Medicine and Health Sciences Commons^™

Treatment Outcomes From The Tdc: A Look At Smoking Cessation Among Patients With Co-Occurring Disorders, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings •Smoking abstinence at end of program:

–Intent to treat analysis: 32.2%(83/258) –Among program completers: 41.3%(83/201)

•Significant predictors of abstinence : –Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder. –Having a lower CO level at program enrolment was a significant predictor of being more likely to quit –Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Creating A Tobacco-Free Residential Substance Abuse Treatment Facility: A Toolkit For Designing An Effective Intervention, Carrie F. Whitney

Public Health Theses

Individuals with a substance addiction and/or mental illness use tobacco at rates much higher than the general population. Approximately 21% of the U.S. population smokes, yet 40%-80% of substance abuse and mental health patients smoke and consume more than 44% of all the cigarettes sold in the United States each year. As a result, these individuals experience increased tobacco related morbidity and mortality. Tobacco use is common and accepted within this population, and has become a norm even within treatment programs. Only 30%-40% of treatment facilities offer smoking cessation resources, and many organizations are hesitant to address cessation or to …

Gender-Specific Profiles Of Tobacco Use Among Non-Institutionalized People With Serious Mental Illness, Joy L. Johnson, Pamela A. Ratner, Leslie A. Malchy, Chizimuzo T.C. Okoli, Ric M. Procyshyn, Joan L. Bottorff, Marlee Groening, Annette Schultz, Marg Osborne

Chizimuzo T.C. Okoli

Background: In many countries, smoking remains the leading preventable cause of death. In North America, reductions in population smoking levels are stabilising and, in recent years, those involved in tobacco control programming have turned their attention to particular segments of society that are at greatest risk for tobacco use. One such group is people with mental illness. A picture of tobacco use patterns among those with mental illness is beginning to emerge; however, there are several unanswered questions. In particular, most studies have been limited to particular in-patient groups. In addition, while it is recognised that men and women differ …

Put Your Money Where Your Butt Is: A Commitment Contract For Smoking Cessation, Xavier Giné, Dean Karlan, Jonathan Zinman

Dartmouth Scholarship

We designed and tested a voluntary commitment product to help smokers quit smoking. The product (CARES) offered smokers a savings account in which they deposit funds for six months, after which they take a urine test for nicotine and cotinine. If they pass, their money is returned; otherwise, their money is forfeited to charity. Of smokers offered CARES, 11 percent took up, and smokers randomly offered CARES were 3 percentage points more likely to pass the 6-month test than the control group. More importantly, this effect persisted in surprise tests at 12 months, indicating that CARES produced lasting smoking cessation. …

Smoking Cessation Outcomes Among Individuals With Co-Occurring Substance Use Disorder History And Mental Illness, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

BACKGROUND: A history of substance use disorder and/or mental illness is associated with tobacco use. However, there is limited information available on tobacco dependence treatment outcomes in such populations. OBJECTIVES: To examine the effects of a history of substance use disorder and/or mental illness on smoking cessation outcomes. METHODS: Data from 202 participants enrolled in a tobacco treatment program were analyzed. Information on sociodemographics, tobacco use and quit attempt history, social supports for quitting, Fagerstrom Test for Nicotine Dependence scores, importance and confidence in quitting smoking, expired carbon monoxide level, substance use history, mental health history, and previous pharmacotherapy use …

Young Women’S Responses To Smoking And Breast Cancer Risk Information, Joan L. Bottorff, Stephanie Barclay Mckeown, Joanne Carey, Rebecca Haines, Chizimuzo T.C. Okoli, Kenneth C. Johnson, Julie Easley, Roberta Ferrence, Lynne Baillie, Erin Ptolemy

Chizimuzo T.C. Okoli

Current evidence confirms that young women who smoke or who have regular long-term exposure to secondhand smoke (SHS) have an increased risk of developing premenopausal breast cancer. The aim of this research was to examine the responses of young women to health information about the links between active smoking and SHS exposure and breast cancer and obtain their advice about messaging approaches. Data were collected in focus groups with 46 women, divided in three age cohorts: 15–17, 18–19 and 20–24 and organized according to smoking status (smoking, non-smoking and mixed smoking status groups). The discussion questions were preceded by information …

Hyperpolarized (3)He Magnetic Resonance Imaging-Derived Pulmonary Pressure-Volume Curves, Stephen Choy, Andrew Wheatley, David G Mccormack, Grace Parraga

