Medicine and Health Sciences Commons^™

Improving Smoking History Screening And Documentation To Increase Lung Cancer Screenings In Primary Care Clinics, Destinee R. Rein

DNP Projects

BACKGROUND: In the United States, lung cancer has the highest mortality rate of all other cancers among men and women. Kentucky is ranked 50th among all states, leading the nation in new lung cancer cases each year. Lung cancer screening using Low dose Computed Tomography (LDCT) can reduce lung cancer-related morbidity and mortality. Lack of smoking history documentation to identify eligible patients is a major contributing factor to low national screening rates. Obtaining complete smoking history remains the most important technique in identifying candidates for lung cancer screening.

PURPOSE: The purpose of this quality improvement project was to evaluate …

Smoking-Induced Sex Differences In Clinical Outcomes In Patients Undergoing Mechanical Thrombectomy For Stroke, Jacqueline A. Frank, Kara Jo Swafford, Jill M. Roberts, Amanda L. Trout, Ann M. Stowe, Douglas E. Lukins, Stephen Grupke, Keith R. Pennypacker, Justin F. Fraser

Neurology Faculty Publications

OBJECTIVE: Ischemic stroke is the fifth leading cause of death in the United States. Smoking accelerates the onset of stroke by 10 years. The effects of smoking status on percent change in National Institutes of Health Stroke Scale (NIHSS) score, infarct volume, and edema volume were examined following mechanical thrombectomy for large vessel occlusion in patients with acute ischemic stroke.

METHODS: Subjects (N = 90; >18 years old) were divided into 3 groups based on smoking status: current smokers, previous smokers (defined as having quit >6 months before the ischemic event), and nonsmokers. Percent change in NIHSS score was …

Persistent Disparities In Smoking Among Rural Appalachians: Evidence From The Mountain Air Project, Kathryn Cardarelli, Susan C. Westneat, Madeline Dunfee, Beverly May, Nancy Schoenberg, Steven R. Browning

Health, Behavior & Society Faculty Publications

BACKGROUND: Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior.

METHODS: A cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015-2017, with a response rate of 82%. Prevalence ratios and 95% confidence intervals for current smoking (compared to nonsmokers) were computed for the entire cohort then stratified by multiple characteristics, including respiratory health. …

Encoding The Odor Of Cigarette Smoke, Timothy S. Mcclintock, Naazneen Khan, Yelena Alimova, Madeline Aulisio, Dong Y. Han, Patrick Breheny

Physiology Faculty Publications

The encoding of odors is believed to begin as a combinatorial code consisting of distinct patterns of responses from odorant receptors (ORs), trace-amine associated receptors (TAARs), or both. To determine how specific response patterns arise requires detecting patterns in vivo and understanding how the components of an odor, which are nearly always mixtures of odorants, give rise to parts of the pattern. Cigarette smoke, a common and clinically relevant odor consisting of > 400 odorants, evokes responses from 144 ORs and 3 TAARs in freely behaving male and female mice, the first example of in vivo responses of both ORs and …

Cancer Patients’ Tobacco Use And Tobacco Treatment Referral Response: Implementation Outcomes At A National Cancer Institute- Designated Cancer Center, Tia Borger

Theses and Dissertations--Psychology

Smoking after cancer diagnosis is linked to cancer-specific and all-cause mortality among other adverse outcomes. Yet, 10-20% of U.S. cancer survivors are current smokers. Implementation of evidence-based tobacco treatment in cancer care facilities is widely recommended, yet rarely accomplished. This study focuses on the early outcomes of a tobacco treatment program integrated within an NCI-designated cancer center. Participants consist of 26,365 patients seen at the cancer center during the first 18 months of implementation. The study is a retrospective chart review of patients’ tobacco use, and among current users, patients’ treatment referral response. Over 99% of patients were screened for …

The Effect Of Smoking On Kentucky’S Workforce, Michael W. Clark, Jenny A. Minier, Charles J. Courtemanche, Bethany L. Paris, Michael T. Childress

