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Hefler M, Durkin SJ, Cohen JE, Henriksen L, O'Connor R, Barnoya J, Hill SE, Malone RE. New policy of people-first language to replace 'smoker', 'vaper' 'tobacco user' and other behaviour-based labels. Tob Control 2023; 32:133-134. [PMID: 36806099 PMCID: PMC9985717 DOI: 10.1136/tc-2023-057950] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Affiliation(s)
- Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia .,NHMRC Centre of Research Excellence in Achieving the Tobacco Endgame, The University of Queensland, Herston, Queensland, Australia
| | - Sarah J Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California, USA
| | - Richard O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Joaquin Barnoya
- Departamento de Investigacion, Unidad de Cirugia Cardiovascular, Guatemala, Guatemala.,Integra Cancer Institute, Guatemala, Guatemala
| | - Sarah E Hill
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Ruth E Malone
- Social and Behavioral Sciences, University of California, San Francisco, California, USA
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Odani S, Tabuchi T. Prevalence and denial of current tobacco product use: Combustible and heated tobacco products, Japan, 2022. Prev Med Rep 2022; 30:102031. [DOI: 10.1016/j.pmedr.2022.102031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/21/2022] [Accepted: 10/23/2022] [Indexed: 11/08/2022] Open
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Correlates of smoker identity among intermittent and light daily young adult smokers: Findings from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. Addict Behav 2019; 98:106034. [PMID: 31301643 DOI: 10.1016/j.addbeh.2019.106034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 06/17/2019] [Accepted: 06/23/2019] [Indexed: 12/30/2022]
Abstract
Identifying as a 'smoker' has been associated with many cigarette smoking-related behaviors, including less frequent and intense cigarette use. Additional smoking behaviors (e.g., use of cannabis or cigars) also may contribute to self-identification as a 'smoker'. This study compared correlates of identifying as a 'smoker' and measurement strategies for non-daily cigarette consumption among young-adult intermittent and light daily smokers. Using data from Wave 1 of the PATH Study, different measurements of past 30-day non-daily cigarette use were evaluated. Weighted logistic regression models were used to compare associations with self-identification as a smoker among 18-24 year-old intermittent and light daily smokers (n = 1531). Use of other smoked products (combustible tobacco, cannabis) and other documented correlates of smoker identity were evaluated. As frequency of monthly smoking increased, self-identification as a smoker increased (1-5 days = 24%, 6-19 days = 48%, 20-29 days = 78%, light daily smokers = 93%, daily smokers using >5 cigarettes per day = 99%). Self-reported smoking status 12 months ago significantly contributed to current identification as a smoker. Smoking cigars daily or using cannabis in the past 30 days were each positively associated with smoker identity. Different measurement approaches to non-daily cigarette use offer different advantages in terms of interpretability and granularity of information. Compared to daily smokers, non-daily smokers exhibit significant variability in identifying as a smoker, and systematic correlates of smoker identification are apparent. These findings may serve to enhance understanding of non-daily smokers and potential targets for intervention among this growing subpopulation of tobacco users.
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Stanley SJ, Pitts MJ. "I'm Scared of the Disappointment": Young Adult Smokers' Relational Identity Gaps and Management Strategies as Sites of Communication Intervention. HEALTH COMMUNICATION 2019; 34:904-911. [PMID: 29469651 DOI: 10.1080/10410236.2018.1440507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
While cigarette smoking is decreasing among young adults, rates of nicotine consumption through other devices, most notably electronic cigarettes, are on the rise. Framed by communication theory of identity, this study examines young adult smokers' experiences with relational others in regard to their smoking. Focus group discussions and individual interviews convened with 20 young adult cigarette and electronic cigarette smokers revealed identity gaps implicating the relational layer of identity, including personal-relational, enacted-relational, and personal-enacted-relational identity gaps. Participants used communicative and behavioral strategies to manage relational discrepancies. The documented identity gaps and management strategies present opportunities for targeted smoking cessation interventions that amplify dissonance created through identity gaps as a motivational tactic.
