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Sheer VC. The State of Norm-Based Antismoking Research: Conceptual Frameworks, Research Designs, and Implications for Interventions. HEALTH COMMUNICATION 2023; 38:310-325. [PMID: 34256674 DOI: 10.1080/10410236.2021.1950296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This synthesis review examined 189 qualified studies on norms and smoking in terms of conceptual frameworks, types of social norms, research designs, dependent variables, independent variables and covariates, and findings related to norms. Results show that 7.9% were experimental, and the remaining were cross-sectional. By far, the reasoned action approach (RAA) was the most-cited theory, but RAA was not used to guide experimental designs. The social norms approach, norm focus theory, social cognitive theory guided the intervention experiments. Harmful norms were more frequently examined than healthful norms. Pro-smoking norms positively predicted smoking intentions and behaviors, whereas antismoking norms positively predicted antismoking intentions and behaviors. The over-application of RAA in cross-sectional antismoking research has yielded repetitive findings. Norm-based experiments can adopt other theoretical perspectives to offer insights into antismoking interventions. The RAA constructs are still applicable and can be integrated into intervention designs.
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Affiliation(s)
- Vivian C Sheer
- Department of Communication Studies, Hong Kong Baptist University
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2
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Wang Q. Smoking Outcome Expectancies in Chinese Young Adults. J Psychoactive Drugs 2022:1-12. [PMID: 35848499 DOI: 10.1080/02791072.2022.2101405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The aims of this study were to: 1) validate the factor structure of the short-form smoking consequences questionnaire (S-SCQ) in Chinese young adults; 2) assess measurement invariance of the S-SCQ across smokers and never-smokers; 3) examine factors of the S-SCQ in relation to smoking-related variables. Data from 1,540 respondents (757 smokers, 783 never-smokers) were collected anonymously via an online survey in June, 2021. All respondents completed the S-SCQ and other smoking-related items. Confirmatory factor analysis (CFA) was conducted to validate the factor structure of S-SCQ. Measurement invariance of the S-SCQ was examined across smoking status. Relations between outcome expectancies and other smoking-related variables were further examined. CFA results supported the four-factor structure of the S-SCQ. Measurement invariance tests supported configural, metric, partial scalar, and strict invariance of the S-SCQ across smoking status. Never-smokers exposed to household SHS or intending to smoke had weight control and reinforcement expectancies. Smokers exposed to moderate household SHS or scored higher on the FTND had greater positive reinforcement expectancies. For never-smokers, household SHS exposure and future smoking intentions may be key constructs to target in smoking prevention efforts. For smokers, smoking-induced sensory satisfaction may be a key construct to transform in expectancy-based interventions.
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Affiliation(s)
- Qian Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Minhang, SH, China
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3
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Shin Y, Lu Y. Investigation of college student smoking perceptions, behaviors and communication about smoking with smoking friends and family. HEALTH EDUCATION 2021. [DOI: 10.1108/he-02-2021-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeCommunication plays an important role in health decisions and behaviors. Friends and family exert influence through communication and, when considering smoking, this is particularly salient among those friends and family who smoke. Guided by primary socialization theory and integrated behavioral model, the present study examined the effects of having smoking friends and family on smoking beliefs (e.g. negative consequences, positive reinforcement and negative reinforcement), cultural normative beliefs, pro-smoking injunctive norms, smoking intentions and recent smoking behaviors.Design/methodology/approachCross-sectional online survey data were collected from college students (N = 227). Multivariate analysis of covariance and path analysis were performed.FindingsCollege students who reported having smoking friends were more likely to report higher levels of positive reinforcement, cultural normative beliefs, pro-smoking injunctive norms, positive attitudes, smoking intentions and recent smoking behaviors than those without smoking friends. Frequent communication with smoking friends was significantly related to cultural normative beliefs, pro-smoking injunctive norms, positive attitudes and smoking intentions. The analysis, however, did not yield statistical support for the associations between frequent communication with smoking family and smoking perceptions, norms and behaviors.Originality/valueThe present study highlights the vital roles of friends' influence for college students' smoking behaviors. Communication-based intervention can help better equip college students with communication strategies that prevent tobacco use by promoting more effective conversations with friends.
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Lu Y, Shin Y, Gitau MW, Njoroge MW, Gitau P, Temple JR. Application of the theory of planned behavior to predict smoking intentions: cross-cultural comparison of Kenyan and American young adults. HEALTH EDUCATION RESEARCH 2021; 36:140-150. [PMID: 33270825 DOI: 10.1093/her/cyaa041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 09/23/2020] [Indexed: 06/12/2023]
Abstract
Despite well-established research on the applications of the theory of planned behavior (TPB) in the American culture, TPB has not been fully tested in the Kenyan culture. This study compared the applications of TPB in predicting smoking intentions (i.e., future and weekend smoking intentions) of Kenyan and American young adults. Data were collected from 252 Kenyans and 227 Americans. The Kenyan participants consisted of 41.7% females with a mean age of 25 years (SD = 4.81). The American participants (49.3% females) had an average age of 19 years (SD = 1.30). Multi-group path analysis was performed to test the equivalence of a TPB-based mediation model in Kenyans and Americans. Significant differences of TPB application were detected. In the American model, smoking consequence beliefs were indirectly associated with smoking intentions through attitudes whereas neither direct nor indirect effects of smoking consequence beliefs were detected in the Kenyan model. Instead, normative beliefs indirectly associated with future and weekend smoking intentions through attitudes and subjective norms in the Kenyan model. Despite some overlapping paths, there were cultural variations on specific associations among TPB constructs between Kenyans and Americans. Cultural adaptations may be needed when applying TPB in the Kenyan cultural context.
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Affiliation(s)
- Yu Lu
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK 73019, USA
| | - YoungJu Shin
- Hugh Downs School of Human Communication, Arizona State University, Tempe, AZ 85287, USA
| | - Mary W Gitau
- Department of Social Work, Clarke University, Dubuque, IA 52001, USA
| | - Margaret W Njoroge
- Department of Psychology, United States International University, Nairobi, Kenya
| | - Peter Gitau
- Student Success and Student Affairs, Fairmont State University, Fairmont, VA 26554, USA
| | - Jeff R Temple
- Center for Violence Prevention, University of Texas Medical Branch, Galveston, TX 77555, USA
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Lareyre O, Gourlan M, Stoebner-Delbarre A, Cousson-Gélie F. Characteristics and impact of theory of planned behavior interventions on smoking behavior: A systematic review of the literature. Prev Med 2021; 143:106327. [PMID: 33227344 DOI: 10.1016/j.ypmed.2020.106327] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/14/2020] [Accepted: 11/15/2020] [Indexed: 12/16/2022]
Abstract
Theoretical frameworks such as the theory of planned behavior (TPB) can be applied to design and evaluate smoking behavior interventions. The present systematic review aimed to: (i) determine the characteristics of TPB-based interventions and their reported impact on smoking behavior and TPB variables, (ii) evaluate the level of methodological quality in the included studies, and (iii) assess the quality of the theoretical implementation. Studies were eligible for inclusion if the intervention targeted smoking behavior, was explicitly based on the TPB, and if smoking behavior or intention was measured at least at post-intervention. Relevant articles were identified through searches on databases and internet search engines, responses to messages sent on thematic forums, consultation of prominent authors, and manual searches on key websites and key TPB-publications. Seventeen studies met the inclusion criteria. A majority of studies (65%) targeted the student population (i.e., elementary school, high school, university). Interventions minimally included the provision of health messages. The proportion of studies that reported a significant impact on smoking behavior, intention, attitude, subjective norm, or PBC ranged between 42% and 50%. Regarding methodological quality, unclear or high risks of bias were notably found regarding the selection of participants, data collection methods, withdrawal and drop-outs, and blinding. Regarding theoretical implementation, the reciprocal link between intervention techniques and TPB variables targeted remain unclear for a majority of studies. To better inform tobacco prevention and TPB research, future studies should more systematically use rigorous methods when designing, implementing, and reporting TPB-based interventions.
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Affiliation(s)
- Olivier Lareyre
- Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, F34000, Montpellier, France; Epidaure-Prevention Department of the Montpellier Cancer Institute, 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
| | - Mathieu Gourlan
- Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, F34000, Montpellier, France; Epidaure-Prevention Department of the Montpellier Cancer Institute, 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
| | - Anne Stoebner-Delbarre
- Onco-Addiction and Patient Education Unit - Supportive Care Department, Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
| | - Florence Cousson-Gélie
- Univ. Paul Valéry Montpellier 3, Univ. Montpellier, EPSYLON EA 4556, F34000, Montpellier, France; Epidaure-Prevention Department of the Montpellier Cancer Institute, 208 Avenue des Apothicaires, 34298 Montpellier cedex 5, France.
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6
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Gaube S, Fischer P, Lermer E. Hand(y) hygiene insights: Applying three theoretical models to investigate hospital patients' and visitors' hand hygiene behavior. PLoS One 2021; 16:e0245543. [PMID: 33444410 PMCID: PMC7808666 DOI: 10.1371/journal.pone.0245543] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Improving hand hygiene in hospitals is the most efficient method to prevent healthcare-associated infections. The hand hygiene behavior of hospital patients and visitors is not well-researched, although they pose a risk for the transmission of pathogens. Therefore, the present study had three aims: (1) Finding a suitable theoretical model to explain patients' and visitors' hand hygiene practice; (2) Identifying important predictors for their hand hygiene behavior; and (3) Comparing the essential determinants of hand hygiene behavior between healthcare professionals from the literature to our non-professional sample. METHODS In total N = 1,605 patients and visitors were surveyed on their hand hygiene practice in hospitals. The employed questionnaires were based on three theoretical models: a) the Theory of Planned Behavior (TPB); b) the Health Action Process Approach (HAPA); and c) the Theoretical Domains Framework (TDF). Structural equation modeling was used to analyze the data. To compare our results to the determinants of healthcare workers' hand hygiene behavior, we searched for studies that used one of the three theoretical models. RESULTS Among patients, 52% of the variance in the hand hygiene behavior was accounted for by the TDF domains, 44% by a modified HAPA model, and 40% by the TPB factors. Among visitors, these figures were 59%, 37%, and 55%, respectively. Two clusters of variables surfaced as being essential determinants of behavior: self-regulatory processes and social influence processes. The critical determinants for healthcare professionals' hand hygiene reported in the literature were similar to the findings from our non-professional sample. CONCLUSIONS The TDF was identified as the most suitable model to explain patients' and visitors' hand hygiene practices. Patients and visitors should be included in existing behavior change intervention strategies. Newly planned interventions should focus on targeting self-regulatory and social influence processes to improve effectiveness.
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Affiliation(s)
- Susanne Gaube
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Peter Fischer
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Eva Lermer
- LMU Center for Leadership and People Management, LMU Munich, Munich, Germany
- FOM University of Applied Sciences for Economics & Management, Munich, Germany
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7
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Underner M, Peiffer G, Perriot J, Jaafari N. [Smoking cessation in asthmatic patients and its impact]. Rev Mal Respir 2021; 38:87-107. [PMID: 33414027 DOI: 10.1016/j.rmr.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 06/18/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The prevalence of smoking in asthmatic patients is similar to, or even higher than in the general population. OBJECTIVES This systematic review addresses (1) the effects of smoking on asthma, (2) smoking cessation strategies in asthmatic patients, and (3) the consequences of smoking cessation for people with asthma. RESULTS Active or passive smoking can promote the development of asthma. The few studies on smoking cessation in asthma confirm the efficacy of validated smoking cessation strategies in these patients (nicotine replacement therapy, varenicline, bupropion, cognitive and behavioural therapies). Smoking cessation in parents with asthmatic children is essential and is based on the same strategies. Electronic cigarettes may be a useful help to quit smoking in some patients. Smoking cessation is beneficial in asthmatic smokers and associated with (1) a reduction of asthma symptoms, acute exacerbations, bronchial hyperresponsiveness, and bronchial inflammation, (2) decreased use of rescue medications and in doses of inhaled corticosteroids, (3) improved asthma control, quality of life, and lung function. CONCLUSION In asthmatic patients, it is essential to assess smoking status and health professionals must assist them to quit smoking.
