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Biomedical subjects

Richard D Hurt

Publications and source records attributed to Richard D Hurt.

At least 19 recordsLinked to original sources
PubMed2006

Randomized clinical trial of an Internet-based versus brief office intervention for adolescent smoking cessation.

OBJECTIVE: Evaluation of novel treatment delivery methods, such as the Internet are notably absent from the adolescent smoking treatment literature. METHODS: Adolescent smokers ages 11-18 years were randomized to a clinic-based, brief office intervention (BOI; N=69) consisting of four individual counseling sessions; or to Stomp Out Smokes (SOS), an Internet, home-based intervention (N=70). Adolescents in SOS had access to the SOS site for 24 weeks. RESULTS: The 30-day, point-prevalence smoking abstinence rates for BOI and SOS were 12% versus 6% at week 24 and 13% versus 6% at week 36, with no significant treatment differences. Among participants who continued to smoke, SOS was associated with a significantly greater reduction in average number of days smoked than BOI (P=0.006). The BOI was found to be feasible with high session attendance rates. SOS participants accessed the site a mean+/-S.D. of 6.8+/-7.1 days. SOS use dropped to less than one-third of participants by week 3. CONCLUSION: Additional research is needed to tap the potential capabilities of the Internet for adolescent smoking cessation using proactive, personalized, patient-education components. PRACTICE IMPLICATIONS: Augmenting the SOS type of intervention with more structured, personal and proactive patient-education components delivered in-person or by telephone or electronic mail is recommended.

Adolescent↗
PubMed2006

Movie moguls: British American Tobacco's covert strategy to promote cigarettes in Eastern Europe.

BACKGROUND: Though the cigarette companies have long publicly denied paying for product placement in films, the documentary evidence from the 1950s-1980s overwhelmingly suggests otherwise. METHODS: Approximately 800,000 pages of previously secret internal corporate British American Tobacco Company documents were reviewed at the Minnesota Tobacco Document Depository from March 2003 through May 2005. Documents were also searched online at the various tobacco document collections between February 2004 and November 2004. RESULTS: A small collection of internal corporate documents from British American Tobacco show that in the late 1990s the company evaluated investing in a movie destined for Eastern Europe. By being an investor, BAT could influence the alteration of the movie script to promote BAT's brands, thus providing marketing opportunities without a clear violation of movie product placement restrictions. CONCLUSION: Future protocols to the WHO Framework Convention on Tobacco Control should seek to curtail more than just payment for tobacco product placement. More restrictive provisions will be needed to hinder creative strategies by the tobacco industry to continue tobacco promotion and trademark diversification through movies.

Europe, Eastern↗
PubMed2006

Characteristics of six-month tobacco use outcomes of Black patients seeking smoking cessation intervention.

Although Blacks experience disproportionately greater morbidity and mortality attributable to smoking than other racially-classified social groups, few studies have examined the impact of clinical interventions for nicotine dependence within this population. The main objective of this study was to examine 6-month outcomes among 146 self-identified adult Black patients who received an individually-tailored nicotine dependence intervention in an academic medical setting. Measures included a baseline demographic questionnaire and telephone follow-up to obtain self-reported 6-month tobacco use status. Univariate analysis was performed to assess the association of baseline patient characteristics with tobacco abstinence at 6 months following the clinic intervention. Of the 146 patients, 83% were seen in an outpatient clinic setting, while 17% were seen as inpatients in the hospital. At baseline, 53% reported smoking an average of 20 or more cigarettes per day, 32% were highly nicotine dependent, and 53% were in the preparation or action stage of change. Six months following the intervention, the 7-day point-prevalence tobacco abstinence rate was 43/146 (29%; 95% C.I. 22% to 37%). An individualized nicotine dependence intervention conducted in an academic medical setting yielded encouraging abstinence rates for Black smokers.

Academic Medical Centers↗
PubMed2005

The prevalence of weight concerns in a smoking abstinence clinical trial.

Recent research has demonstrated there is a high prevalence of weight concerns in smokers and that smokers with weight concerns may respond poorly to treatment for tobacco dependence. Most studies have focused only on females or have consisted of small samples. In this study of a 12-week randomized trial of nicotine inhaler, bupropion or both for smoking cessation, 50% of the 1012 female smokers and 26% of the 680 male smokers, at study entry, were weight concerned. In examining the impact of weight concerns on the 12-week point-prevalence smoking abstinence, 26% of non-weight-concerned smokers quit smoking compared to 22% of weight-concerned smokers (p=0.06). This study, which includes a large sample of both genders, provides further evidence that approximately half of females who are seeking smoking cessation treatment are weight concerned and that one quarter of male smokers are weight concerned. Additionally, being weight concerned may impact the short-term success rates of stopping smoking using pharmacotherapy.

