Smoking control in a hospital setting

Unobtrusive observations of smoking behavior at four hospital areas designated as no-smoking and two designated as smoking revealed almost total compliance to a revised and stringent smoking control policy. The smoking control policy was a radical departure from the traditional, liberal practices. Of particular importance was the relative absence of complaints from patients and employees following the initiation of the smoking control program. The implications of practical, cost-effective smoking control procedures existing for hospitals are discussed in reference to their liability to protect patients from controllable hazards.     

吸烟与种植体周围炎的相关性研究

目的探讨吸烟与种植体周围炎的相关性。方法选取35例吸烟患者口内78个种植牙作为实验组和43例不吸烟患者76个种植牙作为对照组,二期修复3年后进行种植体周健康检查,计算两组种植体存留率(retained rate,RR),及探诊后出血指数(modified SulcusBleeding Index,mSBI),探诊深度(probing depth,PD),种植体边缘骨吸收量(marginal bone loss,MBL),并进行比较。结果吸烟组与不吸烟组比较种植体存留率均为100%无差别;两组探诊后出血指数、探诊深度、边缘骨吸收量差异比较均无统计学差异(P>0.05)。结论吸烟与种植体周围炎的发生没有相关性     

The Effect of Differently Worded No-Smoking Signs on Smoking Behavior

The effect of positively versus negatively worded no-smoking signs was investigated in an attempt to determine the effectiveness of controlling smoking in a hospital setting. Unobtrusive measurements of smoking behavior were taken in the main lobby before and after the placement of positively and negatively worded no-smoking signs. The results clearly showed that there was less smoking under the experimental sign condition. Positively worded signs appeared to produce better compliance than negatively worded signs.     

Compliance behavior in a hospital setting: Employee and patients' reactions to no-smoking signs

Compliance behavior to no-smoking signs by hospital patients and employees was measured. Results showed initial compliance followed by a gradual return to pre-treatment smoking rate. The employees returned to baseline earlier than patients. The results seem to suggest that no-smoking signs by themselves (without enforcement of smoking policy) are not sufficient to produce compliance.     

Effects of post-learning smoking on memory consolidation

The effects of immediate post-learning smoking of low and medium nicotine delivery cigarettes were compared to those of smoking a denicotinised cigarette and a no-smoking control condition in a paired-associate learning task. Thirty-nine male smokers were tested for retention of the memorised material at 1 week post-learning. All subjects received all conditions in a repeated measures design. The low nicotine condition was associated with significantly fewer errors on first trial of recall and fewer total errors to criterion. There were no differences in performance reported between the no-smoking and zero nicotine conditions. The medium nicotine condition produced results part way between the no-smoking and low nicotine conditions. Results are discussed in terms of the effects of nicotine on long-term consolidation mechanisms.     

Smoking Reduces Conflict-Related Anterior Cingulate Activity in Abstinent Cigarette Smokers Performing a Stroop Task

Prior research suggests that abrupt initiation of abstinence from cigarette smoking reduces neural cognitive efficiency. When cognitive efficiency is high, processing speed and accuracy are maximized with minimal allocation of cognitive resources. The study presented here tested the effects of resumption of smoking on cognitive response conflict after overnight abstinence from smoking, hypothesizing that smoking would enhance cognitive efficiency. Twenty paid research volunteers who were chronic cigarette smokers abstained from smoking overnight (>12 h) before undergoing fMRI while performing a color-word Stroop task during two separate test sessions: one that did not include smoking before testing and another one that did. Statistical analyses were performed by modeling the Stroop effect (incongruent >congruent) BOLD response within a collection of a priori regions of interest that have consistently been associated with cognitive control. Behavioral assessment alone did not reveal any significant differences in the Stroop effect between the two sessions. BOLD activations, however, indicated that in the right anterior cingulate cortex (ACC), smokers had significantly less task-related activity following smoking (p<0.02). In contrast, the right middle frontal gyrus exhibited significantly greater activity after smoking as compared to the no-smoking session (p<0.003). Exaggerated neural activity in the ACC during nicotine withdrawal may reflect a compensatory mechanism by which cognitive control networks expend excessive energy to support selective attention processes. Resumption of smoking may enhance cognitive control in smokers, involving a reduction in ACC response conflict activity together with improvement in conflict resolution involving the dorsolateral prefrontal cortex.     

