"I did it my way"--an explorative study of the smoking cessation process among Danish youth

Objective

To explore the smoking cessation process of adolescents and their attitudes and beliefs towards smoking cessation and cessation interventions.

Method

Focus group discussions and individual interviews during April–May 2004 with 26 persons aged 15–21 years who all initiated a quit attempt on 1 January 2004.

Results

The approach towards all stages of the youth smoking cessation process varied greatly among both successful and unsuccessful quitters. Apart from ‘commitment’ or the amount of energy put into a cessation attempt, there were no differences in the way successful and unsuccessful quitters approached the quit attempt. ‘Smoking friends’ and ‘social support’ were important for maintaining cessation. Further, participants had negative attitudes towards formalized smoking cessation interventions.

Conclusion

There are many approaches to the smoking cessation process. Whether an attempt is successful depends more on individual conditions and the amount of commitment invested in the attempt than on the specific cessation strategy used.

Practice Implications

Future adolescent smoking cessation interventions should be flexible regarding both structure and content and should focus on the individual learning process, rather than adhering to rigid cessation strategies.     

The association between prenatal exposure to cigarettes and cortisol reactivity and regulation in 7-month-old infants

We examined the association between prenatal exposure to cigarettes and adrenocortical responses to stress in 7-month-old infants. Cortisol levels were assessed twice prior to and twice following affect-eliciting procedures in 111 (59 exposed and 52 nonexposed) infants. Cortisol reactivity was defined as the difference between the peak poststressor cortisol level and the pretask cortisol level. Higher values indicated higher cortisol reactivity. Exposed infants had higher peak cortisol reactivity than nonexposed infants. There were no differences in pretask cortisol levels. Maternal hostility mediated the association between cigarette exposure and peak cortisol reactivity. Furthermore, infant gender moderated this association such that exposed boys had significantly higher peak cortisol reactivity than nonexposed infants or exposed girls. These findings provide additional evidence that prenatal cigarette exposure is associated with dysregulation during infancy and that early adverse, nonsocial experiences may have relatively long-lasting effects on cortisol reactivity in infants.     

Tobacco smoke: Unraveling a controversial subject

Cigarettes are a modern and industrial form of tobacco use and obviously involve more than just tobacco. A multitude of physical processes and chemical reactions occur inside the burning zone of a cigarette. Cigarette smoke is an aerosol of liquid droplets (the particulate phase) suspended within a mixture of gases and semi-volatile compounds. Two kinds of smoke with different composition and properties are produced during smoking: mainstream smoke inhaled by the smoker and sidestream smoke, which is released into the environment between puffs from the lit end of the cigarette. Several techniques and modifications have altered the design of the cigarette during the last 50 years and changed smoke composition, with the effect of lower tar and nicotine smoke yields. An enormous amount of research has been done since the 1950s on smoke composition. With regard to the numerous toxic or carcinogenic constituents identified in tobacco smoke, there is a strong focus in the industry and with the authorities on the over 40 compounds, called "Hoffmann analytes". The yields of tar and nicotine in mainstream smoke of a cigarette brand as printed on the pack are measured with smoking machines under highly standardized conditions. Yields must comply with regulatory limits set in a number of countries. Smoking by machine is different from the smoking behavior of humans. There is a growing movement to develop more "realistic" methods to estimate smoke yields. But it is unclear whether alternative smoking regimens are more representative of human smoking behavior and provide better predictions of human exposure. Tobacco smoke has strong biological and toxicological effects in vitro and in vivo. There is an obvious need for developing a unified and validated testing approach particularly for the assessment of additives and the evaluation of new potentially reduced exposure products (PREPs). This paper gives a comprehensive overview of cigarette design, the composition and toxicity testing of smoke, and the way machines and people smoke - with links to the more detailed literature.     

