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.     

Nonsmokers' Attributions for the Outcomes of Smokers: Some Potential Consequences of the Stigmatization of Smokers1

The current research examines intergroup attributional biases made by nonsmokers for the outcomes of smokers. Nonsmokers were asked to make attributions for either the success or failure of either an in-group member (a nonsmoker) or an out-group member (a smoker). Overall, subjects attributed the preponderance of cause for the outcomes to external or unstable (approximately 80%) rather than internal (approximately 20%) factors. However, results confirmed the expected in-group protective and in-group enhancing attributions on the part of nonsmokers. Specifically, nonsmokers attributed a significantly higher proportion of success to external factors and a lower proportion of success to internal factors when the target was a smoker compared to when the target was a nonsmoker. The implications of these results for smokers and smoking policy are discussed.     

SMOKING AND SELF-CONCEPT IN YOUNG ADULTS: AN IDIOGRAPHIC METHOD OF MEASUREMENT

An idiographic repertory grid method of measuring self-concept was used in a nomothetic design to study the relation between smoking behavior and four components of self-concept: real self, ideal self, social self, and ideal social self. Personal constructs were elicited from 32 smoker and 32 nonsmoker male and female college students. Differences between smokers and nonsmokers on all four components of self-concept supported the criterion-related validity of the measures. Implications were discussed for the assessment method and clinical practice.     

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 Q-methodological study of smoking identities

In contrast to the psychological literature on adolescent smoking, little research has investigated the social identities of adult smokers. This study aimed to identify shared ‘smoking identities’ amongst a sample of 64 British smokers from different socio-economic groups using Q-methodology. Participants were asked to sort 70 items concerning smoking and smokers according to their agreement/disagreement with them. The 64 Q-sorts were then subjected to a by-person factor analysis yielding six factors, with the first four interpretable factors being presented here. Each factor is understood to represent a distinct ‘identity position’. The first two, the ‘addicted’ smoker, and the ‘in control’ smoker, oriented around a biomedical model of smoking as an addictive health risk. The final two, the ‘no big deal’ smoker and the ‘proud’ smoker reflected alternative understandings and values. The identity positions also differed in the extent to which smoking was considered a core part of self-identity. Unpacking the ‘smoking identities’ of current smokers offers the opportunity to devise targeted health promotion.     

Attentional bias affects change detection

Thirty smokers and 30 nonsmokers participated in aflicker study in which the role of attentional bias in change detection was examined. The participants observed picture pairs of everyday objects flicker on a computer screen until they detected the one object that had changed. In half of the pictures, a smoking-related object (e.g., a lighter) was included among smoking-unrelated objects (e.g., a spoon). Half of the smokers and half of the nonsmokers were aware of the experiment’s focus, and the other half were not. The smokers exhibited shorter detection latencies than did the nonsmokers when a smoking object changed and longer detection latencies when a nonsmoking object changed while a smoking object was present, and they exhibited detection latencies similar to those of the nonsmokers when smoking objects were not present. Interestingly, the nonsmokers displayed the same attentional bias as the smokers when they were aware of the experiment’s smoking focus, but they did not display any attentional bias when they were unaware. Thus, these findings provide evidence for long-term context-independent, as well as for short-term context-dependent, attentional bias.     

Long-term psychological sequelae of smoking cessation and relapse.

The authors examined whether smoking cessation and relapse were associated with changes in stress, negative affect, and smoking-related beliefs. Quitters showed decreasing stress, increasing negative health beliefs about smoking, and decreasing beliefs in smoking's psychological benefits. Quitters became indistinguishable from stable nonsmokers in stress and personalized health beliefs, but quitters maintained stronger beliefs in the psychological benefits of smoking than stable nonsmokers. Relapse was not associated with increases in stress or negative affect However, relapsers increased their positive beliefs about smoking and became indistinguishable from smokers in their beliefs. For quitters, decreased stress and negative beliefs about smoking may help maintain successful cessation. However, for relapsers, declining health risk perceptions may undermine future quit attempts.     

Differences in generosity between smokers and nonsmokers in an upcoming smoking ban

The stigmatization of smokers has become a social norm as new information about its health effects continues to be uncovered. This study investigated smokers in terms of their generosity as a means of stigma management. A field study was undertaken in which the experimenters frequented local establishments in the eight days prior to the 2010 Michigan antismoking legislation taking effect. Experimenters, sometimes while smoking and sometimes while not smoking, approached patrons of the establishments who were either smokers or nonsmokers and asked them for a dollar. Results indicated smokers were more likely to give a dollar than nonsmokers, regardless of whether or not the experimenters were smoking. This was interpreted as a strategy smokers use to combat social stigma.     

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。     

Smoking cessation: social comparison level predicts success for adult smokers.

The affiliation preferences of 151 adult heavy smokers who joined smoking cessation groups were assessed at the 1st group session and were then used to predict their smoking status 6 and 12 months later. Those who preferred to be in groups with other smokers who were having relatively little trouble quitting were more likely to be successful than were those who preferred others who were having more difficulty quitting. This prospective effect was mediated by psychological distancing from the image of the typical smoker: Preference for others who were doing well was associated with a decrease in perceived similarity to the typical smoker, which, in turn, was associated with successful cessation. Implications of these findings for cessation groups and social comparison theory are discussed.     