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Delaney H, MacGregor A, Amos A. " Tell them you smoke, you'll get more breaks": a qualitative study of occupational and social contexts of young adult smoking in Scotland. BMJ Open 2018; 8:e023951. [PMID: 30598486 PMCID: PMC6318505 DOI: 10.1136/bmjopen-2018-023951] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/17/2018] [Accepted: 10/29/2018] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To explore young adults' perceptions and experiences of smoking and their smoking trajectories in the context of their social and occupational histories and transitions, in a country with advanced tobacco control. DESIGN Indepth qualitative interviews using day and life grids to explore participants' smoking behaviour and trajectories in relation to their educational, occupational and social histories and transitions. SETTING Scotland. PARTICIPANTS Fifteen ever-smokers aged 20-24 years old in 2016-2017. RESULTS Participants had varied and complex educational/employment histories. Becoming and/or remaining a smoker was often related to social context and educational/occupational transitions. In several contexts smoking and becoming a smoker had perceived benefits. These included getting work breaks and dealing with stress and boredom, which were common in the low-paid, unskilled jobs undertaken by participants. In some social contexts smoking was used as a marker of time out and sociability. CONCLUSIONS The findings indicate that while increased tobacco control, including smokefree policies, and social disapproval of smoking discourage smoking uptake and increase motivations to quit among young adults, in some social and occupational contexts smoking still has perceived benefits. This finding helps explain why smoking uptake continues into the mid-20s. It also highlights the importance of policies that reduce the perceived desirability of smoking and that create more positive working environments for young adults which address the types of working hours and conditions that may encourage smoking.
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Affiliation(s)
| | | | - Amanda Amos
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
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Lipperman-Kreda S, Antin TM, Hunt GP. The Role of Multiple Social Identities in Discrimination and Perceived Smoking-Related Stigma among Sexual and Gender Minority Current or Former Smokers. DRUGS (ABINGDON, ENGLAND) 2018; 26:475-483. [PMID: 34262244 PMCID: PMC8276780 DOI: 10.1080/09687637.2018.1490391] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 06/08/2018] [Accepted: 06/11/2018] [Indexed: 10/28/2022]
Abstract
AIMS We investigated how intersections of being a racial minority (i.e. being African American) and economically-disadvantaged (i.e. housing insecurity) may influence experiences with discrimination and perceptions of smoking-related stigma among sexual and gender minority (SGM) current and former smokers. Methods: Survey data were collected from 227 SGM current and former smokers in California (19-65 years old), oversampling African American participants. Participants reported their race, ethnicity, past month housing insecurity, number of lifetime experiences with SGM discrimination, and perceptions of smoking-related stigma. FINDINGS Using univariate General Linear Models and controlling for age, ethnicity, and SGM visibility, we found a significant interaction between being African American and facing housing insecurity on experiences with SGM discrimination [F(1,220)=7.21, p=0.01], perceived smoker stigma [F(1,220)=5.48, p=0.02], perceived differential treatment due to smoking [F(1,220)=10.03, p=0.00], and social withdrawal from non-smokers [F(1,220)=6.18, p=0.01]. These interactions suggest that economically-disadvantaged African American SGM current or former smokers experience increased levels of discrimination and perceive more smoking-related stigma compared to other SGM current and former smokers. Conclusions: Results suggest that people's multiple identities intersect to intensify oppression and inequities for some people and raise questions about the unintended consequences of stigmatizing smokers for reducing smoking among SGM adults.
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Affiliation(s)
- Sharon Lipperman-Kreda
- Prevention Research Center, Pacific Institute for Research and Evaluation 180 Grand Avenue, Suite 1200, Oakland, CA 94612
| | - Tamar M.J Antin
- Prevention Research Center, Pacific Institute for Research and Evaluation 180 Grand Avenue, Suite 1200, Oakland, CA 94612
- Institute for Scientific Analysis 1150 Ballena Blvd, Suite 211, Alameda, CA 94501
| | - Geoffrey P. Hunt
- Institute for Scientific Analysis 1150 Ballena Blvd, Suite 211, Alameda, CA 94501
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Berg MB, Lin L, White M, Alfonso-Barry J. Attitudinal and behavioral differences between cigarette users who do and do not identify as "smokers". JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2017; 65:372-379. [PMID: 28362159 DOI: 10.1080/07448481.2017.1312417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 01/10/2017] [Accepted: 02/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The current research aimed to understand differences in smoking-related identity among college students and to illustrate the distinct characteristics of nonidentified smokers (NIS). PARTICIPANTS Students from 2 colleges in Massachusetts (N = 538; April 2016). METHODS Respondents reported by online survey whether or not they had smoked a cigarette in the past 30 days and if they self-identified as smokers. Nonsmokers (NIS) and identified smokers (IS) were then compared on their smoking attitudes and behavior. RESULTS NIS made up 12.5% of the sample and 64% of all tobacco users. NIS perceived themselves as less addicted and were more confident in their ability to quit smoking. They also were less likely to smoke alone, buy their own cigarettes, or have friends who smoked. CONCLUSIONS College health officials can best motivate NIS to quit smoking by focusing on peer norms and the potential of long-term addiction.
