]
Abstract
A growing body of evidence shows smoking is a risk factor for coronavirus disease (COVID-19). We examined the associations of quitting-related behaviors with perceived susceptibility to and severity of COVID-19 in smokers. We conducted a telephone survey of 659 community-based adult smokers (81.7% male) in Hong Kong, where there was no lockdown. Exposure variables were perceptions that smoking can increase the risk of contracting COVID-19 (perceived susceptibility) and its severity if infected (perceived severity). Outcome variables were quit attempts, smoking reduction since the outbreak of the pandemic, and intention to quit within 30 days. Covariates included sex, age, education, heaviness of smoking, psychological distress, and perceived danger of COVID-19. High perceived susceptibility and severity were reported by 23.9% and 41.7% of participants, respectively. High perceived susceptibility was associated with quit attempts (prevalence ratio (PR) 2.22, 95% CI 1.41–3.49), smoking reduction (PR 1.75, 95% CI 1.21–2.51), and intention to quit (PR 2.31, 95% CI 1.40–3.84). Perceived severity of COVID-19 was associated with quit attempts (PR 1.64, 95% CI 1.01–2.67) but not with smoking reduction or intention to quit. To conclude, the perceived susceptibility to and severity of COVID-19 in smokers were associated with quitting-related behaviors in current smokers, which may have important implications for smoking cessation amid the pandemic.
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21
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O'Brien EK, Baig SA, Persoskie A. Developing and validating measures of absolute and relative e-cigarette product risk perceptions: Single items can be surprisingly comprehensive. Nicotine Tob Res 2021; 24:316-323. [PMID: 34343322 DOI: 10.1093/ntr/ntab156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 08/02/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Tobacco risk perceptions are important predictors of behavior and are impacted by tobacco communications. Our systematic literature review (completed in 2018) found there were no measures of e-cigarette risk perceptions that were completely consistent with tobacco researcher recommendations (e.g., specifying use frequency) and had demonstrated validity and reliability. The current study develops measures to assess specific risk perceptions, including absolute risks and risks compared to cigarettes, nicotine replacement therapy, and all nicotine cessation. METHODS AND RESULTS We generated a list of tobacco health effects based on our previous systematic review of tobacco risk perception measures. Based on health effects prioritized by regulatory science experts, we developed 63 items to assess seven types of e-cigarette risk perceptions: absolute health and addiction risks, health and addiction risks relative to cigarettes, pregnancy health risks relative to cigarettes, health risks relative to nicotine replacement therapy, and health risks relative to all nicotine cessation. We fielded these items in an online survey (N=1,642). Through reliability and validity analyses, we reduced this pool to 21 items, including many single-item measures. Supporting the measures' validity, each measure was negatively associated with current e-cigarette use, e-cigarette intentions, and skepticism about e-cigarette harms; and positively associated with perceiving e-cigarettes as equally or more harmful than cigarettes and intentions to quit e-cigarettes. DISCUSSION This study developed and validated brief measures of several types of e-cigarette risk perceptions. Surprisingly, we found that for many types of risk perceptions, multi-item measures were redundant and these perceptions were well-represented by single-item measures. IMPLICATIONS This study developed measures of seven types of e-cigarette health risk perceptions, including absolute health and addiction risk, and risk relative to cigarettes, nicotine replacement therapy, and cessation. We reduced 63 items to 21 to measure all of these constructs. These measures follow tobacco researcher recommendations, were developed using a rigorous measurement-development process, and demonstrated some aspects of reliability and validity. Because these measures are publicly available, they can be used by public health and industry researchers.
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Affiliation(s)
- Erin Keely O'Brien
- Office of Science, Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Sabeeh A Baig
- Office of Science, Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
| | - Alexander Persoskie
- Office of Science, Center for Tobacco Products, Food and Drug Administration (FDA), 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA
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22
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Relationships among Self-Efficacy, Quality of Life, Perceived Vulnerability, and Readiness to Quit Smoking in People Living with HIV. J Smok Cessat 2021; 2021:6697404. [PMID: 34306237 PMCID: PMC8279192 DOI: 10.1155/2021/6697404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 04/22/2021] [Indexed: 11/25/2022] Open
Abstract
Smoking-related diseases (e.g., lung cancer) are the leading cause of mortality in HIV-infected patients. While many PLWH who smoke report a desire to quit, a majority of them have low readiness to quit. This study used logistic and linear regression to examine the relations among two (continuous vs. binary) measures of readiness to quit, smoking cessation self-efficacy (SE), quality of life (QoL), and perceived vulnerability (PV) using baseline data from 100 PLWH who smoke who participated in a clinical trial. Results showed no significant main effects (SE, QoL, and PV) or interaction effects (SE × QoL and SE × PV) on a continuous measure of readiness to quit. However, a follow-up analysis revealed that SE had a curvilinear effect on readiness to quit such that self-efficacy was positively associated with readiness to quit except at the highest levels of self-efficacy where readiness to quit declined. Greater SE significantly increased the likelihood of reporting readiness to quit (yes/no) among those with low QoL or high PV. For PLWH who smoke, improving self-efficacy may increase readiness to quit especially among those with lower quality of life. Psychoeducation tailored to PLWH designed to reduce unrealistic invulnerability to smoking-related diseases along with interventions that target self-efficacy may improve readiness to quit.
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23
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Qin R, Liu Z, Zhou X, Cheng A, Cui Z, Li J, Wei X, Xiao D, Wang C. Adherence and Efficacy of Smoking Cessation Treatment Among Patients with COPD in China. Int J Chron Obstruct Pulmon Dis 2021; 16:1203-1214. [PMID: 33958864 PMCID: PMC8096422 DOI: 10.2147/copd.s301579] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/29/2021] [Indexed: 12/20/2022] Open
Abstract
Background Smoking cessation is a key intervention for all smokers with chronic obstructive pulmonary disease (COPD). Poor treatment adherence is a challenge in clinical practice that might contribute to the lower efficacy of medication (eg, oral drug). However, it is unclear what factors will influence adherence among smokers with COPD. Methods This study was based on an open-label randomized controlled trial (RCT) of varenicline and bupropion for smoking cessation among patients with COPD in China. The medication was given for 12 weeks, and visits and assessments were conducted at weeks 0, 1, 2, 4, 6, 9, 12, and 24. We assessed whether the adherence to smoking cessation treatment affects the smoking cessation efficacy and evaluated predictors of adherence. Results A total of 136 participants were recruited from February 2019 to June 2020, and analyzed using the intention-to-treat (ITT) method. In this study, 48.5% (66/136) of the total participants had good adherence to smoking cessation, and good adherence significantly improved the efficacy of smoking cessation (OR=9.60, 95% CI 4.02–22.96, P < 0.001). After adjusting for age, gender, nationality, education, and marital status, we found older age, higher education level, having more previous quitting attempts, stronger self-efficacy and preparation in quitting smoking, recognizing hazards of smoking, longer duration of COPD, and higher St. George’s Respiratory Questionnaire (SGRQ) scores were relevant to good adherence (P < 0.05). Conclusion To our best knowledge, this is the first study to evaluate adherence to smoking cessation treatment among patients with COPD in China. Our study found that good adherence to smoking cessation treatment significantly improved the smoking cessation efficacy, and predictors of adherence were evaluated. We call on the medical community to pay attention to the adherence to smoking cessation among patients with COPD.
