Medicine and Health Sciences Commons^™

Demographic Associations Of Tobacco Use Among Georgia Secondary Students, Michael G. Cowart

Public Health Theses

As in years past, use of tobacco remains the leading cause of preventable death in this country. Smoking has been associated with elevated risks of 15 other forms of and has also been identified as a major cause of such chronic conditions as cardiovascular disease, cerebrovascular disease, bronchitis and emphysema. In 2008, an estimated 8.6 million Americans suffered from smoking-related chronic conditions (American Cancer Society, 2010).

As 80% of tobacco use begins in adolescence (Villanti, Boulay & Juon, 2010), this age group has long been the focus of intervention efforts. Furthermore, animal studies suggest that the adolescent brain is at …

College Student Reactions To Health Warning Labels: Sociodemographic And Psychosocial Factors Related To Perceived Effectiveness Of Different Approaches, Carla J. Berg, James F. Thrasher, J. Lee Westmaas, Taneisha Buchanan, Erika A. Pinsker, Jasjit S. Ahluwalia

Faculty Publications

Objective. To examine factors associated with perceiving different types of pictorial cigarette health warning labels as most effective in motivating smokers to quit or preventing smoking initiation among college students.

Method. We administered an online survey to 24,055 students attending six Southeast colleges in Fall, 2010. We obtained complete data for the current analysis from 2600.

Results. Current smoking prevalence was 23.5%. The largest majority (78.6%) consistently rated gruesome images as most effective, 19.5% rated testimonial images as most effective, and only a small proportion rated either standard (1.6%) or human suffering images (0.3%) as most effective. Subsequent analyses focused …

The Triumph And Tragedy Of Tobacco Control: A Tale Of Nine Nations, Eric A. Feldman, Ronald Bayer

All Faculty Scholarship

The use of law and policy to limit tobacco consumption illustrates one of the greatest triumphs of public health in the late twentieth and early twenty-first centuries, as well as one of its most fundamental failures. Overall decreases in tobacco consumption throughout the developed world represent millions of saved lives and unquantifiable suffering averted. Yet those benefits have not been equally distributed. The poor and the undereducated have enjoyed fewer of the gains. In this review, we build on existing tobacco control scholarship and expand it both conceptually and comparatively. Our focus is the social gradient of smoking both within …

Smoking And Breast Cancer: Girls’ And Boys’ Reactions To Tailored, Internet Delivered Messages, Joan L. Bottorff, Chris G. Richardson, Rebecca Haines-Saah, John Oliff, Peter Hutchinson, Pamela A. Ratner, Chizimuzo T.C. Okoli, Carolyn Gotay, Kenneth Johnson

Nursing Presentations

Background

• Active smoking and exposure to secondhand smoke (SHS) are causally linked to premenopausal breast cancer (BC).

• To date, there have been few efforts to raise awareness of active smoking and SHS as risk factors for BC.

Purpose

• To develop and evaluate messages for Aboriginal and non-Aboriginal adolescent girls and boys to raise awareness about tobacco exposure as a risk factor for BC.

Outcomes Of An Intensive Smoking Cessation Program For Individuals With Substance Use Disorders, Milan Khara, Lindsay Killam, Chizimuzo T.C. Okoli

Nursing Presentations

BACKGROUND: Individuals with substance use disorders (SUD) are disproportionately affected by tobacco use morbidity and mortality. Yet, with adequate intervention, such individuals can be successful in their smoking cessation efforts. The Tobacco Dependence Clinic (TDC) provides tobacco dependence treatment using combined behavioural counseling and pharmacotherapy for clients through the Mental Health and Addiction Services of the Vancouver Coastal Health Authority, British Columbia, Canada.

OBJECTIVES: To a) provide smoking cessation outcomes of participants accessing the TDC b) examine predictors of program completion and smoking cessation of participants of the TDC.

METHODS: Participants of the TDC receive a structured 8 week group …

Tobacco Use Dependence And Approaches To Treatment, Audrey Darville, Chizimuzo T.C. Okoli

Nursing Presentations

Counseling Demonstrates a Dose-Response Effect/Comes in Many Forms

• Brief advice during a “window of opportunity” can increase quit attempts by 40%

• Medication combined with counseling doubles the success rate

• Quitlines: proactive fax to quitline most effective

• Online (becomeanex.org, smokefree.gov, mylastdip.com)

• Cooper Clayton Classes at many local health departments; schedules and provision of medication varies

• I-Phone apps/text to quit

Tailoring NRT to the tobacco user

• Studies show efficacy in smokers and smokeless tobacco users (Ebbert, et al, 2010)

• Combining patch with shorter acting form of NRT has been shown to be safe and effective (Stead, et al, Cochrane Review, 2008; Kozlowski, …

Effects Of A Smoke-Free Law In Parks And Beaches On Smoking Behaviour: Methods To Determine Effectiveness, Chizimuzo T.C. Okoli, Andrew Johnson, Amanda Fallin, Ann Pederson, Anna Liwander