Medical Biophysics Publications

We aimed to evaluate the potential for the use of hyperpolarized helium-3 magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) surrogates of alveolar size, together with literature-based morphological parameters in a theoretical model of lung mechanics to simulate noninvasive transpulmonary pressure-volume curves. Fourteen ex-smokers with chronic obstructive pulmonary disease (COPD) (n = 8 stage II, n = 6 stage III/IV COPD) and five age-matched never-smokers, provided written, informed consent and were evaluated at baseline and 26 + or - 2 mo later (n = 15 subjects) using plethysmography, spirometry, and (3)He MRI at 3.0 T. Total lung capacity, residual volume, …

Treatment Practices And Outcomes Of Patients With Established Peripheral Arterial Disease Hospitalized With Acute Myocardial Infarction In A Community Setting, Frederick Spencer, Darleen Lessard, Chyke Doubeni, Jorge Yarzebski, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: There are little contemporary data available describing the hospital and long-term outcomes of patients with peripheral arterial disease (PAD) who are hospitalized with acute myocardial infarction (AMI). The objectives of our population-based study were to examine the hospital and long-term outcomes, as well as the use of different treatment practices, among patients with established PAD who were hospitalized with AMI. METHODS: The study sample consisted of 4480 patients hospitalized with AMI at all Worcester, Mass, medical centers in 4 alternate years between 1997 and 2003. RESULTS: Among the metropolitan Worcester residents hospitalized with AMI, 13.5% had a history of …

Smoking Cessation In Patients With Substance Use Disorders: The Vancouver Coastal Health Tobacco Dependence Clinic, Milan Khara, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Summary of Key Findings •Smoking abstinence at end of program:

–Intent to treat analysis: 32.2%(83/258) –Among program completers: 41.3%(83/201)

•Significant predictors of abstinence : –Having an alcohol, heroin (or other opioid) or marijuana use history was a significant predictor of being less likely to quit smoking when compared to having no history of substance use disorder. –Having a lower CO level at program enrolment was a significant predictor of being more likely to quit –Attending the TDC program for a longer duration was a significant predictor of being more likely to quit.

Chronic Obstructive Pulmonary Disease: Longitudinal Hyperpolarized (3)He Mr Imaging, Miranda Kirby, Lindsay Mathew, Andrew Wheatley, Giles E Santyr, David G Mccormack, Grace Parraga

Medical Biophysics Publications

PURPOSE: To quantitatively evaluate a small pilot group of ex-smokers with chronic obstructive pulmonary disease (COPD) and healthy volunteers during approximately 2 years by using hyperpolarized helium 3 ((3)He) magnetic resonance (MR) imaging.

MATERIALS AND METHODS: All subjects provided written informed consent to the study protocol, which was approved by the local research ethics board and Health Canada and was compliant with the Personal Information Protection and Electronic Documents Act and HIPAA. Hyperpolarized (3)He MR imaging, hydrogen 1 MR imaging, spirometry, and plethysmography were performed in 15 ex-smokers with COPD and five healthy volunteers (with the same mean age and …

A Current Examination Of Dietary Intakes Of Fiber, Calcium, Iron, And Zinc And Their Relationship To Blood Lead Levels In U.S. Children Aged 1-5 Years, Stephanie A. Melchert

Department of Nutrition and Health Sciences: Dissertations, Theses, and Student Research

A CURRENT EXAMINATION OF DIETARY INTAKES OF FIBER, CALCIUM, IRON, AND ZINC AND THEIR RELATIONSHIP TO BLOOD LEAD LEVELS IN U.S. CHILDREN AGED 1-5 YEARS Stephanie Ann Melchert, M.S. University of Nebraska, 2010 Adviser: Kaye Stanek Krogstrand The effect of lead on the health and well-being of those exposed has been well documented and many efforts have been made to reduce exposure of lead to the United States population. Despite these efforts, many studies have documented cognitive impairments and behavioral problems in children with even low levels of lead in their blood. Previous studies have suggested that a proper diet …

Human Papillomavirus And Survival Of Patients With Oropharyngeal Cancer., K Kian Ang, Jonathan Harris, Richard Wheeler, Randal Weber, David I Rosenthal, Phuc Felix Nguyen-Tân, William H Westra, Christine H Chung, Richard C Jordan, Charles Lu, Harold Kim, Rita S. Axelrod, Md, C Craig Silverman, Kevin P Redmond, Maura L Gillison

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Oropharyngeal squamous-cell carcinomas caused by human papillomavirus (HPV) are associated with favorable survival, but the independent prognostic significance of tumor HPV status remains unknown.