CBER Research Report

Excerpt from the Executive Summary:

Smoking has been estimated to increase health care costs in the United States by $167.5 billion annually (Xu et al. 2015). In Kentucky, smoking adds $2.5 billion in health care expenditures each year. Most of these costs were paid by public programs such as Medicaid and Medicare. While these costs are significant, they represent only a portion of the costs that smoking imposes on society. Smoking also leads to poorer labor market outcomes. Smokers are more likely to be unemployed, earn lower wages, and die prematurely than non-smokers. These negative labor market effects reduce economic …

Identification Of Susceptibility Pathways For The Role Of Chromosome 15q25.1 In Modifying Lung Cancer Risk, Xuemei Ji, Yohan Bossé, Maria Teresa Landi, Jiang Gui, Xiangjun Xiao, David Qian, Philippe Joubert Joubert, Maxime Lamontagne, Yafang Li, Ivan Gorlov, Mariella De Biasi, Younghun Han, Olga Gorlova, Rayjean J. Hung, Xifeng Wu, James Mckay, Xuchen Zong, Robert Carreras-Torres, David C. Christiani, Neil Caporaso, Mattias Johansson, Geoffrey Liu, Stig E. Bojesen, Loic Le Marchand, Demetrios Albanes, Heike Bickeböller, Melinda C. Aldrich, William S. Bush, Adonina Tardon, Gad Rennert, Susanne M. Arnold

Markey Cancer Center Faculty Publications

Genome-wide association studies (GWAS) identified the chromosome 15q25.1 locus as a leading susceptibility region for lung cancer. However, the pathogenic pathways, through which susceptibility SNPs within chromosome 15q25.1 affects lung cancer risk, have not been explored. We analyzed three cohorts with GWAS data consisting 42,901 individuals and lung expression quantitative trait loci (eQTL) data on 409 individuals to identify and validate the underlying pathways and to investigate the combined effect of genes from the identified susceptibility pathways. The KEGG neuroactive ligand receptor interaction pathway, two Reactome pathways, and 22 Gene Ontology terms were identified and replicated to be significantly associated …

Intention To Quit Smoking And Polytobacco Use Among College Student Smokers, Karen M. Butler, Melinda J. Ickes, Mary Kay Rayens, Amanda T. Wiggins, Kristin Ashford, Ellen J. Hahn

Nursing Faculty Publications

Little is known about polytobacco use in college students. One nationally representative survey indicated 51.3% of tobacco-using college students used more than one product, which may increase risk of tobacco-related disease and premature death. The purpose of this study was to examine the association of intention to quit smoking (ITQS) cigarettes with polytobacco use status, controlling for frequency of tobacco product use and cigarette smoking intensity as measured by cigarettes per day (CPD). Data are from a larger quasi-experimental study conducted at a large state university in the Southeastern United States. Analysis is based on the combined sample of current …

Quitting Together: Formative Research To Develop A Social Marketing Plan For Smoking Cessation Among Women In A Residential Treatment Facility For Substance Abuse Recovery, August D. Anderson

Theses and Dissertations--Communication

Both smoking addiction and illicit substance abuse are prevalent issues in the United States today. Furthermore, these are issues that have significant impact on women’s health and mental state. Despite research that shows that smoking cessation coupled with substance abuse recovery can decrease likelihood of relapse post-recovery, few substance abuse recovery facilities today offer smoking cessation programming options. To address the issue of smoking addiction on top of substance abuse recovery, formative research was conducted through this study to determine the underlying causes of smoking habits coupled with recovery efforts and the attitudes. Through focus group sessions with women in …

Evaluating The Relationship Between Tobacco Use And Pain Perception Using The Global Pain Scale (Gps) In Opioid Dependent Adults: A Retrospective Analysis, Kristina Robinson