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Affiliation(s)
- M Underner
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 86021 Poitiers, France.
| | - G Peiffer
- Service de pneumologie, hôpital de Mercy, CHR Metz-Thionville, 57085 Metz cedex 3, France
| | - J Perriot
- Dispensaire Émile-Roux, CLAT 63, centre de tabacologie, 63100 Clermont-Ferrand, France
| | - N Jaafari
- Unité de recherche clinique, centre hospitalier Henri-Laborit, université de Poitiers, 86021 Poitiers, France
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Chen H, Zhao B, Li X, Xie R, Li W. Nicotine Dependence, Perceived Behavioral Control, Descriptive Quitting Norms, and Intentions to Quit Smoking among Chinese Male Regular Smokers. Subst Use Misuse 2021; 56:145-152. [PMID: 33280473 DOI: 10.1080/10826084.2020.1846195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The association between nicotine dependence and intentions to quit smoking is well established. However, the underlying mechanisms and psychosocial factors that moderate this relationship have not been adequately delineated. Reinforcement theory, social learning theory, the theory of planned behavior, and the focus theory of normative conduct suggest that perceived behavioral control (PBC) over smoking cessation is a central mechanism that underlies the relationship between nicotine dependence and quitting intentions. Purpose/Objectives: The present study tested a moderated mediation model to examine the roles of PBC over smoking cessation and social norms, in the relationship between nicotine dependence and quit intentions among male regular smokers. Methods: Self-report measures of nicotine dependence, PBC over smoking cessation, descriptive and injunctive quitting norms, and intentions to quit smoking were administered to 204 Chinese male regular smokers. Results: Nicotine dependence was negatively related to quit intentions, and this relationship was mediated by PBC over smoking cessation. Further, the relationship between nicotine dependence and PBC was moderated by descriptive rather than injunctive quitting norms. The negative effects of nicotine dependence on PBC over smoking cessation were not significant among male regular smokers who reported strong descriptive quitting norms. Conclusions/Importance: Poor PBC over smoking cessation underlies the negative effects of nicotine dependence, and descriptive quitting norms act as a buffer against the adverse effects of nicotine dependence on PBC over smoking cessation. These findings have implications for smoking cessation interventions for male regular smokers.
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Affiliation(s)
- Haide Chen
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Boqiang Zhao
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Xinwei Li
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Ruibo Xie
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Weijian Li
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
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Avishai A, Meernik C, Goldstein AO, Lazard AJ, Ranney LM, Sheeran P. Impact and mechanisms of cigarillo flavor descriptors on susceptibility to use among young adult nonusers of tobacco. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2020. [DOI: 10.1111/jasp.12706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Aya Avishai
- Department of Psychology and Neuroscience University of North Carolina at Chapel Hill Chapel Hill NC USA
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Clare Meernik
- Department of Epidemiology University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Adam O. Goldstein
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
- Department of Family Medicine University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Allison J. Lazard
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
- Hussman School of Journalism and Media University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Leah M. Ranney
- Department of Family Medicine University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Paschal Sheeran
- Department of Psychology and Neuroscience University of North Carolina at Chapel Hill Chapel Hill NC USA
- Lineberger Comprehensive Cancer Center University of North Carolina at Chapel Hill Chapel Hill NC USA
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Bashirian S, Barati M, Karami M, Hamzeh B, Ezati E. Predictors of shisha smoking among adolescent females in Western Iran in 2019: Using the Prototype-Willingness Model. Tob Prev Cessat 2020; 6:50. [PMID: 32954063 PMCID: PMC7493647 DOI: 10.18332/tpc/125357] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/21/2020] [Accepted: 07/13/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Given the increasing prevalence of shisha smoking (SS) in adolescent females, it is necessary to determine the factors influencing adolescent’s choice of shisha. This study aimed to determine predictors of shisha smoking among adolescent females in Western Iran based on the Prototype-Willingness Model (PWM). METHODS This cross-sectional study was conducted on 1302 adolescent females in Kermanshah city, western Iran, in 2019. The method was multi-stage sampling with a systematic random approach. Data were collected using a questionnaire consisting of sociodemographic questions, history of shisha smoking, and Prototype-Willingness Model structure-based questions. Data were analyzed using SPSS 22 software. Statistical tests included descriptive statistics, Pearson correlation test, and linear and logistic regression analyses. RESULTS The prevalence of current consumers of shisha was 20.4%. Attitude and behavioral willingness and subjective norms were the most important predictors of behavioral intentions, whereas subjective norms, attitudes, and prototypes were the most important predictors for behavioral willingness. The results obtained from the logistic regression analysis revealed that both pathways of PWM constructs (behavioral intention OR=1.37; behavioral willingness OR=1.32) were significant predicting factors for shisha smoking among adolescent females. CONCLUSIONS Given the efficient role of behavioral willingness and intention for shisha smoking (SS) in adolescent females, it is necessary to consider these structures in designing educational strategies for the prevention of adolescent smoking.
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Affiliation(s)
- Saeed Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Manoochehr Karami
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinacies of Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Elahe Ezati
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, Iran
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McDermott MS, East KA, Hitchman SC, McNeill A, Tountas Y, Demjén T, Fernández E, Mons U, Trofor AC, Herbeć A, Janik-Koncewicz K, Fong GT, Vardavas CI. Social norms for e-cigarettes and smoking: associations with initiation of e-cigarette use, intentions to quit smoking and quit attempts: findings from the EUREST-PLUS ITC Europe Surveys. Eur J Public Health 2020; 30:iii46-iii54. [PMID: 32918818 DOI: 10.1093/eurpub/ckaa014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Social norms have received little attention in relation to electronic cigarettes (EC). The current study examine social norms for EC use and smoking tobacco, and their associations with (i) initiation of EC use, (ii) intention to quit smoking and (iii) attempts to quit smoking. METHODS Cross-sectional and longitudinal data analysis from Waves 1 and 2 of the ITC 6 European Country Survey and corresponding waves from England (the ITC Four Country Smoking and Vaping Survey). Current smokers at baseline, who heard of ECs and provided data at both waves were included (n = 3702). Complex samples logistic regression examined associations between the outcomes and descriptive (seeing EC use in public, close friends using ECs/smoking) and injunctive (public approves of ECs/smoking) norms, adjusting for country, demographics, EC use and heaviness of smoking. RESULTS In longitudinal analyses, seeing EC use in public at least some days was the only social norm that predicted initiation of EC use between waves (OR = 1.66, 95%CI = 1.08-2.56). In the cross-sectional analysis, having an intention to quit was associated with seeing EC use in public (OR = 1.37, 95%CI = 1.04-1.81) and reporting fewer than three close friends smoke (OR = 0.59, 95%CI = 0.44-0.80). There was no association between any social norm and making a quit attempt between waves. CONCLUSIONS Initiation of EC use is predicted by seeing EC use in public, which was also associated with greater intention to quit smoking. Friends' smoking was associated with lower intention to quit. These findings may allay concerns that increased visibility of ECs is renormalizing smoking amongst current smokers.
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Affiliation(s)
| | - Katherine A East
- National Addiction Centre, King's College London, London, UK.,Shaping Public Health Policies to Reduce Inequalities and Harm (SPECTRUM), Nottingham, UK
| | - Sara C Hitchman
- National Addiction Centre, King's College London, London, UK.,Shaping Public Health Policies to Reduce Inequalities and Harm (SPECTRUM), Nottingham, UK
| | - Ann McNeill
- National Addiction Centre, King's College London, London, UK.,Shaping Public Health Policies to Reduce Inequalities and Harm (SPECTRUM), Nottingham, UK
| | - Yannis Tountas
- Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens (UoA), Athens, Greece
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation (SHHF), Budapest, Hungary
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat (Barcelona), Catalonia, Spain.,Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain.,School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, L'Hospitalet de Llobregat, Catalonia, Spain
| | - Ute Mons
- German Cancer Research Center (DKFZ), Cancer Prevention Unit & WHO Collaborating Centre for Tobacco Control, Heidelberg, Germany
| | - Antigona C Trofor
- Aer Pur Romania, Bucharest, Romania.,University of Medicine and Pharmacy 'Grigore T.Popa', Iasi, Romania
| | - Aleksandra Herbeć
- Health Promotion Foundation (HPF), Warsaw, Poland.,UCL Tobacco and Alcohol Research Group, London, UK
| | | | - Geoffrey T Fong
- Departments of Psychology and School of Public Health and Health Systems, University of Waterloo (UW), Waterloo, Canada.,Ontario Institute for Cancer Research, Toronto, Canada
| | - Constantine I Vardavas
- European Network on Smoking and Tobacco Prevention (ENSP), Brussels, Belgium.,Laboratory of Toxicology, School of Medicine, University of Crete (UoC), Heraklion, Greece.,European Respiratory Society, Lausanne, Switzerland
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Clawson AH, McQuaid EL, Dunsiger S, Borrelli B. Smokers with children with asthma: Parental perceptions about prototype intervention messages focused on reducing child tobacco exposure and use. J Child Health Care 2020; 24:106-122. [PMID: 30198313 DOI: 10.1177/1367493518798436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Formative research is needed to develop effective interventions that eliminate secondhand smoke exposure (SHSe) and prevent tobacco use (TU) among children with asthma. This online study included 300 parents who smoke and had a child with asthma (ages 10-14) and evaluated their perceptions about prototypes of parent-directed and child-directed feedback intervention messages focused on reducing child SHSe and future TU; correlates of perceptions were explored. Parents rated examples of parent-directed messages on motivation and helpfulness for eliminating SHSe and promoting conversations about TU and also rated child-directed messages on acceptability and helpfulness for promoting conversations about TU. Messages differed by level of personalization, theoretical background, or message content. Parents found all parent-directed messages similarly motivating and helpful and all child-directed messages similarly acceptable and helpful for reducing child tobacco exposure. Differences in perceptions about feedback emerged based on parent gender, parent readiness to quit, smoking ban status, and the presence of additional smokers in the home. Overall, parents rated parent-directed and child-directed feedback message prototypes positively, including established and novel types of feedback. Parent-child feedback interventions may hold promise for breaking the intergenerational transmission of smoking among families with a parent who smokes and a child with asthma.
