Developing a Point-of-Sale Health Communication Campaign for Cigarillos and Waterpipe Tobacco

ABSTRACT

Adolescents and young adults smoke waterpipe tobacco (WT) and cigarillos, at least in part, based on erroneous beliefs that these products are safer than cigarettes. To address this challenge, we used a systematic, three-phase process to develop a health communication campaign to discourage WT and cigarillo smoking among at-risk (tobacco users and susceptible non-users) 16- to 25-year-olds. In Phase 1, we used a national phone survey (N = 896) to determine salient message beliefs. Participants reported constituents (i.e., harmful chemicals) emitted by the products were worrisome. In Phase 2, we developed and evaluated four message executions, with varying imagery, tone, and unappealing products with the same constituents, using focus groups (N = 38). Participants rated one execution highly, resulting in our development of a campaign where each message: (1) identified a tobacco product and constituent in the smoke; (2) included an image of an unappealing product containing the constituent (e.g., pesticides, gasoline) to grab attention; and (3) used a humorous sarcastic tone. In Phase 3, we tested the campaign messages (17 intervention and six control) with a nationally representative online survey (N = 1,636). Participants rated intervention and control messages highly with few differences between them. Exposure to messages resulted in significant increases in all risk beliefs from pre to post (p < 0.05). For WT, intervention messages increased beliefs about addiction more than control messages (p < 0.05). This systematic, iterative approach resulted in messages that show promise for discouraging WT and cigarillo use.     

Testicular cancer susceptibility in the 129.MOLF-Chr19 mouse strain: additive effects,gene interactions and epigenetic modifications

Testicular germ cell tumors (TGCTs) are the most common solid cancers affecting young men. Although the evidence for genetic predisposition to TGCTs in humans is compelling, the genetic control of susceptibility is poorly understood. The 129S1/SvImJ (129/Sv) inbred strain of mice is an excellent model for studying TGCT susceptibility. We previously reported a new mouse strain, the 129.MOLF-Chr19 chromosome substitution strain, which develops spontaneous TGCTs at a high frequency (70-80%) as compared with the much lower rate in the 129/Sv strain (5%). To characterize the genetic control of TGCT susceptibility, we created a panel of single- and double-congenic strains derived from 129.MOLF-Chr19. The frequency of TGCTs in these strains suggests that several genes with additive and epistatic effects located at distinct sites on chromosome 19 control susceptibility. However, an alternative interpretation involving epigenesis is based on a striking correlation between TGCT frequency and the length of the MOLF-derived congenic segment, regardless of their chromosomal location on Chr 19 in each congenic strain. We also show that bilateral TGCT cases result from the coincidental co-occurrence of unilateral TGCTs rather than from the action of distinct genes that control susceptibility to bilateral versus unilateral TGCT cases. Finally, we propose that these TGCTs result from disrupted testicular and spermatogenic developmental programs.     

The rectus myofascial wrap in the management of urethral sphincter incompetence

OBJECTIVE: To review our experience with a modified rectus/pyramidalis myofascial sling, described more than a century ago for treating refractory urinary incontinence in children with neurogenic sphincteric incompetence. PATIENTS AND METHODS: Thirty-seven patients (23 females and 14 males, aged 8-21 years) presented with urinary incontinence which failed to respond to medical treatment. In 36 patients the cause of the incontinence was a neurogenic bladder; one patient had sustained a traumatic injury to the bladder neck and urethra. Patient selection was based on videocysto-urethrographic detection of an incompetent bladder neck, and a low maximum closure pressure during urethral pressure profilometry. The bladder was augmented in 33 of the 37 patients. RESULTS: Of the 37 patients, 34 (92%) are dry between catheterizations; the follow-up was 0.5-10 years. Two of the male patients continued to have persistent incontinence requiring bladder neck closure and creation of a continent stoma. One of the female patients developed stress incontinence after 4 years of being dry, with a rectus sling. CONCLUSION: The rectus myofascial sling provides long-term satisfactory dry intervals between catheterizations in patients with neurogenic sphincteric incompetence. The cinch-wrap modification appears to enhance the occlusive effect of the sling, particularly in males.     