Attitudes toward Smoking and Smoking Rate: Implications for Smoking Discouragement

Attitudes toward smoking were measured among nonsmokers and five levels of smokers (light to heavy). Of 13 attitude items, a relationship between attitudes and number of cigarettes smoked was found to exist in five, three of which dealt with smoking as a health risk. The results suggest that the more cigarettes a person smokes, the greater the likelihood of denial of the health hazards associated with smoking.     

吸烟与2型糖尿病足早期危险性的相关分析

目的探讨吸烟与2型糖尿病病足早期危险性的关系。方法将104例2型糖尿病患者(T_2DM)根据有否吸烟分为吸烟组(45例)和非吸烟组(59例),检测空腹血糖(FBG)、餐后2h血糖(PBG2h)、糖化血红蛋白(HbA_1c)、血胆固醇(TC)、甘油三脂(TG)、高密度和低密度脂蛋白胆固醇(HDL-C、LDL-C)、肾功能(BUN、Cr)、C反应蛋白(CRP)、踝动脉-肱动脉血压比值(ABI)等指标,进行组问对比分析。结果吸烟组与非吸烟组比较,CRP增高[(8．45±13．15)vs(3．56±4．58),P＜0．01],HDL-C降低[(1．04±0．26)vs (1．22±0．45),P＜0．05]；吸烟组糖尿病病足早期发生率显著高于非吸烟组(P＜0．05)。结论吸烟是糖尿病病足早期重要的独立危险因素。     

Effects of nicotine on perceptual speed

Two experiments investigating the effects of nicotine on performance in the inspection time (IT) procedure are reported. Experiment 1 compared ITs in smoking (0.8 mg nicotine cigarette), sham-smoking, and no-smoking conditions. IT was significantly shorter in the smoking condition as compared to both the no-smoking or sham-smoking conditions, suggesting that nicotine enhances early information processing. This result is of particular interest because of the correlation between IT and IQ reported in previous experiments. The nicotine related decrease in IT raises the possibility that nicotine enhances at least a subset of the physiological processes underlying intellectual performance. Experiment 2 examined the persistence of this nicotine related enhancement in IT, and investigated the effects of nicotine across 480 IT trials. Results suggested that ITs derived from the last third of the 480 trials were significantly shorter in the 0.8 mg cigarette condition than in no-smoking condition. The results from these two experiments, taken together with recent work examining the effects of nicotine on the string length measure of AEP waveform complexity and Hick decision time (DT), and studies investigating cognitive functioning and cholinergic system dysfunction in dementia, suggest a role of the cholinergic system in intellectual performance.     

Smoking Attributions and Adolescents' Intention to try to Quit Smoking

The present study investigated the applicability among adolescents of self-attributions about smoking previously identified among adults. Further, the interplay between motivational and ability related factors in predicting adolescents' intention to try to quit smoking was investigated. Data were collected by questionnaire and included 290 smokers. The measures included self-attributions about smoking, perceived addiction, perceived health threat of smoking, previous quit attempts, confidence in the ability to quit and intention to try to quit smoking. A three dimensional structure of the self-attributional items was extracted; external attributions, using smoking as a coping mechanism, and health concern. In a multiple regression analysis, 34% of the variance in intention to quit smoking was explained. The effect from previous quit attempts, perceived addiction, and using smoking as a coping mechanism was mediated through the other cognitive variables. Concern about health consequences had strongest effect on intention to quit, indicating the relevance of focusing on health information also among adolescents.     

A Low-Cost Environmental Intervention for Reducing Smoking among Cardiac Inpatients

Abstinence rates for smokers following a myocardial infarction or coronary artery bypass graft surgery may not be superior to those for non-patient groups, and thus there is a need for novel approaches to smoking cessation in this population. The present study evaluated the effectiveness of using two sets of educational posters to reduce smoking among veterans in an inpatient cardiology unit's designated smoking area. One set of posters outlined the benefits of cessation (positive message) for cardiac patients while the other highlighted the risks of continued smoking (negative message). The positive posters had no consistent effect on indices of smoking, but the negative posters produced a substantial decline in both number of observed smokers and daily cigarette butts.     