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Affiliation(s)
- Rui Qin
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,Peking University China-Japan Friendship School of Clinical Medicine, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China
| | - Zhao Liu
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China
| | - Xinmei Zhou
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China
| | - Anqi Cheng
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China
| | - Ziyang Cui
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China.,Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Jinxuan Li
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China.,Capital Medical University, Beijing, People's Republic of China
| | - Xiaowen Wei
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China.,Capital Medical University, Beijing, People's Republic of China
| | - Dan Xiao
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China
| | - Chen Wang
- Tobacco Medicine and Tobacco Cessation Centre, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.,National Center for Respiratory Medicine, Beijing, People's Republic of China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,National Clinical Research Center for Respiratory Diseases, Beijing, People's Republic of China.,WHO Collaborating Centre for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, People's Republic of China.,Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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24
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Pastor Esplá E, Castelló Faus C, Jordá Baldó A, Boira Enrique I, Chiner Vives E. COVID-19 and Smoking: An Opportunity to Quit. Arch Bronconeumol 2021; 57:S0300-2896(21)00109-5. [PMID: 33832793 PMCID: PMC7986316 DOI: 10.1016/j.arbres.2021.03.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/09/2021] [Accepted: 03/11/2021] [Indexed: 12/27/2022]
Affiliation(s)
- Esther Pastor Esplá
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España.
| | - Carmen Castelló Faus
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España
| | - Ariana Jordá Baldó
- Medicina Familiar y Comunitaria, Hospital Universitario Virgen del Puerto Plasencia, Plasencia, Cáceres, España
| | - Ignacio Boira Enrique
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España
| | - Eusebi Chiner Vives
- Sección de Neumología, Hospital Universitario San Juan de Alicante, Sant Joan d'Alacant, Alicante, España
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25
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Public Perceptions of Harm for Nine Popular Gambling Products. J Gambl Stud 2021; 37:1113-1126. [PMID: 33635504 DOI: 10.1007/s10899-021-10014-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 01/17/2023]
Abstract
Gambling causes significant levels of harm globally and is recognised as a serious public health issue. To reduce gambling-related harm, various strategies and policies have been recommended, including decreasing the availability of gambling products, restricting gambling advertising, and implementing public education campaigns. Government willingness to implement such strategies will be influenced by levels of public support, which in turn will be dependent on public perceptions of the harm caused by gambling products. The aim of the present study was to assess public perceptions of the harm associated with individual gambling products to inform future gambling reform. A sample of 2112 Australian adults provided perceived harm ratings for nine popular gambling products that are known to be associated with gambling-related harm: electronic gambling machines, casino table games, sports betting, bingo, scratch tickets, private betting, horse/dog races, keno, and the lottery. Binary logistic regressions were used to identify factors associated with harm perceptions. Only electronic gambling machines (70%), casino table games (64%), betting on horse/dog races (59%), and sports betting (53%) were perceived by a majority of respondents as being harmful. Less frequent gambling and experiencing greater levels of gambling-related harm were associated with higher harm perceptions. Many potentially harmful gambling products may not be recognised as such by the public, which is likely to reduce support for recommended harm-reduction strategies and policies. Efforts are needed to ensure Australians in general and gamblers in particular understand the levels of harm associated with popular gambling products.
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26
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Kaufman AR, Twesten JE, Suls J, McCaul KD, Ostroff JS, Ferrer RA, Brewer NT, Cameron LD, Halpern-Felsher B, Hay JL, Park ER, Peters E, Strong DR, Waters EA, Weinstein ND, Windschitl PD, Klein WMP. Measuring Cigarette Smoking Risk Perceptions. Nicotine Tob Res 2021; 22:1937-1945. [PMID: 31883013 DOI: 10.1093/ntr/ntz213] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023]
Abstract
Risk perception is an important construct in many health behavior theories. Smoking risk perceptions are thoughts and feelings about the harms associated with cigarette smoking. Wide variation in the terminology, definition, and assessment of this construct makes it difficult to draw conclusions about the associations of risk perceptions with smoking behaviors. To understand optimal methods of assessing adults' cigarette smoking risk perceptions (among both smokers and nonsmokers), we reviewed best practices from the tobacco control literature, and where gaps were identified, we looked more broadly to the research on risk perceptions in other health domains. Based on this review, we suggest assessments of risk perceptions (1) about multiple smoking-related health harms, (2) about harms over a specific timeframe, and (3) for the person affected by the harm. For the measurement of perceived likelihood in particular (ie, the perceived chance of harm from smoking based largely on deliberative thought), we suggest including (4) unconditional and conditional items (stipulating smoking behavior) and (5) absolute and comparative items and including (6) comparisons to specific populations through (7) direct and indirect assessments. We also suggest including (8) experiential (ostensibly automatic, somatic perceptions of vulnerability to a harm) and affective (emotional reactions to a potential harm) risk perception items. We also offer suggestions for (9) response options and (10) the assessment of risk perception at multiple time points. Researchers can use this resource to inform the selection, use, and future development of smoking risk perception measures. IMPLICATIONS Incorporating the measurement suggestions for cigarette smoking risk perceptions that are presented will help researchers select items most appropriate for their research questions and will contribute to greater consistency in the assessment of smoking risk perceptions among adults.
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Affiliation(s)
- Annette R Kaufman
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | | | - Jerry Suls
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Kevin D McCaul
- Department of Psychology, North Dakota State University, Fargo, ND
| | - Jamie S Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rebecca A Ferrer
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Linda D Cameron
- School of Social Sciences, Humanities, and the Arts, University of California, Merced, Merced, CA
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Palo Alto, CA
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Elyse R Park
- Department of Psychiatry and Medicine, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Ellen Peters
- School of Journalism and Communication, University of Oregon, Eugene, OR
| | - David R Strong
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA.,Cancer Prevention and Control Program, Moores Cancer Center, University of California, San Diego, San Diego, CA
| | - Erika A Waters
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, Saint Louis, MO
| | - Neil D Weinstein
- Department of Human Ecology, School of Environmental and Biological Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ
| | - Paul D Windschitl
- Department of Psychological and Brain Sciences, College of Liberal Arts and Sciences, University of Iowa, Iowa City, IA
| | - William M P Klein
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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27
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Asharani PV, Lau JH, Ai Ling Seet V, Devi F, Wang P, Roystonn K, Lee YY, Cetty L, Teh WL, Verma S, Mok YM, Chong SA, Subramaniam M. Smoking-Related Health Beliefs in a Sample of Psychiatric Patients: Factors Associated with the Health Beliefs and Validation of the Health Belief Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041571. [PMID: 33562257 PMCID: PMC7916053 DOI: 10.3390/ijerph18041571] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 12/12/2022]
Abstract
This study examined the (a) health beliefs and emotions (perception of risk, benefits, severity, and worry) about smoking among current and former smokers, (b) their awareness of health warnings, (c) factors associated with smoking-related health beliefs, and (d) the factor structure of the health belief questionnaire. Participants (n = 184) were recruited from a tertiary psychiatric care hospital. Current smokers showed a significantly higher risk perception and lower perceived benefits compared to former smokers. Younger age (<40 years), nicotine dependence (ND), a history of smoking-related diseases (SRD), and intention to quit were significantly associated with a higher risk perception in current smokers. Younger age, a history of SRDs, and motivation to quit were positively associated with health beliefs, while the latter two were associated with worry. Motivation and younger age were associated with a better perception of benefits and severity. Information on the cigarette packets was the major source of awareness for the sample, and 69% reported that existing campaigns were not effective in discouraging their smoking. Personalized risk communication and educational initiatives must focus on improving the knowledge of risk, benefits, and increase motivation to promote health cognition and thus smoking cessation.
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Affiliation(s)
- P. V. Asharani
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
- Correspondence: ; Tel.: +65-63892961
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Vanessa Ai Ling Seet
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Kumarasan Roystonn
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Ying Ying Lee
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Laxman Cetty
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Swapna Verma
- Early Psychosis Intervention Programme, Institute of Mental Health, Singapore 539747, Singapore;
- Office of Education, Duke-NUS Medical School, 8 College Road, Singapore 169857, Singapore
| | - Yee Ming Mok
- Department of Mood and Anxiety, Institute of Mental Health, Singapore 539747, Singapore;
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore 539747, Singapore; (J.H.L.); (V.A.L.S.); (F.D.); (P.W.); (K.R.); (Y.Y.L.); (L.C.); (W.L.T.); (S.A.C.); (M.S.)
