A Qualitative Exploration of the Theory of Triadic Influence in a Nigerian Setting: The Case of Cigarette Smoking

The theory of triadic influence (TTI) was employed as a framework to explore the risk influences for cigarette smoking among an inclusive sample of young smokers. This qualitative study involved a purposive sample of 18 young smokers aged 18–24 years. Data were collected using individual interviews and analysed using thematic analysis. Following the TTI, factors found to influence young people’s initiation and perpetuation of smoking included at the intrapersonal level, sensation seeking, hedonic attitudes and poor coping skills; young smokers engage in cigarettes smoking to cope with social and psychological challenges like stress, worries, to aid digestion and for relaxation. At the interpersonal level, smokers were influenced by their peers and significant others like parents, brothers, teachers and mentors. Immediate risk influences for smoking included experimentation with cigarettes and the use of other substances like marijuana and alcohol. Intervention programmes targeted at building life skills and the ability to resist the pressure from peers and significant others to smoke are needed.     

Marijuana Use Among Daily Tobacco Smokers: Relationship to Anxiety-Related Factors

The present investigation evaluated the incremental validity of regular marijuana use and frequency of such use in relation to anxiety and depressive symptoms and perceived health among young adult tobacco smokers (n = 202). Approximately 72% of the sample were current marijuana smokers, using this drug on an average of 7.6 (SD = 9.2) times per week. As expected, after controlling for theoretically-relevant smoking (cigarettes per day), alcohol use, and affect factors (i.e., negative affectivity and anxiety sensitivity), marijuana use predicted anxiety symptoms and perceived general health, whereas frequency of marijuana use predicted only anxiety symptoms. These results are discussed in relation to better understanding the role of regular marijuana use in terms of anxiety-relevant emotional vulnerability and beliefs about physical health among regular smokers.     

Positive reactions to tobacco predict relapse after cessation

Among chronic smokers, individual differences in subjective reactions to smoking may characterize important facets of nicotine dependence that relate to abstinence-induced craving, withdrawal symptom profiles, and risk for relapse. Although the negative reinforcing properties of smoking have achieved prominent positions in models of relapse (Baker, Brandon, & Chassin, 2004), vulnerability to relapse risk may also arise from seeking positive reinforcement from smoking (Shiffman & Kirchner, 2009). In this study, 183 cessation-motivated smokers provided subjective craving, positive and negative reactions to standardized cigarettes following overnight abstinence. Level of craving, negative mood, and positive mood after overnight abstinence were significantly predictive of withdrawal on quit-day. Increased positive reactions to smoking were uniquely predictive of relapse after quitting (Hazard Ratio = 1.22, p < .001). Individual differences in positive reactions to smoking may be important markers of neurobiological systems that promote dependence and interfere with cessation efforts.     

戒烟社会支持与吸烟者戒烟意向的关系：亲友认同的调节作用和吸烟危害认识的中介作用

研究旨在考察吸烟者的亲友认同和吸烟危害认识在亲友戒烟社会支持与戒烟意向关系中的作用。对340名吸烟者被试进行问卷调查,结果表明：（1）戒烟社会支持显著正向预测戒烟意向;（2）吸烟危害认识对社会支持和戒烟意向的关系起完全中介作用;（3）亲友认同对戒烟社会支持和戒烟意向的关系起显著调节作用。研究拓展了压力缓冲模型,说明了戒烟社会支持的认知功能,且支持了社会认同在社会支持发挥作用过程中的重要性。     

Attitudes, perceptions, and risk-taking behaviors of smokers, ex-smokers, and nonsmokers.

A sample of American adults completed questionnaires relevant to cigarette smoking. The questions were related to three areas: risk, perceptions of their or others' smoking, and satisfaction with life and health. The results revealed that smokers were greater risk-takers, that they perceived their smoking to be due to both physical and psychological addictions, and that they expressed less satisfaction and control. Results also indicated that smokers who saw their smoking as being addictive tended to be less satisfied with their health and felt less control over their lives. On the other hand, those smokers who were more likely to deny the health risks did not differ from either non- or ex-smokers on any of the satisfaction or control questions.     