DNP Projects

Background: Chronic pain, smoking, and opioid use, contribute to a significant economic burden in the United States. Chronic pain affects all aspects of life, and is influenced by the use of cigarettes and opioids alike. Researchers suggest that there is a higher use of cigarettes and opioids in individuals with chronic pain. Chronic pain can promote smoking and smokers are more likely to use opioids. With the evidence that patients who smoke a higher number of cigarettes per day report higher pain, it is possible that smoking may be a stress-reducing behavioral response related to pain. Moreover, higher frequency and …

Pleiotropy Of Genetic Variants On Obesity And Smoking Phenotypes: Results From The Oncoarray Project Of The International Lung Cancer Consortium, Tao Wang, Jee-Young Moon, Yiqun Wu, Christopher I. Amos, Rayjean J. Hung, Adonina Tardon, Angeline Andrew, Chu Chen, David C. Christiani, Demetrios Albanes, Erik H. F. M. Van Der Heijden, Eric Duell, Gadi Rennert, Gary Goodman, Geoffrey Liu, James D. Mckay, Jian-Min Yuan, John K. Field, Jonas Manjer, Kjell Grankvist, Lambertus A. Kiemeney, Loic Le Marchand, M. Dawn Teare, Matthew B. Schabath, Mattias Johansson, Melinda C. Aldrich, Michael Davies, Mikael Johansson, Ming-Sound Tsao, Neil Caporaso, Susanne Arnold

Internal Medicine Faculty Publications

Obesity and cigarette smoking are correlated through complex relationships. Common genetic causes may contribute to these correlations. In this study, we selected 241 loci potentially associated with body mass index (BMI) based on the Genetic Investigation of ANthropometric Traits (GIANT) consortium data and calculated a BMI genetic risk score (BMI-GRS) for 17,037 individuals of European descent from the Oncoarray Project of the International Lung Cancer Consortium (ILCCO). Smokers had a significantly higher BMI-GRS than never-smokers (p = 0.016 and 0.010 before and after adjustment for BMI, respectively). The BMI-GRS was also positively correlated with pack-years of smoking (p < 0.001) in smokers. Based on causal network inference analyses, seven and five of 241 SNPs were classified to pleiotropic models for BMI/smoking status and BMI/pack-years, respectively. Among them, three and four SNPs associated with smoking status and pack-years (p < 0.05), respectively, were followed up in the ever-smoking data of the Tobacco, Alcohol and Genetics (TAG) consortium. Among these seven candidate SNPs, one SNP (rs11030104, BDNF) …

A Longitudinal Study Of The Reciprocal Relationship Between Ever Smoking And Urgency In Early Adolescence, Jessica L. Burris, Elizabeth N. Riley, Gabriella E. Puleo, Gregory T. Smith

Psychology Faculty Publications

Background—Among early adolescents in the United States (U.S.), the prevalence of cigarette smoking is at its lowest level in recent decades. Nonetheless, given the risks of smoking in early development, it remains critically important to study both risk factors for smoking and risks from smoking. This longitudinal study with U.S. early adolescents examines smoking initiation and tests a model of reciprocal prediction between ever smoking and the personality trait of urgency (i.e., mood-based impulsivity), a trait that increases risk for multiple forms of dysfunction.

Methods—Participants (n=1906; 90% 10–11 years old, 50% female, 39% racial minorities at …

Tailoring A Nicu-Based Tobacco Treatment Program For Mothers Who Are Dependent On Opioids, Amanda Fallin-Bennett, Kristin Ashford

Nursing Faculty Publications

Objective—To collect formative information to design a tailored tobacco treatment intervention for women with newborns treated or evaluated for neonatal abstinence syndrome and to explore current tobacco use behaviors and facilitators and barriers to smoking cessation.

Design—Qualitative descriptive study.

Setting—An academic medical center in the southern United States.

Participants—Mothers of newborns who were treated or evaluated for neonatal abstinence syndrome at birth within the preceding three months. Women were recruited who were older than 18 and reported opioid dependence and smoking during pregnancy.