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Affiliation(s)
- Michael B Berg
- a Department of Psychology , Wheaton College , Norton , Massachusetts , USA
| | - Linda Lin
- b Department of Psychology , Emmanuel College , Boston , Massachusetts
| | - Madeleine White
- a Department of Psychology , Wheaton College , Norton , Massachusetts , USA
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Geiser F, Much M, Beyer K. Self-evaluation of tobacco exposure by allied health students in a community college setting. SAGE Open Med 2017; 5:2050312117699503. [PMID: 28491303 PMCID: PMC5406194 DOI: 10.1177/2050312117699503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 02/14/2017] [Indexed: 11/15/2022] Open
Abstract
Objective: Tobacco education is among the initiatives encouraged for health professionals to help them appreciate the significance of addressing tobacco use among their patients. In this pilot study, a nicotine biomarker (cotinine) study was introduced to an applied microbiology course required of all allied health students. Participants assessed their own smoking status in the previous 24 h using a two-dimensional experimental design of a questionnaire and rapid urinary cotinine immunoassay. The study goals were >90% participation of the home-administered assay and high correlation of the results to cotinine standards. Allied health students (medical assistants, respiratory therapists, surgical technicians) were selected as the initial test group. Methods: The study was initiated 10 months after the college became 100% tobacco free. Participants were initially trained on the use and interpretation of the rapid cotinine test using three cotinine standards (0, 400, and 2000 ng/mL urine). Participants subsequently tested their own first-morning urine sample at home and then answered a questionnaire about their tobacco smoke (and/or nicotine) exposure in the previous 24-h period. Results: The cotinine laboratory was offered to a total of 161 students (88% female) over 24 months. Participants who reported no exposure to a nicotine product in any venue made up 55% of the group. Daily smokers made up 17% of the study participants as confirmed by their elevated cotinine levels (greater than 100 ng/mL urine). The remaining participants (28%) either resided with smokers and/or rode in an automobile with an individual smoking in the previous 24 h. Their cotinine levels were moderately elevated in some cases, particularly if they had ridden in a car with a smoker. Conclusion: The pilot study met our objectives of >90% participation and high correlation of urinary cotinine levels with questionnaire self-reports.
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Affiliation(s)
- Fiona Geiser
- Allied Health, Emergency Services and Nursing Department, Delaware County Community College, Media, PA, USA
| | - Meredith Much
- Allied Health, Emergency Services and Nursing Department, Delaware County Community College, Media, PA, USA
| | - Karen Beyer
- Allied Health, Emergency Services and Nursing Department, Delaware County Community College, Media, PA, USA
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Caraballo RS, Sharapova SR, Asman KJ. Does a Race-Gender-Age Crossover Effect Exist in Current Cigarette Smoking Between Non-Hispanic Blacks and Non-Hispanic Whites? United States, 2001-2013. Nicotine Tob Res 2016; 18 Suppl 1:S41-8. [PMID: 26980863 DOI: 10.1093/ntr/ntv150] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION For years, national US surveys have found a lower prevalence of cigarette smoking among non-Hispanic (NH) black adolescents and young adults than their NH white counterparts while finding either similar or higher prevalence in NH blacks among older adults. We present results from four US surveys, including one supplemented by cotinine data, to determine if a race-gender-age crossover effect exists between NH black and NH white current cigarette smokers. METHODS We present NH black and NH white current cigarette smoking estimates in the National Youth Tobacco Survey (2004-2013), National Survey on Drug Use and Health (2002-2013), National Health Interview Survey (2001-2013), and National Health and Nutrition Examination Survey (2001-2012). RESULTS All surveys consistently found that NH black females aged 12-25 years had a lower smoking prevalence than NH white females of the same age while NH black males aged 26 years or older had a higher smoking prevalence than NH white males of the same age. Results were inconsistent between surveys for current smoking estimates for males 12-25 years and females aged 26 years or older. CONCLUSION Our results are inconclusive in consistently detecting the existence of a race-gender-age crossover effect for current cigarette smoking between NH blacks and NH whites. National birth cohort studies are better suited to detect a race-gender-age crossover effect in smoking prevalence between these two racial groups.