METHODS: We performed a retrospective analysis of the association between tumor HPV status and survival among patients with stage III or IV oropharyngeal squamous-cell carcinoma who were enrolled in a randomized trial comparing accelerated-fractionation radiotherapy (with acceleration by means of concomitant boost radiotherapy) with standard-fractionation radiotherapy, each combined with cisplatin therapy, in patients with squamous-cell carcinoma of the head and neck. Proportional-hazards models were used to compare the risk of death among patients with HPV-positive …

The Influence Of Cardiorespiratory Fitness On Lung Cancer Mortality, Xuemei Sui, Duck-Chul Lee, Charles E. Matthews, Swann Arp Adams, James R. Hébert, Timothy S. Church, Chong-Do Lee, Steven N. Blair

Faculty Publications

Purpose—Previous studies have suggested that higher levels of physical activity may lower lung cancer risk; however, few prospective studies have evaluated lung cancer mortality in relation to cardiorespiratory fitness (CRF), an objective marker of recent physical activity habits. Methods—Thirty-eight thousand men, aged 20 to 84 years without history of cancer, received a preventive medical examination at the Cooper Clinic in Dallas, TX, between 1974 and 2002. CRF was quantified as maximal treadmill exercise test duration and was grouped for analysis as low (lowest 20% of exercise duration), moderate (middle 40%), and high (upper 40%). Results—A total of 232 lung cancer …

Evaluating The Comprehensiveness Of Youth Access To Tobacco Legislation, Richard Clark

Graduate Research Symposium (GCUA) (2010 - 2017)

The deadly effects of smoking have been well documented since the 1960s. As laws and ordinances have been instituted at the state level, various measures have been developed in an attempt to measure both the comprehensiveness and effectiveness of such restrictions. This paper seeks to build on the rating systems already developed that currently look at individual laws by developing an overall rating scale of state level smoking restrictions and their effectiveness over time. Results of the overall rating scale will be shared along with recommendations for future research.

A Pda Intervention To Sustain Smoking Cessation In Clients With Socioeconomic Vulnerability, Lynne Buchanan, Deepak Khazanchi

Information Systems and Quantitative Analysis Faculty Publications

This article describes a pilot study to explore use of a personal digital assistant (PDA) to sustain smoking cessation after discharge in clients with socioeconomic vulnerability. The major aim is to describe technology acceptance (perceived ease of use, usefulness, and attitude), portability, technical difficulty, satisfaction, and use time. The sample includes 31 medical surgical clients with average age of 47.35 (±13.3), average household income of $13,629 (±8,204), average number in the household of 2.67 (±2.22), and average education of 11th grade. The results demonstrate mean use time of 9.28 (±3.23) hr, or about 1 hr over 8 weeks. Technology acceptance …

Analysis Of Primary Risk Factors For Oral Cancer From Us States With Increasing Rates, Anthony Bunnell, Nathan Pettit, Nicole Reddout, Kanika Sharma, Susan O'Malley, Michelle Chino, Karl Kingsley

Public Health Faculty Publications

Objectives

To examine the primary risk factor for oral cancer in the US, smoking and tobacco use, among the specific US states that experienced short-term increases in oral cancer incidence and mortality.

Methods

Population-based data on oral cancer morbidity and mortality in the US were obtained from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) database for analysis of recent trends. Data were also obtained from the Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) to measure current and former trends of tobacco usage. To comprehensive measures of previous state tobacco use …

Varenicline – A New Pharmacotherapy For Smoking Cessation In Primary Care Practice, Noorzurani Robson Associate Prof. Dr.

Associate Prof. Dr. Noorzurani Robson

Background: Cigarette smoking causes significant morbidity and mortality and is a major public health concern worldwide. Primary care doctors are in a unique position that enables them to promote smoking cessation, as smokers are more aware of their health at the time of their clinic visit. It is thus important to offer effective treatment to help smokers stop smoking. Methods: A search of PubMed was done up to 16 December 2009, using the keywords “varenicline” alone, “varenicline” and “family medicine”, and “varenicline” and “primary care”. The search produced 426 articles on varenicline. The articles that were chosen were case reports, …

Nicotine-Replacement Therapy: A Proven Treatment For Smoking Cessation: Cpd, Noorzurani Robson Associate Prof. Dr.

Associate Prof. Dr. Noorzurani Robson

Smoking is a major cause of cardiovascular diseases, respiratory diseases and cancer. Despite the high prevalence of smokers worldwide, smokers are often neglected and not offered effective assistance with quitting their habits. In order to overcome this public health burden, effective treatment is needed to help smokers stop smoking. Among the pharmacological treatments available, nicotine-replacement therapy (NRT), when prescribed in combination with behavioural support, has been proven to be effective in helping a wide range of smokers to quit. NRT helps smokers during the withdrawal process by replacing a proportion of the nicotine formerly obtained from cigarettes. NRT is available …

Carcinosarcoma Of The Esophagus, Ziaur Rehman, Inam Pal, Zubair Ahmad, Asim Qureshi

Section of General Surgery

Carcinosarcoma of the esophagus is a rare neoplasm characterized histologically by presence of carcinomatous and sarcomatous elements. Case report of carcinosarcoma of the esophagogastric junction whose morphological and immunohistochemical features makes it quite distinctive from other tumours is presented. It was an ulcerated lesion diagnosed in an elderly Afghan lady located 34 cms from the incisor teeth. The patient was a smoker.

