Relationship of type A behavior pattern in smokers to carbon monoxide exposure and smoking topography

Stress-related physiological factors have been proposed to mediate the Type A behavior pattern (TABP) and coronary heart disease (CHD). However, collateral behavioral factors, such as the exaggerated consummatory response patterns of Type As, may also be involved. Study 1 examined this hypothesis by comparing exposure to cigarette smoke in 42 graduate and undergraduate student smokers assessed for the TABP. After controlling for smoking rate and Federal Trade Commission cigarette carbon monoxide yield, Type As' alveolar carbon monoxide (COa) levels were higher than Type Bs', and Jenkins Activity Survey scores were correlated with COa. To determine the source of this difference, we measured smoking topography in 10 Type As and 10 Type Bs in Study 2. Type As and Type Bs did not differ in number of puffs taken or puff volume, but Type As' inhalation duration was 70% longer than Type Bs'. These results suggest that consummatory behaviors of Type As may help account for the Type A-CHD relationship for smokers. Due to increased smoke exposure, Type A smokers may also be at greater risk for cancer and lung disease than Type B smokers.     

尼古丁依赖对男性吸烟者感知戒烟行为控制的预测：社会支持与抱怨批评的作用

考察尼古丁依赖对男性吸烟者感知戒烟行为控制的预测及他人戒烟社会支持和抱怨批评的调节作用。对326名男性吸烟者进行问卷调查,结果显示：（1）尼古丁依赖显著负向预测感知行为控制;（2）社会支持和抱怨批评共同调节两者关系;在高社会支持且低抱怨批评、高抱怨批评且低社会支持的条件下,尼古丁依赖的预测作用不显著。结果说明,高社会支持在尼古丁依赖削弱感知行为控制过程中起缓冲作用,而高抱怨批评削弱社会支持的缓冲作用。     

Educational inequalities in quantity, duration and type of tobacco consumption among lung cancer patients in Asturias: epidemiological analyses

Socioeconomic inequalities cause different tobacco consumption patterns. The purpose of this study was to examine the relationship between educational level and smoking behaviour, including type of tobacco consumption, in lung cancer patients. To this end, epidemiological analyses of 801 lung cancer patients recruited for a case-control study in four public hospitals in Asturias, Spain, between October 2000 and April 2006 were carried out. Smoking behaviour and educational level data were obtained through personal interview. Analyses indicated that the probability of heavy smoking among low educational-level patients was approximately twice as high as for high educational-level patients (RRR>31.2 packs/years=2.04; CI 95%=1.15-3.62; RRR>52packs/years=2.14; CI 95%=0.98-4.64). Low-educated patients were more than three times as likely to be long-time smokers (RRR>40 years=3.30; CI 95%=1.43-7.62). The probability of smoking exclusively black tobacco was almost four times greater in low educational-level patients (RRRblack only=3.72; CI 95%=1.23-11.19). The results show that there are broad educational inequalities with regard to the quantity, duration and type of tobacco consumption among lung cancer patients in Northern Spain.     

Smoking cessation among Norwegian adolescents and young adults: preferred cessation methods

Despite generally declining smoking rates, particularly among young people, a large number of people remain smokers and many young people still pick up smoking. Helping smokers quit therefore remains a high priority for the public health sector. In the present study we examined adolescents and young adults' preferences regarding cessation methods and if these differed between genders and depended on smoking frequency. The data came from a nationally representative survey in Norway among 16-20 year olds. Only regular (weekly and daily) smokers were included in the statistical analyses (n = 509, 51% females). The findings suggest that the majority of both male (83.6%) and female (78.4%) smokers would prefer to quit smoking without help. More males than females reported that they would consider using snus as a cessation aid, while females more often reported willingness to attend cessation classes or use brochures and diaries as cessation aids. Both males and females had similar preferences albeit low, regarding the use of health services, nicotine gum or patches and internet and sms-services to quit smoking. Daily smokers would more often than weekly smokers prefer to attend cessation classes, seek help from health services, use nicotine gum or patches or use brochures and diaries. In contrast, weekly smokers preferred to use snus as a cessation aid more often than daily smokers. Identifying and making appropriate cessation methods attractive may lead to successful quitting and consequently public health gains.     