Adult↗
PubMed2005

Nicotine dependence treatment: perceived health status improvement with 1-year continuous smoking abstinence.

BACKGROUND: This study evaluated change in health status as a function of change in smoking status among patients treated clinically for nicotine dependence by comparing overall perceived health status of patients who abstained from cigarettes for 1 year versus those who smoked continuously for 1 year. METHODS: Patients from the Mayo Clinic Nicotine Dependence Center completed a quality-of-life questionnaire (SF-36) following their consultation for nicotine dependence (baseline). At 1 year post-intervention, patients were mailed a follow-up survey that included the SF-36 and items assessing interval smoking history. Study patients included those who self-reported continuous smoking (n=60) and those reporting continuous smoking abstinence for the entire follow-up year (n=146). Data from SF-36 scales at 1 year were analysed using analysis of covariance with baseline scale scores serving as covariates along with baseline characteristics that differed significantly between groups. RESULTS: Compared with those who continued to smoke, patients who were continuously abstinent from smoking for the entire year had more improvement in perceived health status for the SF-36 mental composite scale (P=0.009) and for the SF-36 subscales for role limitations (P<0.001 and P=0.017 for emotional and physical role limitations, respectively), social functioning (P=0.010) and general health (P=0.013). CONCLUSIONS: Smokers treated for nicotine dependence who stop smoking for a year report more improvement in-quality-of-life compared with those who continue to smoke.

Adult↗
PubMed2005

Relation between smoking cessation and receiving results from three annual spiral chest computed tomography scans for lung carcinoma screening.

BACKGROUND: The relation between undergoing a single computed tomography (CT) screening for lung carcinoma and the potential long-term impact on smoking status has been equivocal. Perhaps, recommendations from multiple cancer screenings may promote smoking abstinence among individuals at high risk for lung carcinoma. METHODS: The current longitudinal study comprised 926 current smokers and 594 former smokers who participated in 3 annual follow-up low-dose, fast spiral chest CT scan screenings for lung carcinoma. Baseline demographic, pulmonary function, smoking history variables, and previous abnormal findings were evaluated as predictors of self-reported point prevalence smoking abstinence. RESULTS: Among current smokers at baseline, abstinence from smoking during the 3-year follow-up was associated with older age, worse baseline pulmonary function, and abnormal CT finding the previous year requiring interim follow-up. Of participants who received abnormal screens each of the previous 3 years, 41.9% reported smoking abstinence compared with 28.0% with 2 abnormal screens, 24.2% with 1 abnormal screen, and 19.8% with no abnormal screens. Among former smokers, abstinence from smoking was associated with a longer duration of abstinence before the baseline visit. CONCLUSIONS: Smokers with abnormal CT findings from multiple CT screens were more likely to be abstinent from smoking at the 3-year follow-up. Multiple low-dose, fast spiral chest CT scan screenings for lung carcinoma may represent teachable moments and opportunities to enhance motivation for smoking abstinence. Further research is needed to continue to investigate how annual screening may enhance motivation for health behavior change.

Age Factors↗
PubMed2005

Expressive writing intervention for young adult cigarette smokers.

This investigation examined the feasibility and magnitude of the effect of a stress management intervention involving expressive writing as an adjunct to brief office smoking cessation intervention for young adults. Participants aged 18-21 years were randomized to brief office intervention (N=30) or expressive writing plus brief office intervention (N=30). Biochemically confirmed 30-day point-prevalence tobacco abstinence, smoking reduction, perceived stress, negative affect, and treatment compliance were assessed at 4, 12, and 24 weeks post randomization. The expressive writing adjunct was not found to be effective. The 30-day smoking abstinence rates were 0% versus 0% ( p=1.000) at week 4, 20% versus 3% ( p=0.103) at week 12, and 20% versus 10% ( p=0.472) at week 24 for the brief office intervention only versus expressive writing plus brief office intervention groups, respectively. Participants stated they benefited most from the support and structure associated with the brief office intervention. Enthusiasm was lacking for the expressive writing treatment adjunct.