Methods—Participants took part in semi-structured individual interviews that lasted approximately one hour. …

Advertising Exposure And Use Of E-Cigarettes Among Female Current And Former Tobacco Users Of Childbearing Age, Kristin Ashford, Emily Rayens, Amanda T. Wiggins, Mary Kay Rayens, Amanda Fallin-Bennett, Molly Malany Sayre

Nursing Faculty Publications

Objective: The study examined the relationship between exposure to e‐cigarette advertising and e‐cigarette use by pregnancy status, including use of flavored e‐cigarette products, among women of childbearing age.

Design: A cross‐sectional, correlational design was used.

Subjects: Female current or former tobacco users in Central and Eastern Kentucky, 18–45 years old (N = 194, 52% pregnant).

Measures: Demographics, pregnancy status, cigarette and e‐cigarette use, and exposure to e‐cigarette advertising.

Results: Younger age, white non‐Hispanic race, and greater exposure to e‐cigarette advertising were associated with a higher likelihood of ever using e‐cigarettes (p < .05 for each variable). Pregnancy was not associated with ever use (p = .11). Younger age was associated …

Cross-Talk Between Clinical And Host-Response Parameters Of Periodontitis In Smokers, Radha Nagarajan, Craig S. Miller, Dolph R. Dawson Iii, Mohanad Al-Sabbagh, Jeffrey L. Ebersole

Institute for Biomedical Informatics Faculty Publications

Background and Objective

Periodontal diseases are a major public health concern leading to tooth loss and have also been shown to be associated with several chronic systemic diseases. Smoking is a major risk factor for the development of numerous systemic diseases, as well as periodontitis. While it is clear that smokers have a significantly enhanced risk for developing periodontitis leading to tooth loss, the population varies regarding susceptibility to disease associated with smoking. This investigation focused on identifying differences in four broad sets of variables, consisting of: (i) host‐response molecules; (ii) periodontal clinical parameters; (iii) antibody responses to periodontal pathogens …

Psychosocial Factors Related To The Intergenerational Transmission Of Externalizing Behaviors In Early Midlife, Chenshu Zhang, Judith S. Brook, Neo K. Morojele, Mario De La Rosa, Carl G. Leukefeld, David W. Brook

Behavioral Science Faculty Publications

Background: To study the intergenerational transmission of externalizing behaviors. Methods: Participants came from a community-based random sample of residents in two upstate New York counties (N = 548). Data were collected from mothers at mean age 40 and from their children from adolescence (mean age = 14, SD = 2.8) to early midlife (mean age = 43, SD = 2.8) at seven time points. Structural equation modeling (SEM) was used to study the psychosocial factors as related to externalizing behaviors in early midlife. Results: First, maternal externalizing behaviors were indirectly associated with the offspring's externalizing behaviors …

The Effect Of Sazetidine-A And Other Nicotinic Ligands On Nicotine Controlled Goal-Tracking In Female And Male Rats, S. Charntikov, A. M. Falco, K. Fink, Linda P. Dwoskin, R. A. Bevins

Pharmaceutical Sciences Faculty Publications

Nicotine is the primary addictive component of tobacco products and its complex stimulus effects are readily discriminated by humans and non-human animals. Previous preclinical research investigating directly the nature of the nicotine stimulus has been limited to male rodents. The current study began to address this significant gap in the literature by training female and male rats to discriminate 0.4 mg/kg nicotine from saline in the discriminated goal-tracking task. In this task, access to sucrose was intermittently available on nicotine session. On saline session, intermixed with nicotine sessions on separate days, sucrose was not available. Both sexes acquired the discrimination …

Correlation Of Positron Emission Tomography/Computed Tomography Scan With Smoking, Tumor Size, Stage And Differentiation In Head And Neck Cancer Patients, Jordan L. Pleitz, Partha Sinha, Emily V. Dressler, Rony K. Aouad

