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Herrmann DS, McWhirter JJ. Refusal and Resistance Skills for Children and Adolescents: A Selected Review. JOURNAL OF COUNSELING AND DEVELOPMENT 2011. [DOI: 10.1002/j.1556-6676.1997.tb02331.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
The prevalence of smokeless tobacco is significant and reaches as high as 17% past month use in white males aged 18-25. Smokeless tobacco use is of concern because of the potential for addiction and the associated negative health consequences. This article reviews the basis for addiction to smokeless tobacco, examining the nicotine content in smokeless tobacco products, pharmacokinetics, psychoactive effects, tolerance, and withdrawal. It also explores the negative health consequences which include a number of oral pathologies and increased cardiovascular risk factors. Furthermore, it examines the factors associated with the initiation of smokeless tobacco use, and the current prevention programs that address these factors. Current smokeless tobacco treatment approaches are also discussed as well as predictors for abstinence. Finally, the future directions are discussed in light of the limited amount of research that has been conducted in the smokeless tobacco area, particularly related to prevention and treatment.
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Affiliation(s)
- D K Hatsukami
- Department of Psychiatry, University of Minnesota, Minneapolis 55455, USA.
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Sallis JF, Elder JP, Wildey MB, de Moor C, Young RL, Shulkin JJ, Helme JM. Assessing skills for refusing cigarettes and smokeless tobacco. J Behav Med 1990; 13:489-503. [PMID: 2273526 DOI: 10.1007/bf00844834] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hops and colleagues developed an audiotaped refusals skills test in which students respond to cigarette offers and their responses are scored for content. The present study employed a modified analogue skills test. Modifications included adding a separate subscale for smokeless tobacco, emphasizing repeated offers and group pressure, and rating the quality of responses (good, fair, poor). The test was evaluated in four seventh-grade classrooms (N = 78). Half had participated in a refusals skills training program; the others were controls. Intervention subjects provided more "good" responses and fewer "poor" responses than controls. In a multiple regression, repeated and group offers were associated with the quality of response, while offerer's gender and type of tobacco variables were not associated. In a second regression, experimental condition was associated with quality of the responses, while gender, ethnicity, exposure to tobacco, use of tobacco, and attitudes toward the test were not associated.
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Affiliation(s)
- J F Sallis
- Department of Psychology, San Diego State University, California 92182
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Severson HH. Psychosocial factors in the use of smokeless tobacco and their implications for P.L. 99-252. J Public Health Dent 1990; 50:90-7. [PMID: 2404114 DOI: 10.1111/j.1752-7325.1990.tb03564.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This article briefly reviews the prevalence of smokeless tobacco use by males in the United States, the relationship of smokeless tobacco use to cigarette use, and patterns of use that include dosage, topography, products, and function of use. The primary focus of the article is to describe the concurrent and predictive factors associated with onset, use, and cessation of smokeless tobacco. The implications of P.L. 99-252, the Comprehensive Smokeless Tobacco Act of 1986, are discussed in the context of what is known about the psychosocial variables associated with the use of smokeless tobacco.
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Capwell EM. P.L. 99-252 and the roles of state and local governments in decreasing smokeless tobacco use. J Public Health Dent 1990; 50:70-6. [PMID: 2296005 DOI: 10.1111/j.1752-7325.1990.tb03561.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Evaluation of the impact of the Comprehensive Smokeless Tobacco Health Education Act of 1986 (P.L. 99-252) will help determine the level of progress being made to reduce smokeless tobacco use and will help determine changes or new strategies needed to prevent or reduce smokeless tobacco use. Indicators of progress made toward implicit goals and explicit provisions of P.L. 99-252 are proposed as appropriate for local, state, and federal government health agencies to address. Examples of roles that can be played by health agencies relative to implicit goals of the law are drawn from experiences of public health professionals in Ohio and other states. These roles relate to work with the media, research and evaluation, surveillance activity, support for development of materials and implementation of programs, and funding for community educational programs. Indicators to measure impact of explicit provisions of the law focus on provisions specified in the public education section of the law. Proposed indicators involve monitoring the development and availability of programs, materials and media, monitoring research and dissemination of findings, and monitoring technical assistance and grants available. Possible measurement and evaluation strategies are discussed. Survey methodology seems most suitable for monitoring level and type of anti-smokeless tobacco activity in which health agencies engage and for determining awareness of resources available through the law.
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Affiliation(s)
- E M Capwell
- Division of Chronic Diseases, Ohio Department of Health, Columbus 43266-0118
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Ary DV, Lichtenstein E, Severson H, Weissman W, Seeley JR. An in-depth analysis of male adolescent smokeless tobacco users: interviews with users and their fathers. J Behav Med 1989; 12:449-67. [PMID: 2614822 DOI: 10.1007/bf00844878] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Male adolescent smokeless tobacco (ST) users (N = 191) were extensively interviewed, then followed over a 6-month period with monthly telephone interviews. In addition, their fathers (N = 137) were interviewed by telephone. Based on these data, ST use appears similar to cigarette smoking with respect to onset, patterns of use, social influences, attempts to quit, and indications of addiction. Onset and continued use of ST largely occur in a social context. Parents are reportedly aware (73%) of their sons' ST use but appear tolerant. The great majority of S's (92%) believe that there is some health risk associated with ST use. Over half report noticing ST-related changes in their oral cavities, although their dentists generally had not discussed ST use with them. Over one-third of the current users report unsuccessful quit attempts. ST use appears to be part of a more general pattern of substance use, including marijuana and alcohol.
