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At least 307 records · Page 17Linked to original sources

PubMed2002

Patients' views on smoking cessation and tobacco harm reduction during drug treatment.

Efforts to help smokers in drug treatment quit smoking have met with little success. To explore barriers to quitting and interest in tobacco harm reduction we conducted focus groups and interviews among 78 patients from five Methadone Maintenance Treatment (MMT) sites. Measures included a written survey and open-ended questions on (a) motivation for quitting, (b) what quit methods worked and what didn't work, and (c) interest in smoking reduction and nicotine maintenance as an alternative to complete cessation. Discussions were audiotaped, transcribed, and coded using computer-based qualitative software; our interobserver reliability was 83%. Successful quitters used in general a combination of quit methods such as prayer, nicotine gum, keeping busy, quitting 'one day at a time,' nicotine patches, deep breathing, and avoidance of triggers. Nicotine craving, rather than withdrawal, was cited as the biggest challenge to staying quit. Some current smokers feared quitting smoking would divert them from their goal of quitting illicit drug use or tapering off MMT. Current smokers were interested in smoking reduction as an alternative to quitting; however, those who had tried but failed to reduce smoking preferred complete cessation. Nicotine maintenance was favored by only a few participants with major health problems who didn't hold out hope for quitting. Findings suggest combination pharmacotherapy could help patients control withdrawal and acute episodes of craving. Patients have a number of skills from coping with illicit drug dependence that are useful in combating nicotine dependence. Behavioral methods and short-term pharmacotherapy to help patients reduce tobacco exposure should be explored.

Adult↗

PubMed1991

Tobacco prevention in hospitals needs prolonged and sustained effort.

The smoking control, policy implemented at a Barcelona hospital over a 3-year period resulted in a reduction of smoking in the hospital and a raised awareness of the exemplary role health professionals can have. However, participation by health professionals in the project decreased over the 3-year period. Although reduced, the smoking rate in the hospital still is at a high level; this should trigger health professionals to further exploit their potential in smoking reduction efforts.

Female↗

PubMed2001

The effect of stopping smoking on cervical Langerhans' cells and lymphocytes.

OBJECTIVE: To investigate the effects of stopping smoking on cervical Langerhans' cells and lymphocytes. DESIGN: Prospective intervention study. SETTING: A large family planning clinic in central London. POPULATION: Women volunteers prepared to attempt to give up smoking for six months. Their most recent cervical smear showed no abnormality greater than mild dyskaryosis. METHODS: The women were seen at three-month intervals for six months. Reduction in smoking was assessed by self-reporting and validated by salivary cotinine concentrations. Colposcopy and a biopsy of a normal area were performed at the first and last visits. Any area of abnormality was also biopsied at the final visit. Langerhans' cells and lymphocytes were counted. MAIN OUTCOME MEASURES: Proportional changes in counts of Langerhans' cells and lymphocytes with reduction in smoking. RESULTS: Reduction in smoking by 20 to 40 cigarettes per day was significantly associated with a reduction of between 6% and 16% in counts of Langerhans cells, CD8 and total lymphocytes. Heavy smoking was significantly associated (P = 0.02) with an increased chance of persistent human papillomavirus infection. The presence of candida was associated with significantly higher counts of between 41% and 47% in total lymphocytes and CD8 lymphocytes. In contrast, the presence of anaerobic vaginosis was associated with significantly lower counts of between 16% and 30% in Langerhans cells, CD4 and CD8 lymphocytes. CONCLUSIONS: This large intervention study has demonstrated a clear relationship between reduction in smoking and changes in cervical immune cell counts. Future studies need to take into account cytokine interactions, which recent studies suggest may be significant in the immune response to both human papillomavirus and cervical intraepithelial neoplasia and the ever-increasing complexity of the cell-mediated immune system of the cervix.

Adult↗

PubMed1987

Weight gain associated with decreases in smoking rate and nicotine intake.

The mechanisms involved in the weight gain associated with smoking cessation are not well known. This study employed a single-subject design to investigate changes in weight following systematic reductions in smoking rate and cigarette nicotine content. Although there were no changes in the subject's caloric intake or physical activity, a weight gain of 3.6 kg was observed after 4 months of reduced rate and nicotine intake. These results suggest that weight change during smoking reduction and cessation may be primarily due to changes in factors other than caloric intake or activity.

