Objectives: To quantify the implementation of tobacco control policies at country level using a new Tobacco Control Scale and to report initial results using the scale. Method: A questionnaire sent ...to correspondents in 30 European countries, using a scoring system designed with the help of a panel of international tobacco control experts. Results: The 30 countries are ranked by their total score on the scale out of a maximum possible score of 100. Only four countries (Ireland, United Kingdom, Norway, Iceland) scored 70 or more, with an eight point gap (most differences in scores are small) to the fifth country, Malta, on 62. Only 13 countries scored above 50, 11 of them from the European Union (EU), and the second largest points gap occurs between Denmark on 45 and Portugal on 39, splitting the table into three groups: 70 and above, 45 to 62, 39 and below. Ireland had the highest overall score, 74 out of 100, and Luxembourg was bottom with 26 points. However even Ireland, much praised for their ban on smoking in public places, did not increase tobacco taxes in 2005, for the first time since 1995. Conclusions: Although the Tobacco Control Scale has limitations, this is the first time such a scale has been developed and applied to so many countries. We hope it will be useful in encouraging countries to strengthen currently weak areas of their tobacco control policy.
Recent scholarly attention has focused on explicating the nature of tobacco use among anxiety-vulnerable smokers. Anxiety sensitivity (fear of aversive internal anxiety states) is a ...cognitive-affective individual difference factor related to the development and maintenance of anxiety symptoms and disorders and various smoking processes. The present study examined the cross-sectional associations between anxiety sensitivity and a range of cognitive and behavioral smoking processes, and the mediating role of the tendency to respond inflexibly and with avoidance in the presence of smoking-related distress (i.e., avoidance and inflexibility to smoking AIS) in such relations. Participants (n = 466) were treatment-seeking daily tobacco smokers recruited as part of a larger tobacco cessation study. Baseline (pretreatment) data were utilized. Self-report measures were used to assess anxiety sensitivity, AIS, and 4 criterion variables: barriers to smoking cessation, quit attempt history, severity of problematic symptoms reported in past quit attempts, and mood-management smoking expectancies. Results indicated that anxiety sensitivity was indirectly related to greater barriers to cessation, greater number of prior quit attempts and greater mood-management smoking expectancies through the tendency to respond inflexibly/avoid to the presence of distressing smoking-related thoughts, feelings, and internal sensations; but not severity of problems experienced while quitting. The present findings suggest AIS may be an explanatory mechanism between anxiety sensitivity and certain smoking processes.
Rationale
Neurobiological models of addiction suggest that abnormalities of brain reward circuitry distort salience attribution and inhibitory control processes, which in turn contribute to high ...relapse rates.
Objectives
The aim of this study is to determine whether impairments of salience attribution and inhibitory control predict relapse in a pharmacologically unaided attempt at smoking cessation.
Methods
One hundred forty one smokers were assessed on indices of nicotine consumption/dependence (e.g. The Fagerström Test of Nicotine Dependence, cigarettes per day, salivary cotinine) and three trait impulsivity measures. After overnight abstinence, they completed experimental tests of cue reactivity, attentional bias to smoking cues, response to financial reward, motor impulsiveness and response inhibition (antisaccades). They then started a quit attempt with follow-up after 7 days, 1 month and 3 months; abstinence was verified via salivary cotinine levels ≤20 ng/ml.
Results
Relapse rates at each point were 52.5%, 64% and 76.3%. The strongest predictor was pre-cessation salivary cotinine; other smoking/dependence indices did not explain additional outcome variance and neither did trait impulsivity. All experimental indices except responsivity to financial reward significantly predicted a 1-week outcome. Salivary cotinine, attentional bias to smoking cues and antisaccade errors explained unique as well as shared variance. At 1 and 3 months, salivary cotinine, motor impulsiveness and cue reactivity were all individually predictive; the effects of salivary cotinine and motor impulsiveness were additive.
Conclusions
These data provide some support for the involvement of abnormal cognitive and motivational processes in sustaining smoking dependence and suggest that they might be a focus of interventions, especially in the early stages of cessation.
As per China's ratification of the WHO Framework Convention on Tobacco Control (FCTC), it should have implemented effective packaging and labelling measures prior to 9 January 2009 and enacted a ...comprehensive ban on all tobacco advertising, promotion and sponsorship prior to 9 January 2011. In addition, universal protection against secondhand tobacco smoke should have been implemented before 9 January 2011 by ensuring that all indoor workplaces, all indoor public places, all public transportation and possibly other (outdoor or quasi-outdoor) public places are free of secondhand smoke. The authors conducted a review of various sources of information to determine the current status of FCTC implementation in mainland China. Even though China has made considerable efforts to implement the FCTC, there is still a significant gap between the current state of affairs in China and the requirements of the FCTC. The Chinese tobacco monopoly under which commercial and other vested interests of the tobacco industry are jeopardising tobacco control efforts is thought to be the most crucial obstacle to the effective implementation of the FCTC across the country.