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Affiliation(s)
- Ashley H Clawson
- Centers for Behavioral and Preventive Medicine, Alpert Medical School of Brown University, The Miriam Hospital, RI, USA.,Bradley/Hasbro Children's Research Center, Alpert Medical School of Brown University, Rhode Island Hospital, RI, USA.,Department of Psychology, Oklahoma State University, OK, USA
| | - Elizabeth L McQuaid
- Bradley/Hasbro Children's Research Center, Alpert Medical School of Brown University, Rhode Island Hospital, RI, USA
| | - Shira Dunsiger
- Centers for Behavioral and Preventive Medicine, Alpert Medical School of Brown University, The Miriam Hospital, RI, USA
| | - Belinda Borrelli
- Henry M. Goldman School of Dental Medicine, Boston University, MA, USA
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13
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East KA, Hitchman SC, McNeill A, Thrasher JF, Hammond D. Social norms towards smoking and vaping and associations with product use among youth in England, Canada, and the US. Drug Alcohol Depend 2019; 205:107635. [PMID: 31765990 PMCID: PMC6905149 DOI: 10.1016/j.drugalcdep.2019.107635] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/30/2019] [Accepted: 08/03/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study assesses differences in social norms towards smoking and vaping among youth across countries (England, Canada, US) and smoking and vaping status. METHODS Data are from the 2017 ITC Youth Tobacco and Vaping Survey, among youth age 16-19 in England (N = 3444), Canada (N = 3327), and US (N = 3509). Prevalence of friend smoking, friend vaping, peer approval of smoking, and peer approval of vaping were estimated. Adjusted logistic regression models were estimated for each norm to assess associations with country, smoking status, and vaping status, adjusting for sociodemographics, alcohol use, and marijuana use. RESULTS 47% and 52% reported friend smoking and vaping respectively. Perceived peer approval of vaping (44%) was almost double that of smoking (23%). Compared with England, fewer Canadian and US youth reported friend smoking (Canada: AOR = 0.71 [95% CI = 0.62-0.82]; US: AOR = 0.54 [0.47-0.62]) and peer approval of smoking (Canada: AOR = 0.74 [0.63-0.87]; US: AOR = 0.78 [0.67-0.91]), yet more reported peer approval of vaping (Canada: AOR = 1.23 [1.08-1.41]; US: AOR = 1.30 [1.14-1.48]). More Canadian than English youth reported friend vaping (AOR = 1.17 [1.02-1.36]). Friend smoking, peer approval of smoking, and friend vaping were more common among smokers and vapers (all p < .02). Peer approval of vaping was more common among vapers but less common among smokers (all p < .044). CONCLUSIONS Youth had more positive vaping than smoking norms. English youth reported the most pro-smoking but least pro-vaping norms in adjusted models; this was unexpected given country differences in regulatory environments. Norms towards both products were associated with use, with some evidence of cross-product associations between norms and behaviours.
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Affiliation(s)
- Katherine A East
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; UK Centre for Tobacco and Alcohol Studies, UK.
| | - Sara C Hitchman
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; UK Centre for Tobacco and Alcohol Studies, UK.
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; UK Centre for Tobacco and Alcohol Studies, UK.
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA; Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Mexico.
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Canada.
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Mohammed M, Cheung KL, Winkens B, de Vries N, de Vries H. Factors associated with smoking initiation among Saudi male adolescents: A longitudinal study. Tob Prev Cessat 2019; 5:21. [PMID: 32411884 PMCID: PMC7205146 DOI: 10.18332/tpc/109167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Knowing country-specific predictors of smoking behaviour for adolescents is crucial for successful smoking prevention programs. This study aims to assess demographic and socio-cognitive variables related to smoking initiation among Saudi male adolescents. METHODS Longitudinal data were collected at T1 (baseline) and at T2 (followup at 6 months) using a self-administered questionnaire. We assessed smoking behaviour and related demographic variables and socio-cognitive variables. Chi-squared tests and independent-samples t-tests were used to identify differences in baseline characteristics between smokers and non-smokers at T1. Furthermore, non-smokers at T1 were included in logistic regression analyses to examine the predictors of smoking initiation between T1 and T2. RESULTS At T1, the non-smokers who were included in further analysis were 523 (84.9%) of whom 48 (9.2%) had initiated smoking at T2. They differed significantly from non-initiators, including having a more positive attitude towards smoking, reporting more social norms, modelling and pressure to smoke, having a lower self-efficacy to refrain from smoking and higher intention to smoke in the future (all p<0.001). The regression analysis revealed that: adolescents with disrupted-families, being of low academic achievement, with relatively high monthly-income families, having more smoking-peers, high-perceived pressure to smoke from parents (p=0.002) and teachers (p=0.001), have smoking supportive-norms of parents and having high intention to smoke in the future (p<0.001) were at higher risk of being smokers. CONCLUSIONS Findings suggest that health-promoting programs should address strengthening of self-efficacy and enhancing refusal skills against modelling of peers, pressure and norms of parents.
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Affiliation(s)
- Mutaz Mohammed
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht, Netherlands
| | - Kei Long Cheung
- Department of Clinical Sciences, College of Health and Life Sciences, Brunel University, London, United Kingdom
| | - Bjorn Winkens
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht, Netherlands
| | - Nanne de Vries
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht, Netherlands
| | - Hein de Vries
- Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute, Maastricht, Netherlands
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15
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Brinker TJ, Buslaff F, Suhre JL, Silchmüller MP, Divizieva E, Wilhelm J, Hillebrand G, Penka D, Gaim B, Swoboda S, Baumermann S, Walther JW, Brieske CM, Jakob L, Baumert HM, Anhuef O, Schmidt SM, Alfitian J, Batra A, Taha L, Mons U, Hofmann FJ, Haney AC, Haney CM, Schaible S, Tran TA, Beißwenger H, Stark T, Groneberg DA, Seeger W, Srivastava A, Gall H, Holzapfel J, Rigotti NA, Baudson TG, Enk AH, Fröhling S, von Kalle C, Bernardes-Souza B, Pereira RMDOS, Thomas R. Process Evaluation of a Medical Student-Delivered Smoking Prevention Program for Secondary Schools: Protocol for the Education Against Tobacco Cluster Randomized Trial. JMIR Res Protoc 2019; 8:e13508. [PMID: 30973348 PMCID: PMC6482400 DOI: 10.2196/13508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 01/10/2023] Open
Abstract
Background Most smokers start smoking during their early adolescence under the impression that smoking entails positive attributes. Given the addictive nature of cigarettes, however, many of them might end up as long-term smokers and suffering from tobacco-related diseases. To prevent tobacco use among adolescents, the large international medical students’ network Education Against Tobacco (EAT) educates more than 40,000 secondary school students per year in the classroom setting, using evidence-based self-developed apps and strategies. Objective This study aimed to evaluate the long-term effectiveness of the school-based EAT intervention in reducing smoking prevalence among seventh-grade students in Germany. Additionally, we aimed to improve the intervention by drawing conclusions from our process evaluation. Methods We conduct a cluster-randomized controlled trial with measurements at baseline and 9, 16, and 24 months postintervention via paper-and-pencil questionnaires administered by teachers. The study groups consist of randomized schools receiving the 2016 EAT curriculum and control schools with comparable baseline data (no intervention). The primary outcome is the difference of change in smoking prevalence between the intervention and control groups at the 24-month follow-up. Secondary outcomes are between-group differences of changes in smoking-related attitudes and the number of new smokers, quitters, and never-smokers. Results A total of 11,268 students of both sexes, with an average age of 12.32 years, in seventh grade of 144 secondary schools in Germany were included at baseline. The prevalence of cigarette smoking in our sample was 2.6%. The process evaluation surveys were filled out by 324 medical student volunteers, 63 medical student supervisors, 4896 students, and 141 teachers. Conclusions The EAT cluster randomized trial is the largest school-based tobacco-prevention study in Germany conducted to date. Its results will provide important insights with regards to the effectiveness of medical student–delivered smoking prevention programs at school. International Registered Report Identifier (IRRID) DERR1-10.2196/13508
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Affiliation(s)
- Titus Josef Brinker
- Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany.,Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Fabian Buslaff
- Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | | | | | | | - Jilada Wilhelm
- Faculty of Medicine, University of Düsseldorf, Düsseldorf, Germany
| | - Gabriel Hillebrand
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Dominik Penka
- Faculty of Medicine, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Benedikt Gaim
- Faculty of Medicine, University of Regensburg, Regensburg, Germany
| | - Susanne Swoboda
- Faculty of Medicine, University of Regensburg, Regensburg, Germany
| | | | - Jörg Werner Walther
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bochum, Germany
| | | | - Lena Jakob
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | | | - Ole Anhuef
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen, Germany
| | - Selina Marisa Schmidt
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen, Germany
| | - Jonas Alfitian
- Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tübingen, Germany
| | - Lava Taha
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Erlangen, Erlangen, Germany
| | - Ute Mons
- Cancer Prevention Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Ailís Ceara Haney
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Caelán Max Haney
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Samuel Schaible
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Thien-An Tran
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Hanna Beißwenger
- Faculty of Medicine, University of Göttingen, Göttingen, Germany
| | - Tobias Stark
- Faculty of Medicine, University of Regensburg, Regensburg, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University of Frankfurt am Main, Frankfurt am Main, Germany
| | - Werner Seeger
- Faculty of Medicine, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Aayushi Srivastava
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Henning Gall
- Faculty of Medicine, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Julia Holzapfel
- Faculty of Medicine, Justus-Liebig-University of Gießen, Gießen, Germany
| | - Nancy A Rigotti
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Tanja Gabriele Baudson
- Cognitive Science and Assessment Institute, University of Luxembourg, Luxembourg, Luxembourg
| | - Alexander H Enk
- Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Fröhling
- National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Christof von Kalle
- Department of Translational Oncology, National Center for Tumor Diseases, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | | | | | - Roger Thomas
- Health Sciences Centre, University of Calgary, Calgary, AB, Canada
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A Face-Aging Smoking Prevention/Cessation Intervention for Nursery School Students in Germany: An Appearance-Focused Interventional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081656. [PMID: 30081549 PMCID: PMC6121507 DOI: 10.3390/ijerph15081656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 07/24/2018] [Accepted: 08/02/2018] [Indexed: 12/27/2022]
Abstract
The Education Against Tobacco (EAT) network delivers smoking prevention advice in secondary schools, typically using the mirroring approach (i.e., a “selfie” altered with a face-aging app and shared with a class). In November 2017, however, the German assembly of EAT opted to expand its remit to include nursing students. To assess the transferability of the existing approach, we implemented it with the self-developed face-aging app “Smokerface” (=mixed − methods approach) in six nursing schools. Anonymous questionnaires were used to assess the perceptions of 197 students (age 18–40 years; 83.8% female; 26.4% smokers; 23.3% daily smokers) collecting qualitative and quantitative data for our cross-sectional study. Most students perceived the intervention to be fun (73.3%), but a minority disagreed that their own animated selfie (25.9%) or the reaction of their peers (29.5%) had motivated them to stop smoking. The impact on motivation not to smoke was considerably lower than experienced with seventh graders (63.2% vs. 42.0%; notably, more smokers also disagreed (45.1%) than agreed (23.5%) with this statement. Agreement rates on the motivation not to smoke item were higher in females than in males and in year 2–3 than in year 1 students. Potential improvements included greater focus on pathology (29%) and discussing external factors (26%). Overall, the intervention seemed to be appealing for nursing students.