戒烟对新诊断2型糖尿病合并下肢动脉疾病患者高敏C反应蛋白、纤维蛋白原及股动脉内膜中层厚度的影响

目的：了解戒烟后不同时期新诊断2型糖尿病合并下肢动脉硬化性疾病（LEAD）患者高敏CRP（hs—CRP）、纤维蛋白原及股动脉内膜中层厚度（IMT）的变化。方法：将120例初次明确诊断的2型糖尿病合并LEAD伴有吸烟史的男性患者分为吸烟组及戒烟组,每组60例。分别在戒烟前、3个月及1年后对hs-CRP、纤维蛋白原及股动脉IMT进行组间及组内自身对照比较。结果：戒烟3个月后hs-CRP、纤维蛋白原开始变化,1年后较戒烟前及吸烟组有明显改善（P均〈005）。戒烟3个月后戒烟组与吸烟组的股动脉IMT无明显差异（0．89±0．21对比0．91±0．16）,但12个月后戒烟组股动脉IMT与戒烟前及吸烟组比较差异具统计学意义（0．82±0．13对比0．89±0．17,P〈005）。结论：戒烟对新诊断2型糖尿病合并LEAD患者hs—CRP及血浆纤溶活性呈持续改善作用,较短时间戒烟不能改善股动脉IMT,但戒烟1年后股动脉IMT有逆转性改变。     

Expressional evaluation of vascular endothelial growth factor (VEGF) protein in urinary bladder carcinoma patients exposed to cigarette smoke

Angiogenesis is a fundamental process in tumor growth and metastasis. Expression of vascular endothelial growth factor (VEGF) as prognostic indicator has been documented in many types of human tumors. However, the mechanisms responsible for angiogenesis in urinary bladder carcinoma patients are not well defined. Certain carcinogens in tobacco cause DNA damage and may produce specific mutations. In order to investigate the relationship between tobacco smoking, altered patterns of VEGF expression and apoptosis, we have analyzed a group of 125 incident patients with transitional cell carcinoma and 100 cases of control with inflammatory lesions of the bladder. We assessed VEGF overexpression by the use of anti- VEGF antibody through immunohistochemistry, and apoptosis by TUNEL Assay. Expression of VEGF and apoptosis was noticed in 43.2% and 52.8% cases respectively. Both VEGF and apoptosis increased with increasing tumor grade. Apoptosis was seen to be significantly higher in both sexes in the age group of ≥ 50 years (p<0.05) but expression of VEGF was significantly higher among males in the age group of ≥ 50 years (p<0.05). We observed an insignificant association between cigarettes smoking and VEGF overexpression (p>0.05) and significant association with apoptosis. These data support the hypothesis that certain carcinogens derived from cigarette smoking may induce VEGF mutations and apoptosis which in turn are involved in early steps of bladder carcinogenesis.     

兰州理工大学新生吸烟认知情况调查分析

目的了解大学新生吸烟及其对吸烟的认识现状。为学校开展控烟健康教育工作提供依据。方法采用随机抽样的方法抽取兰州理工大学新生735名进行问卷调查,内容包括吸烟情况、吸烟认知和态度。结果尝试吸烟率男生为57.87%,女生为15.23%;现吸烟率男、女生分别为18.66%和2.65%。绝大多数学生95.64%知道吸烟有害健康,知道吸烟与肺癌、慢性支气管炎(分别占92.51%和93.87%)有关,但知道吸烟与消化性溃疡、膀胱癌疾病有关的比例较低,分别为32.38%和17.06%。结论大学新生吸烟率较高,少数新生对吸烟与健康关系的认知不足,态度消极。     

Does the effect go up in smoke? A randomized controlled trial of pictorial warnings on cigarette packaging

Objective

Placing a combination of a written warning and a graphic image on cigarette packaging (so called “pictorial warnings”) is one of the WHO Framework Convention on Tobacco Control's most controversial recommendations. Our randomized controlled trial investigated if pictorial warnings lead to significantly higher motivation to quit, as compared to written warnings alone.

Methods

Four pictorial warnings were selected from the EU Commission's official image catalogue. Study arm 1 (44 adult smokers) viewed only the written warnings while study arm 2 (44 adult smokers) viewed the corresponding pictorial warnings. Self-affirmation was a second randomly manipulated factor, and nicotine dependence a quasi-experimental third factor. The main outcome measured was the motivation to quit, with fear intensity as one of the secondary outcomes.

Results

Pictorial warnings were associated with a significantly higher motivation to quit. A pictorial warning was also associated with higher fear intensity. The effect of warnings appears to be independent of nicotine dependence and self-affirmation.