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28
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Bolívar HA, Elliott RJ, Middleton W, Yoon JH, Okoli CTC, Haliwa I, Miller CC, Ades PA, Gaalema DE. Social Smoking Environment and Associations With Cardiac Rehabilitation Attendance. J Cardiopulm Rehabil Prev 2021; 41:46-51. [PMID: 32925296 PMCID: PMC7755730 DOI: 10.1097/hcr.0000000000000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Continued cigarette smoking after a major cardiac event predicts worse health outcomes and leads to reduced participation in cardiac rehabilitation (CR). Understanding which characteristics of current smokers are associated with CR attendance and smoking cessation will help improve care for these high-risk patients. We examined whether smoking among social connections was associated with CR participation and continued smoking in cardiac patients. METHODS Participants included 149 patients hospitalized with an acute cardiac event who self-reported smoking prior to the hospitalization and were eligible for outpatient CR. Participants completed a survey on their smoking habits prior to hospitalization and 3 mo later. Participants were dichotomized into two groups by the proportion of friends or family currently smoking ("None-Few" vs "Some-Most"). Sociodemographic, health, secondhand smoke exposure, and smoking measures were compared using t tests and χ2 tests (P < .05). ORs were calculated to compare self-reported rates of CR attendance and smoking cessation at 3-mo follow-up. RESULTS Compared with the "None-Few" group, participants in the "Some-Most" group experienced more secondhand smoke exposure (P < .01) and were less likely to attend CR at follow-up (OR = 0.40; 95% CI, 0.17-0.93). Participants in the "Some-Most" group tended to be less likely to quit smoking, but this difference was not statistically significant. CONCLUSION Social environments with more smokers predicted worse outpatient CR attendance. Clinicians should consider smoking within the social network of the patient as an important potential barrier to pro-health behavior change.
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Affiliation(s)
- Hypatia A Bolívar
- Vermont Center on Behavior and Health (Drs Bolívar, Ades, and Gaalema, Ms Elliott, and Mr Middleton) and Departments of Psychiatry (Drs Bolívar and Gaalema and Ms Elliott) and Psychology (Mr Middleton and Dr Gaalema), University of Vermont, Burlington; Departments of Psychiatry and Behavioural Sciences (Dr Yoon and Ms Haliwa) and Cardiothoracic and Vascular Surgery (Dr Miller), University of Texas Health Science at Houston; College of Nursing, University of Kentucky, Lexington (Dr Okoli); and Division of Cardiology, University of Vermont College of Medicine, Burlington (Dr Ades)
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Ma Z, Nan X, Iles IA, Butler J, Feldman R, Wang MQ. Effects of self-affirmation on responses toward graphic cigarette warning labels: testing the mediating role of perceived susceptibility and self-efficacy. HEALTH EDUCATION 2020. [DOI: 10.1108/he-06-2020-0039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this study is to examine the effects of self-affirmation on African American smokers' intentions to quit smoking sooner and desire to stop smoking altogether in response to viewing graphic cigarette warning labels. It also tested the mediating role of perceived susceptibility and self-efficacy in explaining the impact of self-affirmation.Design/methodology/approachAfrican American smokers (N = 158) were recruited to participate in a controlled experiment. Participants first completed a short questionnaire about their demographic background and smoking-related attitudes and behavior. They were then randomly assigned to engage in either a self-affirmation task or a control task and viewed two graphic cigarette warning labels subsequently. Participants then responded to a questionnaire about their perceived susceptibility to smoking-related diseases, perceived self-efficacy to quit smoking, intentions to quit smoking and desire to stop smoking altogether.FindingsResults showed that engaging in self-affirmation prior to exposure to graphic cigarette warning labels increased African American smokers' perceived susceptibility to smoking-related diseases, but decreased their perceived self-efficacy to quit smoking. Furthermore, self-affirmation indirectly enhanced smokers' intentions to quit smoking sooner and desire to stop smoking altogether through increased perceived susceptibility. It also had an unexpected negative indirect effect on intentions to quit smoking sooner through decreased self-efficacy.Originality/valueThis study is one of the few studies that investigates the effect of self-affirmation on African American smokers' responses toward graphic cigarette warning labels.
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30
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Jiang Y, Luo H, Yang F. Influences of Migrant Construction Workers' Environmental Risk Perception on their Physical and Mental Health: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7424. [PMID: 33053832 PMCID: PMC7601608 DOI: 10.3390/ijerph17207424] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 02/07/2023]
Abstract
Employing Chinese General Social Survey 2013 data (N = 678), this study examines the influences of migrant construction workers' environmental risk perception (ERP) on their physical and mental health. The ERP of migrant construction workers is characterized by six dimensions: perceptions of air pollution, industrial waste pollution and noise pollution at working sites, and perceptions of domestic waste pollution, water pollution and food pollution at living sites. The results indicate that migrant construction workers with stronger ERP have better physical and mental health. The results also suggest the influences of ERP on the physical and mental health of migrant construction workers with different gender and age (<50 and ≥50 years) are heterogeneous. Perceptions of industrial waste pollution, noise pollution and domestic waste pollution significantly affect female workers' physical health, but not that of male workers. The six dimensions of ERP all significantly influence male workers' mental health, while except for domestic waste pollution perception, the other perceptions do not influence that of female workers. Perceptions of air pollution, domestic waste pollution, and water pollution significantly influence physical health of workers aged 50 and above, while those of ERP do not work on that of workers younger than 50. Perception of food pollution significantly influences mental health of workers younger than 50, but not that of workers aged 50 and above. The seemingly unrelated regression shows the results in this paper are robust.
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Affiliation(s)
- Yao Jiang
- Department of Accounting, School of Management, Sichuan Agricultural University, Chengdu 611130, China;
| | - Huawei Luo
- Department of Accounting, School of Management, Sichuan Agricultural University, Chengdu 611130, China;
| | - Fan Yang
- Department of Labor and Social Security, School of Public Administration, Sichuan University, Chengdu 610065, China
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Kowitt SD, Cornacchione Ross J, Jarman KL, Kistler CE, Lazard AJ, Ranney LM, Sheeran P, Thrasher JF, Goldstein AO. Tobacco Quit Intentions and Behaviors among Cigar Smokers in the United States in Response to COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5368. [PMID: 32722469 PMCID: PMC7432467 DOI: 10.3390/ijerph17155368] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 12/25/2022]
Abstract
Combustible tobacco users appear to be at greater risk for serious complications from COVID-19. This study examined cigar smokers' perceived risk of COVID-19, quit intentions, and behaviors during the current pandemic. We conducted an online study between 23 April 2020 to 7 May 2020, as part of an ongoing study examining perceptions of different health effects of cigars. All participants used cigars in the past 30 days (n = 777). Three-quarters of the sample (76.0%) perceived they had a higher risk of complications from COVID-19 compared to non-smokers. The majority of participants (70.8%) intended to quit in the next six months due to COVID-19, and almost half of the sample (46.5%) reported making a quit attempt since the start of the COVID-19 pandemic. Far more participants reported increasing their tobacco use since COVID-19 started (40.9%) vs. decreasing their tobacco use (17.8%). Black or African American participants, participants who reported using a quitline, and participants with higher COVID-19 risk perceptions had higher intentions to quit using tobacco due to COVID-19, and higher odds of making a quit attempt since COVID-19 started. More research is needed to understand how tobacco users are perceiving COVID-19 risks and changing their tobacco use behaviors.
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Affiliation(s)
- Sarah D. Kowitt
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.L.J.); (C.E.K.); (L.M.R.); (A.O.G.)