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Affiliation(s)
- Ralph S Caraballo
- Office on Smoking and Health, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA;
| | - Saida R Sharapova
- Office on Smoking and Health, National Center for Chronic Disease and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Katherine J Asman
- Biostatistics and Epidemiology Division, RTI International, Atlanta, GA
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"I Was a Full Time Proper Smoker": A Qualitative Exploration of Smoking in the Home after Childbirth among Women Who Relapse Postpartum. PLoS One 2016; 11:e0157525. [PMID: 27308829 PMCID: PMC4911111 DOI: 10.1371/journal.pone.0157525] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 06/01/2016] [Indexed: 11/19/2022] Open
Abstract
Background Many women stop smoking during pregnancy but relapse shortly afterwards, potentially putting their infants at risk of secondhand smoke (SHS) exposure. Women who were able to stop during pregnancy may be a motivated group, receptive to making behaviour changes postpartum to protect their infant from SHS exposure. Understanding more about their experiences of relapse, and if this influences home smoking behaviours and children’s exposure to SHS in the home may help to inform intervention development to prevent infant SHS exposure. Methods Guided by interpretative phenomenological methodology we conducted and analysed nine semi-structured interviews with women who quit smoking during pregnancy, but relapsed ≤3 months postpartum. Findings Central to mothers’ accounts of their smoking behaviours during pregnancy and postpartum was their desire to be a ‘responsible mother’. Mothers described using strategies to protect their infant from SHS exposure, and held strong negative attitudes towards other smoking parents. After relapsing, mothers appeared to reposition themselves as ‘social’ or ‘occasional’ smokers rather than ‘regular’ smokers. Conclusions Findings suggest that interventions to prevent/reduce infants' home SHS exposure should build on mothers' intentions to be responsible parents. As mothers who relapse principally view themselves as ‘social’ or ‘occasional’ smokers, interventions that are highlighted as relevant for women with these types of smoking patterns may be more likely to be responded to, and, ultimately, be effective.
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Kingsbury JH, Parks MJ, Amato MS, Boyle RG. Deniers and Admitters: Examining Smoker Identities in a Changing Tobacco Landscape. Nicotine Tob Res 2016; 18:2130-2137. [DOI: 10.1093/ntr/ntw110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 04/09/2016] [Indexed: 11/14/2022]
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Guillory J, Lisha N, Lee YO, Ling PM. Phantom smoking among young adult bar patrons. Tob Control 2016; 26:153-157. [PMID: 27048205 DOI: 10.1136/tobaccocontrol-2015-052821] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/14/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore the prevalence and sociodemographic makeup of smokers who do not self-identify as smokers (ie, phantom smokers) compared with self-identifying smokers in a sample of bar-going young adults aged 18-30 years to more accurately assess young adult prevalence of smoking and inform cessation message targeting. METHODS Cross-sectional surveys of smokers (n=3089) were conducted in randomly selected bars/nightclubs in seven US cities. Logistic regression models assessed associations between phantom smoking (past 30-day smoking and denial of being a smoker), tobacco and alcohol use behaviours (eg, social smoking, nicotine dependence, smoking while drinking, past 30-day alcohol use) and demographics. RESULTS Compared with smokers, phantom smokers were more likely to be college graduates (OR=1.43, 95% CI 1.03 to 1.98) and to identify themselves as social smokers (OR=1.60, 95% CI 1.27 to 2.12). Phantom smokers had lower odds of smoking while drinking (OR=0.28, 95% CI 0.25 to 0.32), being nicotine dependent (OR=0.36, 95% CI 0.22 to 0.76) and having quit for at least 1 day in the last year (OR=0.46, 95% CI 0.36 to 0.69) compared with smokers. CONCLUSIONS This research extends phantom smoking literature on college students to provide a broader picture of phantom smoking among young adults in high-risk contexts and of varying levels of educational attainment. Phantom smokers may be particularly sensitive to social pressures against smoking, suggesting the importance of identifying smoking as a behaviour (rather than identity) in cessation messaging to ensure that phantom smokers are reached.