Psychological Reactance and Adolescents' Attitudes Toward Tobacco-Control Measures

The theory of psychological reactance predicts that, to the extent that smoking-control measures are perceived as threatening the individual's freedom to choose among behavioral alternatives, they may be met with resistance. Data were collected from a national representative sample of 2,400 young people (ages 16–20) by telephone interviews. Dispositional reactance was shown to be associated with smoking. Principal components analyses revealed that a distinction should be made between attitudes toward weak and attitudes toward strong smoking-control measures. Attitudes toward strong measures were particularly negative among regular smokers. Among regular smokers, dispositional reactance was found to be significantly associated with attitudes toward strong tobacco-control measures. Processes of psychological reactance deserve attention when designing smoking control programs.     

Anxiety sensitivity: association with intensity of retrospectively-rated smoking-related withdrawal symptoms and motivation to quit

The present cross-sectional study evaluated the associations between anxiety sensitivity, intensity of retrospectively-rated nicotine withdrawal symptoms, and motivation to quit smoking. Participants were 127 young adult (mean age 20.4 years (SD 4.6)) regular smokers (mean cigarettes per day 10.2 (SD 5.1)). Anxiety sensitivity predicted intensity of retrospectively rated withdrawal symptoms during the first week of the most recent quit attempt as well as concurrent and lifetime indices of motivation to quit smoking even after controlling for theoretically-relevant smoking (e.g. nicotine dependence) and affect (e.g. panic attack history) factors. These results are discussed in relation to better understanding panic-related vulnerability factors in smoking cessation.     

A comparative analysis of teenagers who smoke different cigarette brands

This study analyzed and compared the survey responses of teenagers who smoke different cigarette brands. It was found that teen Marlboro and Camel smokers perceived themselves as having more stress in their lives as compared with teen Newport smokers. On average, Marlboro smokers were depressed or sad more often than were Camel or Newport smokers. Camel smokers were generally less interested in a peer stop-smoking program than were Newport or Marlboro smokers. Finally, these teen smokers, regardless of cigarette brand, had similar opinions about quitting. Given the differences across brands, more flexible approaches may be needed to address teenage smoking.     

Social Discounting and Cigarette Smoking During Pregnancy

In this study, we examined the association between social discounting and smoking status in a cohort of pregnant cigarette smokers (n = 91), quitters (n = 27), or never‐smokers (n = 30). The smokers and quitters were participants in clinical trials on smoking cessation and relapse prevention, whereas the never‐smokers were controls in a study on nicotine withdrawal during pregnancy. Social discounting was assessed using a paper‐and‐pencil task that assesses the amount of hypothetical money a person is willing to forgo in order to share with individuals in their social network ranging from the person who is emotionally closest to them to a mere acquaintance. The amount that women were willing to forgo in order to share decreased hyperbolically as a function of social distance, with smokers exhibiting steeper discounting functions (i.e., less generosity) than quitters or never‐smokers; discounting functions of quitters and never‐smokers did not differ significantly. In multivariate analyses controlling for potential sociodemographic and other confounds, social discounting remained a significant predictor of smoking status among smokers versus quitters. Overall, these results suggest that individual differences in social discounting may be a factor influencing the choices that women make about quitting smoking upon learning of a pregnancy. Copyright © 2011 John Wiley & Sons, Ltd.     

The asbestos worker who smokes: adding insult to injury

Evaluates whether asbestos workers who smoke cigarettes, thereby increasing their cancer risk synergistically, differ from asbestos workers who choose not to smoke. Demographic, personality, psychologic, and cognitive differences were examined. Engaging in this highly detrimental health behavior was related exclusively to cognitive factors. Although current smokers were cognitively aware of their added health risk, in comparison to past and "never" smokers, they minimized the salience of awareness by fatalistically attributing their health to chance factors such as luck and by minimizing the dangers of smoking, the benefits of smoking cessation, and their own increased vulnerability to life-threatening illnesses. Results are explained in light of the apparent denial of risk. The need for physician intervention is strongly advocated.     