The motivational effects of thinking and worrying about the effects of smoking cigarettes

We tested a strategy to encourage cigarette smokers to think more frequently about the negative consequences of smoking, reasoning that increased thought might lead to greater worry and motivation to quit. College students who smoked daily were randomly assigned to one of three conditions in which they wore watches for one week that sounded an alarm randomly four times each day. When alerted, the students read one of eight cards that either had a written statement about studying (control condition), a statement about the negative effects of smoking behaviour (text condition), or a negative smoking statement accompanied by a picture (e.g., a blackened lung; image condition). Measures collected at week's end revealed that the smoking cards had no effects on perceived risk, but they increased worry and reports of intrusive thoughts, and had a small but reliable effect on plans to quit. Correlational data also supported the relationship between worry and motivation to quit, and we discuss the possible benefits of “normal” worrying and strategies for capitalising on the worry–motivation relationship to encourage smokers to abandon cigarettes.     

Development and validation of a multidimensional smoking behaviour questionnaire

We administered a 42-item smoking behaviour questionnaire to 150 adult smokers (75 men and 75 women), 18 to 70 years old (M = 37.1 yr., SD = 12.2). A principal component analysis of their responses followed by varimax rotation yielded four factors accounting for about 52% of the total variance: dependence, social integration, regulation of negative affect, and hedonism. Some sociodemographic and dispositional characteristics of the smokers predict these four dimensions. The predictors of each smoking dimension are quite different for male and female smokers.     

Smoking among Norwegian schoolchildren 1975–1980: I. Extent of smoking in the age group 12–15 years, 1975

213600 pupils from grades 6–9 (age 12–15) in the primary school in Norway filled in a questionnaire about smoking habits (1975). The headmaster of each individual of the 2824 schools participating in the study filled in reports giving the local frequencies of daily smokers, occasional smokers and nonsmokers for each grade and for boys and girls separately. The school-reports also contained questions about demographical properties of the school. A sample of 6968 questionnaires from the pupils (those who were born on the sixth irrespective of month) were also submitted for statistical analysis. Compared with previous studies, the percentage of smokers among girls proved to have increased considerably. The tendency found in many western industrialized countries, that smoking is increasing among girls more than among boys, or that boys are reducing smoking to a greater extent than are girls, was confirmed also for Norway. In all 19 counties there was a higher percentage of daily smokers among girls than among boys. Higher percentages of occasional smokers or pupils who had tried smoking were found in small schools and scattered settlements. Norway may be divided into geographical areas according to the differences in the smoking habits of girls and boys. In the counties in the south and to the west, girls have not surpassed boys to the same extent as in the rest of the country. From previous political-cultural research it is known that the south and west is characterized by temperance and prohibition movements, higher frequencies of religious attendance, as well as a distintiveness in voting behaviour.     

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。     

Use of carbon monoxide breath validation in assessing exposure to cigarette smoke in a worksite population

Assessed the usefulness of carbon monoxide (CO) breath validation of self-reported smoking status in a large worksite population (N = 4,647). CO assessment was performed as part of a baseline survey procedure. CO levels differed substantially in relation to self-reported smoking status and amount smoked. Correcting for ambient exposure (estimated by mean CO levels among never smokers) produced more satisfactory results than uncorrected CO levels. Striking company differences were observed in mean CO exposures among self-reported never smokers. An unexpected finding was that 17.1% of current smokers reported smoking less than daily. Although the CO measure was excellent in detecting moderate and heavy smokers, it was inadequate in detecting occasional and light smokers. If detection of occasional or lighter smoking is critical to the purposes of the study, the more expensive (but more accurate) cotinine measure is preferred.     

Smoking motives in the prediction of affective vulnerability among young adult daily smokers

The primary aim of this study was to examine whether smoking to reduce negative affect was uniquely related to a range of affective vulnerability factors (e.g., anxiety sensitivity, anxious arousal, and negative affectivity) among daily smokers. Participants were 276 young adult daily smokers (124 females; M(age)=25.12, SD=10.37). Partially consistent with prediction, the motivation to smoke to reduce negative affect was significantly related to anxiety sensitivity and negative affectivity, but not anxious arousal; the observed significant effects were above and beyond other theoretically relevant factors (e.g., smoking rate, years smoked, age, gender). In contrast to prediction, habitual smoking motives demonstrated significant incremental associations with anxiety sensitivity and anxious arousal symptoms. These results suggest that there are important associations between certain smoking motives and negative affective states and that such relations are not attributable to other smoking factors (e.g., smoking rate).     

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.     