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Affiliation(s)
- Jamie Guillory
- RTI International, Research Triangle Park, North Carolina, USA
| | - Nadra Lisha
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
| | - Youn Ok Lee
- RTI International, Research Triangle Park, North Carolina, USA
| | - Pamela M Ling
- Cardiovascular Research Institute, University of California, San Francisco, San Francisco, California, USA
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Rojewski AM, Baldassarri S, Cooperman NA, Gritz ER, Leone FT, Piper ME, Toll BA, Warren GW. Exploring Issues of Comorbid Conditions in People Who Smoke. Nicotine Tob Res 2016; 18:1684-96. [PMID: 26783291 DOI: 10.1093/ntr/ntw016] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 01/06/2016] [Indexed: 01/21/2023]
Abstract
UNLABELLED Smoking affects comorbid disease outcomes, and patients with comorbid conditions may have unique characteristics that are important to consider when treating tobacco use. However, addressing tobacco in patients being treated for comorbid conditions is not a consistent practice. Recognizing the need for a "call-to-action" to address tobacco use in people with comorbid conditions, the Tobacco Treatment Network within the Society for Research on Nicotine and Tobacco (SRNT) convened a Comorbidities Workgroup to explore the relationship between smoking and comorbid disease to identify common themes including: the harms associated with continued tobacco use, the frequency of comorbid disease and tobacco use, the potential effect of comorbid disease on the ability to quit tobacco use, the association between tobacco use and suboptimal disease-specific treatment response, and evidence regarding potential approaches to improve addressing tobacco use in patients with comorbid disease. Five candidate conditions (psychiatric, cancer, cardiovascular, pulmonary, and human immunodeficiency virus infected patients) were explored. Across comorbid conditions, smoking adversely affects treatment efficacy and promotes other adverse health conditions. People with comorbid conditions who smoke are motivated to quit and respond to evidence-based smoking cessation treatments. However, tobacco cessation is not regularly incorporated into the clinical care of many individuals with comorbidities. Optimal strategies for addressing tobacco use within each comorbid disease are also not well defined. Further work is needed to disseminate evidence-based care into clinical practice for smokers with comorbid disease and addiction research should consider comorbid conditions as an important construct to explore. IMPLICATIONS This article explores how physical and psychiatric conditions may interact in the treatment of tobacco dependence, and discusses the need for smoking cessation as a critical component of comorbid condition management. Five common comorbid domains-psychiatric, cancer, pulmonary, cardiovascular, and human immunodeficiency virus (HIV)-are highlighted to illustrate how these different conditions might interact with smoking with respect to prevalence and harm, motivation to quit, and cessation treatment utilization and success.
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Affiliation(s)
- Alana M Rojewski
- Department of Psychiatry, Yale School of Medicine, New Haven, CT; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Stephen Baldassarri
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT
| | - Nina A Cooperman
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Ellen R Gritz
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Frank T Leone
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania Presbyterian Medical Center, Philadelphia, PA
| | - Megan E Piper
- Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Benjamin A Toll
- Department of Psychiatry, Yale School of Medicine, New Haven, CT; Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC; Department of Cancer Prevention and Control, Yale Cancer Center, New Haven, CT; Tobacco Treatment Service, Smilow Cancer Hospital at Yale-New Haven, New Haven, CT; Tobacco Treatment and Lung Cancer Screening Programs, Hollings Cancer Center, Charleston, SC
| | - Graham W Warren
- Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC; Department of Cell and Molecular Pharmacology, Medical University of South Carolina, Charleston, SC
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Antin TMJ, Lipperman-Kreda S, Hunt G. Tobacco Denormalization as a Public Health Strategy: Implications for Sexual and Gender Minorities. Am J Public Health 2015; 105:2426-9. [PMID: 26469677 DOI: 10.2105/ajph.2015.302806] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Although the population-level success of tobacco denormalization is widely accepted, it remains unclear whether these strategies alleviate health inequities for sexual and gender minorities. The high risk of smoking among sexual and gender minorities together with research that documents a relationship between stigma-related processes and smoking prevalence for these groups raises questions about whether tobacco-related stigma intensifies the disadvantages associated with the stigmas of other social identities. We have not adequately considered how tobacco-related stigma overlaps with other social identity stigmas. Given concerns about the intensification of inequality, this type of inquiry has important implications for understanding both the effectiveness and limitations of tobacco denormalization strategies for sexual and gender minorities and identifying those tobacco prevention, treatment, and public health policies that work to ameliorate health inequities.