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Meernik C, Ranney LM, Lazard AJ, Kim K, Queen TL, Avishai A, Boynton MH, Sheeran PJ, Goldstein AO. The effect of cigarillo packaging elements on young adult perceptions of product flavor, taste, smell, and appeal. PLoS One 2018; 13:e0196236. [PMID: 29672604 PMCID: PMC5909610 DOI: 10.1371/journal.pone.0196236] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/09/2018] [Indexed: 02/02/2023] Open
Abstract
Introduction Product packaging has long been used by the tobacco industry to target consumers and manipulate product perceptions. This study examines the extent to which cigarillo packaging influences perceptions of product flavor, taste, smell, and appeal. Methods A web-based experiment was conducted among young adults. Participants viewed three randomly selected cigarillo packs, varying on pack flavor descriptor, color, type, branding, and warning—totaling 180 pack images. Mixed-effects models were used to estimate the effect of pack elements on product perceptions. Results A total of 2,664 current, ever, and never little cigar and cigarillo users participated. Cigarillo packs with a flavor descriptor were perceived as having a more favorable taste (β = 0.21, p < .001) and smell (β = 0.14, p < .001) compared to packs with no flavor descriptor. Compared to packs with no color, pink and purple packs were more likely to be perceived as containing a flavor (β = 0.11, p < .001), and were rated more favorably on taste (β = 0.17, p < .001), smell (β = 0.15, p < .001), and appeal (β = 0.16, p < .001). While warnings on packs decreased favorable perceptions of product taste (pictorial: β = -0.07, p = .03) and smell (text-only: β = -0.08, p = .01; pictorial: β = -0.09, p = .007), warnings did not moderate the effects of flavor descriptor or color. Conclusions To our knowledge, this study provides the first quantitative evidence that cigarillo packaging alters consumers’ cognitive responses, and warnings on packs do not suffice to overcome the effects of product packaging. The findings support efforts at federal, state, and local levels to prohibit flavor descriptors and their associated product flavoring in non-cigarette products such as cigarillos, along with new data that supports restrictions on flavor cues and colors.
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Affiliation(s)
- Clare Meernik
- Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
- * E-mail:
| | - Leah M. Ranney
- Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
| | - Allison J. Lazard
- School of Media and Journalism, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - KyungSu Kim
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Tara L. Queen
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Aya Avishai
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Marcella H. Boynton
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Paschal J. Sheeran
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Adam O. Goldstein
- Department of Family Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Li W, Gao L, Chen H, Cao N, Sun B. Prediction of injunctive and descriptive norms for willingness to quit smoking: The mediating role of smoking risk perception. JOURNAL OF SUBSTANCE USE 2017. [DOI: 10.1080/14659891.2017.1394378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Weijian Li
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Lingfeng Gao
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Haide Chen
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Ningmeng Cao
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Binghai Sun
- Institute of Psychological and Brain Sciences, Zhejiang Normal University, Jinhua, Zhejiang, China
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19
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Clawson AH, McQuaid EL, Borrelli B. Smokers who have children with asthma: Perceptions about child secondhand smoke exposure and tobacco use initiation and parental willingness to participate in child-focused tobacco interventions. J Asthma 2017; 55:373-384. [PMID: 28759279 DOI: 10.1080/02770903.2017.1339797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study examined, among parents who smoke and have children with asthma, perceptions about child secondhand smoke exposure (SHSe), child tobacco use (TU) initiation, and parent willingness to participate in child-focused tobacco interventions. METHODS Participants were 300 caregivers who smoked and had a child with asthma (aged 10-14). Parents completed an online survey and self-reported perceptions about child SHSe elimination, child TU prevention, and willingness to participate in three types of interventions with and without their child (SHSe reduction intervention, tobacco prevention intervention, and the combination of the two). Correlates of perceptions and willingness were examined. RESULTS Parents who were ready to quit smoking and who reported home smoking bans (HSBs) were more motivated to eliminate SHSe (p < 0.05). Being white, younger, ready to quit, and having HSBs were associated with greater confidence to eliminate SHSe (p < 0.05). Parents with HSBs reported higher perceived importance about preventing child TU (p < 0.05). Parents were less confident about preventing male children from using tobacco (p = 0.001). Parents were highly willing to participate in all the described intervention approaches, with or without their child. CONCLUSIONS Parents were willing to participate in child-focused tobacco interventions, with or without their child with asthma, including interventions that address both child SHSe and TU prevention. This research demonstrates the acceptability of child-focused tobacco interventions among a high-risk population and may be a foundational step for intervention development.
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Affiliation(s)
- Ashley H Clawson
- a Centers for Behavioral and Preventive Medicine , Alpert Medical School of Brown University and The Miriam Hospital. Providence , RI , USA.,b Bradley/Hasbro Children's Research Center , Alpert Medical School of Brown University and Rhode Island Hospital. Providence , RI , USA.,c Department of Psychology , Oklahoma State University , Stillwater , OK , USA
| | - Elizabeth L McQuaid
- b Bradley/Hasbro Children's Research Center , Alpert Medical School of Brown University and Rhode Island Hospital. Providence , RI , USA
| | - Belinda Borrelli
- d Department of Health Policy & Health Services Research , Boston University, Henry M. Goldman School of Dental Medicine , Boston , MA , USA
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Brinker TJ, Owczarek AD, Seeger W, Groneberg DA, Brieske CM, Jansen P, Klode J, Stoffels I, Schadendorf D, Izar B, Fries FN, Hofmann FJ. A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Germany: Randomized Controlled Trial. J Med Internet Res 2017; 19:e199. [PMID: 28588007 PMCID: PMC5478798 DOI: 10.2196/jmir.7906] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 05/15/2017] [Accepted: 05/23/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND More than 8.5 million Germans suffer from chronic diseases attributable to smoking. Education Against Tobacco (EAT) is a multinational network of medical students who volunteer for school-based prevention in the classroom setting, amongst other activities. EAT has been implemented in 28 medical schools in Germany and is present in 13 additional countries around the globe. A recent quasi-experimental study showed significant short-term smoking cessation effects on 11-to-15-year-old adolescents. OBJECTIVE The aim of this study was to provide the first randomized long-term evaluation of the optimized 2014 EAT curriculum involving a photoaging software for its effectiveness in reducing the smoking prevalence among 11-to-15-year-old pupils in German secondary schools. METHODS A randomized controlled trial was undertaken with 1504 adolescents from 9 German secondary schools, aged 11-15 years in grades 6-8, of which 718 (47.74%) were identifiable for the prospective sample at the 12-month follow-up. The experimental study design included measurements at baseline (t1), 6 months (t2), and 12 months postintervention (t3), via questionnaire. The study groups consisted of 40 randomized classes that received the standardized EAT intervention (two medical student-led interactive modules taking 120 minutes total) and 34 control classes within the same schools (no intervention). The primary endpoint was the difference in smoking prevalence from t1 to t3 in the control group versus the difference from t1 to t3 in the intervention group. The differences in smoking behavior (smoking onset, quitting) between the two groups, as well as gender-specific effects, were studied as secondary outcomes. RESULTS None of the effects were significant due to a high loss-to-follow-up effect (52.26%, 786/1504). From baseline to the two follow-up time points, the prevalence of smoking increased from 3.1% to 5.2% to 7.2% in the control group and from 3.0% to 5.4% to 5.8% in the intervention group (number needed to treat [NNT]=68). Notable differences were observed between the groups for the female gender (4.2% to 9.5% for control vs 4.0% to 5.2% for intervention; NNT=24 for females vs NNT=207 for males), low educational background (7.3% to 12% for control vs 6.1% to 8.7% for intervention; NNT=30), and migrational background (students who claimed that at least one parent was not born in Germany) at the 12-month follow-up. The intervention appears to prevent smoking onset (NNT=63) but does not appear to initiate quitting. CONCLUSIONS The intervention appears to prevent smoking, especially in females and students with a low educational background.
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Affiliation(s)
- Titus Josef Brinker
- Universities of Giessen and Marburg Lung Center; Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Andreas Dawid Owczarek
- Universities of Giessen and Marburg Lung Center; Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Werner Seeger
- Universities of Giessen and Marburg Lung Center; Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
| | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Christian Martin Brieske
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Philipp Jansen
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Joachim Klode
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Ingo Stoffels
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Dirk Schadendorf
- Essen University Hospital, Department of Dermatology, Venerology and Allergology, University of Duisburg-Essen, Essen, Germany
- West German Cancer Center, University Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK), University of Heidelberg, Heidelberg, Germany
| | - Benjamin Izar
- Dana-Farber Cancer Institute, Department of Medical Oncology, Boston, MA, United States
| | - Fabian Norbert Fries
- Saarland University Medical Center and Saarland University Faculty of Medicine, Department of Ophthalmology, University of Homburg, Homburg, Germany
| | - Felix Johannes Hofmann
- Universities of Giessen and Marburg Lung Center; Member of the German Center for Lung Research (DZL), Department of Internal Medicine, Justus-Liebig-University of Giessen, Giessen, Germany
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21
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Xavier LEDF, Bernardes-Souza B, Lisboa OC, Seeger W, Groneberg DA, Tran TA, Fries FN, Corrêa PCRP, Brinker TJ. A Medical Student-Delivered Smoking Prevention Program, Education Against Tobacco, for Secondary Schools in Brazil: Study Protocol for a Randomized Trial. JMIR Res Protoc 2017; 6:e16. [PMID: 28137703 PMCID: PMC5306613 DOI: 10.2196/resprot.7134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 01/15/2017] [Accepted: 01/21/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Smoking is the largest preventable cause of morbidity and mortality in Brazil. Education Against Tobacco (EAT) is a large network of medical students in 13 countries who volunteer for school-based prevention in the classroom setting. A recent quasi-experimental EAT study conducted in Germany showed significant short-term smoking cessation effects on 11- to 15-year-old adolescents. OBJECTIVE The aim of this study is both to describe and to provide the first randomized long-term evaluation of the EAT intervention involving a photoaging app for its effectiveness to reduce the smoking prevalence among 12- to 17-year-old pupils in Brazilian public schools. METHODS A randomized controlled trial will be conducted among approximately 1500 adolescents aged 12 to 17 years in grades 7-11 of public secondary schools in Brazil. The prospective experimental study design includes measurements at baseline and at 6 and 12 months postintervention. The study groups will consist of randomized classes receiving the standardized EAT intervention (90 minutes of mentoring in a classroom setting) and control classes within the same schools (no intervention). The questionnaire measures smoking status, gender, social, and cultural aspects as well as predictors of smoking. Biochemical validation of smoking status is conducted via random carbon monoxide measurements. The primary end point is the difference of the change in smoking prevalence in the intervention group versus the difference in the control group at 12 months of follow-up. The differences in smoking behavior (smoking onset, quitting) between the 2 groups as well as effects on the different genders will be studied as secondary outcomes. RESULTS The recruitment of schools, participating adolescents, and medical students was conducted from August 2016 until January 2017. The planned period of data collection is February 2017 until June 2018. Data analysis will follow in July 2018 and data presentation/publication will follow shortly thereafter. CONCLUSIONS This is the first evaluative study of a medical student-delivered tobacco prevention program in Brazil and the first randomized trial on the long-term effectiveness of a school-based medical student-delivered tobacco prevention program in general. CLINICALTRIAL ClinicalTrials.gov NCT02725021; https://clinicaltrials.gov/ct2/show/NCT02725021 (archived by WebCite at http://www.webcitation.org/6njy3nNml).