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC 27157, USA;
| | - Kristen L. Jarman
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.L.J.); (C.E.K.); (L.M.R.); (A.O.G.)
| | - Christine E. Kistler
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.L.J.); (C.E.K.); (L.M.R.); (A.O.G.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.J.L.); (P.S.)
| | - Allison J. Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.J.L.); (P.S.)
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Leah M. Ranney
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.L.J.); (C.E.K.); (L.M.R.); (A.O.G.)
| | - Paschal Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.J.L.); (P.S.)
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA;
| | - Adam O. Goldstein
- Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (K.L.J.); (C.E.K.); (L.M.R.); (A.O.G.)
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA; (A.J.L.); (P.S.)
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Herbst N, Wiener RS, Helm ED, O'Donnell C, Fitzgerald C, Wong C, Bulekova K, Waite M, Mishuris RG, Kathuria H. Effectiveness of an Opt-Out Electronic Heath Record-Based Tobacco Treatment Consult Service at an Urban Safety Net Hospital. Chest 2020; 158:1734-1741. [PMID: 32428510 DOI: 10.1016/j.chest.2020.04.062] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 04/06/2020] [Accepted: 04/17/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND To address the burden of tobacco use in underserved populations, our safety net hospital developed a tobacco treatment intervention consisting of an "opt-out" electronic health record-based best practice alert + order set, which triggers consultation to an inpatient tobacco treatment consult (TTC) service for all hospitalized smokers. RESEARCH QUESTION We sought to understand if the intervention would increase patient-level outcomes (receipt of tobacco treatment during hospitalization and at discharge; 6-month smoking abstinence) and improve hospital-wide performance on tobacco treatment metrics. DESIGN AND METHODS We conducted two retrospective quasi-experimental analyses to examine effectiveness of the TTC service. Using a pragmatic design and multivariable logistic regression, we compared patient-level outcomes of receipt of nicotine replacement therapy and 6-month quit rates between smokers seen by the service (n = 505) and eligible smokers not seen because of time constraints (n = 680) between July 2016 and December 2016. In addition, we conducted an interrupted time series analysis to examine the effect of the TTC service on hospital-level performance measures, comparing reported Joint Commission measure rates for inpatient (Tob-2) and postdischarge (Tob-3) tobacco treatment preimplementation (January 2015-June 2016) vs postimplementation (July 2016-December 2017) of the intervention. RESULTS Compared with inpatient smokers not seen by the TTC service, smokers seen by the TTC service had higher odds of receiving nicotine replacement during hospitalization (260 of 505 [51.5%] vs 244 of 680 [35.9%]; adjusted ORs [AOR], 1.93 [95% CI, 1.5-2.45]) and at discharge (164 of 505 [32.5%] vs 84 of 680 [12.4%]; AOR, 3.41 [95% CI, 2.54-4.61]), as well as higher odds of 6-month smoking abstinence (75 of 505 [14.9%] vs 68 of 680 [10%]; AOR, 1.48 [95% CI, 1.03-2.12]). Hospital-wide, the intervention was associated with a change in slope trends for Tob-3 (P < .01), but not for Tob-2. INTERPRETATION The "opt-out" electronic health record-based TTC service at our large safety net hospital was effective at improving both patient-level outcomes and hospital-level performance metrics, and could be implemented at other safety net hospitals that care for hard-to-reach smokers.
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Affiliation(s)
- Nicole Herbst
- Division of General Internal Medicine, Boston University School of Medicine, Boston, MA
| | - Renda Soylemez Wiener
- Pulmonary Center, Boston University School of Medicine, Boston, MA; Center for Healthcare Organization and Implementation Research, ENRM VA Hospital, Bedford, MA
| | - Eric D Helm
- Pulmonary Center, Boston University School of Medicine, Boston, MA
| | | | | | - Carolina Wong
- Pulmonary Center, Boston University School of Medicine, Boston, MA
| | - Katia Bulekova
- Research Computing Services Group, Information Services and Technology, Boston University, Boston, MA
| | - Meg Waite
- Analytics and Public Reporting, Boston Medical Center, Boston, MA
| | - Rebecca G Mishuris
- Division of General Internal Medicine, Boston University School of Medicine, Boston, MA
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Pacek LR, McClernon FJ. Risk perceptions regarding cigarette smoking in the United States continue to decline. Drug Alcohol Depend 2020; 209:107887. [PMID: 32044588 PMCID: PMC8211396 DOI: 10.1016/j.drugalcdep.2020.107887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/21/2020] [Accepted: 01/25/2020] [Indexed: 11/30/2022]
Abstract
Nationally representative data from the years 2006-2015 indicate that the prevalence of perceived great risk of smoking one or more packs of cigarettes per day has declined significantly among the United States general population. These findings have important implications for initiation of cigarette smoking, as well as interest in quitting, quit attempts, and sustained cessation. Findings based on more recent data (i.e., years 2016-2018) show that the prevalence of perceived great risk of cigarette smoking has continued to decline significantly (71.76 % versus 72.77 % in 2016 and 73.89 % in 2006). We aim to draw attention to this continued decline in risk perceptions, particularly given the possible associated public health impacts.
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Affiliation(s)
- Lauren R. Pacek
- Corresponding author at: 2608 Erwin Road, Suite 300, Durham, NC 27705 USA. (L.R. Pacek)
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Kruse GR, Thawal V, Gupte HA, Chaudhuri L, Pradhan S, Howard S, Rigotti NA. Tobacco Use and Subsequent Cessation Among Hospitalized Patients in Mumbai, India: A Longitudinal Study. Nicotine Tob Res 2020; 22:363-370. [PMID: 30778542 DOI: 10.1093/ntr/ntz026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 02/14/2019] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Hospitalization is an important setting to address tobacco use. Little is known about post-discharge cessation and treatment use in low- and middle-income countries. Our objective was to assess tobacco use after hospital discharge among patients in Mumbai, India. METHODS Longitudinal observational study of inpatients (≥15 years) admitted at one hospital from November 2015 to October 2016. Patients reporting current tobacco use were surveyed by telephone after discharge. RESULTS Of 2894 inpatients approached, 2776 participated and 15.7% (N = 437) reported current tobacco use, including 5.3% (N = 147) smokers, 9.1% (N = 252) smokeless tobacco (SLT) users, and 1.4% (N = 38) dual users. Excluding dual users, SLT users, compared to smokers, were less likely to report a plan to quit after discharge (42.6% vs. 54.2%, p = .04), a past-year quit attempt (38.1% vs. 52.7%, p = .004), to agree that tobacco has harmed them (57.9% vs. 70.3%, p = .02) or caused their hospitalization (43.4% vs. 61.4%, p < .001). After discharge, 77.6% of smokers and 78.6% of SLT users reported trying to quit (p = .81). Six-month continuous abstinence after discharge was reported by 27.2% of smokers and 24.6% of SLT users (p = .56). Nearly all relapses to tobacco use after discharge occurred within 30 days and did not differ by tobacco type (log-rank p = .08). Use of evidence-based cessation treatment was reported by 6.5% (N = 26). CONCLUSIONS Three-quarters of tobacco users in a Mumbai hospital attempted to quit after discharge. One-quarter reported continuous tobacco abstinence for 6 months despite little use of cessation treatment. Increasing post-discharge cessation support could further increase cessation rates and improve patient outcomes. IMPLICATIONS No prior study has measured the patterns of tobacco use and cessation among hospitalized tobacco users in India. Three-quarters of tobacco users admitted to a hospital in Mumbai attempted to quit after discharge, and one-quarter remained tobacco-free for 6 months, indicating that hospitalization may be an opportune time to offer a cessation intervention. Although smokers and SLT users differed in socioeconomic status, perceived risks and interest in quitting, they did not differ in their ability to stay abstinent after hospital discharge.
