Determinants of smoking cessation among adolescents in South Africa

Applying Collective Intelligence in Health Recommender Systems for Smoking Cessation: A Comparison Trial

Background: Health recommender systems (HRSs) are intelligent systems that can be used to tailor digital health interventions. We compared two HRSs to assess their impact providing smoking cessation support messages. Methods: Smokers who downloaded a mobile app to support smoking abstinence were randomly assigned to two interventions. They received personalized, ratable motivational messages on the app. The first intervention had a knowledge-based HRS (n = 181): it selected random messages from a subset matching the users’ demographics and smoking habits. The second intervention had a hybrid HRS using collective intelligence (n = 190): it selected messages applying the knowledge-based filter first, and then chose the ones with higher ratings provided by other similar users in the system. Both interventions were compared on: (a) message appreciation, (b) engagement with the system, and (c) one’s own self-reported smoking cessation status, as indicated by the last seven-day point prevalence report in different time intervals during a period of six months. Results: Both interventions had similar message appreciation, number of rated messages, and abstinence results. The knowledge-based HRS achieved a significantly higher number of active days, number of abstinence reports, and better abstinence results. The hybrid algorithm led to more quitting attempts in participants who completed their user profiles.

Impact of Cognitive and Social Factors on Smoking Cessation Attempts among US Adult Muslim Smokers

Background

Muslims in the United States (US) exhibit high rates of cigarette smoking. Guided by the Social Cognitive Theory, the study aimed to investigate the associations between the number of serious cigarette smoking cessation attempts and cognitive as well as environmental factors in adult US Muslim smokers.

Methods

This cross-sectional study was based on a convenience sample of adult (≥ 18 years) US Muslim smokers. After receiving IRB approval, data were collected using an on-line survey. Unadjusted Poisson regression followed by adjusted multivariable Poisson regression analyses were conducted to answer the research question.

Results

One hundred thirty-two smokers completed the questionnaire. Smokers reported more serious cigarette smoking cessation attempts if they 1) had more knowledge about the consequences of cigarette smoking cessation, 2) had more positive attitudes regarding quitting, and 3) reported greater religiosity. Additionally, smokers reported fewer serious cigarette smoking cessation attempts if they 1) were employed, 2) affiliated with Sunnah sect, 3) reported better self-assessed health, 4) reported higher perceived value for quitting, and 5) indicated that using tobacco was not allowed inside the home. Only three smokers reported using both prescription medications and counseling to aid with smoking cessation attempts.

Conclusions

Inadequate utilization of pharmaceutical smoking cessation products and provider professional assistance may exacerbate the problems associated with elevated rates of smoking among US Muslim smokers. Knowledge of the consequences, more positive attitudes, and greater religiosity can be influential constructs in future interventions aimed at encouraging smoking cessation attempts in this population.

Pattern and quitting of tobacco smoking among Egyptian university students

OBJECTIVES

University students are at high risk of practicing the smoking habit being exposed to smoking peers and easier cigarette availability.

METHODS

This study aims to explore prevalence, attitude and pattern of tobacco smoking and quitting among Beni-Suef University students. A cross-sectional study was conducted from March to May 2019. A total of 4,599 students were selected by using randomized multi-stage sampling using self-administered questionnaire for data collection.

RESULTS

The mean age of students found to be smokers was 20.8 ± 1.42 years. Males: Females' ratio was 2:1 (66 vs.34%). Prevalence of smoking was 17.4%. Students of non-medical and non-health colleges showed a significant high smoking rate (18.8 and 18.3% respectively) than students in health faculties (15.2%); p=0.017. Participants believed that they might smoke because of: peers' pressure (73.3%), stress (71.4%), imitating popular figures (61.7%) and availability of money (60.4%). Regarding smoking provinces; 86.1% did smoke in coffee-shops, 73.1% in university yards and only 16.87% used to smoke at home Regarding the attitudes of smokers and nonsmokers towards smoking; the acceptance of indoor smoking was significantly higher (85.6%) among smokers than non-smokers (6.42%); p=0.0001. Of note; 51.2% of smokers versus 86.3% of non-smokers agreed to ban smoking in public places (P=0.001). Majority of smokers (72.1%) had the desire to stop smoking while (57.8%) tried to stop smoking but failed.

CONCLUSIONS

Smoking is becoming a habit among university students and initiative of a smoke free environment should be encouraged and subject and method.

Tobacco Use among Adult Muslims in the United States

BACKGROUND

Compared with the general United States (US) population, Muslims in the US exhibit elevated rates of tobacco use. As a result, they might be at a higher risk for preventive disease and premature death as compared with the general US population.

OBJECTIVE

This study investigated the Social Cognitive Theory (SCT) factors that are associated with tobacco use among a sample of adult Muslims in the US.