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Affiliation(s)
| | | | | | - Werner Seeger
- Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research, Department of Internal Medicine, University of Giessen, Giessen, Germany
| | - David Alexander Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - Thien-An Tran
- Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research, University of Heidelberg, Heidelberg, Germany
| | - Fabian Norbert Fries
- Saarland University Medical Center and Saarland University Faculty of Medicine, Saarland University, Homburg, Germany
| | | | - Titus Josef Brinker
- Universities of Giessen and Marburg Lung Center, Member of the German Center for Lung Research, Department of Internal Medicine, University of Giessen, Giessen, Germany
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Brinker TJ, Holzapfel J, Baudson TG, Sies K, Jakob L, Baumert HM, Heckl M, Cirac A, Suhre JL, Mathes V, Fries FN, Spielmann H, Rigotti N, Seeger W, Herth F, Groneberg DA, Raupach T, Gall H, Bauer C, Marek P, Batra A, Harrison CH, Taha L, Owczarek A, Hofmann FJ, Thomas R, Mons U, Kreuter M. Photoaging smartphone app promoting poster campaign to reduce smoking prevalence in secondary schools: the Smokerface Randomized Trial: design and baseline characteristics. BMJ Open 2016; 6:e014288. [PMID: 27821601 PMCID: PMC5128772 DOI: 10.1136/bmjopen-2016-014288] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Smoking is the largest cause of preventable death globally. Most smokers smoke their first cigarette in early adolescence. We took advantage of the widespread availability of mobile phones and adolescents' interest in appearance to develop a free photoaging app which is promoted via a poster campaign in secondary schools. This study aims to evaluate its effectiveness regarding smoking prevalence and students' attitudes towards smoking. METHODS AND ANALYSIS A randomised controlled trial is conducted with 9851 students of both genders with an average age of 12 years in grades 6 and 7 of 126 secondary schools in Germany. At present, cigarette smoking prevalence in our sample is 4.7%, with 4.6% of the students currently using e-cigarettes (1.6% use both). The prospective experimental study design includes measurements at baseline and at 6, 12 and 24 months postintervention via a questionnaire plus a random cotinine saliva sample at 24 months postintervention. The study groups consist of randomised schools receiving the Smokerface poster campaign and control schools with comparable baseline data (no intervention). The primary end point is the difference of change in smoking prevalence in the intervention group versus the difference in the control group at 24 months follow-up. Longitudinal changes in smoking-related attitudes, the number of new smokers and quitters and the change in the number of never-smokers will be compared between the two groups as secondary outcomes. ETHICS AND DISSEMINATION Ethical approval was obtained from the ethics committee of the University of Gießen and the ministries of cultural affairs, both in Germany. Results will be disseminated at conferences, in peer-reviewed journals, on our websites and throughout the multinational Education Against Tobacco network. TRIAL REGISTRATION NUMBER NCT02544360, Pre-results.
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Affiliation(s)
- Titus J Brinker
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Julia Holzapfel
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | | | | | - Lena Jakob
- University of Freiburg, Freiburg im Breisgau, Germany
| | | | | | - Ana Cirac
- Technical University of Munich, Munich, Germany
| | | | - Verena Mathes
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Fabian N Fries
- Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
| | - Hannah Spielmann
- Saarland University Medical Center and Saarland University Faculty of Medicine, Homburg, Germany
| | - Nancy Rigotti
- Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Werner Seeger
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Felix Herth
- Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt, Germany
| | - Tobias Raupach
- Department of Cardiology and Pneumology, University Medical Centre, Göttingen, Germany
| | - Henning Gall
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Claudia Bauer
- Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
| | - Pat Marek
- Division of Public Health Sciences, Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Anil Batra
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany
| | - Chase H Harrison
- Department of Government, Faculty of Arts and Sciences, Harvard University, Cambridge, Massachusetts, USA
| | - Lava Taha
- University of Erlangen-Nuremberg, Erlangen, Germany
| | - Andreas Owczarek
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Felix J Hofmann
- Universities of Gießen and Marburg Lung Center (UGMLC); Member of the German Center for Lung Research (DZL), Justus-Liebig-University of Gießen, Gießen, Germany
| | - Roger Thomas
- University of Calgary, Health Sciences Centre, Calgary, Alberta, Canada
| | - Ute Mons
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Kreuter
- Pulmonary and Respiratory Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), Member of the German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Germany
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Predictors of the Onset of Cigarette Smoking: A Systematic Review of Longitudinal Population-Based Studies in Youth. Am J Prev Med 2016; 51:767-778. [PMID: 27180028 DOI: 10.1016/j.amepre.2016.04.003] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/17/2016] [Accepted: 04/01/2016] [Indexed: 11/23/2022]
Abstract
CONTEXT The onset of cigarette smoking typically occurs during childhood or early adolescence. Nicotine dependence symptoms can manifest soon after onset, contributing to sustained, long-term smoking. Previous reviews have not clarified the determinants of onset. EVIDENCE ACQUISITION In 2015, a systematic review of the literature in PubMed and EMBASE was undertaken to identify peer-reviewed prospective longitudinal studies published between January 1984 and August 2015 that investigated predictors of cigarette smoking onset among youth aged <18 years who had never smoked. EVIDENCE SYNTHESIS Ninety-eight conceptually different potential predictors were identified in 53 studies. An increased risk of smoking onset was consistently (i.e., in four or more studies) associated with increased age/grade, lower SES, poor academic performance, sensation seeking or rebelliousness, intention to smoke in the future, receptivity to tobacco promotion efforts, susceptibility to smoking, family members' smoking, having friends who smoke, and exposure to films, whereas higher self-esteem and high parental monitoring/supervision of the child appeared to protect against smoking onset. Methodologic weaknesses were identified in numerous studies, including failure to account for attrition or for clustering in samples, and misidentification of potential confounders, which may have led to biased estimates of associations. CONCLUSIONS Predictors of smoking onset for which there is robust evidence should be considered in the design of interventions to prevent first puff in order to optimize their effectiveness. Future research should seek to define onset clearly as the transition from never use to first use (e.g., first few puffs).
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Neppl TK, Dhalewadikar J, Lohman BJ. Harsh Parenting, Deviant Peers, Adolescent Risky Behavior: Understanding the Meditational Effect of Attitudes and Intentions. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2016; 26:538-551. [PMID: 28042227 PMCID: PMC5193236 DOI: 10.1111/jora.12212] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Although research supports the influence of parents and peers on adolescent risky behavior, less is known about mechanisms proposed to explain this relation. This study examined the influence of adolescent attitudes and intentions about such behaviors. Prospective, longitudinal data came from rural youth who participated throughout adolescence (n= 451). Observed harsh parenting and relationship with deviant peers was assessed in early adolescence, attitudes and intentions were measured during middle adolescence, and risky behavior was assessed in late adolescence. Results indicated that parenting and deviant peers was related to engagement in tobacco use, alcohol use, and risky sexual behaviors. Moreover, attitudes and intentions mediated this relationship even after parent use and adolescent early involvement in these behaviors were taken into account.
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Affiliation(s)
- Tricia K Neppl
- Dept. of Human Development and Family Studies, Iowa State University, 4389 Palmer Suite 2356, Ames, IA 50011; ; phone: 515-294-8502
| | - Jui Dhalewadikar
- Department of Human Development and Family Studies, Iowa State University;
| | - Brenda J Lohman
- Dept. of Human Development and Family Studies, Iowa State University, 4389 Palmer Suite 2356, Ames, IA 50011; ; phone: 515-294-6230
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Jones RM, Wiseman KP, Kharitonova M. Association between high school students' cigarette smoking, asthma and related beliefs: a population-based study. BMC Public Health 2016; 16:913. [PMID: 27586515 PMCID: PMC5008004 DOI: 10.1186/s12889-016-3579-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/23/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Smoking has a detrimental effect on the symptoms and severity of asthma, a common chronic disease among adolescents. The purpose of this study was to examine the association between asthma and smoking among high school students and assess provider-patient communication with asthmatic adolescents regarding smoking and adolescents' beliefs about the harms of smoking. METHODS In fall 2014, data from high school students, ages 14-18 years, completing the 2009-2010 Virginia Youth Tobacco Survey (N = 1796) were used in descriptive analyses and multivariable logistic regression models adjusting for model-specific confounders as appropriate. RESULTS Overall, an estimated 19 % of high school students in Virginia smoked and 16 % had asthma. Odds of smoking did not differ by asthma status; however, asthmatics had 1.5 times higher odds of being asked if they smoke (95 % CI 1.06-2.13) and being advised not to smoke by a health professional (95 % CI 1.10-2.14) compared to non-asthmatics. Asthmatics who believed second-hand smoke or smoking 1-5 cigarettes/day was not harmful had respectively 4.2 and 2.8 times higher odds of smoking than those who thought each was harmful. Further, asthmatics who thought smoking 1-2 years is safe had 3.4 times higher odds of smoking than those who did not (95 % CI 1.57-10.1). CONCLUSIONS While asthmatic adolescents are just as likely to smoke as non-asthmatics, less healthy beliefs about the risks of smoking increase the odds of smoking among asthmatics. Thus, targeted asthma-specific smoking prevention and education to change attitudes and beliefs could be an effective tool for adolescents.
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Affiliation(s)
- Resa M. Jones
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, 830 E. Main St., 8th Floor, Box 980212, 23298-0212 Richmond, VA USA
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA USA
- Center on Health Disparities, Virginia Commonwealth University, Richmond, VA USA
| | - Kara P. Wiseman
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, 830 E. Main St., 8th Floor, Box 980212, 23298-0212 Richmond, VA USA
| | - Marina Kharitonova
- Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, 830 E. Main St., 8th Floor, Box 980212, 23298-0212 Richmond, VA USA
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Jiang S, Beaudoin CE. Smoking Prevention in China: A Content Analysis of an Anti-Smoking Social Media Campaign. JOURNAL OF HEALTH COMMUNICATION 2016; 21:755-764. [PMID: 27232655 DOI: 10.1080/10810730.2016.1157653] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The China Tobacco Control Media Campaign on Sina Weibo is novel in the context of smoking prevention and cessation in China and has not to date been evaluated. This study draws on health behavior theories and dialogic theory in public relations to analyze microblog campaign postings and their relationships with the outcome of online audience engagement. Microblog postings from May 2011 to January 2015 were content analyzed, showing that the most common persuasive content characteristic was perceived risk, followed by subjective norms and self-efficacy. Perceived risk and self-efficacy postings positively influenced online audience engagement, whereas subjective norm postings was a nonsignificant predictor. Postings were more likely to share information than aim to interact with audience members. However, both information sharing and audience interaction postings were positive predictors of online audience engagement. There was also evidence of main and interactive effects of message originality on online audience engagement. The current study has, to the best of our knowledge, broken new ground in 2 regards: (a) using health behavior theories as a basis for analyzing the content of an anti-smoking social media campaign and (b) examining the content of an anti-smoking media campaign of any type in China.
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Affiliation(s)
- Shaohai Jiang
- a Department of Communication , Texas A&M University , College Station , Texas , USA
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27
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Abedini S, MorowatiSharifabad M, Chaleshgar Kordasiabi M, Ghanbarnejad A. Predictors of non- hookah smoking among high-school students based on prototype/willingness model. Health Promot Perspect 2014; 4:46-53. [PMID: 25097836 DOI: 10.5681/hpp.2014.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/01/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The aim of the study was to determine predictors of refraining from hookah smoking among high-school students in Bandar Abbas, southern Iran based on Prototype/Willingness model. METHODS This cross- sectional with analytic approach was performed on 240 high-school students selected by a cluster random sampling. The data of demographic and Prototype-Willingness Model constructs were acquired via a self-administrated questionnaire. Data were analyzed by mean, frequency, correlation, liner and logistic regression statistical tests. RESULTS Statistically significant determinants of the intention to refrain from hookah smoking were subjective norms, willingness, and attitude. Regression model indicated that the three items together explained 46.9% of the non-smoking hookah intention variance. Attitude and subjective norms predicted 36.0% of the non-smoking hookah intention variance. There was a significant relationship between the participants' negative prototype about the hookah smokers and the willingness to avoid from hookah smoking (P=0.002). Also willingness predicted non-smoking hookah better than the intention (P<0.001). CONCLUSION Deigning intervention to increase negative prototype about the hookah smokers and reducing situations and conditions which facilitate hookah smoking, such as easy access to tobacco products in the cafés, beaches can be useful results among adolescents to hookah smoking prevention.