Alterations in hypothalamic vasoactive intestinal peptide-like immunoreactivity are associated with reproduction and prolactin release in the female turkey

Vasoactive intestinal peptide (VIP) has potent PRL-releasing activity, but its physiological role in the regulation of PRL release during the avian reproductive cycle is not known. We used indirect immunofluorescence to determine if changes in hypothalamic VIP are associated with the shifts in circulating PRL during the reproductive cycle of the domestic turkey. In the naturally hyperprolactinemic incubating hen, the majority of VIP immunoreactivity (VIP-IR) existed within neurons of the infundibular nuclear complex (INF) and fibers in the external layer of the median eminence. Within the INF, the numbers of VIP-IR cells increased during the cycle, paralleling increases in serum PRL. In the reproductively inactive, nonphotostimulated hen with low serum PRL, essentially no positive cells were noted, whereas the incubating hen exhibited 32.1 +/- 2.2 cells/pair of adjacent sections in the anterior INF and 59.6 +/- 2.0 cells in the posterior INF. Exposure of inactive hens to a stimulatory photoperiod resulted in a 2.6-fold increase in serum PRL with the appearance of VIP-IR cells in the INF. During laying and incubation, further increases were observed in the number of positive cells in the INF and serum PRL as well as a greater fiber density in the median eminence. To further examine the association between changes in VIP-IR and serum PRL, circulating PRL was artificially lowered by depriving incubating hens of their nests for 0, 2, 5, and 10 days. On day 2 of nest deprivation, serum PRL declined markedly to 12% of day 0 levels, with VIP-IR cell numbers at 64% and 46% in the anterior and posterior INF, respectively. By day 10, birds exhibited cell numbers in the INF averaging 20% of those observed in the day 0 incubating hens, with serum PRL at 6% of day 0 levels. The results of these studies indicate a possible causal relationship between hypothalamic VIP and changes in PRL secretion during the avian reproductive cycle, providing a basis for further research on the importance of this peptide as well as factors responsible for the modulation of its expression in hypothalamic INF neurons.     

Inhibitory effects of nordihydroguaiaretic acid (NDGA) on the IGF-1 receptor and androgen dependent growth of LAPC-4 prostate cancer cells

BACKGROUND: Nordihydroguaiaretic acid (NDGA) is an inhibitor of the IGF-1 receptor (IGF-1R) in breast and other cancers, and concomitantly inhibits tumor growth both in cultured cells and animals. The current study evaluates the effect of NDGA on the androgen-stimulated growth of human prostate cancer cells. METHODS: LAPC-4 prostate cancer cells in tissue culture were androgen starved for 3 days, 1 nM dihydrotestosterone (DHT) and other androgens were then added for up to 7 days, and cell proliferation measured. IGF-1R protein expression was measured by Western blot, and IGF-1R mRNA expression by quantitative PCR. IGF-1R receptor kinase activation was measured by ELISA. RESULTS: After 7 days, LAPC-4 growth was doubled by 1 nM DHT. NDGA had a rapid effect to inhibit IGF-1R autophosphorylation induced by IGF-1. DHT increased the expression of IGF-1R protein and mRNA levels. Maximal IGF-1R protein levels were observed 3 days after the addition of androgen. In addition, NDGA, at 10 microM or less, inhibited DHT-induced proliferation in both cells grown in plates and cells grown in soft agar. Androgen receptor (AR) studies by FRET revealed that NDGA had no conformational effects on the AR in response to ligand. CONCLUSIONS: NDGA blocks the DHT-induced growth of LAPC-4 prostate cancer cells by several mechanisms including rapid inhibition of the IGF-1R kinase, and a dose-dependent inhibition of androgen stimulation of IGF-1R expression. Clinical studies of this agent will determine its efficacy in the setting of androgen-dependent prostate cancer.     

Unilateral kainic acid lesions reveal dominance of right archistriatum in avian fear behavior

Unilateral injections of 1 microgram of kainic acid in the archistriatum of 5-day-old domestic chicks reduced fear, as expressed by distress calls (peeps), significantly more than did identical injections in the same structure on the left side. This result adds affective behavior to the growing list of functions that have been shown to be differentially controlled by the right and left hemispheres in birds. The directions of the specializations are intriguingly similar to those for verbal and affective functions in human beings.     

Public support for pictorial warnings on cigarette packs: an experimental study of US smokers

Background

Understanding factors that influence public support for “nudging” policies, like pictorial cigarette pack warnings, may offer insight about how to increase such support. We sought to examine factors that influence smokers’ support for requiring pictorial warnings on cigarette packs.

Methods

In 2014 and 2015, we randomly assigned 2149 adult US smokers to receive either pictorial warnings or text-only warnings on their cigarette packs for 4 weeks. The outcome examined in the current study was support for a policy requiring pictorial warnings on cigarette packs in the US.

Results

Support for pictorial warnings was high at baseline (mean: 3.2 out of 4). Exposure to pictorial warnings increased policy support at week 4 (β = .05, p = .03). This effect was explained by increases in perceived message effectiveness (p < .001) and reported conversations about policy support (p < .001). Message reactance (i.e., an oppositional reaction to the warning) partially diminished the impact of pictorial warnings on policy support (p < .001).

Conclusions

Exposing people to a new policy through implementation could increase public support for that policy by increasing perceived effectiveness and by prompting conversations about the policy. Reactance may partially weaken the effect of policy exposure on public support.