Otolaryngology--Head & Neck Surgery Faculty Publications

The goal of this study was to identify associations between positron emission tomography/computed tomography (PET/CT) maximum standardized uptake value (SUVmax) in patients presenting with head and neck squamous cell carcinoma (SCC) with tumor site, size, histologic differentiation, smoking, and diabetes. Charts of patients with oropharyngeal and laryngeal SCC who underwent ¹⁸F-fluorodeoxyglucose PET/CT scans were reviewed between May 2007 and August 2013. Statistical analyses included modeling log-transformed SUVmax values by tumor site, size, histologic differentiation, smoking status, and diabetes using unadjusted linear regressions. Differences were considered statistically significant for P< 0.05. A total of 111 patients (54 with oropharynx and 57 with larynx cancers) were included, 83 men and 28 women with an average age of 57.5 years old. There was a significantly higher pack-year smoking history (P = 0.005) in the larynx cancer group. While tumor …

Developmental Toxicity Of Nicotine: A Transdisciplinary Synthesis And Implications For Emerging Tobacco Products, Lucinda J. Enland, Kjersti Aagaard, Michele Bloch, Kevin Conway, Kelly Cosgrove, Rachel Grana, Thomas J. Gould, Dorothy Hatsukami, Frances Jensen, Denise Kandel, Bruce Lanphear, Frances Leslie, James R. Pauly, Jenae Neiderhiser, Mark Rubinstein, Theodore A. Slotkin, Eliot Spindel, Laura Stroud, Lauren Wakschlag

Pharmaceutical Sciences Faculty Publications

While the health risks associated with adult cigarette smoking have been well described, effects of nicotine exposure during periods of developmental vulnerability are often overlooked. Using MEDLINE and PubMed literature searches, books, reports and expert opinion, a transdisciplinary group of scientists reviewed human and animal research on the health effects of exposure to nicotine during pregnancy and adolescence. A synthesis of this research supports that nicotine contributes critically to adverse effects of gestational tobacco exposure, including reduced pulmonary function, auditory processing defects, impaired infant cardiorespiratory function, and may contribute to cognitive and behavioral deficits in later life. Nicotine exposure during …

A Population-Based Survival Analysis Of Mesothelioma And Smoking In Appalachian And Non-Appalachian Kentucky, Peter Van Wie

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Mesothelioma is one of the most aggressive cancers in the United States and around the world, with a grim 5-year survival rate of only 8%. After diagnosis there is little that can be done to stop the progression of the disease. Smoking has been negatively associated with mesothelioma survival. This may be due to several factors including increased oxidative stress or sequestration of tobacco-related carcinogenic compounds by asbestos fibers trapped in the lung. This study investigated the association between smoking and mesothelioma survival in the Kentucky population. It examines the risk of living in the low socioeconomic region of Appalachian …

Inter-Relationships Linking Probability Of Becoming A Case Of Nicotine Dependence With Frequency Of Tobacco Cigarette Smoking, Olga A. Vsevolozhskaya, James C. Anthony

Biostatistics Faculty Publications

INTRODUCTION: Once smoking starts, some tobacco cigarette smokers (TCS) can make very rapid transitions into tobacco dependence syndromes (TCD). With adjustment for smoking frequency, we posit female excess risk for this rapid-onset TCD. In a novel application of functional analysis for tobacco research, we estimate four Hill function parameters and plot TCD risk against a gradient of smoking frequency, as observed quite soon after smoking onset.

METHODS: In aggregate, the National Surveys of Drug Use and Health, 2004-2013, identified 1546 newly incident TCS in cross-sectional research, each with standardized TCD assessment.

RESULTS: Hill function estimates contradict our apparently over-simplistic hypothesis. …

Employing The Precautionary Principle To Evaluate The Use Of E-Cigarettes, Ashley M. Bush, James W. Holsinger Jr., Lawrence D. Prybil

Health Management and Policy Faculty Publications

Electronic cigarettes (e-cigarettes) have emerged onto the public market as an alternative to tobacco cigarettes; however, science is inconclusive as e-cigarettes have not been thoroughly investigated, including their short- and long-term risks and benefits (1, 2). The question arises of whether e-cigarettes will become the future tobacco crisis. This paper connects the precautionary principle to the use of e-cigarettes in an effort to guide decision-makers in the prevention of adverse health outcomes and societal costs.