Nursing Presentations

As part of a comprehensive approach to tobacco control,smoke free laws have resulted in reductions of indoor air pollution, improvements in respiratory and cardiovascular health, reduction of smoking uptake by youth, and increasing tobacco use cessation in various jurisdictions. Although many studies have demonstrated the beneficial effects of smoke-free policies in indoor spaces (e.g., restaurants, bars, workplaces, hospital settings, etc.), little is known about the effectiveness of such policies in outdoor public spaces. On September 1st, 2010, Vancouver’s smoke-free by-law for the city’s parks, beaches, and facilities came into effect. The aims of this study are two-fold: a) to examine …

Smoking On The Margins? Assessing The Health Equity Effects Of A Smoke-Free Law In Parks And Beaches, Chizimuzo T.C. Okoli, Ann Pederson, Steve Chasey, Wendy Rice, Phoebe M. Long, Lorraine Greaves, Joan L. Bottorff, Nancy Poole, Natalie Hemsing

Nursing Presentations

Policies which aim to limit secondhand smoke (SHS) exposure by restricting spaces where people can smoke have been shown to improve population health and garner a high level of support from the public, health professionals and policy makers. Following local, national and international examples, Vancouver’s Board of Parks and Recreation approved a smoke-free by-law for the city’s parks, beaches, and facilities effective September 1, 2010. Research suggests that such smoke-free by-laws, when enacted indoors, may affect men and women in different ways, but little research has examined the effects of such outdoor smoking bans on women and men and other …

Outcomes Of A Tailored Tobacco Treatment Approach For Individuals With Substance Use Disorders And/Or Psychiatric Disorders, Chizimuzo T.C. Okoli, Milan Khara

Nursing Presentations

Summary of Key Findings

• Smoking abstinence at end of program:
• Intent to treat analysis: 31% (167/540)
• Among program completers: 41% (167/406)

• Significant predictors of abstinence:
• Having a history of an anxiety disorder is predictive of being less likely to quit smoking when compared to having no history of a psychiatric 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.

Combined Impact Of Lifestyle Factors On Cancer Mortality In Men, Chong-Do Lee, Xuemei Sui, Steven P. Hooker, James R. Hébert, Steven N. Blair

Faculty Publications

PURPOSE - The impact of lifestyle factors on cancer mortality in the U.S. population has not been thoroughly explored. We examined the combined effects of cardiorespiratory fitness, never smoking, and normal waist girth on total cancer mortality in men.

METHODS - We followed a total of 24,731 men ages 20-82 years who participated in the Aerobics Center Longitudinal Study. A low-risk profile was defined as never smoking, moderate or high fitness, and normal waist girth, and they were further categorized as having 0, 1, 2, or 3 combined low-risk factors.

RESULTS - During an average of 14.5 years of follow-up, …

Parental, Peer, And Tobacco Marketing Influences On Adolescent Smoking In South Africa, Reynolds A. Morrison

Public Health Theses

Tobacco use is a major preventable cause of morbidity and mortality worldwide. Most smokers initiate smoking in childhood, become addicted, and continue the habit into adulthood. Various factors have been shown to impact smoking behavior. It is important to determine how these factors impact smoking behavior in developing regions of the world, such as in South Africa. This study examines the association between parental smoking status; peer smoking status; exposure to pro-tobacco marketing; and current smoking status among adolescents in South Africa. It also determines which factor is the most significant predictor of current smoking status among the study population …

Smoking Cessation And Relapse Among Pregnant African-American Smokers In Washington, Dc, Ayman El-Mohandes, M. Nabil El-Khorazaty, Michele Kieley, Marie G. Gantz

Publications and Research

Smoking is the single most preventable cause of perinatal morbidity. This study examines smoking behaviors during pregnancy in a high risk population of African Americans. The study also examines risk factors associated with smoking behaviors and cessation in response to a cognitive behavioral therapy (CBT) intervention. This study is a secondary analysis of data from a randomized controlled trial addressing multiple risks during pregnancy. Five hundred African-American Washington, DC residents who reported smoking in the 6 months preceding pregnancy were randomized to a CBT intervention. Psycho-social and behavioral data were collected. Self-reported smoking and salivary cotinine levels were measured prenatally …

Smoking During Pregnancy: Its Effects On The Prevalence Of Low Birth Weight Infants, Lynda M. Colussi

Master of Public Health Program Student Publications

Objective: The purpose of this research was to determine what impact demographic characteristics and the smoking status of mothers had on the prevalence and risk for LBW births. Methods: Birth certificate data from Montgomery County, Ohio from 2006-2009 was analyzed. Among the information collected were the infant's birth weight, the mother's age, marital status, education level, race, payer status at time of delivery, WIC status, and smoking status. The impact demographic characteristics and smoking status had on the prevalence of LBW births was determined by a logistic regression model. The effect of when women smoked during pregnancy had on the …

The Relationship Between Secondhand Tobacco Smoke (Shs) Exposure And Smoking Behaviours: Designing A Program Of Research, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Overview

- Background and Significance

- Study 1: Literature Review Study

- Study 2: SHS Exposure, Nicotine Dependence, and Smoking Cessation

- Study 3: Hair Nicotine as a Measure of SHS Exposure

- Study 4: Effects of Nicotine Exposure from SHS Among Bar and Restaurant Workers