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Affiliation(s)
- Gina R Kruse
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | | | | | | | | | - Sydney Howard
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
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Krebs P, Sherman SE, Wilson H, El-Shahawy O, Abroms LL, Zhao X, Nahvi S, Shelley D. Text2Connect: a health system approach to engage tobacco users in quitline cessation services via text messaging. Transl Behav Med 2020; 10:292-301. [PMID: 32011721 DOI: 10.1093/tbm/ibz033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mobile technology has created the opportunity for health systems to provide low cost tobacco cessation assistance to patients. The goal of the present study was to examine the feasibility and effectiveness of an intervention (Text2Connect) that uses text messages to offer proactive connection to the New York State Smokers' Quitline. The electronic health record at two urban health systems was queried for patients who were current smokers and who had an outpatient visit between March 2015 and February 2016. Smokers (N = 4000) were sent an informational letter. Those who did not opt out (N = 3719) were randomized to one of 6 message sequences in order to examine the effect of theoretically informed message frames on response rates. Participants were sent a series of text messages at baseline and at 1 month and were asked to reply in order to be contacted by the state quitline (QL). After removing 1403 nonworking numbers, texts were sent to 2316 patients, and 10.0% (205/2060) responded with a QL request. Almost one quarter (23.6%, 486/2060) replied STOP and 66.4% (1369/2060) never responded. QL request rates were significantly higher when response efficacy messages were not used (p < .001). There were no differences by message framing on STOP requests (p > .05). The Text2Connect intervention was well accepted with a minority opting out. A 10% QL response rate is noteworthy given that only 5-7 brief outreach text messages were used. Results indicate that simple self-efficacy-focused messaging is most effective at supporting response rates.
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Affiliation(s)
- Paul Krebs
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Scott E Sherman
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Hannah Wilson
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Omar El-Shahawy
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Lorien L Abroms
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Xiaoquan Zhao
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Shadi Nahvi
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Donna Shelley
- Department of Population Health, NYU School of Medicine, New York, NY, USA
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Grobe JE, Goggin K, Harris KJ, Richter KP, Resnicow K, Catley D. Race moderates the effects of Motivational Interviewing on smoking cessation induction. PATIENT EDUCATION AND COUNSELING 2020; 103:350-358. [PMID: 31466882 PMCID: PMC7012686 DOI: 10.1016/j.pec.2019.08.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/31/2019] [Accepted: 08/17/2019] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Health disparities necessitate exploration of how race moderates response to smoking cessation treatment. Data from a randomized clinical trial of Motivational Interviewing (MI) for smoking cessation induction were used to explore differential treatment response between African American (AA) vs Non-Black (NB) smokers. METHODS Adult tobacco smokers (138 AA vs 66 NB) with low desire to quit were randomly assigned to four sessions of MI or health education (HE). Outcomes (e.g., quit attempts) were assessed 3- and 6-months. RESULTS There was evidence of a Race by Treatment interaction such that MI was less effective than HE in AA smokers. Mean Cohen's d for the interaction effect was -0.32 (95% CI [-0.44, -0.20]). However, the race interaction could be accounted for by controlling for baseline relationship status and communication preference (wants directive approach). CONCLUSIONS MI may be less effective for smoking cessation induction in AA vs NB smokers when compared to another active and more directive therapy. The differential response between races may be explained by psychosocial variables. PRACTICE IMPLICATIONS MI may not be an ideal choice for all African American smokers. Patients' relationship status and preference for a directive counseling approach might explain disparities in response to MI treatment.
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Affiliation(s)
- James E Grobe
- JEGrobe Consulting, 9209 Heatherdale Drive, Dallas, Texas, 75243, United States.
| | - Kathy Goggin
- Division of Health Services and Outcomes Research, Children's Mercy Kansas City Hospitals and Clinics, and Schools of Medicine and Pharmacy, University of Missouri - Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, United States.
| | - Kari Jo Harris
- School of Public and Community Health Sciences, 32 Campus Drive Skaggs Building Room 352, The University of Montana, Missoula, Montana, 406-243-4685, United States.
| | - Kimber P Richter
- Department of Preventive Medicine & Public Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1008, 4004 Robinson, Kansas City, KS, 66160, United States.
| | - Ken Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, United States.
| | - Delwyn Catley
- Center for Children's Healthy Lifestyles & Nutrition, Children's Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, 64108, United States.
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Kagabo R, Gordon AJ, Okuyemi K. Smoking cessation in inpatient psychiatry treatment facilities: A review. Addict Behav Rep 2020; 11:100255. [PMID: 32467844 PMCID: PMC7244912 DOI: 10.1016/j.abrep.2020.100255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/06/2020] [Accepted: 01/21/2020] [Indexed: 12/02/2022] Open
Abstract
Smoking rates are high among people with psychiatric illness. Smoking cessation interventions are rarely available in inpatient psychiatry settings. Smokers with psychiatric illness are just as interested in quitting smoking.
Background Tobacco-related diseases are a leading cause of death among individuals with severe mental illness (SMI), yet interventions to address tobacco cessation are rare in inpatient settings where persons with SMI are hospitalized. While cigarette smoking rates have declined in the general population, they remain high in persons with SMI. Inpatient settings would be a prime location to intervene on tobacco consumption among persons with SMI. The objective of this review was to examine evidence of smoking cessation interventions in psychiatric inpatient facilities. Method Using narrative overview guidelines, we searched PubMed, PsycINFO, and CINAHL for smoking cessation RCT studies published between 1950 and 2018. Studies included had to have at least started in inpatient psychiatry settings. Examples of search terms included: smoking cessation in inpatient psychiatry, smoking cessation in inpatient mental health treatment facilities, and smoking cessation and mental health. Results Following the inclusion criteria, eight RCT studies were reviewed. One study was among adolescent psychiatric inpatient smokers ages 13–17, and 7 were among adult psychiatric inpatients with mean age 41 years. Treatment periods lasting 8 to 12 weeks started in inpatient settings and continued post discharge. A combination of behavioral and pharmacological interventions were used. Pharmacological interventions were nicotine replacement therapies, and at least one study used varenicline. At baseline, participants smoked an average of 18.1 cigarettes per day. Conclusion Smoking cessation in inpatient psychiatry settings is rare or delayed. There is a need for more tailored treatments among this population to help them quit smoking.
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Affiliation(s)
- Robert Kagabo
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
- Corresponding author at: 375 Chipeta Way Ste. A, Salt Lake City, UT 84108, United States.
| | - Adam J. Gordon
- Program for Addiction Research, Clinical Care, Knowledge and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Kola Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
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Awareness of the Harms of Continued Smoking Among Cancer Survivors. Support Care Cancer 2019; 28:3409-3419. [DOI: 10.1007/s00520-019-05175-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 11/05/2019] [Indexed: 10/25/2022]
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Hoover DS, Wetter DW, Vidrine DJ, Nguyen N, Frank SG, Li Y, Waters AJ, Meade CD, Vidrine JI. Enhancing Smoking Risk Communications: The Influence of Health Literacy and Message Content. Ann Behav Med 2019. [PMID: 29538662 DOI: 10.1093/abm/kax042] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Efforts are needed to ensure that smokers with lower health literacy are provided with understandable and impactful information about the health consequences of smoking and benefits of quitting. Purpose To test the influence of health literacy on smokers' responses to health risk messages manipulated on framing (gain vs. loss) and emotionality (factual vs. emotional). Methods Participants (N = 402) were randomized to evaluate one of four sets of smoking risk messages (factual gain-framed, factual loss-framed, emotional gain-framed, or emotional loss-framed). Multiple linear regressions examined main effects of health literacy, message emotionality, and message framing on: (a) risk perceptions, (b) behavioral expectations (i.e. cut down, limit, quit), and (c) risk knowledge. Two-way interactions of health literacy with emotionality and framing were examined for these outcomes. Analyses were based on theory-driven, a priori hypotheses. Results As hypothesized, main effects emerged such that smokers with higher health literacy reported stronger risk perceptions and knowledge retention regardless of message type. Additionally, emotional (vs. factual) and gain- (vs. loss-) framed messages were associated with certain lower risk perceptions regardless of health literacy level. Consistent with hypotheses, two-way crossover interactions emerged between health literacy and emotionality. Among smokers with higher health literacy, factual messages produced higher perceived risk and stronger expectations for quitting. Among smokers with lower health literacy, emotional messages produced higher perceived risk and stronger expectations for quitting. Conclusions Health literacy plays an important role in influencing how smokers respond to different risk messages. One's health literacy should be considered when determining whether risk communications emphasize factual or emotional content.