Smoking Prevalence among US Veterans Brown, David W.
Journal of general internal medicine : JGIM,
02/2010, Letnik:
25, Številka:
2
Journal Article
Recenzirano
Odprti dostop
BACKGROUND/OBJECTIVE
Cigarette smoking is a significant health problem within the US military. Data from the 2003–2007 Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate and ...compare the prevalence of smoking among US veterans with that of adults who did not serve in the US armed forces.
METHODS
Data from the BRFSS, a state-based random-digit dialed telephone survey supported by the Centers for Disease Control and Prevention, were used to estimate the prevalence of current smoking among adults (aged ≥18 years) who reported ever serving on active duty in the United States Armed Forces. We compared, by birth cohort, age-adjusted smoking prevalence among veterans with that of adults who did not serve in the military.
RESULTS
A total of 224,169 US veterans participated during 2003–2007. The age-adjusted prevalence of smoking during the period was 27.0% (standard error, 0.36) among veterans and 21% (0.12) among non-veterans. For both groups, the prevalence decreased across years from 29% (0.79) in 2003 to 25% (0.82) in 2007 among veterans and from 23% (0.29) in 2003 to 20% (0.26) in 2007 among non-veterans. Among veterans, smoking prevalence was highest among men born between 1975–1984 (36%; 90%CI = 33.7–37.5) and those born between 1985–1989 (37%; 90%CI = 31.7–48.2) with lower prevalences among men born between 1945–1954 (26%; 90%CI = 25.1–26.3), 1955–1964 (33%; 90%CI = 32.3–34.3), and 1965–1974 (27%; 90%CI = 26.0–28.1). The prevalence of smoking was 43% (90%CI = 39.0–47.6) among veterans with self-reported coronary heart disease (CHD), greater than that for non-veterans with CHD (31%; 90%CI = 28.6–33.1).
CONCLUSIONS
Although the prevalence of smoking has declined among US adults, there are opportunities to further reduce smoking among US veterans, particularly young veterans for whom the prevalence of smoking is similar to that of the US adult population during the late 1960s/early 1970s. Continued work is necessary to target the high smoking prevalence among veterans with CHD, a group for which smoking cessation is especially important.
The goal of this study was to investigate the effects of different strategies for regulating emotions associated with smoking on subjective, cognitive, and behavioral correlates of smoking. Emotion ...regulation was manipulated by instructing participants to reappraise (n = 32), accept (n = 31), or suppress (n = 31) their emotions associated with smoking. The dependent measures included subjective reports of craving, negative affect, and attentional biases, as measured by a modified dot-probe task, and persistence during a task to measure distress tolerance. Individuals who were encouraged to reappraise the consequences of smoking showed diminished craving, lower negative affect, had reduced attentional biases for smoking-related cues, and exhibited greater task persistence than those who were instructed to accept and suppress their urge to smoke. These findings suggest that reappraisal techniques are more effective than acceptance or suppression strategies for targeting smoking-related problems.
► Reappraisal reduces smoking-related craving and increases task persistence. ► Reappraisal is associated with lower attentional bias for smoking-related cues. ► Reappraisal is more effective than acceptance and suppression. ► Acceptance and suppression strategies exhibited the same effects on smoking craving.
Compared to the general population, cigarette smokers report poorer sleep quality. Poor sleep quality in cigarette smokers is associated with greater nicotine dependence. While exercise is known to ...improve sleep quality in the general population, less is known about how exercise effects sleep in those who smoke. The goal of this study was to explore the relationships between exercise, sleep, and smoking in cigarette smokers.
Data on sleep quality (Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI)), smoking-related outcomes (e.g., cigarettes/day, Fagerstrom Test for Nicotine Dependence, Minnesota Nicotine and Withdrawal Scale, and Questionnaire of Smoking Urges) and exercise (Fitbit activity measures) were collected for 32 participants (63% female, mean age 30.3 ± 1.0 years) participating in a 12-week clinical research study. Analyses included simple linear regression models.