Implicit alcohol and smoking associations among young adult heavy drinkers: Associations with smoking status and alcohol-cigarette co-use

Implicit memory associations may play a role in motivation to use alcohol and cigarettes, but the relationship between implicit associations and co-use of alcohol and cigarettes is currently unknown. This study provided an initial examination of alcohol and smoking implicit associations among young adult drinkers who were either nonsmokers or relatively light smokers (i.e., 10 or fewer cigarettes per day) as a function of smoking frequency and daily-level alcohol-cigarette co-use. Drinkers (n?=?129) completed alcohol-arousal and smoking-valence variants of the implicit association test as well as a daily-level assessment of past 90-day alcohol and cigarette use. Smokers were grouped according to whether they reported daily or nondaily smoking frequency. Results showed that although implicit alcohol-arousal associations did not differ between smokers and nonsmokers, stronger implicit alcohol-arousal associations were observed for nondaily smokers relative to daily smokers after controlling for drinking frequency. Further, implicit positive-smoking associations were stronger for smokers relative to nonsmokers. Within the subgroup of nondaily smokers, more frequent co-use of alcohol and cigarettes was associated with stronger implicit positive-smoking associations when controlling for total drinking and smoking frequency. The findings suggest that implicit alcohol and smoking associations may be linked with smoking patterns (daily vs. nondaily) and co-use of alcohol and cigarettes among young adult drinkers who are not heavy smokers, highlighting the need for more research on the role of implicit associations in the co-use of cigarettes and alcohol.     

Self-monitored motives for smoking among college students.

College student smokers (N = 50) were asked to carry electronic diaries for 14 days and record smoking events (n = 1,139). They indicated why they were smoking each cigarette on a checklist of potential motives. Results suggest that a desire to reduce craving (62.8% of occasions) and habit/automatic processes (42.8%) were the most frequent motives. More dependent and daily smokers were especially likely to endorse smoking to reduce craving and for habit/automatic reasons and were less likely to cite coping with negative emotion as a reason for smoking. Dependent and daily smokers were more likely to endorse at least 1 dependence-like motive and were less likely to exclusively attribute smoking to nondependence motives. Self-monitored motives appeared valid, according with conceptually related states, activities, and events in the diary records. Diary-recorded motives were compared with smokers' responses to a retrospective motives questionnaire administered at baseline. The 2 assessment modes produced discrepant estimates of the most influential motivational processes. Questionnaire responses incompletely forecast conceptually similar diary-reported motives. Dependence and daily smoking showed a different pattern of associations with diary-based versus retrospective motives measures.     

吸烟利弊权衡对戒烟计划的预测作用：一个有调节的中介模型

考察吸烟利弊权衡对戒烟计划的预测,以及戒烟意愿的中介作用和未来取向的调节作用。对340名吸烟者进行问卷调查结果的统计分析发现：（1）吸烟利弊权衡显著正向预测戒烟计划;（2）戒烟意愿对吸烟利弊权衡和戒烟计划的关系起完全中介作用;（3）未来取向负向调节吸烟利弊权衡和戒烟计划的关系,但对吸烟利弊权衡和戒烟意愿关系的调节不显著。这些结果说明,吸烟者戒烟计划发展经历前决策和前行动阶段,且该过程受未来取向的调节。     

Quitting smoking: The importance of non-smoker identity in predicting smoking behaviour and responses to a smoking ban

Objective: We examined how ‘smoker’ and ‘non-smoker’ self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e. the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban.

Design: Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers.

Main outcome measures: Intention to quit, quit attempts and ‘rejecting’, ‘victimizing’, ‘socially conscious smoking’ and ‘active quitting’ responses to the smoking ban.

Results: Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES.

Conclusion: Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.     

Personality correlates of smoking behaviour in men with heart disease

In two populations of male patients attending a cardiac clinic who underwent invasive procedures [coronary angiography (n = 67)] and coronary artery bypass graft surgery (n = 78) there was an association between smoking behaviour and the personality dimension of psychoticism. Follow-up assessment 12 months after both procedures revealed that the resumption of smoking was also highly correlated with psychoticism, and to a lesser extent with extraversion. There was an inverse association between duration of anginal symptoms and a smoking history, and among smokers, those with the heaviest consumption had shorter histories of chest pain both non-smokers and light smokers. Poor compliance among high P scorers has implications for the management of patients with coronary heart disease (CHD). Because cessation of smoking is the most important single measure in reducing mortality from CHD, more effort should be directed towards patients with these personality characteristics before cardiac surgery is undertaken.     