Adolescent↗
PubMed2005

Exploring the association of John Henry active coping and education on smoking behavior and nicotine dependence among Blacks in the USA.

Although smoking is used as a coping tool in response to stress and Blacks have been found to report smoking more in response to stress than Whites, little research exists that has examined ethno-culturally specific constructs of stress and coping as they relate to smoking behavior and nicotine dependence among Blacks in the USA. This study explored the association between the ethno-culturally interactively defined construct of John Henryism, as well as the individual contributions of John Henry active coping and education on smoking behavior and nicotine dependence in a relatively urban-Midwestern Black population. Self-identified Black patients (n = 146) who had previously received a clinical intervention for nicotine dependence were followed to assess smoking status and John Henry active coping. Results revealed that patients with low levels of education who had low levels of John Henry active coping reported higher nicotine dependence scores than any other education by John Henry active coping group. Furthermore, low levels of John Henry active coping were associated with the use of menthol cigarettes and lower-educational level was associated with smoking greater than 20 cigarettes per day. Further community-based studies examining this construct among Black smokers in various socio-cultural contexts are needed to clarify the association between John Henry active coping and socioeconomic status on smoking behavior and nicotine dependence among Blacks.

Adaptation, Psychological↗
PubMed2005

Playing hide-and-seek with the tobacco industry.

Despite many peer-reviewed works that draw on tobacco industry documents that have now been made public, questions remain about how complete a picture has emerged. We present a conceptual framework that identifies and evaluates tobacco industry efforts to conceal information. Widespread document destruction like that in recent litigation in Australia is just one of more than a dozen tobacco industry efforts to prevent access, or at least timely access, to documents. Industry efforts range from small, locally employed initiatives to company-wide tactics. Some efforts, such as using "oral only" procedures, scrambling telephone lines, or involving lawyers in scientific projects, are preemptive. Others seek to deal with already existing documents by invoking bogus claims of legal privilege, stipulating "read then destroy" for memos, and rewriting problematic memos. That evidence of concealment has, in fact, been found in tobacco company archives attests to the futility of attempting to control the flow of millions of pieces of paper among tens of thousands of employees. However, researchers have yet to reveal the full story: We know of the industry's failures in concealing information, but not its successes. The industry's objective is not destruction of information per se, but prevention of public disclosure of that information. Exposing the tobacco industry's many approaches to concealment provides greater insight into companies' intentions and potential means for stripping away that concealment.

Australia↗
PubMed2005

Iqmik--a form of smokeless tobacco used by pregnant Alaska natives: nicotine exposure in their neonates.

OBJECTIVE: To determine the concentration of nicotine and cotinine in maternal blood and neonatal cord blood among pregnant Alaska Native women and to assess the neonates for neurobehavioral effects. METHODS: In a nonrandomized, clinical observational pilot trial, 60 pregnant Alaska Native women were enrolled for assessment of Iqmik (a mixture of leaf tobacco and ash) and other tobacco use during pregnancy and at delivery. Neonatal cord blood, nicotine and cotinine concentrations were obtained, and neonatal neurobehavioral effects were assessed using the Lipsitz scale. RESULTS: At delivery, there were 22 subjects who reported using only Iqmik, and 10 who used other tobacco products. Subjects who reported using only Iqmik prior to delivery had higher concentrations of cotinine (167+/-116 vs. 81+/-100) in maternal blood (rank sum test, p=0.036) and higher concentrations of nicotine (8.4+/-7.3 vs. 4.4+/-5.1, p=0.048) and cotinine (153+/-115 vs. 70+/-95, p=0.048) in cord blood compared to subjects who reported using other tobacco products. Neurobehavioral signs as assessed by the Lipsitz score were increased in neonates born to mothers using only Iqmik (3.7+/-1.8, p=0.011), or to mothers using other tobacco products (3.4+/-1.4, p=0.034) compared to neonates born to women who reported no tobacco use (1.8+/-1.4). CONCLUSIONS: Mothers who use Iqmik and their neonates have higher cotinine concentrations compared to mothers who use cigarettes and/or other forms of tobacco. Neurobehavioral signs occur in neonates born to women who use Iqmik but also in neonates born to mothers who use other forms of tobacco during pregnancy.

Adult↗
PubMed2005

Revision of the Self-Administered Alcoholism Screening Test (SAAST-R): a pilot study.

