sleep complaints,behavioral characteristics and vital exhaustion in myocardial infarction cases

Abstract

Prodromal symptoms of vital exhaustion and sleep complaints are increasingly being recognized as important risk indicators for myocardial infarction (MI). In this study, the relationships between vital exhaustion, behavioral characteristics, and MI, and between several sleep complaints and MI were investigated. The subjects were 133 male cases with first MI, 192 male hospital controls, and 133 male neighborhood controls. The instruments used were the Maastricht Questionnaire (vital exhaustion), the Life Styles Questionnaire (sleep complaints, coffee consumption, and current smoking), and the Structured Interview (Type A behavior). All sleep complaints, vital exhaustion, Type A behavior, excessive coffee consumption, and current smoking occurred significantly more often in MI-cases. After controlling for these potential confounders, and age, most sleep complaints retained significant associations with MI, in particular often taking naps during the day and waking up in the morning feeling tired and exhausted.     

Parenting style and adolescent smoking cognitions and behaviour

Parenting style and smoking-related cognitions have both successfully predicted adolescent smoking behaviour. Data were collected among 482 Dutch adolescents to examine whether effects of parenting styles (authoritative, permissive, authoritarian, rejecting, neglecting, measured by underlying dimensions support, strict control, and psychological control) on adolescent lifetime smoking were mediated by cognitions (pro-smoking attitude, social norm, self-efficacy, intention) and to study the role of gender in this process. Support was not significantly associated with smoking behaviour. The inverse relation between strict control and smoking was partly mediated by attitude and intention, both associated with increased smoking. Psychological control related directly to increased lifetime smoking. Combinations of dimensions creating the specific styles were not associated with cognitions or behaviour. Maternal and paternal parenting were equally associated with smoking cognitions and behaviour; nor were effects moderated by adolescent gender. Interventions to prevent adolescent smoking initiation should aim at increasing strict control and reducing psychological control.     

Changes in self-regulatory cognitions as predictors of changes in smoking and nutrition behaviour

Most longitudinal, correlational studies on health-behaviour change examine effects of Time1 social-cognitive predictors on subsequent behaviour. In contrast, our research focusses on associations between changes in predictors with change in behaviour. The Health Action Process Approach (HAPA) distinguishes between motivational predictors for intention formation and volitional predictors for behavioural change and served as theoretical basis. Two online-studies were launched targeting different behaviours (low-fat diet, smoking), different samples (Study 1: N = 469; Study 2: N = 441) and different time spans (Study 1: 3 months, Study 2: 4 weeks). Data were analysed by means of structural equation modelling with latent difference scores. Both studies resulted in almost parallel prediction patterns. Change in risk awareness and change in outcome expectancies did not result in change in intentions, whereas change in self-efficacy was of crucial importance. Change in behaviour was associated with change in action planning and action control over and above the effects of intentions. In one study, increases in self-efficacy yielded increases in behaviour change. Results demonstrate that change in action planning and especially action control was of great importance for behaviour change across two different behaviours. Analysing change in social-cognitive predictors allows drawing precise conclusions for interventions.     

Stigma and hostility towards pregnant smokers: Does individuating information reduce the effect?

Australia is at the forefront of tobacco control, yet 17% of Australian women smoke during pregnancy. Negative attitudes to smoking are intensified when the smoker is pregnant, consistent with a discourse that encourages surveillance of pregnant women. Such overt anti-smoking attitudes create a context which may make it difficult for pregnant smokers to seek assistance to stop. However, there is little evidence on the extent to which pregnant smokers are stigmatised by community members. We used vignettes to examine the degree of smoking-related stigma expressed by 595 Australian university students who rated a woman, described as a mother who was smoking or not, and pregnant or not. Further, we examined whether provision of individuating information reduced the degree of stigma. Mothers described as smokers were rated more negatively than those not, particularly if they were pregnant: smokers were perceived as unhealthy, and also as bad mothers. Provision of individuating information slightly reduced these effects. These findings support the view that smokers – particularly if pregnant – are subject to negative moral judgement. Our findings contribute to the ethical debate about stigma-inducing tobacco control efforts, and suggest that anti-smoking campaigns that contextualise smoking in pregnancy might reduce stigma and assist cessation.     

The development of a smoking-specific locus of control scale

Abstract

A 32-item questionnaire was designed to measure multidimensional locus of control beliefs specifically about giving up smoking (SLC Scale), and administered along with the Multidimensional Health Locus of Control Scale (MHLC) and a short smoking information questionnaire to 211 smokers. Psychometric analyses of the SLC scales included a series of repeated factor and reliability analyses which resulted in a final three-factor solution, containing 11 of the original SLC items. The three factors represented the following types of locus of control for smoking: a combined Internal-Chance factor, a Significant Others factor, and a Powerful Others factor with Chronbach's alpha coefficients of internal reliability of 0.63, 0.56 and 0.55 respectively. Analyses relating to the reliability and validity of the SLC scale are presented and discussed. As expected the SLC correlated more sensibly and significantly with subjects' reported behaviour and intentions regarding giving up smoking than did the MHLC scales.     

