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 …

Can Antioxidant-Rich Berries Improve Risk Factors Associated With Cardiovascular Disease In Postmenopausal Smokers?, Jordan Alaine Teeple

Graduate Theses and Dissertations

The purpose of this study was to examine the effects of smoking on risk factors associated with cardiovascular disease (CVD) and determine the efficacy of antioxidant-rich berries in ameliorating these risk factors in postmenopausal smokers. Menopause and cigarette smoking have been identified as major risk factors for CVD due to a decrease in antioxidant protection, increase in inflammation and oxidative stress, and adverse changes in serum lipids. Antioxidants, specifically flavonoid compounds found in blackberries and blueberries, have been shown to prevent low-density lipoprotein cholesterol oxidation and thus prevent downstream inflammation and oxidative stress. Healthy, postmenopausal nonsmokers (n=14) and smokers (n=31) …

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 …

Alcohol Dependence, Smoking Status, Reproductive Characteristics, And Bone Mineral Density In Premenopausal Women, M. Clark, M. Sowers

M. Kathleen Clark

OBJECTIVE: The overall purpose of this study was to compare bone mineral density of the lumbar spine and femoral neck between premenopausal women who were alcohol dependent and those who were not, considering potential confounding effects of cigarette smoking and selective reproductive characteristics which may influence bone mineral density. DESIGN: Matched case-control. SETTING: Eastern Iowa community-based center for the treatment of chemical dependencies. POPULATION: Case subjects consisted of 25 Caucasian women, aged 20 to 40 years, who were recruited from women undergoing voluntary inpatient treatment for alcohol dependence. Control subjects were selected from women who participated in the 1992 follow-up …

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, …

Lung Cancer Epidemiology – A Global View, Patricia Tai, Edward Yu, Rashmi Koul, Arbind Dubey

Edward Yu

Smoking, air pollution and radon exposure are causally related to lung cancer. This review analyzes trends of smoking habits by age, sex and ethnicity and their correlation with incidence and mortality of lung cancer. Unfortunately the use of tobacco by adolescents is on the rise. Most developed countries are still showing the rising trend of mortality in female smokers. In Asia, cigarette smoking has become a major health risk with one in three of all cigarettes in the world today are smoked in China. Estimated one hundred million young ( < 29 years old) Chinese smokers will eventually die from lung …

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 …

The Electrochemical Detection Of Interleukin-8, Cancer Biomarker, Based On A Gold Nanoparticle Platform And Its Political Implications, Jaimee Doucette

Pell Scholars and Senior Theses

Herein we report on an ultrasensitive immunosensor based on glutathione protected gold nanoparticle (GSH-AuNP) for the electrochemical detection of interleukin 8 (IL-8), cancer biomarker in calf serum and proof of concept IL-8 detection in HNSCC cells. GSH-AuNP were bioconjugated to the primary antibodies (Ab1) and used to capture human IL-8 in a sandwich electrochemical immunoassay coupled to horseradish peroxidase enzyme labels. Using the optimized concentrations of the primary (Ab1) and secondary antibodies (Ab2), two sensor approaches were used to measure ultra low (≤ 500 fg mL-1) and elevated levels of IL-8. Biotinylated Ab2 bound to streptavidin HRP with 14-16 labels …

Gender Differences In Smoking Behaviour And Cessation, Chizimuzo T.C. Okoli, Iris Torchalla, Natalie Hemsing, Lorraine Greaves

Chizimuzo T.C. Okoli

This article reviews the literature to compare differential outcomes among men and women after smoking cessation, assess barriers they may face during cessation and provide recommendation to address gender-specific challenges in smoking cessation interventions. There is some evidence that women achieve lower abstinence rates than men after a quit attempt with nicotine replacement therapy, as well as without pharmacotherapy, and several underlying mechanisms were discussed to account for these findings. These include: (a) women have specific genetic variants that affect pharmacokinetics and pharmacodynamics of the medication, (b) hormonal influences increase nicotine metabolism and withdrawal symptoms, (c) women are more responsive …