- Study 5: Nicotine Dependence Symptoms among Young Never-Smokers Exposed to SHS

- Study 6: An Examination of the Relationship between Adolescents’ Initial Smoking Experience and their Exposure to Peer and Family Member Smoking

Conclusions and Future Directions

Smoking And Secondhand Tobacco Smoke Exposure: Prevalence, Prevention, Protection, And Treatment, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Prevalence and Disease Burden of Smoking

Strategies for Prevention and Protection

Approaches to Tobacco Dependence Treatment

Example of a Smoking Cessation Program

Trauma, Psychiatric Disorders, Substance Use, And Smoking Among Women, Chizimuzo T.C. Okoli, Nancy Poole, Natalie Hemsing, Karin O'Leary

Chizimuzo T.C. Okoli

Despite decreasing smoking rates among women in the general population, there remain subgroups of women characterized by high nicotine dependence, who remain less able to quit.

One subgroup of women who continue to smoke at rates higher than the general population are those who: have past experiences of trauma, are vulnerable to psychiatric disorders and have substance use problems/addictions.

However, the prevalence of the co-occurrence of trauma, psychiatric disorders, and substance use problems/ addictions, with smoking among women has not previously been synthesized.

The purpose of this study is to conduct a comprehensive review to identify the prevalence of smoking …

Factors Associated With Tobacco Use Among Rural And Urban Pregnant Women, Whitney Jeanne Katirai

University of Kentucky Doctoral Dissertations

The purpose of this study was to investigate the influences of smoking on rural and urban pregnant women. More specifically, the variables of the knowledge of health effects, health provider recommendations, subscores from the Health Belief Model (HBM), and social support were explored in relation to the smoking behavior of pregnant women. A secondary purpose was to investigate the accuracy of self-reported smoking during pregnancy using biochemical validation. Pregnant women (N=71) completed an anonymous questionnaire, designed by the researcher, to identify variables that predicted smoking for urban and rural women. Participants also gave a saliva sample for cotinine testing.

Approximately …

Treatment Outcomes From The Tdc: A Look At Smoking Cessation Among Patients With Co-Occurring Substance Use And Psychiatric 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.

Analysis Of Smoking Patterns And Contexts Among College Student Smokers, Nikole J. Cronk, Kari J. Harris, Solomon W. Harrar, Kathrene Conway, Delwyn Catley, Glenn E. Good

Public and Community Health Sciences Faculty Publications

Many who smoke in college do so infrequently and smoking conditions are not well-understood. We examined smoking patterns among college fraternity and sorority members (N=207) from a Midwestern university in three successive fall semesters in 2006–2008. Participants completed calendar-assisted retrospective assessments of 30-day smoking at up to 5 assessment points over 96 days. Overall smoking rates declined over the course of each semester and higher smoking on weekends was observed, with more variability among daily smokers. The most frequent categories of events to cue recall of smoking were socializing, work, and school. Findings can be used to target prevention efforts.

Development And Evaluation Of A Personalized Normative Feedback Intervention For Hispanic Youth At High Risk Of Smoking, Holly Mata

Open Access Theses & Dissertations

Despite reductions in overall smoking rates, data show that adolescents continue to smoke at higher rates than adults and that adolescents living in the Texas-Mexico border area are more likely than their counterparts living elsewhere in Texas to smoke. While adult smoking in the Paso del Norte Region has decreased significantly over the past decade, area youth smoking rates exceed both state and national averages. Recent estimates report cigarette smoking among El Paso youth in the past month to be slightly more than 28% as compared with 21% among Texas youth participating in the 2009 statewide Youth Risk Behavior Survey …

Addicted Youth: The Understanding Of Smoking-Related Health Risks In Female College Students, Rebekah Agnes Ann Morris

All Graduate Theses, Dissertations, and Other Capstone Projects

Young adults are at the greatest risk for initiation of smoking or becoming daily smokers. Smoking has a unique history in the United States and is associated with health risks beyond heart disease and lung cancer, many specifically affecting women. Although the majority of people are aware of the risks for heart disease and lung cancer, many other risks are not recognized. By evaluating the known knowledge of smoking-related health risks beyond and including heart disease and lung cancer in the high risk population of female college students, education programs and cessation teaching can be altered, potentially resulting in lower …

Tobacco Companies Influence On Youth Smoking Prevalence In Spain (La Influencia De Las Tabaqueras En La Prevalencia De Tabaquismo Entre Los Jóvenes Españoles), Francisco Soto Mas

Francisco Soto Mas

Background: Tobacco companies’ strategies to promote tobacco use and undermine tobacco control policy are key in tobacco use among young people. The analysis of tobacco companies’ internal documents can be instrumental in identifying those strategies, improving social support for tobacco control policy, and planning public health interventions. The goal of this study was to identify and analyze internal documents related to the activities of tobacco companies during the 1980s and 90s aimed at promoting smoking in young Spaniards. Methods: Electronic search by key word of tobacco industry documents held at the Legacy Tobacco Documents Library. Results: More than 1,000 documents …