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Affiliation(s)
- Sedigheh Abedini
- Department of Health Education and Promotion, Shahid Sadoughi University of Medical Science, Yazd, Iran ; Department of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | | | | | - Amin Ghanbarnejad
- Department of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Rhee KE, McEachern R, Jelalian E. Parent readiness to change differs for overweight child dietary and physical activity behaviors. J Acad Nutr Diet 2014; 114:1601-10. [PMID: 24953789 DOI: 10.1016/j.jand.2014.04.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 04/24/2014] [Indexed: 01/23/2023]
Abstract
Parent involvement is important to help overweight children lose weight. However, parent readiness to make changes around child eating and physical activity (PA) behaviors can differ across domains. Using a cross-sectional design, our aim was to examine which factors were associated with parents being in the Action/Maintenance stage of change in each domain. From November 2008 to August 2009, parents of overweight/obese children (n=202) attending a tertiary care obesity clinic in Providence, RI, answered questions assessing their stage of change, beliefs about child health and weight, and provider behaviors. Separate multivariate logistic regression models were created to determine which factors were associated with parent readiness to make changes for child dietary and PA behaviors. Almost 62% of parents were in the Action stage of change for child dietary behaviors, but only 41% were in the Action stage of change for PA behaviors. Parents who believed their own weight was a health problem were less likely to be ready to make changes to their child's dietary behaviors. Physician discussion of strategies was related to readiness to make changes for child dietary behaviors, but not PA behaviors. In the PA domain, parents of younger children were more likely to be ready to make changes. Training health care providers to address PA readiness and be aware of factors influencing dietary and PA readiness may result in more effective conversations with parents and improve behavior change efforts for pediatric weight loss.
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Hollier JM, Hinojosa-Lindsey M, Sansgiry S, El-Serag HB, Naik AD. Clinical and psychosocial variables associated with behavioral intentions to undergo surveillance endoscopy. BMC Gastroenterol 2014; 14:107. [PMID: 24916457 PMCID: PMC4079921 DOI: 10.1186/1471-230x-14-107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 05/29/2014] [Indexed: 11/12/2022] Open
Abstract
Background Many patients with Barrett’s esophagus do not adhere to guideline-recommended endoscopic surveillance. Among patient factors related to cancer prevention behaviors, patients’ stated behavioral intention is a strong predictor of behavior performance. Little is known about the patient factors associated with having a strong behavioral intention to pursue surveillance endoscopy. This study explores the association of clinical and psychosocial variables and behavioral intention to pursue surveillance endoscopy among patients with Barrett’s Esophagus and no or low-grade dysplasia. Methods Potential subjects were screened using electronic medical records of a regional Veterans Affairs Medical Center and a pathologically confirmed Barrett’s esophagus registry. Eligible participants were recruited by a mailer or phone call and completed a questionnaire to measure six distinct psychosocial factors, their behavioral intention to undergo surveillance endoscopy, and various demographic and clinical variables. Univariate and multivariate linear regression identified the relation of behavioral intention with each of six psychosocial variables. Results One-hundred and one subjects consented and returned surveys. The analytical sample for this study consists of the 94% of surveys with complete responses to the behavior intention items. Three of the six psychosocial domains were statistically significant predictors of intention in both univariate and adjusted univariate analysis (salience/coherence β = 0.59, 95% CI = 0.45-0.76, P <0.01; self-efficacy β = 0.30, 95% CI = 0.10-0.51, P <0.01; and social influence β = 0.20, 95% CI = 0.08-0.33, P <0.01). In a multivariate analysis only salience/coherence (β = 0.65, 95% CI = 0.42-0.88, P <0.01) remained statistically significant predictor of intention. Conclusion This study established the validity of a scale to measure psychosocial variables associated with behavioral intentions to undergo surveillance endoscopy. Results demonstrate the importance of assessing self-efficacy, social influences, and bottom-line belief in the value of surveillance endoscopy when evaluating a patient’s likelihood of completing surveillance endoscopy.
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Affiliation(s)
| | | | | | | | - Aanand D Naik
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Michael E, DeBakey Department of Veterans Affairs Medical Center, (152), 2002 Holcombe Blvd, Houston, TX 77030, USA.
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Abstract
Abstract
Objectives: Research identifying reliable and country-specific predictors of smoking is needed in order to develop effective adolescent smoking prevention programmes. The objective of this study was to assess the cognitive and socio-demographic factors associated with smoking onset among Romanian teenagers, using both cross-sectional and longitudinal data.
Methods: The data were obtained from a two-wave, one-year longitudinal study carried out among 316 senior high school non-smokers from Cluj-Napoca, Romania. Questionnaires assessed smoking behaviour, attitudes, social influence, self-efficacy and intention regarding smoking (motivational variables) as well as different sociodemographic features.
Results: The cross-sectional analyses showed that socio-demographics and motivational variables were strongly associated with smoking behaviour; the explained variance was 76%. The longitudinal analyses revealed that four variables explained 33% of the variance in change of status from non-smoking to regular smoking over a period of one year. Regular smoking onset after one year was predicted by baseline low self-efficacy in refraining from smoking in different situations, having more smoking friends and playing truant from school. Having a brother was a protective factor.
Conclusion: The results suggest that smoking prevention programmes in Romania should strengthen self-efficacy beliefs and resistance against peer modelling and help Romanian young people to develop skills and action plans to cope with pressure to smoke and challenging situations.
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Fallin A, Johnson AO, Riker C, Cohen E, Rayens MK, Hahn EJ. An intervention to increase compliance with a tobacco-free university policy. Am J Health Promot 2013; 27:162-9. [PMID: 23286592 DOI: 10.4278/ajhp.110707-quan-275] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To test the effects of a population-based self-efficacy message card campaign on compliance with a tobacco-free campus policy. SETTING This study was conducted at a large public university in the South. SUBJECTS Three hundred twelve observational periods at 39 campus sites. INTERVENTION The message card campaign, based on the Theory of Planned Behavior, consisted of distributing approximately 6000 efficacy-enhancing cards over 3 days. The intent of the cards was to increase awareness of the policy and resources available to help individuals stop smoking or remain comfortable while on campus. MEASURES Policy compliance was measured using the Tobacco-Free Compliance Assessment Tool. Field notes were used to assess campaign reaction. ANALYSIS Mann-Whitney U-test was conducted to compare number of cigarette butts in hot spot areas before and after the intervention. A rate ratio was also calculated using Geographic Information System (GIS) mapping software to compare cigarette butts collected per day before and after the intervention at each of the study sites. RESULTS The median number of cigarette butts per day after the intervention was significantly lower than before the intervention (1.9 vs. 4.7, χ(2): 8.1, p = .004). Eighteen sites (66.6%) had a post-pre ratio of .11 to .75, indicating a decrease in cigarette butts per day. CONCLUSION An efficacy-enhancing message card campaign shows promise in improving compliance with tobacco-free campus policies.
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Affiliation(s)
- Amanda Fallin
- Tobacco Policy Research Program, College of Nursing, University of Kentucky, Lexington, KY, USA.
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Byrd-Bredbenner C, Berning J, Martin-Biggers J, Quick V. Food safety in home kitchens: a synthesis of the literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:4060-85. [PMID: 24002725 PMCID: PMC3799528 DOI: 10.3390/ijerph10094060] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 08/20/2013] [Accepted: 08/21/2013] [Indexed: 11/24/2022]
Abstract
Although foodborne illness is preventable, more than 56,000 people per year become ill in the U.S., creating high economic costs, loss of productivity and reduced quality of life for many. Experts agree that the home is the primary location where foodborne outbreaks occur; however, many consumers do not believe the home to be a risky place. Health care professionals need to be aware of consumers' food safety attitudes and behaviors in the home and deliver tailored food safety interventions that are theory-based. Thus, the purpose of this paper is to synthesize/summarize the food safety literature by examining the following: consumers' perceptions and attitudes towards food safety and their susceptibility to foodborne illness in the home, work, and school; common risky food safety practices and barriers to handling food safely; and the application of theory-based food safety interventions. Findings will help healthcare professionals become more aware of consumers' food safety attitudes and behaviors and serve to inform future food safety interventions.
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Affiliation(s)
- Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, 211 Davison Hall, New Brunswick, NJ 08901, USA; E-Mail:
| | - Jacqueline Berning
- Biology Department, University of Colorado at Colorado Springs, 1420 Austin Bluffs Parkway, Colorado Springs, CO 80918, USA; E-Mail:
| | - Jennifer Martin-Biggers
- Department of Nutritional Sciences, Rutgers University, 26 Nichol Avenue, 211 Davison Hall, New Brunswick, NJ 08901, USA; E-Mail:
| | - Virginia Quick
- Eunice Kennedy Shriver National Institute of Child Health and Human Development/National Institutes of Health, 6100 Executive Blvd, Bethesda, MD 20892, USA; E-Mail:
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Zaleski AC, Aloise-Young PA. Using Peer Injunctive Norms to Predict Early Adolescent Cigarette Smoking Intentions. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2013; 43:E124-E131. [PMID: 24078745 DOI: 10.1111/jasp.12080] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The present study investigated the importance of the perceived injunctive norm to predict early adolescent cigarette smoking intentions. A total of 271 6th graders completed a survey that included perceived prevalence of friend smoking (descriptive norm), perceptions of friends' disapproval of smoking (injunctive norm), and future smoking intentions. Participants also listed their five best friends, in which the actual injunctive norm was calculated. Results showed that smoking intentions were significantly correlated with the perceived injunctive norm but not with the actual injunctive norm. Secondly, the perceived injunctive norm predicted an additional 3.4% of variance in smoking intentions above and beyond the perceived descriptive norm. These results demonstrate the importance of the perceived injunctive norm in predicting early adolescent smoking intentions.