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Affiliation(s)
- Diana Stewart Hoover
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, USA
| | - David W Wetter
- Center for Health Outcomes and Population Equity, University of Utah, Salt Lake City, USA
| | - Damon J Vidrine
- Stephenson Cancer Center and the Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Nga Nguyen
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Summer G Frank
- Stephenson Cancer Center and the Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Yisheng Li
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Services, Bethesda, USA
| | - Cathy D Meade
- Division of Population Science, Health Outcomes, and Behavior, Moffitt Cancer Center, Tampa, USA.,Department of Oncologic Sciences, University of South Florida College of Medicine, Tampa, USA
| | - Jennifer I Vidrine
- Stephenson Cancer Center and the Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
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40
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Pacek LR, Berry MS, Rass O, Mercincavage M, McClernon FJ, Johnson MW. Graphic Warning Labels Affect Hypothetical Cigarette Purchasing Behavior among Smokers Living with HIV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183380. [PMID: 31547374 PMCID: PMC6765870 DOI: 10.3390/ijerph16183380] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/03/2019] [Accepted: 09/06/2019] [Indexed: 12/25/2022]
Abstract
Cigarette pack graphic warning labels (GWLs) are associated with increased knowledge of tobacco-related harms; scant research has evaluated their effects on behavior among vulnerable populations. We used a behavioral economic approach to measure the effects of GWLs and price on hypothetical cigarette purchasing behavior among HIV-positive smokers. Participants (n = 222) completed a cigarette valuation task by making hypothetical choices between GWL cigarette packs at a fixed price ($7.00) and text-only warning label cigarette packs at increasing prices ($3.50 to $14.00; $0.25 increments). More than one-quarter (28.8%) of participants paid more to avoid GWLs. The remaining participants’ purchasing decisions appear to have been driven by price: 69.8% of participants chose the cheaper pack. Across all participants, overall monetary choice value observed for GWL cigarette packs (mean = $7.75) was greater than if choice was driven exclusively by price ($7.00). Most (87.4%) preferred the text-only warning label when GWL and text-only cigarette packs were equally priced. Correlation analysis indicated GWL pack preference was associated with agreement with statements that GWLs would stop individuals from having a cigarette or facilitate thoughts about quitting. These data suggest that GWLs may influence some HIV-positive smokers in such a way that they are willing to pay more to avoid seeing GWLs.
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Affiliation(s)
- Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
| | - Meredith S Berry
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
- Department of Health Education and Behavior & Department of Psychology, University of Florida, Gainesville, FL 32611, USA.
| | - Olga Rass
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
| | - Melissa Mercincavage
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA.
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
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Stevens EM, Wetter DW, Vidrine DJ, Hoover DS, Frank-Pearce SG, Nguyen N, Li Y, Waters AJ, Meade CD, Wagener TL, Vidrine JI. Enhancing Smoking Risk Communications: The Influence of Need for Cognition. Am J Health Behav 2019; 43:950-962. [PMID: 31439101 PMCID: PMC7045173 DOI: 10.5993/ajhb.43.5.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: One way to enhance the impact of smoking health risk messages may be to tailor their content to individual difference factors such as need for cognition (NFC). In this study, we examined how NFC influenced responses to different smoking risk messages. Outcomes included knowledge, risk perceptions, and behavioral expectations related to quitting smoking. Methods: We randomized 402 participants to one of 4 different risk message sets that were manipulated in terms of emotionality and framing in a 2x2 design: (1) factual gain-framed, (2) factual loss-framed, (3) emotional gain-framed, and (4) emotional loss-framed. Results: Statistically significant main effects emerged for NFC and emotionality. For certain risk perceptions, those with lower NFC reported greater perceived risk in response to emotional messages and lower risk in response to factual messages; those with higher NFC showed an opposite pattern. Similarly, those with lower NFC reported greater risk in response to gain-framed messages and lower risk in response to loss-framed messages; the opposite pattern emerged for those lower in NFC. Conclusions: Findings highlight the importance of an individual difference variable in influencing the impact of different types of smoking risk messages.
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Affiliation(s)
- Elise M Stevens
- Postdoctoral Research Fellow, Oklahoma Tobacco Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK; and ,
| | - David W Wetter
- Jon M. and Karen Huntsman Presidential Professor, and Director of the Center for Health Outcomes and Population Equity (HOPE), University of Utah and the Huntsman Cancer Institute, Salt Lake City, UT
| | - Damon J Vidrine
- Professor and Program Co-leader, Cancer Prevention and Control Program, Stephenson Cancer Center and the Director of Intervention Research for the Oklahoma Tobacco Research Center
| | - Diana Stewart Hoover
- Assistant Professor, Department of Health Disparities Research, MD Anderson Cancer Center, University of Texas, Houston, TX
| | - Summer G Frank-Pearce
- Assistant Professor of Research in Biostatistics, Department of Biostatistics and Epidemiology, College of Public Health, Oklahoma Tobacco Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Nga Nguyen
- Biostatistician, MD Anderson Cancer Center, The University of Texas, Houston, TX
| | - Yisheng Li
- Associate Professor, MD Anderson Cancer Center, The University of Texas, Houston, TX
| | - Andrew J Waters
- Professor, Medical and Clinical Psychology, Uniformed Services University, Bethesda, MD
| | - Cathy D Meade
- Professor, Moffitt Cancer Center, University of South Florida, Tampa, FL
| | - Theodore L Wagener
- Associate Professor and Director of Tobacco Regulatory Science Research, Oklahoma Tobacco Research Center at the Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Jennifer I Vidrine
- Professor and Associate Director for Cancer Prevention and Control and Director of the Oklahoma Tobacco Research Center, Stephenson Cancer Center, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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42
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Castellanos Cuellar SP, Londoño Pérez C. Identidad como fumador y riesgo percibido en adolescentes fumadores de tabaco: un modelo predictivo. DRUGS AND ADDICTIVE BEHAVIOR 2019. [DOI: 10.21501/24631779.3124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Este estudio descriptivo correlacional con análisis de corte multivariante tuvo como objetivo determinar si la identidad del fumador y el riesgo percibido predecían el nivel de consumo de tabaco en una muestra de 935 de los cuales 554 hombres (59.3%) y 381 mujeres (40.7%). Se utilizó el Cuestionario de Consumo de Cigarrillo (C4), el Cuestionario de Identificación con el Consumo de Cigarrillo (CICC) y el Cuestionario de Expectativas sobre el Consumo de Cigarrillo (CECC). Se realizaron análisis correlacionales bivariados y multivariados para la identidad del modelo de ecuaciones estructurales y se evaluó en el modelo las bondades de los criterios de ajuste. Los resultados indicaron que el 33.2% fumaba y que tanto el riesgo percibido como la no identificación del fumador en conjunto con otros factores predecían el 40.1% de la varianza en el modelo propuesto.