Initial responses to the first dose of nicotine in novel smokers: The role of exposure to environmental smoking and genetic predisposition

Background: Sensitivity to initial smoking constitutes an early predictor of the risk of dependence. We investigated the role of exposure to smoking (by parents, siblings, and peers) and reward-related candidate gene polymorphisms (OPRM1 A118G, DRD2 TaqlA and DRD4?bp VNTR) in adolescents’ responses to initial smoking.

Methods: We used cross-sectional survey data and saliva samples from 171 Dutch students who had never inhaled on a cigarette (mean age: 13.9?years). The outcome measure was adolescents’ self-reported responses to initial smoking.

Results: Exposure to peer smoking was associated with increased liking (OR?=?1.74, CI?=?1.13–2.70) and more pleasant sensations (β?=?.21, p?=?.01). Exposure to maternal smoking was associated with less unpleasant sensations (β?=??.20, p?=?.01). Adolescents carrying the G-variant of the OPRM1 A118G polymorphism were more likely to report liking (OR?=?2.50, CI?=?1.09–5.73) and adolescents homozygous for the C-variant of the DRD2 TaqlA polymorphism reported less unpleasant sensations (β?=?.18, p?=?.04).

Conclusion: Although preliminary, these findings suggest that exposure to environmental smoking and polymorphisms in the OPRM1 and DRD2 gene may affect initial sensitivity to nicotine, an early phenotype of the risk of dependence. In the future, collaborative efforts to combine data from multiple studies in meta-analyses are needed to improve accuracy of estimated effects in genetic studies.     

The role of prior quitting experience in the prediction of smoking cessation

Aims: In the Transtheoretical Model (TTM), the preparation stage (as applied to smoking cessation) is defined as planning to quit in the next 30 days plus having quit for at least 24 h in the last year. This study examined the value of prior quitting experience as a stage classification criterion by investigating whether prediction of making a quit attempt differed as a function of prior quitting experience. Participants: One thousand and forty-six participants, all planning to quit in the next 30 days, in a randomised trial of the effectiveness of a telephone counselling and computer-generated tailored advice intervention were followed up at 3 months. Findings: A multivariate predictive model had markedly greater capacity to predict making a quit attempt among participants with prior quitting experience (as defined in several different ways), compared to analyses of the overall sample. A previous attempt of 24 h in the previous month was associated with the greatest difference in prediction. A quit attempt in the previous year (the TTM definition) did not discriminate. Conclusions: Recent prior quitting experience moderated the predictive capacity of some variables that influence smoking cessation. The findings provide some support for a stage model of smoking cessation but not its operationalisation by the TTM.     

Racial disparities in smoking knowledge among current smokers: Data from the health information national trends surveys

Although African-Americans (Blacks) smoke fewer cigarettes per day than European-Americans (Whites), there is ample evidence that Blacks are more susceptible to smoking-related health consequences. A variety of behavioural, social and biological factors have been linked to this increased risk. There has been little research, however, on racial differences in smoking-related knowledge and perceived risk of lung cancer. The primary goal of the current study was to evaluate beliefs and knowledge that contribute to race disparities in lung cancer risk among current smokers. Data from two separate nationally representative surveys (the Health Information National Trends surveys 2003 and 2005) were analysed. Logistic and hierarchical regressions were conducted; gender, age, education level, annual household income and amount of smoking were included as covariates. In both studies, Black smokers were significantly more likely to endorse inaccurate statements than were White smokers, and did not estimate their lung cancer risk to be significantly higher than Whites. Results highlight an important racial disparity in public health knowledge among current smokers.     

Mood as a resource in dealing with health recommendations: How mood affects information processing and acceptance of quit-smoking messages

Objective: An experimental study tested the effects of positive and negative mood on the processing and acceptance of health recommendations about smoking in an online experiment. It was hypothesised that positive mood would provide smokers with the resources to systematically process self-relevant health recommendations.

Design: One hundred and twenty-seven participants (smokers and non-smokers) read a message in which a quit smoking programme was recommended. Participants were randomly assigned to one of four conditions: positive versus negative mood, and strong versus weak arguments for the recommended action.

Main outcome measures: Systematic message processing was inferred when participants were able to distinguish between high- and low-quality arguments, and by congruence between attitudes and behavioural intentions. Persuasion was measured by participant's attitudes towards smoking and the recommended action, and by their intentions to follow the action recommendation.

Results: As predicted, smokers systematically processed the health message only under positive mood conditions; non-smokers systematically processed the health message only under negative mood conditions. Moreover, smokers’ attitudes towards the health message predicted intentions to quit smoking only under positive mood conditions.

Conclusion: Findings suggest that positive mood may decrease defensive processing of self-relevant health information.     

Perspectives on relapse prevention: An exploratory study

This article explores the hypothesis that factors associated with relapse early in a quit attempt may lose their predictive power over time. Participants were 195 recent ex-smokers calling a telephone Quitline. Quitters were interviewed, then re-interviewed three weeks later to determine outcome (relapse or maintenance of attempt). There was strong evidence for a discontinuity in prediction of outcome between those who quit for less than one week, or who reported at least daily strong urges to smoke and those who quit for more than a week who reported less than daily strong urges to smoke. Several variables, including self-efficacy and scales of positive social and negative affect temptations, reversed predictive value. This study provides evidence of a perspective or stage within the Action stage of the TTM. More work is required to confirm both the findings and the exact nature of the discontinuity point.