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Affiliation(s)
- Adam C Zaleski
- Department of Psychology, Colorado State University at Fort Collins
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Karimy M, Niknami S, Heidarnia AR, Hajizadeh I, Montazeri A. Prevalence and determinants of male adolescents' smoking in iran: an explanation based on the theory of planned behavior. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:187-93. [PMID: 23983996 PMCID: PMC3745745 DOI: 10.5812/ircmj.3378] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Revised: 06/04/2012] [Accepted: 06/25/2012] [Indexed: 11/16/2022]
Abstract
Background Adolescent smoking problem has still remained as a public health concern, but factors that attributing to the initiation of adolescent smoking are not well known in Iran. Objectives The aim of this study is to estimate the prevalence of smoking, and its associations among high school male adolescents in Iran, in the context of the theory of planned behavior (TPB). Patients and Methods This was a cross-sectional study involving male adolescent students (high school) in the city of Zarandieh, Iran. A multiple-stage sampling protocol was used. The participants completed an anonymous, voluntary, and self-report questionnaire. Prevalence was estimated, and demographic variables, psychological factors, and the theory of planned behavior components were used to indicate factors contributing to adolescents’ cigarette smoking. Results In all, 365 students were entered the study. The mean age of respondents was 16.49 ± 1.11 years. The prevalence of current smoking was 15.1%. The result obtained from logistic regression analysis revealed that all theory of planned behavior (TPB) components [knowledge (OR = 0.75; 95% CI: (0.59-0.97), attitude (OR = 0.75; 95% CI: (0.65-0.86), self-efficacy (OR = 0.82; 95% CI: (0.71-0.95), subjective norms (OR = 0.84; 95% CI: (0.72-0.98)] were significant predating factors for adolescents smoking habits. In addition, having parents who smoke (OR = 4.75; 95% CI: (1.38-12.35), smoking friends (OR = 3.76; 95% CI: (1.20-11.76), and smoking siblings (OR = 4.21; 95% CI: (1.17-11.16) were significant contributing factors to adolescents’ cigarette smoking behavior. Conclusions The results showed that the prevalence of cigarette smoking in adolescents was high, and the theory of planned behavior (TPB) components were significant predictors of cigarette smoking. It seems that interventions targeting adolescents’ smoking habits might benefit using the TPB model.
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Affiliation(s)
- Mahmood Karimy
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | - Shamsaddin Niknami
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
- Corresponding author: Shamsaddin Niknami, School of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran. Tel: +98-02182883549, Fax: +98-02182883549, E-mail:
| | - Ali Reza Heidarnia
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | - Ibrahim Hajizadeh
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | - Ali Montazeri
- Mental Health Research Group, Mother and Child Health Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, IR Iran
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Van De Ven MOM, van Zundert RMP, Engels RCME. Effects of asthma on nicotine dependence development and smoking cessation attempts in adolescence. J Asthma 2013; 50:250-9. [PMID: 23347267 DOI: 10.3109/02770903.2013.766751] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to investigate whether asthma predicts the development of nicotine dependence and unsuccessful smoking cessation attempts in adolescent smokers. In addition, whether nicotine dependence could explain the relation between asthma and unsuccessful cessation attempts was also investigated. METHODS A longitudinal survey study was conducted among 286 adolescents (aged 12-15 at T1) who had never used tobacco at baseline and were current smokers at follow-up 22 months later. Regression analyses were applied to test the effects of four asthma indicators (current wheeze, indication of asthma, symptom severity, and current diagnosed asthma) on nicotine dependence and smoking cessation attempts. RESULTS Both adolescents who had an indication of asthma as well as adolescents with higher symptom severity developed higher levels of nicotine dependence over time and made a greater number of unsuccessful smoking cessation attempts in the past 12 months compared to those without asthma or less severe symptoms. Nicotine dependence partly mediated the effects of asthma symptoms on unsuccessful cessation attempts. Current wheezing and current diagnosed asthma did not predict nicotine dependence or unsuccessful quit attempts. CONCLUSIONS Nicotine dependence develops more quickly in youth with symptoms of asthma, and this partly explains the increased number of unsuccessful cessation attempts of adolescents with asthma. Smoking prevention and smoking cessation programs are encouraged to provide additional support for youth with asthma, focusing on both the physiological and psychological aspects of dependence.
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Bleakley A, Piotrowski JT, Hennessy M, Jordan A. Predictors of parents' intention to limit children's television viewing. J Public Health (Oxf) 2013; 35:525-32. [PMID: 23335598 DOI: 10.1093/pubmed/fds104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Scientific evidence demonstrates a link between viewing time and several poor health outcomes. We use a reasoned action approach to identify the determinants and beliefs associated with parents' intention to limit their children's television viewing. METHODS We surveyed a random sample of 516 caregivers to children ages 3-16 in a large Northeastern city. Multiple regression analyses were used to test a reasoned action model and examine the differences across demographic groups. RESULTS The intention to limit viewing (-3 to 3) was low among parents of adolescents (M: 0.05) compared with parents of 3-6 year olds (M: 1.49) and 7-12 year olds (M: 1.16). Attitudes were the strongest determinant of intention (β = 0.43) across all demographic groups and normative pressure was also significantly related to intention (β = 0.20), except among parents of adolescents. Relevant beliefs associated with intention to limit viewing included: limiting television would be associated with the child exercising more, doing better in school, talking to family more and having less exposure to inappropriate content. CONCLUSIONS Attitudes and normative pressure play an important role in determining parents' intention to limit their child's television viewing. The beliefs that were associated with parents' intention to limit should be emphasized by health professionals and in health communication campaigns.
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Affiliation(s)
- Amy Bleakley
- Annenberg Public Policy Center, University of Pennsylvania, 202 S. 36th Street, Philadelphia, PA 19104, USA
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Simms DC, Byers ES. Heterosexual daters' sexual initiation behaviors: use of the theory of planned behavior. ARCHIVES OF SEXUAL BEHAVIOR 2013; 42:105-116. [PMID: 22875717 DOI: 10.1007/s10508-012-9994-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 02/02/2012] [Accepted: 02/05/2012] [Indexed: 06/01/2023]
Abstract
The current study investigated sexual initiations within the framework of the Theory of Planned Behavior (TPB) (Ajzen, 1991; Ajzen & Madden, 1986). Male and female daters in heterosexual dating relationships completed an online survey that assessed their sexual relationship with their partner and the TPB components (perceptions of social norms, attitudes, perceived behavioral control, and intentions). The TPB was supported for both men and women in that, as predicted, the more an individual perceived that important others would approve of them initiating sexual activities with their partner, the more positive their evaluations were of the outcomes of initiating, and the more confident they were in their ability to initiate, the stronger were their initiation intentions. In turn, stronger sexual initiation intentions were associated with more frequent initiation behaviors. Compared to women, men initiated more frequently, had stronger sexual initiation intentions, and perceived more positive social norms regarding initiation; men and women did not differ in their attitudes toward sexual initiation or in their perceived behavioral control. Both men and women who reported initiating more frequently and perceived their partner as initiating more frequently reported greater sexual satisfaction. These results are discussed in terms of the utility of the TPB for understanding sexual initiations and the role of the traditional sexual script in initiation-related cognitions and behavior.
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Affiliation(s)
- Deanne C Simms
- Department of Psychology, University of New Brunswick, POB 4400, Fredericton, NB, E3B 6E4, Canada.
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Karimy M, Niknami S, Hidarnia AR, Hajizadeh I. Intention to start cigarette smoking among Iranian male adolescents: usefulness of an extended version of the theory of planned behaviour. HEART ASIA 2012; 4:120-4. [PMID: 27326046 DOI: 10.1136/heartasia-2012-010140] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/28/2012] [Indexed: 11/03/2022]
Abstract
BACKGROUND Smoking is one of the risk behaviours that begin in adolescence, and therefore identifying predictors of smoking is necessary for planning prevention programmes. OBJECTIVES To examine the ability of the extended theory of planned behaviour (TPB) to predict the intention to smoke. METHODS This was a cross-sectional study carried out in Iran, 2011. The data were collected by a self-administered questionnaire which included items on demographics, smoking behaviour, components of the TPB model (attitude, subjective norms, perceived behaviour control and intention) and an added construct on smoking self-identity. Data were analysed using descriptive, correlation and linear regression statistics. RESULTS 365 male high school students with a mean age of 16.5 (SD=1.2) years were studied. Fifty-five (15.1%) of the students surveyed were current smokers. All components of the TPB model and smoking self identity were statistically significantly related to intention to smoke (p<0.001). The TPB constructs with and without smoking self-identity accounted for 58.5% (adjusted R(2)) and 54.8% of the variance observed for intention to smoke, respectively. Result also revealed the highest weights for perceived behaviour control (β=-0.35). CONCLUSIONS The extended model of the TPB predicted 'intention to smoke' better than the original TPB. The findings of this study might be used as a framework in designing heart disease prevention programmes. Thus the findings have implications for both health promotion specialists and cardiologists. They could place an emphasis on perceived behaviour control, specifying that individuals who do not smoke should not start and if they are smokers it is possible to stop smoking.
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Affiliation(s)
- Mahmood Karimy
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Shamsaddin Niknami
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Ali Reza Hidarnia
- Department of Health Education, Tarbiat Modares University, Tehran, Iran
| | - Ibrahim Hajizadeh
- Department of Biostatistics, Tarbiat Modares University, Tehran, Iran
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The theory of planned behavior: precursors of marijuana use in early adolescence? Drug Alcohol Depend 2012; 123:22-8. [PMID: 22056217 DOI: 10.1016/j.drugalcdep.2011.10.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2011] [Revised: 09/16/2011] [Accepted: 10/13/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Precursors of marijuana use in early adolescence are largely unknown because studies generally focus on marijuana use among older adolescents or adults. METHODS In this study, we examined precursors of marijuana use in a sample of 1023 Dutch early adolescents (aged 11-14 at Time 1) who were never-marijuana user at baseline, by applying a 3-wave longitudinal design. The theory of planned behavior (TPB) was used as a theoretical framework and posits that marijuana-specific cognitions (i.e., positive and negative expectancies, evaluative attitude, social approval, and self-efficacy) are antecedents of marijuana use and that this relationship is mediated by the intention to start using marijuana. RESULTS In accordance with these premises, our results indicated that evaluative attitude, social approval, and self-efficacy at Time 1 are related to marijuana use at Time 3 (20 months follow-up) via the intention to start using marijuana at Time 2 (8 months follow-up). More specifically, the structural equation models showed that more positive marijuana attitudes, more approval from the social environment, and lower self-efficacy were related to marijuana use initiation through a stronger intention to start using marijuana. CONCLUSION This outcome is important for prevention efforts in that our results underline the importance of weakening adolescents' positive attitudes toward marijuana, decrease social approval of marijuana use, and stimulating the development of early adolescents' refusal skills with respect to marijuana use.
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Hennessy M, Bleakley A, Fishbein M. Measurement Models for Reasoned Action Theory. THE ANNALS OF THE AMERICAN ACADEMY OF POLITICAL AND SOCIAL SCIENCE 2012; 640:42-57. [PMID: 23243315 PMCID: PMC3520136 DOI: 10.1177/0002716211424709] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Quantitative researchers distinguish between causal and effect indicators. What are the analytic problems when both types of measures are present in a quantitative reasoned action analysis? To answer this question, we use data from a longitudinal study to estimate the association between two constructs central to reasoned action theory: behavioral beliefs and attitudes toward the behavior. The belief items are causal indicators that define a latent variable index while the attitude items are effect indicators that reflect the operation of a latent variable scale. We identify the issues when effect and causal indicators are present in a single analysis and conclude that both types of indicators can be incorporated in the analysis of data based on the reasoned action approach.