METHODS

Data were collected (November 2016-March 2017) using a cross-sectional, on-line survey from a convenience sample of adult (≥ 18 years) US Muslims. Participants with a lung cancer history were excluded. Associations between SCT factors and tobacco use were investigated with bivariate analyses and multinomial logistic regression models.

RESULTS

Eligible participants (n = 271) from 30 states completed the survey; 52.8% reported current tobacco use. A higher rate of current tobacco use was reported by men (62.8%) as compared to women (41.3%), x2(1, N = 271) = 12.49, p < .001. In terms of cognitive factors, individuals who (1) expected more personal consequences for tobacco use on health, and (2) had more confidence regarding ability to abstain from tobacco use, were less likely to report current tobacco use. In terms of environmental factors, individuals whose family members did not use tobacco were less likely to report current tobacco use.

CONCLUSION

The study findings suggest that family-oriented interventions emphasizing self-efficacy and personal consequences to prevent tobacco use can potentially be effective in reducing tobacco use rates in the adult US Muslim population.

Are you in or out? Recruitment of adolescent smokers into a behavioral smoking cessation intervention

Even though many adolescent smokers want to quit, it is difficult to recruit them into smoking cessation interventions. Little is known about which adolescent smokers are currently reached by these measures. In this study we compare participants of a group-based, cognitive behavioral smoking cessation intervention with adolescent smokers who decided against participating.

Within a non-randomized controlled trial, data of 1053 smokers (age 11–19) from 42 German secondary schools were analyzed. Of these smokers, 272 were recruited into 47 courses of the intervention. An in-class information session, individually addressing potential participants, and incentives were used as means of recruitment. Personal predictors of participation were analyzed using regression analyses and multivariate path analyses to test for mediation. In the path analysis model, nicotine dependence, quit motivation, and a previous quit attempt were directly positively related to participation. Heavier smoking behavior was indirectly positively associated with participation through nicotine dependence and negatively through quit motivation, yielding an overall positive indirect effect. The positive effect of a previous quit attempt on participation was partially mediated through nicotine dependence and quit motivation. The proportion of smoking friends were indirectly positively related to participation, mediated through nicotine dependence.

Since adolescents with heavier smoking behavior and stronger nicotine dependence are less likely to undertake a successful unassisted quit attempt, the reach of these young smokers with professional cessation interventions is desirable. Further measures to improve the recruitment of those currently not motivated to quit have to be examined in future studies.

Psychosocial determinants of cigarette smoking among university students in Jordan

The objectives of this study were to describe the prevalence of cigarette use and water pipe smoking in Jordanian university students and to analyze differences in determinants between cigarette smokers and non-smokers. A cross-sectional questionnaire was administered to a random sample of 400 students (18-24 years, 51% males). Smokers were compared with non-smokers on several smoking-related determinants. Data were analyzed using descriptive statistics, t-test, χ 2 test and binary logistic regression analysis. The prevalence rates of cigarette use and water pipe smoking were 25.9% and 23.3%, respectively. Cigarette smokers differed significantly from non-smokers on almost all of the assessed determinants. The I-Change model explained 85% of the total variance of cigarette-smoking behavior. Cigarette smoking was determined by being male and older, having more depressive symptoms, having less Muslim identity, being more emancipated, perceiving more pros of smoking, having more modeling from peers and having lower self-efficacy. The popularity of cigarette use and water pipe smoking among Jordanian students necessitates health promotion interventions that motivate students not to engage in smoking behaviors by clearly outlining the outcomes of smoking and the healthier alternatives, how to cope with social influences and difficult situations in order to increase self-efficacy.

Racial and non-racial discrimination and smoking status among South African adults 10 years after apartheid

BACKGROUND

Despite a long history of discrimination and persisting racial disparities in smoking prevalence, little research exists on the relationship between discrimination and smoking in South Africa.

METHODS

This analysis examined chronic (day-to-day) and acute (lifetime) experiences of racial and non-racial (eg, age, gender or physical appearance) discrimination and smoking status among respondents to the South Africa Stress and Health study. Logistic regression models were constructed using SAS-Callable SUDAAN.

RESULTS

Both chronic racial discrimination (RR=1.45, 95% CI 1.14 to 1.85) and chronic non-racial discrimination (RR=1.69, 95% CI 1.37 to 2.08) predicted a higher risk of smoking, but neither type of acute discrimination did. Total (sum of racial and non-racial) chronic discrimination (RR=1.46, 95% CI 1.20 to 1.78) and total acute discrimination (RR=1.28, 95% CI 1.01 to 1.60) predicted a higher risk of current smoking.

CONCLUSIONS

Racial and non-racial discrimination may be related to South African adults' smoking behaviour, but this relationship likely varies by the timing and frequency of these experiences. Future research should use longitudinal data to identify the temporal ordering of the relationships studied, include areas outside of South Africa to increase generalisability and consider the implications of these findings for smoking cessation approaches in South Africa.