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43
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Keyte R, Egan H, Mantzios M. An Exploration Into Knowledge, Attitudes, and Beliefs Towards Risky Health Behaviours in a Paediatric Cystic Fibrosis Population. Clin Med Insights Circ Respir Pulm Med 2019; 13:1179548419849427. [PMID: 31210738 PMCID: PMC6545634 DOI: 10.1177/1179548419849427] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/13/2019] [Indexed: 11/27/2022] Open
Abstract
Risky behaviours are prevalent within the cystic fibrosis (CF) population; however, there is a lack of research which has investigated risky behaviour engagement among adolescents with CF, with reasons for initiation currently being unknown, as no qualitative studies have been conducted. This research therefore examines knowledge, attitudes, and beliefs towards risky behaviours at an age commonly associated with initiation. Ten paediatric participants were recruited. Thematic analysis illustrated several psychological factors associated with risky behaviours. A desire for normalcy was evident, with this been associated with a desire to engage in normalised risky behaviours. Evidence of a life-orientated illness perspective was also prevalent, with participants believing that many individuals engage in risky behaviours for fun. Overall, there was a reported lack of knowledge on consequences of risky behaviours, with many participants not being informed of these by health care professionals (HCPs). This research provides insight into an area of CF paediatric care which could be improved on, with the provision of awareness regarding risky behaviours not being embedded within paediatric CF care. Consequently, this research demonstrates the need for interventions to be integrated into paediatric CF care for the prevention and reduction of risky behaviours.
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Affiliation(s)
- Rebecca Keyte
- Department of Psychology, School of Social Sciences,
Birmingham City University, Birmingham, UK
| | - Helen Egan
- Department of Psychology, School of Social Sciences,
Birmingham City University, Birmingham, UK
| | - Michail Mantzios
- Department of Psychology, School of Social Sciences,
Birmingham City University, Birmingham, UK
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44
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Hall DL, Neil JM, Ostroff JS, Hawari S, O'Cleirigh C, Park ER. Perceived cancer-related benefits of quitting smoking and associations with quit intentions among recently diagnosed cancer patients. J Health Psychol 2019; 26:831-842. [PMID: 31035808 DOI: 10.1177/1359105319845131] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
One third of smokers diagnosed with cancer continue smoking, perhaps due to low perceived cancer-related benefits of cessation. To examine perceived cancer-related benefits of quitting among newly diagnosed cancer patients who smoke and associations with quit intentions, baseline measures from patients (N = 303) enrolled in a randomized controlled trial were analyzed using hierarchical regression models and bootstrapping. Higher perceived cancer-related benefits of quitting were associated with having a smoking-related cancer and less education. Perceived cancer-related benefits of quitting and quit intentions were positively correlated, particularly among patients with smoking-related cancers. For smokers with smoking-related cancers, perceived cancer-related benefits of quitting are correlated with quit intentions.
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Affiliation(s)
- Daniel L Hall
- Massachusetts General Hospital, USA.,Harvard Medical School, USA
| | - Jordan M Neil
- Massachusetts General Hospital, USA.,Harvard Medical School, USA
| | | | - Saif Hawari
- Massachusetts General Hospital, USA.,Harvard Medical School, USA
| | | | - Elyse R Park
- Massachusetts General Hospital, USA.,Harvard Medical School, USA
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45
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Jiamsakul A, Lee MP, Nguyen KV, Merati TP, Cuong DD, Ditangco R, Yunihastuti E, Ponnampalavanar S, Zhang F, Kiertiburanakul S, Avihingasanon A, Ng OT, Sim BLH, Wong WW, Ross J, Law M. Socio-economic status and risk of tuberculosis: a case-control study of HIV-infected patients in Asia. Int J Tuberc Lung Dis 2019; 22:179-186. [PMID: 29506614 DOI: 10.5588/ijtld.17.0348] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Tuberculosis (TB) is the most common human immunodeficiency virus (HIV) related opportunistic infection and cause of acquired immune-deficiency syndrome related death. TB often affects those from a low socio-economic background. OBJECTIVE To assess the socio-economic determinants of TB in HIV-infected patients in Asia. DESIGN This was a matched case-control study. HIV-positive, TB-positive cases were matched to HIV-positive, TB-negative controls according to age, sex and CD4 cell count. A socio-economic questionnaire comprising 23 questions, including education level, employment, housing and substance use, was distributed. Socio-economic risk factors for TB were analysed using conditional logistic regression analysis. RESULTS A total of 340 patients (170 matched pairs) were recruited, with 262 (77.1%) matched for all three criteria. Pulmonary TB was the predominant type (n = 115, 67.6%). The main risk factor for TB was not having a university level education (OR 4.45, 95%CI 1.50-13.17, P = 0.007). Burning wood or coal regularly inside the house and living in the same place of origin were weakly associated with TB diagnosis. CONCLUSIONS These data suggest that lower socio-economic status is associated with an increased risk of TB in Asia. Integrating clinical and socio-economic factors into HIV treatment may help in the prevention of opportunistic infections and disease progression.
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Affiliation(s)
- A Jiamsakul
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - M-P Lee
- Queen Elizabeth Hospital, Hong Kong, SAR China
| | - K V Nguyen
- National Hospital for Tropical Diseases, Hanoi, Viet Nam
| | - T P Merati
- Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia
| | | | - R Ditangco
- Research Institute for Tropical Medicine, Manila, The Philippines
| | - E Yunihastuti
- Working Group on AIDS, Faculty of Medicine, University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - S Ponnampalavanar
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - F Zhang
- Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - S Kiertiburanakul
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok
| | - A Avihingasanon
- HIV-Netherlands Australia Thailand Research Collaboration, The Thai Red Cross AIDS Research Centre and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - O T Ng
- Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore
| | - B L H Sim
- Hospital Sungai Buloh, Sungai Buloh, Malaysia
| | - W-W Wong
- Taipei Veterans General Hospital, Taipei, Taiwan
| | - J Ross
- Therapeutics Research, Education, and AIDS Training in Asia, amfAR - The Foundation for AIDS Research, Bangkok, Thailand
| | - M Law
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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46
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Relative Risk Perceptions between Snus and Cigarettes in a Snus-Prevalent Society-An Observational Study over a 16 Year Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050879. [PMID: 30862006 PMCID: PMC6427464 DOI: 10.3390/ijerph16050879] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 02/07/2023]
Abstract
Background: Most studies on perceived risks of smokeless tobacco products (SLT) have been conducted in the U.S., and the vast majority conclude that perceptions of the relative harmfulness of SLT versus cigarettes in the population are inconsistent with epidemiologically-based risk estimates, and typically conflated to that of cigarettes. We tested whether such inaccuracies also existed in Norway, where SLT-products are less toxic (Swedish snus) and SLT use is more prevalent than in the U.S. Methods: Over a 16 years period (2003⁻2018), 13,381 respondents (aged 16⁻79 years) answered questions about risk perceptions in Statistics Norway's nationally representative survey of tobacco behavior. We applied an indirect measure of comparative harm where risk beliefs for eight nicotine products were assessed independently of other products and then compared the answers. The wording of the question was: "We will now mention a variety of nicotine products and ask you how harmful you think daily use of these are. Use a scale from 1 to 7, where 1 is slightly harmful and 7 is very harmful". Mean scores with 95% confidence intervals were calculated. Results: The overall risk score for cigarettes was 6.48. The risk score for snus was 5.14⁻79.3% of the risk score of cigarettes. The relative risk scores for e-cigarettes (3.78) and NRT products (3.39) was 58.4% and 52.3% when compared to cigarettes. Perceptions of risk were stable over time. A strong association was observed between perceived risk of snus and having used snus in attempts to quit smoking. Conclusion: Perceptions of relative risk between snus and cigarettes is inconsistent with estimates from medical expert committees, which assess the overall health risk from use of Swedish snus to be minor when compared to the risk from smoking. Like the situation in the US, incorrect beliefs about SLT risks seem to be prevalent also in the snus-prevalent Norwegian setting. Accurate information on differential harms needs to be communicated. Future research should try to identify reasons why health authorities in the US and Scandinavia allow these well-documented misconceptions to persist.