The Use Of Social Marketing Messages In An Anti-Tobacco Context: An Investigation Of Irish Female Adolescents, Barry Griffin

Theses

The WHO (2008) report states that although tobacco deaths rarely make headlines, tobacco kills one person globally every six seconds. Tobacco kills a third to a half of all people who use it, on average 15 years prematurely. Today tobacco use causes 1 in 10 deaths among adults worldwide - more than 5 million people a year (Murray and Lopez, 2006). The Irish Office of Tobacco Control’s research has confirmed that initiation into smoking is largely a childhood phenomenon. More than 75% of all smokers in Ireland started to smoke before they reached the age of 18 (HBSC Ireland, 2006). …

Quit In General Practice: A Cluster Randomised Trial Of Enhanced In-Practice Support For Smoking Cessation, Nicholas Arnold Zwar, Robyn Richmond, Elizabeth Halcomb, John Furler, Julie Smith, Oshana Hermiz, Irene Blackberry, Ron Borland

Faculty of Science, Medicine and Health - Papers: part A

Background This study will test the uptake and effectiveness of a flexible package of smoking cessation support provided primarily by the practice nurse (PN) and tailored to meet the needs of a diversity of patients. Methods/Design This study is a cluster randomised trial, with practices allocated to one of three groups 1) Quit with Practice Nurse 2) Quitline referral 3) GP usual care. PNs from practices randomised to the intervention group will receive a training course in smoking cessation followed by access to mentoring. GPs from practices randomised to the Quitline referral group will receive information about the study and …

Public Health Clinical Demonstration Project For Smoking Cessation In Veterans With Posttraumatic Stress Disorder, Eric A. Dedert, Sarah M. Wilson, Patrick S. Calhoun, Scott D. Moore, Kim W. Hamlett-Berry, Jean C. Beckham

Public Health Resources

Veterans with post traumatic stress disorder are at high risk for smoking and experience difficulty with smoking cessation. We designed this clinical demonstration project to provide a low-cost, feasibly implemented smoking cessation intervention that would maximize the number of smokers who accessed the intervention. Five hundred eighty-four veteran smokers were contacted by invitational letters. Interested veterans received follow-up telephone calls using standardized scripts offering three intervention resources: 1) a referral to the National Cancer Institute's Smoking Quitline, 2) web-based counseling, and 3) local Veteran Affairs pharmacologic treatment for smoking cessation. Twenty-three percent of survey recipients participated in the clinical program. …

Effect Of Passive Smoking On The Development Of Chronic Obstructive Pulmonary Disease In Southeastern Turkey, Teki̇n Yildiz, Füsun Topçu, Yusuf Çeli̇k, Levent Akyildiz, Güngör Ateş, Di̇lek Durak

Turkish Journal of Medical Sciences

To determine the effect of passive smoking on the development of chronic obstructive pulmonary disease (COPD) among persons who spend a long time in cafes. Materials and methods: The study sample included 348 male smokers who were older than 40 years and spend a long time in cafes. The questions were derived from the European Coal and Steel Community (ECSC) questionnaire. We also inquired about the nature of cafe visits (hours/day, visits/week, visits/month). Results: COPD was found in 18.1% (63/348 subjects) of the smokers aged >=40 years. In these 63 subjects, based on spirometry results, the rate of mild and …

Correlation Between Increased Urinary Serotonin Levels And Coronary Artery Disease In Cigarette Smoking Patients, Necat Yilmaz, Yakup Mermerdaş, Esi̇n Eren, Ayşenur Yeği̇n, Emi̇ne Namiduru

Turkish Journal of Medical Sciences

Platelets secrete serotonin (5-hydroxytryptamine), which has several effects on the vascular wall and promotes thrombogenesis, mitogenesis, and the proliferation of smooth muscle cells. We therefore measured excreted levels of 5-hydroxytryptamine (5-HT) concentrations in urine as a means of assessing vascular lesions in patients with coronary artery disease ( CAD). Materials and methods: Subjects who underwent coronary angiography were classified into 2 groups according to their diagnosis. The CAD group consisted of 33 patients with coronary artery stenosis, whereas the healthy control group consisted of 30 subjects. An isocratic high-performance liquid chromatographic (HPLC) system with an electrochemical detector was used for …