Body Weight↗

PubMedDate not supplied

Smoking cessation in pregnancy: the effect of hypnosis in a randomized study.

At Buskerud Central Hospital in Norway, a county hospital with 2000 deliveries per year, an intervention study, using hypnosis, aimed at smoking cessation and reduction among pregnant women still smoking around 18th week of pregnancy was carried out during the period 1992-1993. Two sessions (each lasting 45 minutes) using conventional induction into a superficial nonsomnabulistic stage of trance were performed. A tape was played, encouraging the pregnant woman's wish to quit smoking and her capacity to do so. Relaxation techniques together with self-hypnotic methods were introduced to combat craving. Changes in smoking pattern were investigated at delivery time. No significant effect on smoking cessation or smoking reduction was obtained (p > 0.05). We recorded a 10% quit rate in both intervention group and control group, and 42% and 31% reduced their smoking in the intervention group and control group, respectively.

Adult↗

PubMed1999

Risk factors for meningococcal disease in Cape Town.

OBJECTIVE: To determine the risk factors associated with meningococcal disease among children living in Cape Town. DESIGN: A case-control study was conducted from October 1993 to January 1995. SETTING: The study population consisted of all children under the age of 14 years who were resident in the Cape Town metropolitan region. Cases and controls were selected from Red Cross War Memorial Children's Hospital. RESULTS: A total of 70 cases and 210 controls were interviewed. Significant risk factors for meningococcal disease included being breast-fed for less than 3 months (adjusted odds ratio (OR) 2.4); overcrowding (adjusted OR 2.3); and age less than 4 years (adjusted OR 2.3). Exposure to two or more household members who smoked was also a risk factor, but only in the presence of a recent upper respiratory tract infection (adjusted OR 5.0). CONCLUSION: This is the first case-control study in South Africa examining risk factors for meningococcal disease. It provides further evidence for reduction of smoking, reduction of overcrowding and promotion of breast-feeding as important public health measures.

Adolescent↗

PubMed1986

Marijuana smoking as cause of reduction in single-breath carbon monoxide diffusing capacity.

To investigate the effects of chronic marijuana smoking on lung function, pulmonary function tests including single-breath carbon monoxide diffusing capacities were performed in 15 healthy women who smoked 1.7 +/- 1.4 (mean +/- SD) marijuana cigarettes per day for 235 +/- 135 days per year for a mean of 10.5 +/- 3.7 years. Control groups included 27 nonsmoking and 26 tobacco-smoking women. Results revealed that marijuana smoking with or without tobacco is associated with a reduction in the single-breath carbon monoxide diffusing capacity to 74 +/- 20 percent of predicted, which was significantly different from that in the nonsmoking control subjects (92 +/- 11 percent; p less than 0.05). The subset of subjects who smoked marijuana and tobacco had a further reduction of the single-breath carbon monoxide diffusing capacity to 65 +/- 17 percent, which was significantly different from that in both nonsmoking and smoking control subjects (80 +/- 7 percent). These results suggest that heavy marijuana smoking when added to tobacco smoking may damage the gas exchange surface of the lung.

Adult↗

PubMed1990

Clinical and pharmacokinetic properties of a transdermal nicotine patch.

We examined the pharmacokinetics of a transdermal nicotine patch and evaluated the usefulness of such a patch in a pilot smoking-cessation program. Use of the patch was associated with plasma nicotine concentrations that were comparable to smoking or to the use of other smoking-cessation devices. However, these plasma concentrations were maintained for 24 hours, and the patch appeared to be suitable for use once a day. Its use in a 6-week placebo-controlled double-blind study resulted in a significant degree of smoking cessation or in reduction of smoking activity. The findings suggest that it may be valuable to extend investigations to a larger population and that transdermal nicotine may have a useful role in smoking-cessation therapy.

Administration, Cutaneous↗

PubMed1999

Behavioral and cognitive effects of smoking: relationship to nicotine addiction.