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Affiliation(s)
- Tamar M J Antin
- Tamar M. J. Antin is with the Prevention Research Center of the Pacific Institute for Research and Evaluation, Oakland, CA, and the Institute for Scientific Analysis, Alameda, CA. Sharon Lipperman-Kreda is with the Prevention Research Center of the Pacific Institute for Research and Evaluation. Geoffrey Hunt is with the Institute for Scientific Analysis, Alameda
| | - Sharon Lipperman-Kreda
- Tamar M. J. Antin is with the Prevention Research Center of the Pacific Institute for Research and Evaluation, Oakland, CA, and the Institute for Scientific Analysis, Alameda, CA. Sharon Lipperman-Kreda is with the Prevention Research Center of the Pacific Institute for Research and Evaluation. Geoffrey Hunt is with the Institute for Scientific Analysis, Alameda
| | - Geoffrey Hunt
- Tamar M. J. Antin is with the Prevention Research Center of the Pacific Institute for Research and Evaluation, Oakland, CA, and the Institute for Scientific Analysis, Alameda, CA. Sharon Lipperman-Kreda is with the Prevention Research Center of the Pacific Institute for Research and Evaluation. Geoffrey Hunt is with the Institute for Scientific Analysis, Alameda
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Tombor I, Shahab L, Herbec A, Neale J, Michie S, West R. Smoker identity and its potential role in young adults' smoking behavior: A meta-ethnography. Health Psychol 2015; 34:992-1003. [PMID: 25622078 PMCID: PMC4577249 DOI: 10.1037/hea0000191] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Identity is an important influence on behavior. To identify potential targets for smoking cessation interventions in young adults, we synthesized findings from qualitative studies on smoker identity and potential influences on smoking and smoking cessation. METHODS A systematic search of 4 electronic databases up to September 19, 2013, was conducted to identify qualitative studies on smoker identity in smokers and ex-smokers aged 16-34. Key concepts were extracted from individual studies and synthesized into higher-order interpretations by following the principles of meta-ethnography. RESULTS Seventeen relevant papers were identified. At the highest level of interpretation, we identified 4 types of findings: (a) contributory factors to identity, (b) identity in relation to smoking, (c) contextual and temporal patterning, and (d) behavior in relation to smoking. Contributory factors included the desire to establish aspirational individual and social identities, enact a smoker identity appropriate to the momentary social context, and alter personal nonsmoking rules when consuming alcohol. Smoker identity was multifaceted and incorporated individuals' defensive rationalizations, and both positive and negative feelings attached to it. Smoker identities took time to develop, were subject to change, and were context dependent. Identity was found to play a role in quit attempts. CONCLUSIONS Qualitative research into the identity of young adult smokers has established it as a multifaceted phenomenon serving important functions but also involving conflict and defensive rationalizations. It develops over time and contextual factors influence its expression. The nature of a smoker's identity can play an important role in smoking cessation. (PsycINFO Database Record
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Affiliation(s)
- Ildiko Tombor
- Cancer Research UK Health Behaviour Research Centre, University College London
| | - Lion Shahab
- Cancer Research UK Health Behaviour Research Centre, University College London
| | - Aleksandra Herbec
- Cancer Research UK Health Behaviour Research Centre, University College London
| | - Joanne Neale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London
| | - Susan Michie
- Department of Clinical, Educational and Health Psychology, University College London
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, University College London
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