     

Involvement of dopamine in prolactin release induced by electrical stimulation of the hypothalamus of the female turkey (Meleagris gallopavo).

Controversy exists regarding the role of dopamine (DA) in the regulation of avian prolactin (PRL) secretion. Consequently, we injected apomorphine, a DA agonist, and pimozide, a DA receptor blocker, into laying and nest-deprived incubating turkeys and studied their effect on PRL secretion before (-20, -10, 0 min), during (5, 10, 20, 30 min), and after (5, 15, 30 min) electrical stimulation in the ventromedial nucleus of the hypothalamus. Apomorphine (10 mg/kg, ip) completely abolished the electrical stimulation-induced PRL increase in both laying and nest-deprived incubating hens. Pimozide (2 mg/kg, ip) potentiated electrical stimulation-induced PRL secretion in laying hens. In the two pimozide experiments, peak responses were 10.9-fold for the pimozide-treated group vs 2.9-fold for the control group, and 5.4-fold for the pimozide-treated group vs 2.6-fold for the control group. In nest-deprived incubating hens, PRL response to electrical stimulation was unaffected by pimozide treatment. These data support the concept that DA is inhibitory to the neuroendocrine system which stimulates PRL secretion in laying hens. In incubating hens, the dopaminergic inhibition is diminished, allowing for the increased PRL level observed during incubation.     

Dopamine infusion into the third ventricle increases gene expression of hypothalamic vasoactive intestinal peptide and pituitary prolactin and luteinizing hormone beta subunit in the turkey

Turkey prolactin (PRL) secretion is controlled by vasoactive intestinal peptide (VIP) neurons residing in the infundibular nuclear complex (INF) of the hypothalamus. The VIPergic activity is modulated by dopamine (DA) via stimulatory D(1) DA receptors. DA (10 nmol/min for 40 min) was infused into the third ventricle of laying turkey hens to study its effect on circulating PRL, hypothalamic VIP and pituitary PRL and LHbeta subunit mRNA levels. Plasma PRL was significantly elevated after 20 min of DA infusion and remained elevated 30 min after cessation of infusion. Hypothalamic VIP mRNA content was significantly greater in the INF of DA-infused birds than it was in the INF of vehicle-infused control birds. No increase in VIP mRNA due to DA infusion was noted in the preoptic area. Pituitary PRL and LHbeta subunit mRNAs were increased in DA-infused hens as compared to vehicle-infused controls but the rate of increase was more in PRL than LHbeta subunit. This study demonstrates that exogenous DA activates hypothalamic VIP gene expression and this increased expression is limited exclusively to the avian INF. The increased VIP mRNA in the INF is correlated with increased levels of circulating PRL and PRL and LHbeta mRNAs in the anterior pituitary.     

Effects of streptozotocin-induced diabetes on glucose transport in skeletal muscle

Female Sprague-Dawley rats were injected with streptozotocin (45 mg/kg) to induce mild diabetes (glucose, greater than 13 mM). Half of the animals received daily insulin injections to reduce hyperglycemia. After 10 weeks, sarcolemmal membranes were isolated from hindlimb muscles to study glucose transport, and the number of glucose transporters was assessed by cytochalasin-beta binding. Both glucose transport (19.2 +/- 1.6 vs. 31.93 +/- 3.29 pmol/mg protein.15 sec) and cytochalasin-beta binding (3.06 +/- 0.28 vs. 6.14 +/- 0.59 pmol/mg protein) were significantly (P less than 0.05) reduced in the diabetic untreated rats compared to control values. Daily insulin injections restored both (P less than 0.05) basal transport (33.22 +/- 3.62 pmol/mg protein.15 sec) and cytochalasin-beta binding (5.52 +/- 0.66 pmol/mg protein) to control levels. Maximum insulin stimulation (1 U/kg, iv) significantly increased (P less than 0.05) both glucose transport (30.18 +/- 3.76 vs. 96.48 +/- 4.21 pmol/mg protein.15 sec) and cytochalasin-beta binding (4.38 +/- 0.29 vs. 9.40 +/- 0.42 pmol/mg protein) in the untreated diabetic and control rats. However, the stimulation in the untreated diabetic rats only reached basal control levels, which was significantly (P less than 0.05) below the insulin-stimulated value for the controls. In the rats receiving daily insulin injections, maximum insulin stimulation increased (P less than 0.05) both glucose transport (58.67 +/- 15.24 pmol/mg protein.15 sec) and cytochalasin-beta binding (6.4 +/- 0.7 pmol/mg protein), but both transport and binding were significantly (P less than 0.05) below insulin-stimulated values for the control rats. These data show that insulin deficiency adversely affected the glucose transport system in skeletal muscle. Both basal and maximum insulin-stimulated transport and the number of transport molecules were reduced. Daily insulin treatment corrected some of the defects, but maximum insulin stimulation was still significantly below values for control animals.