Nursing Commons^™

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 Among Persons With Co-Occurring Substance Use Disorder And Mental Illness, Chizimuzo T.C. Okoli, Milan Khara

Chizimuzo T.C. Okoli

Aims: A history of either a substance use disorder (SUD) or psychiatric disorder (PD) is associated with tobacco use. However, there is limited information available on tobacco dependence treatment outcomes among individuals with co-occurring SUD and PD. Methods: Data from 202 participants enrolled in a tobacco dependence treatment program in an outpatient clinic setting were analysed. Findings: In multivariate analysis, having a history of SUD only (OR =.11, 95% CI = .02–.76) and having a co-occurring SUD and PD (OR = .13, 95% CI = .02–.81), as compared to having neither, were significant predictors of a lower likelihood of achieving …

Men's Smoking Cessation Interventions: A Brief Review, Chizimuzo T.C. Okoli, Iris Torchalla, John L. Oliffe, Joan L. Bottorff

Chizimuzo T.C. Okoli

Background: Smoking is associated with adverse health effects and significant disease burden among men, making it an important men's health issue. Conversely, smoking cessation is associated with significant reductions in smoking-attributable risk. However, few studies have examined men-specific smoking cessation programs. The aim of our study was to conduct a comprehensive review of the literature to identify men-specific smoking cessation programs to make recommendations about future efforts to develop, implement and evaluate men-centered smoking cessation interventions.

Methods: A comprehensive search of the COCHRANE Library, MEDLINE, and PsycINFO and SIGLE databases was performed. Out of 873 studies that we retrieved from …

Challenges And Strategies In Developing Transdisciplinary Research Capacity, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

Definitions of Intradisciplinary, Multidisciplinary, Interdisciplinary, and Transdisciplinary

Challenges in developing Transdisciplinary Capacity

Models of Transdisciplinary Research

Case Example of Transdisciplinary Research Team: The iTAG Team

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 …

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.

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.

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 …

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 …

Intensive Treatment Of Tobacco Dependence In An Out - Patient Addictions Services Setting, Milan Khara, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

BACKGROUND

• Drug treatment populations are disproportionately affected by morbidity and mortality attributable to tobacco use. However, with appropriately intensive intervention, individuals in drug treatment settings can succeed in their efforts towards smoking cessation.

• The Tobacco Dependence Clinic (TDC) is a program that provides smoking cessation counseling and up to 26 weeks of free pharmacotherapy for clients through Vancouver Coastal Health Addiction Services, British Columbia, Canada.

• The purpose of this study is to provide evaluation data (in terms of program completion and smoking cessation outcomes) from the TDC.

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 …

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.

Intensive Tobacco Dependence Treatment For Clients With Substance Use Disorder And/Or Mental Illness, Milan Khara, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

BACKGROUND •Drug treatment populations are disproportionately affected by morbidity and mortality due to tobacco use. However, with appropriately intensive intervention, individuals in drug treatment settings can succeed in their efforts towards smoking cessation. •The Tobacco Dependence Clinic (TDC) is a program that provides smoking cessation counseling and up to 26 weeks of free pharmacotherapy for clients through Vancouver Coastal Health Addiction Services , British Columbia, Canada. There are currently three clinic sites: Pacific Spirit, Three Bridges, and Downtown Community Health Centre (DCHC). •The purpose of this study is to provide 2-year pilot evaluation data (in terms of program completion and …

Are There Differences In The Smoking Identities Of Adolescents Boys And Girls?, Chizimuzo T.C. Okoli, Iris Torchalla, Pamela A. Ratner, Joy L. Johnson

Chizimuzo T.C. Okoli

Purpose:

To assess sex-disaggregated differences in youth characterizations of their own smoking behaviour

Background:

•Smoking identities represent psychosocial constructions of how adolescents who smoke perceive themselves in relation to their smoking behaviour (e.g, ex-smoker, social smoker, occasional smoker, e.t.c.)

•These smoking identities converge (or diverge) with established taxonomies used to describe youth smoking behaviour

•Few quantitative studies have examined differences in smoking identity between boys and girls

Is Exposure To Peer And Family Smoking Associated With Youths' Initial Smoking Experiences?, Chizimuzo T.C. Okoli, Chris G. Richardson, Joy L. Johnson

Chizimuzo T.C. Okoli

Background:

- Peers and family member’s smoking is associated with adolescent smoking.