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Affiliation(s)
- Michael Hennessy
- Annenberg Public Policy Center, University of Pennsylvania, 202 S. 36 Street, Philadelphia, PA 19104
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McEachan RRC, Conner M, Taylor NJ, Lawton RJ. Prospective prediction of health-related behaviours with the Theory of Planned Behaviour: a meta-analysis. Health Psychol Rev 2011. [DOI: 10.1080/17437199.2010.521684] [Citation(s) in RCA: 718] [Impact Index Per Article: 55.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schuck K, Otten R, Engels RCME, Kleinjan M. The relative role of nicotine dependence and smoking-related cognitions in adolescents' process of smoking cessation. Psychol Health 2011; 26:1310-26. [PMID: 21598190 DOI: 10.1080/08870446.2010.520715] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present study evaluates the role of distinct components of nicotine dependence (craving, withdrawal, behavioural dependence) in comparison to smoking-related cognitions (attitudes, perceived social approval, self-efficacy) in adolescent smoking cessation. In the process towards smoking cessation, we distinguish between distinct behavioural transitions, respectively, short-term abstinence, reduction in smoking behaviour and prolonged cessation, to evaluate differences in cessation-related antecedents as a function of varying behavioural outcomes. A total of 850 adolescent smokers (age 14-16) participated in the present study. Smoking behaviour was assessed 1 year after baseline. Results showed that all dependence components had a distinct role in the prediction of behavioural change towards cessation. Furthermore, each behavioural transition was predicted by a distinct set of variables, indicating that contributions of cessation-related factors vary across the course towards cessation. Overall, our findings suggest that smoking-related cognitions are particularly relevant in the initiation of behavioural change, such as short-term abstinence, whereas nicotine dependence, craving in particular, becomes increasingly important in the prediction of maintained behavioural change, such as prolonged cessation. Implications encompass enhanced attention to the multidimensional nature of nicotine dependence and the value of comparing different behavioural outcomes in a comprehensive understanding of cessation-related factors.
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Affiliation(s)
- Kathrin Schuck
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
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Verlato G, Bortolami O, Accordini S, Olivieri M, Cappa V, Bugiani M, Corsico A, Pirina P, Villani S, de Marco R. Asthma in childhood reduces smoking initiation in subsequent teens among males. J Adolesc Health 2011; 48:253-8. [PMID: 21338896 DOI: 10.1016/j.jadohealth.2010.07.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 07/05/2010] [Accepted: 07/09/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND The association between smoking habits and asthma is complex because subjects with asthma could avoid smoking, whereas smoking could increase asthma severity or incidence. PURPOSE The relation between asthma in childhood (0-10 years) and smoking initiation in the second decade (11-20 years) was investigated using the database of the Italian Study on Asthma in Young Adults, performed in 1998-2000 on people aged 20-45 years. METHODS The cumulative incidence of smoking initiation was compared among (1) subjects not reporting asthma attacks in the first 20 years of life (n = 17,384), (2) subjects reporting asthma onset in the first decade and no disease remission by the age of 20 years (n = 305), (3) subjects reporting asthma onset in the first decade and remission in the first and second decades (n = 573). RESULTS Among men, the cumulative incidence of smoking onset was higher among nonasthmatics (49%) than among asthmatics (35.6%), and intermediate among asthmatics with disease remission (44.2%) (p = .001). These differences were larger in males born between 1953 and 1965, and tended to decrease in males born between 1966 and 1979: cumulative incidence of smoking onset decreased from 54.3% to 43.8% in nonasthmatics, whereas it remained stable in asthmatics (from 36.8% to 35%). Women, instead, had similar cumulative incidence of smoking initiation, irrespective of asthma onset or remission (p = .849). CONCLUSION Asthma in childhood reduces smoking initiation during the subsequent teenage in men, but not in women. This protective effect tends to fade when asthma remission occurs. In the last decades, smoking initiation has decreased among nonasthmatic males, but not among asthmatic males.
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Affiliation(s)
- Giuseppe Verlato
- Department of Public Health and Community Medicine, University of Verona, Verona, Italy.
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Choi S. A critical review of theoretical frameworks for health service use among older immigrants in the United States. SOCIAL THEORY & HEALTH 2011. [DOI: 10.1057/sth.2010.13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
To examine if the theory of planned behavior (TPB) predicts smoking behavior, 35 data sets (N = 267,977) have been synthesized, containing 219 effect sizes between the model variables, using a meta-analytic structural equation modeling approach (MASEM). Consistent with the TPB's predictions, 1) smoking behavior was related to smoking intentions (weighted mean r = 0.30), 2) intentions were based on attitudes (weighted mean r = 0.16), and subjective norms (weighted mean r = 0.20). Consistent with TPB's hypotheses, perceived behavioral control was related to smoking intentions (weighted mean r = -0.24) and behaviors (weighted mean r = -0.20) and it contributes significantly to cigarette consumption. The strength of the associations, however, was influenced by the characteristics of the studies and participants.
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Affiliation(s)
- Gabriela Topa
- Department of Social and Organizational Psychology, UNED, Madrid, Spain
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Malmberg M, Overbeek G, Kleinjan M, Vermulst A, Monshouwer K, Lammers J, Vollebergh WA, Engels RC. Effectiveness of the universal prevention program 'Healthy School and Drugs': study protocol of a randomized clustered trial. BMC Public Health 2010; 10:541. [PMID: 20825669 PMCID: PMC2941689 DOI: 10.1186/1471-2458-10-541] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 09/08/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substance use is highly prevalent among Dutch adolescents. The Healthy School and Drugs program is a nationally implemented school-based prevention program aimed at reducing early and excessive substance use among adolescents. Although the program's effectiveness was tested in a quasi-experimental design before, many program changes were made afterwards. The present study, therefore, aims to test the effects of this widely used, renewed universal prevention program. METHODS/DESIGN A randomized clustered trial will be conducted among 3,784 adolescents of 23 secondary schools in The Netherlands. The trial has three conditions; two intervention conditions (i.e., e-learning and integral) and a control condition. The e-learning condition consists of three digital learning modules (i.e., about alcohol, tobacco, and marijuana) that are sequentially offered over the course of three school years (i.e., grade 1, grade 2, and grade 3). The integral condition consists of parental participation in a parental meeting on substance use, regulation of substance use, and monitoring and counseling of students' substance use at school, over and above the three digital modules. The control condition is characterized as business as usual. Participating schools were randomly assigned to either an intervention or control condition.Participants filled out a digital questionnaire at baseline and will fill out the same questionnaire three more times at follow-up measurements (8, 20, and 32 months after baseline). Outcome variables included in the questionnaire are the percentage of binge drinking (more than five drinks per occasion), the average weekly number of drinks, and the percentage of adolescents who ever drunk a glass of alcohol and the percentage of adolescents who ever smoked a cigarette or a joint respectively for tobacco and marijuana. DISCUSSION This study protocol describes the design of a randomized clustered trial that evaluates the effectiveness of a school-based prevention program. We expect that significantly fewer adolescents will engage in early or excessive substance use behaviors in the intervention conditions compared to the control condition as a direct result of the intervention. We expect that the integral condition will yield most positive results, compared with the e-learning condition and control condition. TRIAL REGISTRATION The protocol for this study is registered with the Nederlands Trial Register NTR1516.
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Affiliation(s)
- Monique Malmberg
- Behavioural Science Institute, Radboud University Nijmegen, The Netherlands.
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McLeish AC, Zvolensky MJ. Asthma and cigarette smoking: a review of the empirical literature. J Asthma 2010; 47:345-61. [PMID: 20528586 DOI: 10.3109/02770900903556413] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this review paper is to present and evaluate the empirical literature on the association between asthma and cigarette smoking. The authors conducted a literature search utilizing electronic search engines (i.e., PsycINFO and MEDLINE) to examine databases using the following key word algorithms: smoking OR nicotine OR tobacco AND asthma. Only articles that focused on active tobacco smoking and analyzed groups with asthma patients only were examined in the present review. Overall, empirical evidence suggests that (1) smoking is more prevalent among individuals with asthma than those without; (2) smoking is a risk candidate for the development of asthma; (3) smoking is associated with decreased asthma control and increased risk of mortality and asthma attacks and exacerbations; (4) smokers with and without asthma may have different risk factors for smoking onset as well as different smoking motives and outcome expectancies; and (5) smoking cessation is associated with improvements in lung functioning and asthma symptoms. Future work in this domain of study will lead to clinically relevant health care advances as well as the development of theoretically driven, methodologically diverse lines of research exploring asthma-smoking comorbidity issues.
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Affiliation(s)
- Alison C McLeish
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio 45221-0376, USA.
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Eine Analyse des Rauchverhaltens von Fünftklässlern in Vorpommern. PRAVENTION UND GESUNDHEITSFORDERUNG 2009. [DOI: 10.1007/s11553-009-0192-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Van De Ven MOM, Engels RCME, Sawyer SM. Asthma-specific predictors of smoking onset in adolescents with asthma: a longitudinal study. J Pediatr Psychol 2008; 34:118-28. [PMID: 18567925 DOI: 10.1093/jpepsy/jsn063] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Despite even occasional smoking being more risky for adolescents with asthma, the smoking rate in this vulnerable population remains high. This is the first longitudinal study investigating asthma-specific predictors of smoking initiation. METHODS A three-wave longitudinal survey study (22 months) among 257 adolescents with asthma was conducted. The effects of asthma-specific factors [symptom severity, medication adherence, coping, attitude towards asthma, and quality of life (QOL)] on smoking onset were tested with logistic regression models. RESULTS Poorer self-reported adherence and the maladaptive coping strategy of hiding asthma predicted smoking onset. Poorer QOL predicted smoking in boys only. CONCLUSIONS Our findings underscore the importance of recognizing and addressing adherence problems during adolescence as low adherence is a risk factor for smoking initiation. Moreover, psychosocial factors, such as coping and QOL for boys, were associated with smoking initiation. This highlights the importance of attending to the psychosocial needs of youth with asthma.
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Tak NI, Te Velde SJ, Brug J. Are positive changes in potential determinants associated with increased fruit and vegetable intakes among primary schoolchildren? Results of two intervention studies in the Netherlands: the Schoolgruiten Project and the Pro Children Study. Int J Behav Nutr Phys Act 2008; 5:21. [PMID: 18439265 PMCID: PMC2390589 DOI: 10.1186/1479-5868-5-21] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Accepted: 04/25/2008] [Indexed: 12/04/2022] Open
Abstract
Background To investigate if positive changes or maintenance high scores on potential behavioral determinants of fruit and vegetable (F&V) intake are associated with increased or maintenance favorable levels of F&V intake frequency in the same time lapse or later in time. Data were used from two intervention studies in the Netherlands: the Schoolgruiten Project and the Pro Children Study. Methods A design with baseline and two follow-up measurements. 344 children of the Dutch Schoolgruiten Project and 258 children of the Pro Children Study completed questionnaires, including questions on general demographics, usual F&V intake frequency, important potential determinants of F&V intake, such as taste preferences of F&V, availability of F&V, knowledge of recommended intake levels of F&V, self-efficacy for eating F&V, and parental influences for eating F&V. Three different associations between changes in determinants of F&V intake and changes in F&V intake frequency were assessed by multilevel multinomial regression analyses. Results Results of one of the investigated associations indicated that in both studies behavior change (increase in F&V intake frequency) was preceded by changes in the following variables; liking of fruit, parental facilitation of vegetables, family rules for eating vegetables and availability at home of vegetables. Furthermore, changes in F&V intake frequency preceded changes in liking of F&V later in time. Conclusion In accordance with behavior change theories, the present study provides some evidence that behavior change was preceded by changes in certain potential determinants of F&V intake. Potential determinants of F&V intake that appear to be important to induce behavior change were liking of fruit, parental facilitation of vegetables, family rules for eating vegetables and availability at home of vegetables. Some evidence was also found that behavior changes may precede changes in presumed determinants of F&V intake, such as liking of F&V.
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Affiliation(s)
- Nannah I Tak
- EMGO-institute, VU University Medical Centre, Amsterdam, The Netherlands.
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