Quitting Smoking

Four factors which influence smoking treatment outcome are identified: environmental variables, client characteristics, process variables, and specific treatment approaches. Important environmental factors are stress and social support. Of client characteristics, sex is the best predictor of treatment success. Men are more likely to quit and maintain abstinence than women. However, the majority of women alter their smoking habits during pregnancy. Low-income persons and ethnic minorities are underrepresented among subjects in treatment studies and have larger percentages of smokers in the population at large. Extraverted smokers are more likely to begin to smoke and have difficulty quitting. Also, the more anxious, poorly adjusted smoker has more trouble quitting than the less troubled smoker. The higher the client's sense of self-efficacy, the better the chance of that person entering treatment and doing well. Furthermore, smokers who take in lower levels of nicotine are more successful at quitting. Many process questions are suggested. Few have been approached empirically. The effectiveness of ex-smokers as therapists in smoking cessation programs has not been systematically investigated, even though the smoking history of therapists is a question frequently asked by clients. We suggest that the skill and empathy of group leaders is more important than smoking history. Smoking therapists should be aware of nonspecific treatment factors such as positive expectations, social reinforcement, and self-disclosure which may have a powerful influence on the efficacy of smoking treatment. Specific treatment approaches were classified into three categories: low-contact approaches, including educational, self-help, and minimal treatment approaches; psychological treatments; and pharmacological treatment. Education, self-help, and minimal treatment approaches are thought to be accretively effective when the large size of the audience is considered. Also, innovative treatments which address the influence of social support systems and physiological addiction are promising treatments for individuals requiring a structured or intensive method of quitting.     

戒烟健康教育辅以行为疗法对脑卒中患者戒烟行为的影响

目的了解戒烟健康教育辅以行为疗法对脑卒中患者戒烟行为的影响。方法对100例脑卒中患者(观察组)进行戒烟健康教育,辅以使用行为疗法,并与100例仅作一般性戒烟劝告的患者(对照组)的戒烟率作比较分析。分别在1年和3年后追踪观察组近期戒烟者的复吸率,并与对照组戒烟者复吸率作比较分析。结果观察组近期戒烟成功率为94例(94%),而对照组近期戒烟成功率21例(21%),两组比较有非常显著性差异(P<0.01),1年后追踪观察组近期戒烟者94例,复吸3例(3.3%),对照组21例,复吸4例(19.0%),两组比较有非常显著性差异(P<0.01),3年后追踪观察组83例,复吸5例(6%),对照组18例,复吸6例(33.3%),两组比较有非常显著性差异(P<0.01)。结论戒烟健康教育辅以行为疗法对脑卒中患者戒烟行为效果显著,复吸率低。     

Smoking cessation in pregnancy: a self-help approach

During a 3-month recruitment period, a smoking cessation program was provided to all pregnant women who attended an HMO prenatal clinic and reported either that they were currently smokers (n = 35) or that they had quit at pregnancy onset (n = 23). Except for its in-clinic introduction, the behavioral smoking cessation program used a home-correspondence format with seven weekly mailings and a telephone answering system adjunct. At follow-up, all 23 women who identified themselves at baseline as self-initiated quitters reported continued abstinence from smoking. Urine thiocyanate assays confirmed these self-report data in 82% of the cases. Results of a multivariate analysis identified three factors--gravida, number of years a smoker, and number of friends who smoke--as significant predictors of self-initiated quitting. Of the 35 women who indicated that they were still smoking at baseline, 10 (28.5%) reported that they had stopped smoking at the time of the postprogram assessment. Available urine thiocyanate assays confirmed a nonsmoking status in all cases. The multivariate results indicated that four variables--gravida, severe nausea, baseline smoking rate, and spouse's smoking status--were significant predictors of quitting following exposure to the program. The majority of both self-initiated quitters and postprogram quitters reported that the program was useful in helping them to quit smoking and/or to remain abstinent over time. These results lend support to the viability of a home-correspondence, self-help program as a means for facilitating smoking cessation and continued abstinence from smoking during pregnancy.     

Smoking and suicide: a brief overview

This article provides a brief overview of the rationales, possible mechanisms and epidemiological data on the association of smoking, smoking cessation and cessation medications with suicide. Current smoking is reliably associated with suicide both in case-control and cohort studies. The three most plausible (but relatively untested) explanations for the association are that smokers have pre-existing conditions that increase their risk for suicide, smoking causes painful and debilitating conditions that might lead to suicide, and smoking decreases serotonin and monoamine oxidase levels. Stopping smoking appears to lead to major depression in some smokers; thus, it could induce suicide; however, smoking cessation has not been associated with suicide in the few studies available. Regulatory agencies have stated bupropion, rimonabant and varenicline appear to be associated with suicide; however, the data for these statements have not been presented in sufficient detail to assess their validity. Most prior data have come from post hoc analyses. Studies that a priori focus on understanding smoking and suicide are now needed.     