Relationship of Acculturation and Family Functioning to Smoking Attitudes and Behaviors Among Asian-American Adolescents

The primary objective of this study was to examine the combination of acculturation, family functioning, and parental smoking as predictors of smoking attitudes and behaviors among Asian-American adolescents. The participants were 106 Asian-American high school students whose ages ranged from 15 to 19 (51 male and 55 female, mean age = 16.30 years). Of the sample, 49% reported having tried smoking, and 27% identified themselves as regular smokers. The results indicated that smoking attitudes were significantly associated with smoking behaviors. Compared to nonsmokers, adolescent regular smokers had more positive smoking attitudes, lower acculturation, poorer family functioning and were more likely to have a father who smoked.     

Perceived health: a test of incremental validity in relation to smoking outcome expectancies, motivation to smoke and desire to quit smoking

This study examined the role of perceived health in predicting theoretically-relevant aspects of smoking behavior among 161 young adult regular smokers (67 females; mean age = 21.9 years (SD = 7.2), cigarettes per day (M) = 12.2 (SD = 5.7)) recruited from the general community. Consistent with prediction, results indicated that relative to anxiety sensitivity, gender, number of cigarettes smoked per day and nicotine dependence, perceived physical health uniquely and significantly predicted expectancies for negative affect reduction and expectancies that smoking would lead to negative personal consequences. Additionally, perceived health incrementally predicted motivation to smoke to reduce negative affect. In contrast to expectation, perceived health was unrelated to motivation to quit smoking. Results are discussed in relation to the role of perceived health as a cognitive vulnerability factor for specific types of smoking patterns.     

Perceived Health: A Test of Incremental Validity in Relation to Smoking Outcome Expectancies,Motivation to Smoke and Desire to Quit Smoking

This study examined the role of perceived health in predicting theoretically‐relevant aspects of smoking behavior among 161 young adult regular smokers (67 females; mean age = 21.9 years (SD = 7.2), cigarettes per day (M) = 12.2 (SD = 5.7)) recruited from the general community. Consistent with prediction, results indicated that relative to anxiety sensitivity, gender, number of cigarettes smoked per day and nicotine dependence, perceived physical health uniquely and significantly predicted expectancies for negative affect reduction and expectancies that smoking would lead to negative personal consequences. Additionally, perceived health incrementally predicted motivation to smoke to reduce negative affect. In contrast to expectation, perceived health was unrelated to motivation to quit smoking. Results are discussed in relation to the role of perceived health as a cognitive vulnerability factor for specific types of smoking patterns.     

An "Epidemic" Model of Adolescent Cigarette Smoking

The prevalence of regular smoking increases rapidly during adolescence. We applied modeling methods from the study of epidemic infectious disease to smoking behavior. Our "epidemic" models dealt with the process of transition among four states: nonsmoker (susceptible), trier (exposed), regular smoker (infected), and ex-smoker (recovered). The best fitting model was one in which the transition from nonsmoker to trier was a social contagion process where nonsmokers contacted either triers or regular smokers. All other transitions were treated as constant rate processes in which a constant proportion of eligible individuals made the transition in a given year. The recursive equation model embodying these assumptions was able to predict accurately the proportion of adolescents in each state in Grades 6–11. Our results support a "stage" model of smoking, suggesting that different psychological and physiological processes are involved in the initiation of smoking than in developing a habit of regular smoking. A possible sex difference was found in the non-contact transition between trier and smoker states, with the transition being more probable in females than in males.     

Parental Smoking and the “Epidemic” Spread of Cigarette Smoking1

“Epidemic” models of transitions between stages of cigarette smoking describe the spread of smoking behavior through face-to-face encounters. An epidemic model was successfully fitted that allowed epidemic parameters to be conditioned on the smoking status of adolescents' parents. Model comparisons supported the conclusion that the transition from nonsmoker to trier involved social contacts, whereas the transition from trier to regular smoker was best modeled as a constant rate (i.e., did not depend on the population prevalence of smokers). The transition rate from nonsmoker to trier was more rapid in children of smoking parents than in children of nonsmoking parents. Adolescents with and without smoking parents did not differ in the rate of transition from trier to regular smoking.     