Effect of Depressive Symptoms and Sex on the Relationship Between Loneliness and Cigarette Dependence: A Moderated Mediation

Loneliness is a subjective and emotionally unpleasant experience of perceiving insufficient social relationships. Previous research has revealed that loneliness constitutes a psychosocial risk factor for depression, and is also related to unhealthy behaviors such as smoking. This study aims to examine the relation between loneliness, depression, and cigarette dependence, and to explore the role of sex in this relationship. A total sample of 275 adult treatment-seeking daily smokers (Mage = 45.3; 61.5% females) was used. Our results showed a significant correlation between higher scores of loneliness, depressive symptoms, and cigarette dependence. In addition, mediation analysis showed a significant indirect effect of loneliness on cigarette dependence, via depressive symptoms. Regarding the effect of sex, we found that this variable significantly moderated the relationship between depressive symptoms and cigarette dependence. Results of this study extend previous literature by showing that, in treatment seeking smokers, loneliness is a significant predictor of depressive symptoms, and through this relation, it predicts cigarette dependence. Additionally, sex was a significant moderator of this relation. These findings have several clinical implications, and also contribute to the understanding of cigarette dependence, which is a well-known barrier for smoking cessation.     

Tobacco use in adolescence: longitudinal links to later problem behavior among African American and Puerto Rican urban young adults

In this study, the authors assessed the relationship between adolescent tobacco smoking and measures of inner control, deviant behavior, and associating with deviant peers, which are indicators of problem behavior. African American (N = 333) and Puerto Rican (N = 329) early adolescents completed questionnaires in their classrooms in 1990 at Time 1 (T1) and were individually interviewed thereafter when they were late adolescents in 1995 at Time 2 (T2) and as young adults in 2000 at Time 3 (T3). The authors used ordinary least squares regression analysis to assess the comparative association of adolescent smoking patterns at T1 and T2 and the young adult outcomes at T3; they controlled for demographic variables, level of the outcome measure at T2, and marijuana use at T2. The analyses suggested that experimental tobacco smokers demonstrated more problem behaviors than did nonsmokers, and late and continuous smokers demonstrated more problem behaviors as young adults than did experimental smokers and nonusers. These findings may provide a useful guide to a next step that involves translational research.     

Predictors of Smoking Status After Eight Years: The Interaction of Stages of Change and Addiction Variables

Abstract

With a smoking rate of 30% of the population Switzerland has one of the highest rates of all industrialised countries. Changes in smoking status over eight years are examined by analysing the course of non-smokers, former smokers and current smokers between 1987 and 1995. Stages of change and addiction variables, as well as their interaction, are analysed for 1987 as predictors of smoking status in 1995.A sample of 953 non-smokers and former and current smokers was interviewed in 1987 and followed up in 1995. Between 1987 and 1995 every fifth non-smoker (20.9%) began smoking. The higher one is in the stage hierarchy the higher the probability of forward than of backward movement. Within the stages of change the likelihood of cessation is moderated by addiction variables. Thus, in the case of contemplating smokers in 1987, the more cigarettes they smoked daily at that time the less likely they were to be former smokers by 1995, but for preparating smokers who had already made an attempt to quit the converse holds - the more they smoked in 1987, the more likely they were to be non-smokers eight years later. The same holds for former smokers in 1987: former moderate smokers then were more likely to relapse than former heavy smokers. The implications for prevention and intervention are discussed.     

Prevalence of cigarette smoking in Iran.

The current research assessed the prevalence of cigarette smoking in Shiraz, Iran by randomly selecting 1,335 subjects (782 men and 553 women) from the city for a face-to-face interview and completion of a questionnaire. Of the participants, 205 (26%) of the men and 20 (3.6%) of the women reported being current smokers. The mean ages of smokers and nonsmokers were 41.8 and 37.0 yr., respectively (range between 16 and 90 years for smokers and nonsmokers). The mean age of starting to smoke cigarettes was 21.3 yr. (range of 10 to 60). The most common reasons for current cigarette smoking were Need to avoid withdrawal symptoms, Release of tension, and Pleasurable purposes. Foreign filter-tipped cigarettes were the most common type consumed. The mean number of cigarettes per day was 13.4 (SD = 10.3). Reports for onset of cigarette smoking included Modeling, Release of tension, and Pleasurable purposes. Cigarette smoking was reported by more males than females. The most common reason for onset of cigarette smoking was different from that for current smoking. Frequencies of smokers within age groups were varied.