- Sensitivity to the initial smoking experience, determined by positive (for e.g., feeling relaxed, high, and good) and/or negative (for e.g., feeling nervous, sick, coughing) symptoms upon initial smoking experimentation, is also associated with youth smoking.

- However, the effect of peer and family member’s smoking on the initial smoking experiences of adolescents has not been previously studied.

- We present the findings of a cross-sectional analysis assessing the association between exposure to smoking from peers and family members on the symptoms of the initial smoking experience of …

Assessing Secondhand Tobacco Smoke Exposure Among Persons With Severe And Persistent Mental Illness, Chizimuzo T.C. Okoli, Joy L. Johnson, Leslie Malchy

Chizimuzo T.C. Okoli

Background

• Secondhand tobacco smoke (SHS) exposure increases the risk for cancer, respiratory illness, and cardiovascular disease.

• Individuals with severe and persistent mental illness (SPMI) have a higher smoking prevalence than the general population, placing them at increased risk for related morbidity and mortality.

• Given the higher smoking prevalence in this population, the risk for SHS exposure among smokers and nonsmokers with SPMI should be an issue of concern. Yet, SHS exposure in this population is understudied.

• The purpose of our study was to examine the correlates of SHS exposure in this population. Our specific aims were …

The Tobacco Dependence Clinic (Tdc): Providing Smoking Cessation For A Drug Treatment Population, Milan Khara, Chizimuzo T.C. Okoli, Deanna Barlow, Catherine Hanley

Chizimuzo T.C. Okoli

BACKGROUND: Drug treatment populations are disproportionately affected by tobacco use morbidity and mortality. However, with adequate intervention, individuals in drug treatment settings can succeed in their efforts towards smoking cessation. The Tobacco Dependence Clinic (TDC) is a program that provides smoking cessation counseling and pharmacotherapy for clients through the Addiction Services program of the Vancouver Coastal Health Authority, British Columbia, Canada. OBJECTIVES: To a) describe smoking cessation services and programs provided by the TDC, and b) evaluate 26 week smoking cessation outcomes of drug treatment clients in the TDC. METHODS: Participants of the TDC program receive a structured 8 week …

Smoking Cessation And Drug Treatment: Identifying Gaps, Milan Khara, Chizimuzo T.C. Okoli, Ric M. Procyshyn, Joy Johnson, Alasdair Barr, Lorraine Greaves

Chizimuzo T.C. Okoli

BACKGROUND: An estimated 70% - 90% of individuals in drug treatment con-currently smoke cigarettes. Although individuals in drug treatment settings are motivated and can succeed in smoking cessation, there is still a lack of systematic knowledge regarding the long-term abstinence, methods employed for successful cessation, and the barriers to smoking cessation in this population.

OBJECTIVES: To: a) describe types of smoking cessation interventions (i.e., cognitive-behavioral and/or pharmacotherapy) employed in drug treatment settings, b) determine the effectiveness of such interventions, and c) identify gaps in knowledge regarding smoking cessation interventions among the drug treatment populations

METHODS: A comprehensive review of the …

Action Required: Revisiting Better Practices In Smoking Cessation Interventions For Pregnant Girls And Women, Chizimuzo T.C. Okoli, Lorraine Greaves, Joan Bottorff, Lenora Marcellus, Charmaine Enns, Richard Stanwick

Chizimuzo T.C. Okoli

Background

Despite considerable medical and research attention, smoking in pregnancy remains a serious public health problem, especially among young and disadvantaged women in high income countries and general populations of women in low and middle income countries. Facilitating successful and enduring smoking cessation during pregnancy and preventing relapse is therefore an ongoing public health challenge globally

Objectives

This Canadian project is aimed at better breaking the cycle of smoking during pregnancy, or quitting and relapsing during postpartum; especially for young, disadvantaged women. Equally, it will address the apparent blockages to effective uptake by health professionals, of research evidence and better …

Are Adolescents Smoking Identities Valid Descriptors Of Their Smoking Behaviour?, Chizimuzo T.C. Okoli, Chris G. Richardson, Pamela A. Ratner, Joy L. Johnson

Chizimuzo T.C. Okoli

Background: Studies have raised concerns regarding mismatches between researchers’ and adolescents’ characterizations of youth smoking behaviour; which may impede tobacco use prevention and cessation programs to reach their intended youth audience. Understanding how youth’s characterize their own smoking behaviour is an important factor for designing tailored interventions.