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 …

Social Marketing, Stages Of Change, And Public Health Smoking Interventions, Paula Diehr

Paula Diehr

As a "thought experiment," the authors used a modified stages of change model for smoking to define homogeneous segments within various hypothetical populations. The authors then estimated the population effect of public health interventions that targeted the different segments. Under most assumptions, interventions that emphasized primary and secondary prevention, by targeting the Never Smoker, Maintenance, or Action segments, resulted in the highest nonsmoking life expectancy. This result is consistent with both social marketing and public health principles. Although the best thing for an individual smoker is to stop smoking, the greatest public health benefit is achieved by interventions that target …

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 …

Causes Of Smoking In Pakistan: An Analysis Of Social Factors, Sobia Nizami, Zain A Sobani, Emmon Raza, Noor-Ul-Ain Baloch, Javaid Khan

Section of Pulmonary & Critical Care

OBJECTIVE: To determine the factors contributing to the initiation and propagation of smoking in visitors to a major tertiary health center in Karachi, Pakistan.

METHODS: Seven major contributing factors to the initiation and propagation of smoking were presented to consenting study participants (n=170) in a questionnaire. Participants were then requested to use their experience and opinion to rate each of the given factors on a scale of 1 to 5 regarding its importance as a causative factor in the initiation and propagation of smoking. Results were analyzed using SPSSv16.0.

RESULTS: Preliminary analysis revealed occupational stress relief as the most important …

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 …

Carbon Monoxide And Nitric Oxide Induced-Heme-Based Modification Of Alpha-2-Antiplasmin And Plasmin Activity, Matthew R. Arkebauer

PCOM Biomedical Studies Student Scholarship

Objectives: Carbon monoxide (CO) derived from cigarette smoke or released from carbon monoxide releasing-molecule 2 (CORM-2), diminishes fibrinolysis. The primary purpose of this study was to determine if CO diminished fibrinolysis by means of enhancing α2-antiplasmin via an alleged heme group. Methods: Plasma, isolated α2-antiplasmin and isolated plasmin were exposed to CO released from CORM-2 (tricarbonyldichlororuthenium (II) dimer) and nitric oxide (NO) via a NO donor to induce carboxyheme and metheme states. Exposed, isolated enzymes were placed in either α2-antiplasmin deficient or normal plasma. Effects of CO and NO on tissue-type plasminogen activator initiated fibrinolysis were determined by thrombelastography. Liquid …

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.

Feasibility And Effectiveness Of Nurse-Delivered Smoking Cessationcounselling Combined With Nicotine Replacement In Australiangeneral Practicedar_2, Nicholas Zwar, Robyn Richmond, Gail Forlonge, Iqbal Hasan

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

Introduction and Aims. Practice nurses (PN) are an alternative workforce for cessation support in primary care, but their role and effectiveness is underdeveloped and underresearched. This study evaluated a model of smoking cessation intervention in Australian general practice based on PNs. Smokers were identified by their general practitioner (GP) and referred to the PN for cessation support over four counselling visits and offered free nicotine patches. Design and Methods. Pre- and post-study using mixed quantitative and qualitative methods. Cessation outcomes were collected by patient self-report at 6months. Semistructured interviews were conducted with PNs and GPs to provide qualitative data on …

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 …

Work Intensity And Substance Use Among Adolescents Employed Part-Time In Entry-Level Jobs, Jessica Samuolis

Psychology Faculty Publications

This study investigated the relationship between number of hours worked, or work intensity, and substance use in a sample of adolescent employees of a supermarket chain. Employees working half-time or more per week (high-intensity hours) were over three times as likely to smoke compared to those working an average of 10 hours or less per week (low-intensity hours). Males working a high intensity number of hours were more than twice as likely to drink compared to males working at low intensity. Utilizing participants drawn from a uniform employment setting, the research findings add to the growing body of evidence linking …