Nicotine addiction is an extremely complex process that involves biological, psychological, behavioral, and cultural factors. Three factors that influence smoking and that are influenced by smoking are performance, stress, and body weight. We know that if nicotine-addicted smokers are deprived of nicotine, attentional and cognitive abilities can be impaired, and such deficits can be reversed if the person smokes or is given nicotine. In nonsmokers and nondeprived smokers, nicotine enhances finger tapping, focused and sustained attention, recognition memory, and reasoning. Stress results in increased smoking, but there is little empirical evidence that smoking reduces stress. Stress reduction from smoking is likely the relief of withdrawal-induced negative mood that is experienced between cigarettes. Smokers weigh on average 3-4 kg less than nonsmokers, and the weight-gain seen after quitting smoking also averages 3-4 kg. Changes in eating and energy expenditure are responsible for the body weight changes seen during smoking cessation and relapse. We need to know the full range of conditions under which nicotine affects behavior. The mechanisms by which stress functions to maintain nicotine addiction are not well understood. We do not know what interventions are effective in addressing the stress experienced during smoking cessation. Because no effective interventions have been developed to prevent weight-gain after quitting, research should focus on the concern or perception of weight-gain. We need to understand how and why body weight concerns vary across gender, age, and ethnicity because of the implications for designing effective smoking-cessation programs.

Attention↗

PubMed2001

The discriminative stimulus and reinforcing effects of nicotine in humans following nicotine pretreatment.

Smokers often report that the first cigarette of the day is the most rewarding, and subsequent smoking is less rewarding. Reduction in smoking enjoyment later in the day may be related to acute tolerance to the discriminative stimulus effects of nicotine. We examined changes in nicotine discrimination behaviour in humans as a function of acute nicotine pretreatment. Male and female dependent smokers (n = 15) were initially trained to discriminate 20 microg/kg nicotine by nasal spray from placebo (0 microg/kg) without nicotine pretreatment. They then were tested on generalization of discrimination across a range of spray doses from 0-20 microg/kg following pretreatment with placebo, moderate dose (14-21 mg) or high dose (28-42 mg) transdermal nicotine. Generalization testing involved both two- and three-response ('novel' option) quantitative procedures. Subjects also engaged in a self-administration phase at the end of each session, involving choices between nicotine (20 microg/kg) and placebo spray. Nicotine pretreatment significantly attenuated nicotine-appropriate responding at higher nicotine spray doses, suggesting acute tolerance, but only in women. Similar results were seen for subjective 'head rush', suggesting this effect may be related to discrimination behaviour in women. However, nicotine pretreatment also increased novel-appropriate responding, especially in men, following intermediate generalization doses, suggesting qualitatively different stimulus effects. Although differences were not significant, nicotine self-administration tended to be inversely associated with nicotine pretreatment dose in men but not in women. These results only modestly support the notion of acute tolerance to the discriminative stimulus effects of nicotine, and even then only in women and not in men.

Administration, Cutaneous↗

PubMed1981

The efficacy of acupuncture as an aid to stopping smoking.

The present study examines the usefulness of acupuncture as an aid to stopping smoking. Results from 405 subjects show acupuncture can help between 5 and 15 percent of the population to stop smoking for at least six months. Using chronically implanted press needles, previously reported 'effective' auricular acupuncture points for smoking cessation are shown to be no better than 'placebo' auricular points. Additional electroacupuncture on the hand neither increases the probability of stopping smoking nor enhances the reduction in smoking at three week, three month or six month follow-up periods. It is therefore likely that a large psychological component is attached to acupuncture to stop people smoking.

Acupuncture Therapy↗

PubMed2004

Interventions for promoting smoking cessation during pregnancy.