Smoking, carbon monoxide, and atherosclerotic diseases

Smoking habits and random measurements of the proportion of haemoglobin bound to carbon monoxide (COHb%) were examined for their association with atherosclerotic diseases in 1068 men aged 55 to 74 years from rural areas of Finland. COHb% and smoking history were similarly associated with claudication and coronary heart disease. Random measurements of COHb% did not show a better overall relation to the prevalence of atherosclerotic diseases than smoking history, though COHb% showed a stronger association with a probable previous myocardial infarction. Further studies are needed to clarify the role of carbon monoxide in atherosclerosis.     

The Influence of Religious Attendance on Smoking

Generalized linear models were used to assess the relationship between religious attendance and lifetime smoking status among middle-aged adults (n = 666) sampled from waves three (1993 to 1996) and four (2004 to 2005) of the Baltimore Epidemiologic Catchment Area (ECA) study. Religious attendance once per week or greater as compared to never was inversely associated with smoking status. Future research should explore potential mediating factors of the association between religious attendance and smoking among middle-aged adults in order to gain a greater understanding of the mechanisms underlying this relationship. Funding: NIMH grant DA026652; NIDA grant T32DA007292.     

Smoking tobacco along with marijuana increases symptoms of cannabis dependence

AIM: User practices/rituals that involve concurrent use of tobacco and marijuana - smoking blunts and "chasing" marijuana with tobacco - are hypothesized to increase cannabis dependence symptoms. DESIGN: Ethnographers administered group surveys to a diverse, purposive sample of marijuana users who appeared to be 17-35 years old. SETTING: New York City, including non-impoverished areas of Manhattan, the transitional area of East Village/Lower East Side, low-income areas of northern Manhattan and South Bronx, and diverse areas of Brooklyn and Queens. PARTICIPANTS: 481 marijuana users ages 14-35, 57% male, 43% female; 27% White, 30% Black, 19% Latino, 5% Asian, 20% of other/multiple race. MEASUREMENTS: Among many other topics, group surveys measured cannabis dependence symptoms; frequencies of chasing, blunt smoking, joint/pipe smoking, using marijuana while alone, and general tobacco use; and demographic factors. FINDINGS: Blunt smoking and chasing marijuana with tobacco were each uniquely associated with five of the seven cannabis dependence symptoms. Across symptoms, predicted odds were 2.4-4.1 times greater for participants who smoked blunts on all 30 of the past 30 days than for participants who did not smoke blunts in the past 30 days. Significant increases in odds over the whole range of the five-point chasing frequency measure (from never to always) ranged from 3.4 times to 5.1 times. CONCLUSIONS: Using tobacco with marijuana - smoking blunts and "chasing" marijuana with tobacco - contributes to cannabis dependence symptoms. Treatment for cannabis dependence may be more effective it addresses the issue of concurrent tobacco use.     

Smoking Among Teenage Girls

SUMMARY

The current paper reviews the existing literature about smoking among teenage girls. We begin with a summary of recent epidemiological data concerning gender differences in the rates of various smoking behaviors among adolescents. We next focus on how gender may influence smoking initiation, maintenance, and cessation among adolescents. Specifically, we examine weight control motives, social influences, mood management motives, and image-related motives as particularly important factors in teenage girls' smoking. We then offer a brief review of some of the more popular adolescent smoking interventions. We conclude the paper with recommendations for ways in which the effectiveness of smoking prevention and intervention programs for girls may be improved.     

Smoking and vigilance

The effects of tobacco smoking on vigilance (Critical Flicker Fusion, CFF) measured by a computerized forced-choice interactive technique, was studied in a group of 28 male moderate smokers. Subjects participated in a Smoking (S) and a Non-Smoking (NS) condition each of 1 h duration. CFF performance was measured during fifteen 2-min trials in each condition. In the S condition subjects smoked three puffs during each of five pauses between five successive trials. Vigilance was significantly improved by smoking. An initial sharp increase in CFF performance was noticed with a maximum 8 min after the first puff. Performance was significantly higher in the S condition compared to the NS condition up to 20 min after the last puff. Two extreme groups, based on differences in CFF performance between the S and NS condition were compared by questionnaires on personality and smoking habits. The most improved group had significantly higher scores in an extraversion scale. Ratings of the effect of smoking on level of alertness indicated that the objective effect of increased vigilance had no counterpart on the subjective level.Dr. Sten Levander was responsible for the construction of the computerized technique for CFF measurement and for the adaptation of this technique to the present experiment. Further he initiated and supplied the technology for the infra-red pupillography