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47
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Perez GK, Gareen IF, Sicks J, Lathan C, Carr A, Kumar P, Ponzani C, Hyland K, Park ER. Racial Differences in Smoking-related Disease Risk Perceptions Among Adults Completing Lung Cancer Screening: Follow-up Results from the ACRIN/NLST Ancillary Study. J Racial Ethn Health Disparities 2019; 6:676-685. [PMID: 30737732 DOI: 10.1007/s40615-019-00566-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 10/27/2022]
Abstract
Previous work suggests that, compared to white adults, black adults have lower perceived risk for smoking-related diseases (SRDs), which may influence cessation behavior and health outcomes; however, racial differences in SRD risk perceptions among high-risk patients (i.e., a group that exhibits elevated risk for SRDs) following lung screening remain unknown. This paper thus examined differences in risk perceptions for lung cancer and other SRDs among black and white National Lung Screening Trial (NLST) participants. We administered a 10-item measure of perceived lifetime risk of lung cancer and other SRD (Smoking Risk Perceptions Scale; SRPS) to NLST participants at 1 year following lung screening to (1) establish the internal consistency of the SRPS for both black and white participants, (2) compare smoking-related disease risk perceptions between black and white participants, and (3) identify predictors of risk perceptions for black and white participants using multivariable linear regression models. We determined the SRPS items loaded onto two factors (personal and comparative risks; Cronbach's alpha = 0.93 and 0.95 for 1743 white and 194 black participants, respectively), thus demonstrating high internal consistency for both black and white adults. Compared to white participants, black adults demonstrated lower SRD risk perceptions (SRPS range = 10-50, mean difference = 2.55, SE = 0.50, p < 0.001), even after adjusting for smoking status and sociodemographics. Younger age, female gender, higher education, white race, and current smoking status were independently associated with high risk perceptions. Sociodemographic factors associated with lower risk perceptions resemble factors related to continued smoking. Findings suggest current and former black smokers are at risk of having lower risk perceptions for lung cancer and SRDs than white adults following lung cancer screening; these differences may explain observed racial differences in cessation outcomes. Although similar factors influence black and white adults' beliefs, risk perceptions may differentially impact smoking behavior among these groups. Behavior change models that guide tobacco treatment approaches, particularly for high-risk black smokers, should consider the influence of cultural factors on risk perceptions and cessation efforts.
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Affiliation(s)
- Giselle K Perez
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, 100 Cambridge Street, 15th floor, Boston, MA, 02114, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Ilana F Gareen
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.,Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA
| | - JoRean Sicks
- Center for Statistical Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Christopher Lathan
- Harvard Medical School, Boston, MA, USA.,Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Alaina Carr
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, 100 Cambridge Street, 15th floor, Boston, MA, 02114, USA
| | - Pallavi Kumar
- Abramsom Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Kelly Hyland
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, 100 Cambridge Street, 15th floor, Boston, MA, 02114, USA.,University of South Florida and Moffitt Cancer Center, Tampa, FL, USA
| | - Elyse R Park
- Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, 100 Cambridge Street, 15th floor, Boston, MA, 02114, USA.,Harvard Medical School, Boston, MA, USA
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48
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Poggiolini C. High self-efficacy regarding smoking cessation may weaken the intention to quit smoking. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1574096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Claudia Poggiolini
- IKMZ – Department of Communication and Media Research, University of Zurich, Andreasstrasse 15, Zürich 8050, Switzerland
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49
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McDonald D, Kaufmann A, Haaga DAF. Development and validation of the cigarette smoking consequences looming scale. Addict Behav 2018; 87:238-243. [PMID: 30081352 DOI: 10.1016/j.addbeh.2018.07.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 07/13/2018] [Accepted: 07/30/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Experimental manipulations intended to alter cognitive appraisals of smoking-related threats may affect cigarette smoking and motivation to quit. However, no previous measure has directly assessed perceptions of smoking-related threats as increasing and coming closer in space and/or time (i.e., "looming"). The current research develops such a measure of dynamic smoking-related threat appraisal: the Cigarette Smoking Consequences Looming Scale (CSCLS). METHODS In Study 1 (N = 124 daily smokers), the researchers created an initial, scenario-based version of the CSCLS and refined the measure based on factor analysis. In Study 2, 143 daily smokers completed a condensed CSCLS organized around two factors (Physical and Social consequence of smoking). In each study, participants also completed measures of dispositional looming perception, motivation to quit smoking, and smoking outcome expectancies. RESULTS The CSCLS showed strong internal consistency and concurrent validity in that scores on the measure correlated as expected in both studies with a general tendency to perceive threats as looming, outcome expectancies for smoking, and motivation to quit smoking. CONCLUSIONS Measuring perceptions of smoking-related consequences as looming may provide greater insight into the cognitive factors associated with motivation to quit smoking, which in turn may inform communications about the risks of smoking.
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50
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Berg CJ, Fong GT, Thrasher JF, Cohen JE, Maziak W, Lando H, Drope J, Mejia R, Barnoya J, Nakkash R, Salloum RG, Parascandola M. The impact and relevance of tobacco control research in low-and middle-income countries globally and to the US. Addict Behav 2018; 87:162-168. [PMID: 30041132 DOI: 10.1016/j.addbeh.2018.07.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 07/11/2018] [Accepted: 07/15/2018] [Indexed: 11/15/2022]
Abstract
International and cross-cultural research is critical for understanding multilevel influences on health, health behaviors, and disease. A particularly relevant area of need for such research is tobacco control. The tobacco epidemic is one of the biggest public health threats globally, killing over 7 million people a year. Research critical to addressing this public health problem has leveraged variability in tobacco use, history, product market, and policies across different countries, settings, and populations, particularly in low- and middle-income countries (LMICs) where the tobacco burden is increasing. These efforts are needed in order to advance the science and inform practice and policy in various settings, including the US. Several funding agencies provide support for international research focused on tobacco control in LMICs because of the importance and implications of such research. This paper provides some concrete examples of how such research has advanced our knowledge-base and informed practice and policy globally, particularly in high-income countries including the US. Some prominent themes emphasized in this manuscript include: the development of knowledge regarding the diverse tobacco products on the market; better understanding of tobacco use and its impact among different populations; generating knowledge about the impacts including unintended consequences of tobacco control policy interventions; and better understanding tobacco industry strategies and informing advocacy efforts. In summary, international tobacco control research, particularly in LMICs, is critical in effectively and efficiently building the evidence base to advance tobacco control research, policy, and practice globally, including the US, with the ultimate goal of curbing the tobacco epidemic.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA 30322, United States.
| | - Geoffrey T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L G1 Canada, Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
| | - James F Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, United States; Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
| | - Joanna E Cohen
- Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 2213 McElderry Street, Baltimore, MD 21205, United States.
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8h Street, AHC5 505, Miami, FL 33199, United States.
| | - Harry Lando
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 South Second Street, Minneapolis, MN 55454, United States.
| | - Jeffrey Drope
- Department of Economic and Health Policy Research, American Cancer Society, 250 Williams St, Atlanta, GA, 30303, United States.
| | - Raul Mejia
- Centro de Estudios de Estado y Sociedad, Sánchez de Bustamante 27, C1173AAA, Buenos Aires, Argentina.
| | - Joaquin Barnoya
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, 660 South Euclid Ave, St. Louis, MS 63110, United States.
| | - Rima Nakkash
- Department of Health Promotion and Community Health, American University of Beirut, PO, Box 11-0236, Beirut, Lebanon.
| | - Ramzi G Salloum
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 2004 Mowry Rd, Gainesville, FL 32610, United States.
| | - Mark Parascandola
- Tobacco Control Research Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Bethesda, MD 20892, United States.
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