BACKGROUND: Smoking remains one of the few potentially preventable factors associated with low birthweight, preterm birth and perinatal death. OBJECTIVES: To assess the effects of smoking cessation programs implemented during pregnancy on the health of the fetus, infant, mother, and family. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Tobacco Addiction Group trials register (July 2003), MEDLINE (January 2002 to July 2003), EMBASE (January 2002 to July 2003), PsychLIT (January 2002 to July 2003), CINAHL (January 2002 to July 2003), and AUSTHEALTH (January 2002 to 2003). We contacted trial authors to locate additional unpublished data. We handsearched references of identified trials and recent obstetric journals. SELECTION CRITERIA: Randomised and quasi-randomised trials of smoking cessation programs implemented during pregnancy. DATA COLLECTION AND ANALYSIS: Four reviewers assessed trial quality and extracted data independently. MAIN RESULTS: This review included 64 trials. Fifty-one randomised controlled trials (20,931 women) and six cluster-randomised trials (over 7500 women) provided data on smoking cessation and/or perinatal outcomes. Despite substantial variation in the intensity of the intervention and the extent of reminders and reinforcement through pregnancy, there was an increase in the median intensity of both 'usual care' and interventions over time. There was a significant reduction in smoking in the intervention groups of the 48 trials included: (relative risk (RR) 0.94, 95% confidence interval (CI) 0.93 to 0.95), an absolute difference of six in 100 women continuing to smoke. The 36 trials with validated smoking cessation had a similar reduction (RR 0.94, 95% CI 0.92 to 0.95). Smoking cessation interventions reduced low birthweight (RR 0.81, 95% CI 0.70 to 0.94) and preterm birth (RR 0.84, 95% CI 0.72 to 0.98), and there was a 33 g (95% CI 11 g to 55 g) increase in mean birthweight. There were no statistically significant differences in very low birthweight, stillbirths, perinatal or neonatal mortality but these analyses had very limited power. One intervention strategy, rewards plus social support (two trials), resulted in a significantly greater smoking reduction than other strategies (RR 0.77, 95% CI 0.72 to 0.82). Five trials of smoking relapse prevention (over 800 women) showed no statistically significant reduction in relapse. REVIEWERS' CONCLUSIONS: Smoking cessation programs in pregnancy reduce the proportion of women who continue to smoke, and reduce low birthweight and preterm birth. The pooled trials have inadequate power to detect reductions in perinatal mortality or very low birthweight.

Female↗

PubMed2004

Recent quitters' interest in recycling and harm reduction.

Many smoking cessation attempts are followed by failure or relapse. The optimal time to initiate a new quit attempt is not known. Administrative databases documenting recent use of a pharmacological aid for smoking cessation provide access to a population of smokers recently in the action phase of quitting. This study describes interest in further treatment among this population. A total of 2,340 smokers from the Minneapolis Veterans Administration Medical Center received prescriptions for a smoking cessation aid during an 18-month period. We conducted a cross-sectional survey of a random sample of this population a minimum of 3 months following the prescription, using a structured telephone interview (N=391). The response rate was 75.8%. The 1-month point-prevalent abstinence rate was 19.7%. Of continuing smokers, 98% were willing to make another quit attempt--50% immediately, and 28% within 1 month. There was no relationship between time since the last quit attempt and interest in trying again immediately. Some 95% of continuing smokers were willing to try a reduction strategy. Of these, 82.7% were interested in using nicotine replacement therapy (NRT) to accomplish this goal. Most cessation programs do not systematically approach participants who relapse. These data suggest that this population would welcome further help in quitting or reducing smoking shortly following failure, and that smokers do not commonly relapse to a precontemplation stage of change.

Administration, Cutaneous↗

PubMed2001

Airway hyperresponsiveness to bronchoconstrictor challenge after wood smoke exposure in guinea pigs.

Prior airway exposure to wood smoke induces an increase in airway responsiveness to subsequent smoke inhalation in guinea pigs (Life Sci. 63: 1513, 1998; 66: 971, 2000). To further characterize this airway hyperreactivity, we investigated and compared the airway responsiveness to bronchoconstrictor challenge before and 30 min after sham air exposure or wood smoke exposure in anesthetized and artificially ventilated guinea pigs. Various doses of substance P (0.8-6.4 microg/kg), capsaicin (0.2-3.2 microg/kg), prostaglandin F2alpha (30-3000 microg/kg), histamine (1-8 microg/kg), or acetylcholine (5-20 microg/kg) were intravenously injected at 2-min intervals in successively increasing doses to obtain the dose required to provoke a 200% increase in baseline total lung resistance (ED200). Wood smoke exposure significantly lowered the ED200 of substance P, capsaicin, and prostaglandin F2alpha whereas sham air exposure failed to do so. Furthermore, wood smoke exposure did not significantly alter the ED200 of histamine or acetylcholine. Pretreatment with phosphoramidon (2 mg/kg), an inhibitor of the neutral endopeptidase (the major degradation enzyme of substance P), before smoke exposure did not significantly affect the smoke-induced reduction in ED200 of substance P. Sectioning both cervical vagi before smoke exposure did not significantly alter the smoke-induced reduction in ED200 of capsaicin or prostaglandin F2alpha. These results suggest that airway exposure to wood smoke acutely produces airway hyperresponsiveness to substance P, capsaicin, and prostaglandin F2alpha, but not to histamine or acetylcholine. Since the combination of phosphoramidon and wood smoke exposure did not result in an additive potentiation of smoke-induced airway hyperresponsiveness to substance P, it is suggested that an inhibition of the degradation enzyme of substance P may contribute to this increase in airway reactivity. Furthermore, vagally-mediated bronchoconstriction does not play a vital role in enhanced airway responsiveness to capsaicin or prostaglandin F2alpha.