The original Self-Administered Alcoholism Screening Test (SAAST; Swenson and Morse, 1975) is a self-report alcoholism screening measure intended for use with adult medical patients. However, the SAAST does not indicate the recency of alcohol use-related problems, not all items use the appropriate verb tense for assessing lifetime experience of alcohol use-related problems, many of the items contain out-dated language, and the diagnostic criteria for alcohol dependence and alcohol abuse are not fully represented. The SAAST was revised to address these issues. This paper describes the rationale for revision and the process through which the SAAST was revised. Preliminary information about comparability of the original SAAST and the revised version (SAAST-R) was obtained. Data are presented from two intervention trials for smokers in which both the SAAST and SAAST-R were administered. One sample was comprised of participants in recovery from alcoholism (N = 60; 82% male) and the other sample consisted of participants not meeting criteria for alcohol abuse or dependence within the previous year (N = 98; 45% male). The results suggest that the SAAST-R is highly correlated with the original SAAST, has a similar factor structure, good internal consistency, and correctly identifies those in recovery from alcoholism. Areas for refinement in the format and items of the SAAST-R were identified and suggestions for further validation studies are presented.

Adult↗
PubMed2005

Treating nondepressed smokers with alcohol dependence in sustained full remission: nicotine patch therapy tailored to baseline serum cotinine.

OBJECTIVE: Studies of the efficacy of nicotine replacement therapy among alcoholic smokers have produced mixed findings. Our objective was to examine the smoking abstinence rate in smokers in sustained full remission from alcoholism (as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) who are receiving nicotine patch therapy with the dose tailored to the baseline serum cotinine concentration. METHOD: In this pharmacological relapse prevention study for 195 smokers with alcohol dependence in sustained full remission, the primary aim was to determine the 7-day point prevalence smoking abstinence rate at the end of 8 weeks of nicotine patch therapy in doses projected to achieve 100% venous replacement. Nicotine patch dose was based on the baseline serum venous cotinine as follows: (1) participants with < or = 200 ng/ml received a patch dose of 22 mg per day; (2) those with 201-300 ng/ml received a 33-mg dose per day, and (3) those with > 300 ng/ml received a 44-mg dose per day. A second (steady-state) serum cotinine concentration was obtained between weeks 2 and 7 to determine the percentage replacement. RESULTS: The point prevalence smoking abstinence rate at the end of the 8 weeks of nicotine patch treatment was 51% (95% confidence interval [CI]: 45%-58%) which is higher than would be expected, and percent replacement of > 80% was achieved in 49 of 85 (58%) tobacco-abstinent subjects. Higher cigarettes per day (odds ratio [OR] = 1.030, 95% CI: 1.004-1.057, p = .023) and a history of depressed mood on the Diagnostic Interview Schedule (OR = 1.940, 95% CI: 1.044-3.605, p = .036) were found to be multivariate independent predictors of smoking at week 8. However, percentage replacement did not predict smoking abstinence. CONCLUSION: We achieved > 80% replacement in most subjects, and there was no evidence of severe nicotine toxicity associated with the tailored dose of nicotine patch therapy.

Administration, Cutaneous↗
PubMed2005

Personality correlates related to tobacco abstinence following treatment.

OBJECTIVE: The five-factor model of personality was used to describe the correlates of smoking abstinence. METHODS: Following treatment in the Mayo Clinic Nicotine Dependence Center, the six month abstinence status was determined by self-report. Sixteen months to 2.4 years following the initial treatment evaluation, and 10 months to 1.9 years after the abstinence status was determined, 475 patients were mailed a Neuroticism, Extraversion, Openness, Five-Factor Inventory questionnaire. Ninety-nine abstinent and 151 smoking patients returned a completed questionnaire. RESULTS: Multivariate analysis showed that low scores on neuroticism and openness were associated with tobacco abstinence. In addition, high scores on neuroticism and low scores on agreeableness and conscientiousness were associated with predictors of poor outcome including greater number of cigarettes smoked per day, initiation of smoking prior to age 18, and a Fagerström Test for Nicotine Dependence score of > or = 6. CONCLUSIONS: Personality characteristics as predictors of smoking abstinence following treatment warrant further investigation in prospective clinical trails. Treatment matching using personality profiling as a guide may be a valuable tool for improving abstinence rates following treatment for nicotine dependence.

Adult↗
PubMed2004

Body image treatment for weight concerned smokers: a pilot study.