Conclusions

Nationwide implementation of pictorial warnings may be effective in increasing heavy smokers’ motivation to quit.

Practice implication

Due to the fact that perceived vulnerability, response and self-efficacy are not more strongly affected by pictorial warnings this effect may turn out to be short-term.     

Protective effects of liquiritin apioside on cigarette smoke-induced lung epithelial cell injury

Cigarette smoking is associated with an increased incidence of chronic obstructive pulmonary disease (COPD). In this study, we hypothesized that liquiritin apioside (LA), a main flavonoid component from Glycyrrhiza uralensis, had antioxidant properties by inducing glutathione (GSH) biosynthesis via the inhibition of cytokines and protected lung epithelial cells against cigarette smoke-mediated oxidative stress. A549 cells were treated with cigarette smoke extract (CSE) and/or LA. ICR mice were exposed to cigarette smoke (CS) for four days with increasing exposure time for up to 6 h per day to elicit epithelial cells injury. One hour before smoke exposure, mice were treated with LA by gavage; 18 h after the last CS exposure all examinations were performed. Treatment with LA concentration-dependently prevented CSE-induced cytotoxicity, increase of TGF-β and TNF-α mRNA expression, depletion of GSH and apoptosis in A549 cells. LA at doses 3, 10 and 30 mg/kg dose-dependently inhibited pulmonary neutrophil and macrophage inflammation. Lung sections of the CS-exposed LA treated mice showed an apparently reduced pulmonary inflammation and a significant inhibitory effect on mucus containing goblet cells in the large airways. Furthermore, the CS-induced pulmonary release of TGF-β, TNF-α and myeloperoxidase activity was reduced, and superoxide dismutase activity was enhanced.These results indicate that protective roles of LA on CS-induced the lung epithelial cell injury are mediated by inhibiting TGF-β and TNF-α expression and increasing anti-oxidative levels of GSH, suggesting that LA might be effective as protective agent against epithelial injury in COPD.     

吸烟对慢性阻塞性肺疾病患者血清及肺泡灌洗液中肿瘤坏死因子-α及干扰素-γ的影响

目的:评价吸烟对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者急性期、稳定期血清及肺泡灌洗液中肿瘤坏死因子-α(TNF-α)及干扰素-γ(IFN-γ)的影响.方法:分别测定正常对照组、非吸烟COPD组、持续吸烟COPD组及戒烟COPD组患者急性期、稳定期血清及肺泡灌洗液中TNF-α及IFN-γ的水平,并对各组血清及肺泡灌洗液中TNF-α及IFN-γ水平分别进行比较.结果:COPD患者无论在急性期还是稳定期,肺泡灌洗液中TNF-α水平较正常对照组高(P＜0.05).其中,持续吸烟的COPD患者肺泡灌洗液中TNF-α水平较非吸烟COPD组及戒烟COPD组高(P＜0.05).急性期及稳定期COPD患者血清中TNF-α水平较正常组高(P＜0.05).急性期及稳定期COPD患者血清及肺泡灌洗液中IFN-γ水平均较正常组高(P＜0.05).其中,持续吸烟的COPD患者肺泡灌洗液中IFN-γ水平较非吸烟COPD及戒烟COPD患者均高(P＜0.05).结论:COPD患者急性期及稳定期存在TNF-α及IFN-γ介导的全身及气道局部炎症反应增强.持续吸烟的COPD患者气道局部的炎症反应增强最显著,而戒烟的COPD患者较持续吸烟的COPD患者该炎症反应减弱.     

吸烟与中年人颈动脉粥样硬化的剂量-反应关系探讨

目的探讨中年人吸烟与颈动脉粥样硬化的关系。方法选择308例研究对象,进行问卷调查、实验室检查和颈动脉超声检查。结果吸烟组颈动脉斑块形成的人数明显高于不吸烟组,差异有高度统计学意义（P〈0．01）;吸烟者颈动脉斑块形成的例数随着吸烟指数的增加而增多,趋势性检验具有统计学意义（P〈0．01）。结论吸烟可增加中年人颈动脉粥样硬化的风险,且存在一定的剂量－反应关系。