Differences between 1-month quitters and relapsers in biospsychosocial characteristics among male smokers in Korea

PURPOSE

The purpose of this study was to compare and contrast biopsychosocial characteristics and processes of change (POC) between 1-month quitters and relapsers among male smokers in Korea.

METHODS

This study employed a prospective study design. Forty-one male smokers were recruited on one university campus. The instruments used in this study included blood pressure (BP), body mass index, salivary cortisol, perceived stress, self-efficacy, and POC. After collection of baseline data, participants were encouraged to adopt smoking cessation, either by obtaining smoking cessation counseling or self-abstinence. Baseline data and data collected after 1 month from smoking cessation were compared.

RESULTS

The mean age of the participants was 24.9 years (SD = 1.90 years), and 51.2% were overweight or obese. According to results of the study, SBP, DBP, and perceived stress were significantly lower, whereas self-efficacy was significantly higher among quitters, compared with relapsers, after 1 month (p < .05). Results of within-group comparison indicated that, among POC, self-liberation, helping relationship, and reinforcement management showed a significant decrease among 1-month relapsers (p < .05), whereas, counter conditioning showed a significant increase among 1-month quitters (p < .05).

CONCLUSIONS

According to the results of this study, BP and perceived stress showed a significant decrease among 1-month quitters, whereas those less likely to utilize behavioral processes were more likely to have relapsed after 1 month.

Internet guidance in oncology practice: determinants of health professionals' Internet referral behavior

BACKGROUND

Many cancer patients turn to the Internet to obtain information on their disease. This digital quest is often motivated by a perceived discrepancy between the information received from health professionals and patients' actual informational needs. This discrepancy may be reduced by supplementing standard patient education with reliable online information sources. This study investigates health professionals' opinions, cognitions, and behavior regarding referring cancer patients to Internet-based information.

METHODS

Online and written questionnaires were distributed among Dutch oncology nurses and medical specialists, measuring perception of patients' informational needs, prompted and unprompted Internet referral, and socio-cognitive factors regarding referral behavior.

RESULTS

Health professionals (N = 130) positively appraised Internet use among cancer patients. Despite recognizing patients' needs for additional information (84%) and need for referral to reliable websites (67%), only 20% frequently referred patients to Internet-based information. Prompted Internet referral was higher (64%). Motives for nonreferral included unfamiliarity with websites and uncertainty about information quality. Intentions towards future referral were moderate to high. To translate intentions into referral, health professionals need reminder tools and information on reliability and content of websites. Cognitive determinants of referral behavior included professionals' attitude, self-efficacy, and intentions regarding referral.

CONCLUSIONS

Recognition of patients' information needs does not culminate in Internet referral among health professionals in cancer care. High intentions to change, however, indicate good prospects for future referral. This study yields valuable insights into behavioral determinants of health professionals' Internet referral behavior. Targeting determinants and barriers in future interventions will provide opportunities for optimization of educational practices.

The Relationship Between Receptivity to Media Models of Smoking and Nicotine Dependence Among South African Adolescents

The purpose of this study is to determine the association of receptivity to media models of smoking and nicotine dependence among South African adolescents from four ethnic groups. A stratified random sample of 731 adolescents aged 12 to 17 years (mean=14. 55, SD=1.68) was drawn from Johannesburg, South Africa. A structured questionnaire was administered to the participants in their homes by trained interviewers. Receptivity to media models of smoking was assessed with a three-item Likert scale. The dependent variable, nicotine dependence, was assessed with the Fagerström Test for Nicotine Dependence (FTND). Regression analyses showed a positive relationship between media receptivity and nicotine dependence, with control on demographic variables and hours of TV watched by the adolescent. This relationship was found to be strongest among White adolescents and weakest among Black adolescents. Though equally receptive to media models of smoking, Black adolescents have lower FTND scores than their peers from other South African ethnic groups. This may be related to the low prevalence of images in South Africa depicting Black people smoking cigarettes. Cultural norms against smoking among Black adolescents may also serve as a protective factor.

A cross-cultural and historical survey of tobacco use among various ethnic groups

This review of tobacco use in diverse historical and cultural contexts reveals a range of behaviors engaged in and perspectives held by members of respective ethnic groups, such as whether to consider tobacco as a medicine or as a problem. After its introduction to Western societies, many attributed tobacco with an array of medicinal uses, while condemning recreational use and identifying it as immoral. Tobacco has been used variously by respective ethnic groups at different times and places and these customs have flavored understandings of the relationships between tobacco and the body. Considerable ethnic variation exists not only in terms of tobacco use and abuse, but also with respect to pharmacogenetic factors that influences the consequences of tobacco exposure. There have also been different societal responses to the use of tobacco, including those related to the media, as well as to issues of treatment and prevention.