Objective: To address observations that youths’ smoking identities are valid descriptors of their smoking behaviour we examined the relationships between youths’ self-reported smoking identities, their perceived levels of addiction, and established taxonomies of smoking behaviour.

Methods: Cross-sectional data were collected on demographics, perceived extent of addiction to tobacco, smoking history, and self-reported smoking …

Are Adolescents Smoking Identities Valid Descriptors Of Their Smoking Behaviour? (2008), Chizimuzo T.C. Okoli, Chris G. Richardson, Pamela A. Ratner, Joy L. Johnson

Chizimuzo T.C. Okoli

Background

•Smoking identities represent psychosocial constructions of how adolescents who smoke perceive themselves in relation to their smoking behaviour

•These smoking identities converge (or diverge) with established taxonomies used to describe youth smoking behaviour

•The purpose of this study is to examine the validity of adolescents’ ‘smoking identities’ by comparing them to established smoking behaviour categorizations and perceived addiction to tobacco

Action Required: Revisiting Better Practices In Smoking Cessation Interventions For Pregnant Girls And Women (2008), Chizimuzo T.C. Okoli, Lorraine Greaves, Joan Bottorff, Lenora Marcellus, Charmaine Enns, Richard Stanwick

Chizimuzo T.C. Okoli

Background

•Despite considerable efforts by health care professionals, and an overall reduction in smoking prevalence, it is estimated that approximately 20% to 30% of pregnant women still smoke during pregnancy

•To date, smoking cessation interventions to reduce smoking during pregnancy and postpartum have been relatively unsuccessful. Despite the influx of research examining smoking and pregnancy over the last five years, the prevalence of smoking among pregnant and postpartum women has only slightly decreased

•Advice to quit smoking by health care providers, is associated with increased smoking cessation attempts in the general population. Also, studies have shown that smoking cessation interventions …

Smoking During Pregnancy More Common Among Girls And Young Women Under 35, Chizimuzo T.C. Okoli

Chizimuzo T.C. Okoli

No abstract provided.

Effects Of Smoke-Free Laws On Indoor Air Pollution, Chizimuzo T.C. Okoli, Ellen J. Hahn, Kiyoung Lee

Chizimuzo T.C. Okoli

Purpose:

To assess the impact of smoke-free laws on indoor air quality by monitoring particulate matter smaller than 2.5μm (PM 2.5) under both smoking and nonsmoking conditions in Kentucky, USA

Background:

• In April 2004, Lexington, Kentucky implemented the first comprehensive smoke-free ordinance in the state

• Tobacco smoke substantially contributes to indoor particle concentration in hospitality venues and can be greatly reduced by smoke-free laws.

Methods:

• Descriptive, prospective study of hospitality venues in Lexington (n = 10) and Louisville (n = 10)

• Pre-law in Lexington: Friday and Saturday, September 2003, 7:30 PM-12:30 AM

• Post-law and in …

Behavioural Effects Of Nicotine Exposure From Secondhand Smoke Among Bar And Restaurant Workers, Chizimuzo T.C. Okoli, Ellen J. Hahn, Mary Kay Rayens

Chizimuzo T.C. Okoli

Introduction

• Besides the adverse physical health effects of secondhand tobacco smoke (SHS) exposure, not much is known about its behavioural outcomes.

• SHS exposure is a source of involuntary nicotine exposure with potential behavioural consequences in smokers and nonsmokers alike.

• Hospitality workers are a population at high risk for health problems related to occupational SHS exposure.

• This study explores self-reported behavioural symptoms commonly associated with nicotine withdrawal among smoking and nonsmoking bar and restaurant workers exposed to SHS.

Methods • This is a cross-sectional analysis of existing data obtained from a larger study examining the effect of …