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Affiliation(s)
- D V Ary
- Oregon Research Institute, Eugene 97401
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Abstract
Oral snuff and chewing tobacco, commonly referred to as smokeless tobacco, are being used by many adolescent and young adult males, and no indication exists that use by this group is declining. Users are at risk for oral cancer, noncancerous oral pathology such as leukoplakias, and addiction. Information about patterns of smokeless tobacco use and motivations of users may help planners develop and implement interventions. Variables include the importance of peer and family influences, social image, knowledge of harmful effects, regional differences, use of other substances, and addiction. Due to the addictive nature of smokeless tobacco, older youth may need cessation programs. Health educators are encouraged to include smokeless tobacco in their tobacco use prevention programs and to develop and implement comprehensive tobacco interventions appropriate for their youth population.
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Affiliation(s)
- G M Boyd
- Smoking, Tobacco, and Cancer Program, National Cancer Institute, Bethesda, MD 20892
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Gerber RW, Newman IM, Martin GL. Applying the theory of reasoned action to early adolescent tobacco chewing. THE JOURNAL OF SCHOOL HEALTH 1988; 58:410-3. [PMID: 3236832 DOI: 10.1111/j.1746-1561.1988.tb05816.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
Beliefs and social norms elicited from adolescents were employed in the theory of reasoned action to predict early adolescent males' intention to chew tobacco. About 50% of males had chewed tobacco. Responses of chewing intenders and nonintenders differed in response direction and in response strength. Response differences regarding physical effects (cancer, yellow teeth, habit forming) as well as psychosocial effects (look cool, relax, have a good time with friends) suggested specific educational strategies. Intenders and nonintenders both reported not believing chewing causes cancer, an erroneous belief. Nonintenders reported belief carry over from smoking: chewing will "make my clothes smelly" and chewing will "give me shortness of breath," both unfounded. Nonintenders reported less referent support for chewing. Both groups reported a general unwillingness to comply with their significant others.
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Affiliation(s)
- R W Gerber
- Nebraska Prevention Center for Alcohol and Drug Abuse, University of Nebraska, Lincoln 68588-0138
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Olds RS. Patterns and prevalence of smokeless tobacco use by high school seniors in New York. THE JOURNAL OF SCHOOL HEALTH 1988; 58:374-8. [PMID: 3230878 DOI: 10.1111/j.1746-1561.1988.tb00573.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
Patterns and prevalence of smokeless tobacco use by high school seniors in New York state were identified in this study. A questionnaire was administered to a sample of 10% of each senior class in 96 randomly selected public and nonpublic secondary schools in New York; 1,830 students participated. Data analysis included descriptive statistics, t-tests, and chi-square tests. Comparisons were made by gender, hometown status, concurrent use of smokeless tobacco and cigarettes, and smokeless tobacco use versus cigarette smoking. Results revealed a significant difference existed between males and females and between urban and rural smokeless tobacco use (p = .05). Use of chewing tobacco related significantly to use of cigarettes (p = .05). A significant difference existed between prevalence of cigarette smoking and smokeless tobacco use (p = .05). Smokeless tobacco use by high school seniors in New York is predominantly a habit of rural males. Use of chewing tobacco is related to cigarette smoking, and smokeless tobacco was less prevalent than cigarette smoking in the sample (p = .05). Further research on the relationship between smokeless tobacco and cigarette smoking should be conducted. Use of chemical assays or the bogus pipeline to validate self-reported data is recommended. Identified high-risk groups such as rural males should receive particular attention in future research efforts.
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Affiliation(s)
- R S Olds
- Dept. of Adult, Counseling, Health, and Vocational Education, Kent State University, OH 44242
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Abstract
Self-reports on smokeless tobacco consumption were obtained from 438 students attending a small Midwestern liberal arts college. While use among 249 female students was negligible, 9% of 189 male respondents reported routine use of smokeless tobacco products.
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Wilson MG, Wilson KM. Strategies and materials for smokeless tobacco education. THE JOURNAL OF SCHOOL HEALTH 1987; 57:74-5. [PMID: 2434729 DOI: 10.1111/j.1746-1561.1987.tb02305.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
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Brubaker RG, Loftin TL. Smokeless tobacco use by middle school males: a preliminary test of the reasoned action theory. THE JOURNAL OF SCHOOL HEALTH 1987; 57:64-7. [PMID: 3644086 DOI: 10.1111/j.1746-1561.1987.tb02302.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
This study identified psychosocial variables associated with smokeless tobacco use within the context of the reasoned action theory. One hundred twelve male students, ages ten-14, completed a questionnaire that operationalized components of the theoretical model. Multiple regression analyses revealed intention to use smokeless tobacco correlated significantly with attitude toward the behavior and perceived social pressure. As predicted by the theory, significant differences between those who intended to use smokeless tobacco and those who did not were found on several outcome and normative beliefs. The data support the utility of the theory as a means of explaining smokeless tobacco use. Future research recommendations are offered.
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