The effect of smoking on brainstem auditory evoked potentials in positive- and negative-symptom schizophrenia

Studying brainstem auditory evoked potentials (BAEPs) and comparing the specific waves in smokers vs nonsmokers in both positive- and negative-symptom schizophrenia may elucidate the role of smoking in information processing. BAEPs were recorded in 40 patients with schizophrenia; 20 had predominantly positive symptoms (10 smokers and 10 nonsmokers) and 20 had predominantly negative symptoms (10 smokers and 10 nonsmokers). The severity of positive and negative symptoms was assessed by scale of assessment of positive symptoms and scale of assessment of negative symptoms (SANS). The BAEP results were compared with 15 healthy control individuals matched with the patients by age, sex, and cultural background. The smokers with negative symptoms showed a significant increase in the alogia, summary, and composite scores of SANS as compared to the nonsmokers. Although, most of the BAEP abnormalities were among patients with positive symptoms. The effect of smoking on the BAEPs was only in patients with negative symptoms. We also studied the interaction between smoking factor (smokers vs nonsmokers) and group type (group with mostly positive symptoms vs group with mostly negative symptoms) on the BAEPs and found a significant difference only for the first-wave latency mainly on the right side (P=0.012). The absence of a significant effect of smoking on most of the parameters of the BAEPs on interaction with the group factor suggests that the effect of smoking on the BAEPs is more apparent when negative symptoms prevail. However, studies are warranted to substantiate this finding.     

Smoking related to anxiety and depression in Greek medical staff

We assessed the relation of anxiety and depression to smoking behavior in a sample of 80 physicians and surgeons, using the Spielberger State-Trait Anxiety Scale and the Beck Depression Inventory. 27 doctors were nonsmokers, 14 were former smokers, and 39 were current smokers. Current smokers showed significantly higher Anxiety and Depression scores compared to nonsmokers and former smokers, while the latter presented significantly lower Anxiety scores than nonsmokers. In current smokers, the daily quota of cigarettes was not correlated with Anxiety or Depression scores. From our results we can hypothesize that, among medical staff, smoking behavior is more anxiety-related than depression-related. In conclusion, we believe that interventions such as stress management techniques could be effective in lessening Anxiety and diminishing the need for relief searched for in smoking.     

A model of situational preference amongst smokers

Seventy-five medium-light smokers rated their performance for smoking in 25 situations covering a range of high- and low-stress situations. Information on personality, age, sex, length of habit, number of cigarettes smoked, amount inhaled and amount of cigarettes smoked was also obtained. Six main factors were extracted by principal-factor analysis which were related respectively to situations involving preparatory activity, attentional stress, neutral relaxation conditions, unpleasant (anxiety) and pleasant (excited) emotional stress and social vs isolated activity. Smokers who scored high on Neuroticism tended to smoke more when experiencing unpleasant emotions; older smokers smoked predominantly in pleasant relaxing conditions; extraverts and low-activity situational smokers, reported inhaling more. A model of smoker motivation is developed which suggests that both pharmacological and psychological factors contribute to habit maintenance. Three basic motivational types of smokers are identified: high-stress smokers for whom smoking is a secondary activity, and who rely on smoking to form a minor distraction for their current task. Low-activity smokers who wish to act, or change their current affective state in some way and who rely on pharmacological factors. Neutral relaxation smokers for whom smoking is a pleasurable activity in its own right.     

Attachment Style,Perceived Loneliness,and Psychological Well-Being in Smoking and Non-Smoking University Students

The growing rate of smoking cigarettes among the youths necessitates examining its contributing factors. Accordingly, we aimed to compare smoking and nonsmoking university students in their attachment styles, perceived loneliness, and psychological well-being. To this end, we recruited 100 current smokers and 100 nonsmoking students by using a convenience sampling method from Shahid Beheshti University, Tehran, Iran. All participants completed the Adult Attachment Scale, Loneliness Scale, and General Health Questionnaire. Data analysis indicated that compared to nonsmokers, smokers had a more anxious attachment style and they felt lonelier. Moreover, current results showed that smokers suffered from higher rates of psychological problems than nonsmokers. These results suggest that smoking is influenced by a set of psychological factors and therefore, prevention and treatment programs targeting these factors may be effective in reducing the rate of smoking cigarettes among university students.     

Tobacco Smoking as an Index of Military Personnel Quality

Previous studies indicate that smokers attrite from military service at significantly higher rates than nonsmokers. The purpose of the current effort is twofold: (a) to examine the implications of treating smoking status as a third military accession quality indicator along with educational credential and mental ability, and (b) to explore preservice psychosocial and health differences between smokers and nonsmokers in support of hypothesis development about reasons for elevated attrition rates in smokers. The results indicate that individuals who smoke tobacco prior to entering military service are almost twice as likely to attrite as nonsmokers, even after statistically controlling for education and mental ability. Moreover, smokers report higher rates of psychosocial and health problems prior to military service. These results support using smoking status as a personnel quality indicator for recruiting and assignment purposes and indicate that smokers, as a group, enter the military with identifiable psychosocial and physical vulnerabilities.     

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.     

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.     

Perceived Believability Among Adolescents of Health Warning Labels on Cigarette Packs1

This study investigated the extent to which adolescents believe the health warning labels on cigarette packs, and the relationship of current smoking status and gender to the believability ratings. Subjects were 691 students in grades 5 through 12. MANOVAs revealed that, smokers, both male and female, reported significantly less belief in the validity of 3 of the health warning labels than nonsmokers. These findings support prior investigations which indicate that adolescent smokers are less likely to accept the specific health risks associated with smoking than nonsmokers. The results, however, also raise the question as to what value such health warning labels have as a deterrent to cigarette smoking.