In this pilot project, 41 female weight-concerned smokers were randomly assigned to receive either 12 group sessions of cognitive behavioral therapy for body image concerns or 12 group sessions for weight management. All subjects received open-label bupropion SR, 300 mg daily, exercise instruction, and weekly behavioral counseling for tobacco cessation. At week 12, 7(35%) of the body image participants had 7-day point prevalence smoking abstinence, compared to 5(24%) of the participants in the weight management group (p=0.505).

Adult↗
PubMed2004

Tobacco use outcomes among patients with head and neck carcinoma treated for nicotine dependence: a matched-pair analysis.

BACKGROUND: The current study described tobacco use outcomes among patients with head and neck carcinoma who underwent treatment for nicotine dependence at the Mayo Clinic Nicotine Dependence Center (NDC; Rochester, MN). METHODS: Using a 1:1 matched-pair design, conditional logistic regression was employed to compare the 6-month tobacco abstinence outcomes of patients with head and neck carcinoma (n = 101) with controls (n = 101) from the general patient population treated for nicotine dependence between 1988 and 2001. The two groups were matched with regard to age, gender, date of treatment, and type of NDC treatment service. RESULTS: Baseline demographics were similar between both groups. However, patients with head and neck carcinoma smoked significantly more cigarettes per day (cpd) than controls (P = 0.003). The self-reported tobacco abstinence rate at the 6-month follow-up was 33% for patients with head and neck carcinoma compared with 26% for matched controls (P = 0.279; after adjusting for baseline cpd and stage of change, P = 0.205). Among patients with head and neck carcinoma, the tobacco abstinence rates were 47%, 22%, and 19%, respectively, for those receiving an NDC consult within 3 months, between 3 months and 5 years, and > 5 years after their diagnosis (P = 0.021). Furthermore, the patients with head and neck carcinoma treated within 3 months of diagnosis who received surgery (with or without radiation therapy) were more likely to be tobacco abstinent than those who received primary radiation therapy (P = 0.042). CONCLUSIONS: These findings suggested that nicotine dependence treatments were effective among patients with head and neck carcinoma, particularly when delivered shortly after initial diagnosis and for those who received surgery as their primary treatment.

Head and Neck Neoplasms↗
PubMed2004

Big tobacco is watching: British American Tobacco's surveillance and information concealment at the Guildford depository.

The 1998 State of Minnesota legal settlement with the tobacco industry required British American Tobacco (BAT) to provide public access to the 8 million pages housed in its document depository located near Guildford, UK, and to any company documents sent to the Minnesota depository. While the Minnesota depository is managed by an independent third party, BAT's Guildford depository is run by the company itself. Starkly different from the Minnesota depository, at the Guildford depository it is extraordinarily more difficult to access, search, and obtain requested documents. BAT's approach to running the Guildford depository, in our view, amounts to concealing what is supposed to be public information. Newly produced BAT documents from subsequent litigation, dating from 1996 to 2001 disclose the company's efforts to gather intelligence on visitors and their work. We believe that BAT has acted to make access to information more difficult by delaying document production requested by public visitors and refusing to supply requested documents in an electronic format despite, in the company's own words, the establishment of "big time imaging" capabilities at the Guildford depository. During testimony in 2000, then BAT Chairman, Martin Broughton stated to the UK House of Commons Health Select Committee that the scanning and subsequent placement of the Guildford collection online "would be an extreme effort for absolutely no purpose whatsoever", stating that "there is no indication to me that serious researchers are showing any interest in the papers em leader ". New documents show that not only did the company recognise the importance of research undertaken by visitors, but also invested substantial resources and undertook numerous scanning projects during that time. The vulnerability of this important resource is demonstrated by the decreased number of files listed on the electronic database and the inadvertent deletion of an audio tape housed at the depository. With regard to intelligence gathering, BAT's law firm reported to BAT on the daily activities of depository visitors. Despite assurances to the contrary, these depository visitor reports show that BAT apparently tracked the database searches of a visitor. The company also tracked the physical movement of visitors and, in at least one instance, observed and noted the personal mobile phone use of a visitor. These activities raise ethical issues about BAT and/or its solicitors observing the work of lawyers and researchers representing health and government bodies. Given this new evidence, we assert that BAT is incapable of operating its depository in the spirit of the Minnesota settlement and should, therefore, be divorced from its operation. Accordingly, we recommend that the company provide its entire document collection electronically to interested parties thus allowing greater access to the public-health community as has been done in the USA.

Access to Information↗