Overall, participants reported poor sleep quality at baseline (PSQI > 5). Poorer sleep quality at baseline was associated with increased withdrawal (β = 1.63 ± 0.53, p = 0.0043), craving (β = 0.51 ± 0.43, p = 0.2471), and total smoking urges (β = 1.10 ± 0.41, p = 0.0118). During follow-up (i.e., from baseline to week 12), a daily increase in exercise was associated with improved sleep quality over the same time period (PSQI: β = −0.82 ± 0.35, p = 0.0379).
Our data suggest that better sleep quality may be associated with lower levels of withdrawal, craving, and smoking urges. Further, exercise may be associated with better sleep quality in cigarette smokers. Future work should explore how increasing exercise and improving sleep quality could inform future smoking cessation interventions.
•Cigarette smokers are at increased risk for poor sleep quality.•Poorer sleep quality was associated with greater withdrawal and cravings.•An increase in exercise was associated with improved sleep quality.
In recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. This study aimed to investigate the association between the use of ...O&D and LC incidence.
In this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 280 healthy controls matched by age, sex, and place of residence were included. Data, including O&D use, cigarette smoking, alcohol use, and diet, were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression adjusted for tobacco smoking, education, daily intake of fruit, vegetables, red meat, and hydrogenated fats.
Opium ever-use was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) =5.95, 95% CI: 1.87-18.92). Participants were divided into low and high use groups based on the median of opium use in the control group. A significant dose-response relation was observed between the amount of daily O&D use and LC; and the relation was stronger in high users (AOR
= 3.81% CI: 1.13-12.77 and OR
= 9.36, 95% CI: 2.05-42.72). Also, LC was higher among participants starting the use of O&D at younger ages (≤ 41 years old vs never users AOR = 8.64, 95% CI: 1.90-39.18) compared to those who started at an older age (> 41 years old vs never users, AOR = 4.71, 95% CI: 1.38-16.08). The association between opium, and lung cancer among non-smokers was OR: 6.50 (95% CI: 2.89 to 14.64).
The results of this study show that opium use is probably a dose related risk factor for lung cancer.
Objectives. Tobacco product risk perceptions may influence whether individuals use those products instead of or in addition to regular cigarettes. This study aimed to explore risk perceptions of ...various tobacco products relative to traditional cigarettes with young adults, a group with higher rates of tobacco use. Method. We examined risk perception responses among a nationally representative sample of young adults (age 18-34 years; n = 2,871, including tobacco and non–tobacco users) from the 2011 National Young Adult Health Survey. Results. Most (57.8%) respondents believed that e-cigarettes were less risky than cigarettes. Respondents were more likely to rate combustible products hookah (24.5%) and cigars (13.9%) as being less risky compared to noncombustible snus (10%) and other smokeless tobacco (SLT) products (7.1%) relative to cigarettes. Few (2.5%) rated menthol cigarettes as less risky. For e-cigarettes, hookah, and SLT, less risky beliefs were significantly higher among ever or current versus never product users. Between 22% and 33% of all respondents believed that SLT, snus, menthol cigarettes, and cigars were more risky than cigarettes, but differences in this belief between current and nonusers of these products were small and insignificant. Younger young adults were more likely to rate e-cigarettes and hookah as being “less risky” and rate cigars and SLT as being “more risky” than older young adults. Conclusion. The public’s views of comparative tobacco risk perceptions vary widely by tobacco product type and age-group. While “less risky” perceptions may be associated with product use, perceptions that products are “more risky” than cigarettes may not necessarily dissuade people from their use.
Current tobacco treatment guidelines have established the efficacy of available interventions, but they do not provide detailed guidance for common implementation questions frequently faced in the ...clinic. An evidence-based guideline was created that addresses several pharmacotherapy-initiation questions that routinely confront treatment teams.
Individuals with diverse expertise related to smoking cessation were empaneled to prioritize questions and outcomes important to clinicians. An evidence-synthesis team conducted systematic reviews, which informed recommendations to answer the questions. The GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach was used to rate the certainty in the estimated effects and the strength of recommendations.
The guideline panel formulated five strong recommendations and two conditional recommendations regarding pharmacotherapy choices. Strong recommendations include using varenicline rather than a nicotine patch, using varenicline rather than bupropion, using varenicline rather than a nicotine patch in adults with a comorbid psychiatric condition, initiating varenicline in adults even if they are unready to quit, and using controller therapy for an extended treatment duration greater than 12 weeks. Conditional recommendations include combining a nicotine patch with varenicline rather than using varenicline alone and using varenicline rather than electronic cigarettes.
Seven recommendations are provided, which represent simple practice changes that are likely to increase the effectiveness of tobacco-dependence pharmacotherapy.
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