The Link Between Smoking, Lung Cancer And Socioeconomic Factors In Kentucky, Shreya Berlia

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Background and Purpose

Lung cancer is the leading cause of cancer death and the second most diagnosed cancer in both men and women in the United States. An estimated 158,080 deaths from lung cancer are expected to occur in 2016, which will account for approximately 1 in 4 of all cancer deaths. The 1- and 5-year relative survival rates for lung cancer are 44% and 17%, respectively. The incidence rate for lung cancer has been declining since the mid-1980s in men, but only since the mid-2000s in women. Tobacco smoke is the leading cause of preventable disease and death in …

Plasminogen Activator Inhibitor-1 In Cigarette Smoke Exposure And Influenza A Virus Infection-Induced Lung Injury, Yashodhar P. Bhandary, Shwetha K. Shetty, Amarnath S. Marudamuthu, Krishna K. Midde, Hong-Long Ji, Homoyoun Shams, Renuka Subramaniam, Jian Fu, Steven Idell, Sreerama Shetty

Center for Research on Environmental Disease Faculty Publications

Parenchymal lung inflammation and airway and alveolar epithelial cell apoptosis are associated with cigarette smoke exposure (CSE), which contributes to chronic obstructive pulmonary disease (COPD). Epidemiological studies indicate that people exposed to chronic cigarette smoke with or without COPD are more susceptible to influenza A virus (IAV) infection. We found increased p53, PAI-1 and apoptosis in AECs, with accumulation of macrophages and neutrophils in the lungs of patients with COPD. In Wild-type (WT) mice with passive CSE (PCSE), p53 and PAI-1 expression and apoptosis were increased in AECs as was lung inflammation, while those lacking p53 or PAI-1 resisted AEC …

Caffeine Consumption In A Long-Term Psychiatric Hospital: Tobacco Smoking May Explain In Large Part The Apparent Association Between Schizophrenia And Caffeine Use, Manuel Arrojo-Romero, Carmen Armas Barbazán, Javier D. López-Moriñigo, Ramón Ramos-Rios, Manuel Gurpegui, José M. Martinez-Ortega, Dolores Jurado, Francisco J. Diaz, Jose De Leon

Psychiatry Faculty Publications

This study further explores the association between schizophrenia and caffeine use by combining two prior published Spanish samples (250 schizophrenia outpatients and 290 controls from the general population) with two Spanish long-term inpatient samples from the same hospital (145 with schizophrenia and 64 with other severe mental illnesses). The specific aims were to establish whether or not, after controlling for confounders including tobacco smoking, the association between schizophrenia and caffeine is consistent across schizophrenia samples and across different definitions of caffeine use. The frequency of caffeine use in schizophrenia inpatients was not significantly higher than that in non-schizophrenia inpatients (77%, …

Identifying Cases Of Undiagnosed, Clinically Significant Copd In Primary Care: Qualitative Insight From Patients In The Target Population, Nancy K. Leidy, Katherine Kim, Elizabeth D. Bacci, Barbara P. Yawn, David M. Mannino, Byron M. Thomashow, R. Graham Barr, Stephen I. Rennard, Julia F. Houfek, Meilan K. Han, Catherine A. Meldrum, Barry J. Make, Russ P. Bowler, Anna W. Steenrod, Lindsey T. Murray, John W. Walsh, Fernando Martinez

Preventive Medicine and Environmental Health Faculty Publications

BACKGROUND: Many cases of chronic obstructive pulmonary disease (COPD) are diagnosed only after significant loss of lung function or during exacerbations.

AIMS: This study is part of a multi-method approach to develop a new screening instrument for identifying undiagnosed, clinically significant COPD in primary care.