A population study of low-rate smokers: quitting history and instability over time.

This study used 1 longitudinal and 2 cross-seconal population surveys to compare stability of low-rate daily smokers (less than 5 cigarettes per day) with other daily smokers and occasional smokers. Few low-rate smokers maintained consumption level; 36% retained smoking status after 20 months, compared with 82% and 44% for regular daily and occasional smokers, respectively. In a dynamic process, established smokers quit smoking and/or modified (decreased or increased) consumption. Low-rate and occasional smokers quit at higher rates than regular daily smokers (odds ratios 3:1) but were replenished by new members, many converted from regular daily smoker. The overall trend is an increasing proportion of low-consumption smokers while smoking prevalence declines. The dynamic process has implications for tobacco control efforts and for addiction theory.     

吸烟者感知吸烟社会规范与社交性吸烟行为的关系：身份认同和关系观的作用

考察吸烟者身份认同和关系观在感知吸烟社会规范与社交性吸烟行为关系中的作用。对1016名吸烟者进行问卷调查,结果表明：（1）感知吸烟社会规范显著正向预测社交性吸烟;（2）身份认同对感知吸烟社会规范和社交性吸烟关系起部分中介作用;（3）关系观正向调节感知吸烟社会规范和社交性吸烟的关系,而对感知吸烟社会规范和身份认同关系的调节不显著。研究支持了感知吸烟社会规范影响社交性吸烟的身份认同机制和文化价值观调节机制。     

Examining gender differences in received,provided, and invisible social control: an application of the dual-effects model

The dual-effects model of social control not only assumes that social control leads to better health practices but also arouses psychological distress. However, findings are inconsistent. The present study advances the current literature by examining social control from a dyadic perspective in the context of smoking. In addition, the study examines whether control, continuous smoking abstinence, and affect are differentially related for men and women. Before and three weeks after a self-set quit attempt, we examined 106 smokers (77 men, mean age: 40.67, average number of cigarettes smoked per day: 16.59 [SD = 8.52, range = 1–40] at baseline and 5.27 [SD = 6.97, range = 0–40] at follow-up) and their nonsmoking heterosexual partners, assessing received and provided control, continuous abstinence, and affect. With regard to smoker's affective reactions, partner's provided control was related to an increase in positive and to a decrease in negative affect, but only for female smokers. Moreover, the greater the discrepancy between smoker received and partner's provided control was the more positive affect increased and the more negative affect decreased, but again only for female smokers. These findings demonstrate that female smokers' well-being was raised over time if they were not aware of the control attempts of their nonsmoking partners, indicating positive effects of invisible social control. This study's results emphasize the importance of applying a dyadic perspective and taking gender differences in the dual-effects model of social control into account.     

Cigarette smokers do more than just smoke cigarettes

In this study, we hypothesized that light and moderate-to-heavy cigarette smokers, when compared with nonsmokers, would exhibit significantly less healthy attitudes and behaviors on several dimensions relevant to the risk of coronary heart disease (CHD). A factor analysis of survey items measuring knowledge, attitudes, and behaviors in five CHD risk areas produced four major factors, which we labeled Attitudes (Factor 1), Health Consciousness (Factor 2), Knowledge (Factor 3), and Unhealthy Behaviors (Factor 4). Factor-based scales generated for each of these four factors were used in a one-way multivariate analysis of variance to examine differences between nonsmokers, light smokers, and moderate-to-heavy smokers. Cigarette smokers versus nonsmokers exhibited less positive attitudes toward CHD risk behaviors, whereas moderate-to-heavy cigarette smokers, as compared with the light smokers and the nonsmokers, exhibited lower levels of health consciousness and enacted unhealthy behaviors at a greater frequency. The moderate-to-heavy cigarette smokers also exhibited a lower commitment to enact healthy behavioral changes in the immediate future, even after corrections were introduced for their lower frequency of healthy behaviors during the past week. Overall, these results support our hypothesis that cigarette smokers, particularly as they become more involved with cigarette smoking, do more than just smoke cigarettes; they exhibit a less healthy lifestyle as shown by cognitive, behavioral, and motivational dimensions related to cardiovascular health.