Acetylcholine↗

PubMed1984

Relationship between weight change and the reduction or cessation of cigarette smoking.

To determine the relationship between body weight and reduction or cessation of cigarette smoking, body weight and height as well as serum thiocyanate concentration were measured in 107 persons before and after participation in smoking-cessation programs. Body weight increased in only 67.3 percent of cases, but increases in body weight were associated with the greater reduction in cigarette consumption while the absence of weight gain was associated with a small reduction in cigarette consumption. Body weight increases after participation in the program were significantly (P less than 0.05) greater in men than in women despite the absence of a significant difference in the reduction of cigarette consumption between men and women. Analysis of variance failed to show a significant deviation from linearity in the significant relationship between reduction in tobacco consumption and increase in body weight. A number of variables assessed at entry into the study, such as age, age at starting smoking, cigarette consumption, initial body weight or anxiety level (Manifest Anxiety Scale) did not correlate with the change in weight in men or women. These data suggest that the most important determinant of weight gain is the amount of reduction in cigarette consumption and that there are important sex differences in response of body weight to reduction of tobacco consumption.

Adult↗

PubMed1994

Smoking and cancer: smoking cessation.

Smoking is the single most important cause of cancer. The risk of developing cancer is reduced by stopping smoking and decreases substantially after five years. Reduction in smoking must be central to any programme aimed seriously at the prevention of cancer. An individual approach, based in primary care, has the potential to bring about modest but important reductions in risk. Many randomised trials have shown the effectiveness of various smoking cessation interventions in primary care. Given resource limitations in primary care, individual effort should be focused on those at highest risk who are motivated to stop smoking. A population strategy has considerable advantages over the high risk approach as the potential for reducing morbidity and mortality in the whole population is much greater. The government must acknowledge its major responsibility; the outstanding example of its failure to do this is its persistent refusal to ban outright all forms of advertising and promotion of tobacco. There is clear evidence that a ban would contribute to a reduction in smoking prevalence and especially in the uptake of smoking by children.

Adolescent↗

PubMed1993

Smoking habits in early pregnancy related to age of smoking debut.

During 1 year, 187 general practitioners in western Norway recruited 530 daily smoking, pregnant women for a smoking cessation study. At the first medical check-up in pregnancy each woman filled in a questionnaire. Women who had started smoking within 15 years of age reported more heavy smoking the last 3 months before pregnancy (P < 0.0001) and at the first check-up in pregnancy (P < 0.01) than those who had started smoking later. They also reported less reduction in smoking habits during earlier pregnancies (P < 0.0001) and more serious tobacco addiction judged by starting smoking early in the morning (P < 0.005). However, even those who had started smoking before 15 years of age reported a reduction of 30% in cigarette consumption during the first few weeks of the present pregnancy. In addition to increasing the antismoking efforts among pregnant women, health education among girls 12-15 years of age to prevent smoking initiation should be intensified.

Adolescent↗

PubMed1982

Self-administered programs for health behavior change: smoking cessation and weight reduction by mail.

Forty smokers and 47 overweight individuals were recruited for a home correspondence program for either smoking cessation or weight loss. Participants were assigned to one of four programs for changing their respective health behaviors: (1) a home correspondence program conducted entirely by mail, (2) the mail program with supplemental financial contigency contracts tied to completion of written homework, (3) the correspondence programs supplemented both by homework contracts and by regular calls to a telephone answering system, and (4) a standard behavioral group program which acted as a comparison condition. Results showed that all three correspondence approaches produced significant changes in health behaviors equal to the changes experienced by participants in the standard group program. The implication of these findings for development of low cost programs for disease prevention are discussed.

Adult↗