METHODS: Subjects with varied histories of COPD diagnosis, risk factors and history of exacerbations were recruited through five US clinics (four pulmonary, one primary care). Phase I: Eight focus groups and six telephone interviews were conducted to elicit descriptions of risk factors for COPD, recent or historical acute respiratory events, and symptoms to inform the …

Continuing To Confront Copd International Surveys: Comparison Of Patient And Physician Perceptions About Copd Risk And Management, Ana M. Menezes, Sarah H. Landis, Meilan K. Han, Hana Muellerova, Zaurbek Aisanov, Thys Van Der Molen, Yeon-Mok Oh, Masakazu Ichinose, David M. Mannino, Kourtney J. Davis

Preventive Medicine and Environmental Health Faculty Publications

PURPOSE: Using data from the Continuing to Confront COPD International Physician and Patient Surveys, this paper describes physicians' attitudes and beliefs regarding chronic obstructive pulmonary disease (COPD) prognosis, and compares physician and patient perceptions with respect to COPD.

METHODS: In 12 countries worldwide, 4,343 patients with COPD were identified through systematic screening of population samples, and 1,307 physicians who regularly saw patients with COPD were sampled from in-country professional databases. Both patients and physicians completed surveys about their COPD knowledge, beliefs, and perceptions; physicians answered further questions about diagnostic methods and treatment choices for COPD.

RESULTS: Most physicians (79%) responded …

Menthol Cigarette Smoking And Obesity In Young Adult Daily Smokers In Hawaii, Alyssa Marie M. Antonio, Pebbles Fagan, Faith D. Hamamura, Ian Joseph N. Lagua, Jenny Liu, Devin J. Park, Pallav Pokhrel, Thaddeus A. Herzog, Ian Pagano, Kevin Cassel, Angela Sy, Dorothy Jorgensen, Tania Lynch, Crissy Kawamoto, Carol J. Boushey, Adrian Franke, Mark S. Clanton, Eric T. Moolchan, Linda A. Alexander

Health, Behavior & Society Faculty Publications

This study investigates 1) the relationship between menthol cigarette smoking and obesity and 2) the association of body mass index with the nicotine metabolite ratio among menthol and non-menthol daily smokers aged 18–35 (n = 175). A brief survey on smoking and measures of height and weight, carbon monoxide, and saliva samples were collected from participants from May to December 2013 in Honolulu, Hawaii. Multiple regression was used to estimate differences in body mass index among menthol and non-menthol smokers and the association of menthol smoking with obesity. We calculated the log of the nicotine metabolite ratio to examine differences …

Explore The Relationship Among Lung Cancer Stigma, Social Support, And Psychosocial Distress, Lisa Maggio

Theses and Dissertations--Nursing

There is longstanding causal relationship between cigarette smoking and lung cancer. Smoke-free policies and anti-smoking campaigns have been linked to the decline in smoking acceptance and contribute to the unintended consequence of stigmatizing smokers. Lung cancer is viewed as a self-inflicted disease and patients’ feel judged in a manner different from other cancers affecting social interactions between family, friends, and healthcare professionals. Lung cancer stigma contributes to depression, anxiety, poor self-esteem, guilt, shame, blame, threatens a person’s social identity, and limits social support that deeply affects patients and their support persons.

This dissertation contains a review of the literature related …

Financial Strain, High Stress And Smoking Among United Way Missouri 2-1-1 Callers, Brandon Cofield

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Objectives.

We evaluated the influence of financial strain and perceived stress on smoking status among United Way Missouri 2-1-1 callers of predominantly low socioeconomic status.

Methods.

Data for this study were collected as part of a randomized, controlled intervention trial integrating cancer control referrals into regular United Way 2-1-1 Missouri services. Those who consented, completed the assessment and had at least one cancer control need were invited to participate in a longitudinal study that included completing the baseline assessment used in this study. We conducted chi-square analyses to assess the bivariate relationships between each financial strain variable and smoking status, …