Unexpected benefits: pathways from smoking restrictions in the home to psychological well-being and distress among urban Black and Puerto Rican Americans

Factors associated with baseline smoking self-efficacy among male Qatari residents enrolled in a quit smoking study

Smoking self-efficacy, described as confidence in one’s ability to abstain from smoking in high-risk situations is a key predictor in cessation outcomes; however, there is a dearth of research on factors that influence self-efficacy surrounding smoking behavior. This study examines factors associated with baseline self-efficacy among treatment seeking participants enrolled in a pilot feasibility smoking cessation study. Participants (n = 247) were daily male smokers, residents of Doha in Qatar (18–60 years) who were enrolled in a telephone-based smoking cessation study. Baseline assessments included self-efficacy, home smoking rules, socio-demographic variables, smoking history, and psychosocial characteristics. Factors associated with self-efficacy were assessed using multiple linear regression analysis. Results showed that after controlling for relevant variables, number of cigarettes smoked (β^ = -0.22; 95% CI: -0.37, -0.06), having at least one quit attempt in the past year (β^ = 2.30; 95% CI: 0.27, 4.35), and reporting a complete home smoking ban (β^ = 3.13; 95% CI: 0.56, 5.70) were significantly associated with higher self-efficacy to quit smoking. These results provide data-driven indication of several key variables that can be targeted to increase smoking self-efficacy in this understudied population.

Association of Environmental tobacco smoke exposure with depression among non-smoking adults

Background

Depression is a psychological dysfunction that impairs health and quality of life. However, whether environmental tobacco smoke exposure (ETSE) is associated with depression is poorly understood. This study was designed to evaluate the association of ETSE with depression among non-smoking adults in the United States.

Method

Using the 2015–2016 United States National Health and Nutrition Examination Survey (NHANES), we identified 2623 adults (females – 64.2%, males – 35.8%) who had never smoked and applied multivariable adjusted-logistic regression to determine the adjusted odds ratio (aOR) and 95% confidence interval (CI) at P < 0.05 for the association of ETSE with depression adjusting for relevant confounders.

Results

Mean age of respondents was 46.5 ± 17.9 years, 23.5% reported ETSE, and 4.7% reported depression. Also, aORs for the association of ETSE with depression were 1.992 (1.987, 1.997) among females and 0.674 (0.670, 0.677) among males. When we examined the association by age groups, the aORs were 1.792 (1.787, 1.796) among young adults (< 60 years) and 1.146 (1.140, 1.152) among older adults (≥60 years).

Conclusions

We found that ETSE was associated with higher odds of depression among females but not among males.

Vaping and Mental Health

"Vaping" refers to the inhalation of aerosols produced in devices that heat liquid solutions. The aerosols may contain various additives, flavours, nicotine and other drugs such as cannabis. Nicotine is the most common psychoactive substance in vaping devices (or e-cigarettes) in Canada. While vaping has been viewed primarily as a cessation method or harm reduction strategy for smokers of combustible tobacco cigarettes, a new pattern is becoming evident in adolescents and youth (age 15-24) in Canada. In this age group, vaping is reported in increasing frequencies among those who have never smoked. This suggests the possible emergence of a de novo pattern of substance use and suggests the emergence of an unmet treatment need, vaping cessation. The mental health implications of vaping are largely unknown but available data suggest that vaping is associated with mental health changes similar to those seen with combustible tobacco cigarettes. Understanding the mental health impact of "vaping" will be challenging and research is needed. An important message from the smoking literature is that data from randomized cessation trials may be especially valuable because of complex issues of temporality and confounding connected to observational data.

Longitudinal and Reciprocal Relationships Between Psychological Well-Being and Smoking

INTRODUCTION

Smoking cessation treatments currently succeed at a rate of approximately 20%-30%, underscoring the importance of exploring factors that might increase intervention effectiveness. Although negative affect has been studied extensively in relation to smoking cessation, psychological well-being (PWB; eg, life satisfaction, optimism, positive affect, purpose in life) has received little attention. This study tested longitudinal and reciprocal relationships between PWB and smoking status in older adults.

METHODS

Panel data were obtained from the biennial, longitudinal Health and Retirement Study. Using structural equation modeling, we developed cross-lagged models to examine the relationships of PWB in 2006 with smoking status in 2010 and of smoking status in 2006 with PWB in 2010 while controlling for covariates (Ns = 2939-4230, 55% women, 89% white, mean age = 64 years, mean years of education = 13, 25% smokers in 2006 and 21% smokers in 2010). Separate cross-lagged models were developed for each of the PWB variables: life satisfaction, optimism, positive affect, and purpose in life.

RESULTS

Greater life satisfaction (standardized path coefficient = -0.04), optimism (standardized path coefficient = -0.07), and positive affect (standardized path coefficient = -0.08) in 2006 predicted a reduced likelihood of smoking in 2010. Being a smoker in 2006 predicted lower life satisfaction (standardized path coefficient = -0.25), optimism (standardized path coefficient = -0.10), positive affect (standardized path coefficient = -0.10), and purpose in life (standardized path coefficient = -0.13) in 2010.

CONCLUSIONS

Findings warrant further exploration of the relationships between PWB and smoking, and support the incorporation of PWB-boosting components into existing treatments.

IMPLICATIONS

Given the relatively low success rate of current smoking cessation treatments, the present results suggest that increasing PWB might promote abstinence and therefore warrant consideration as a focus of future cessation treatment research. Moreover, these results suggest that smoking might inhibit PWB, illuminating a negative consequence of smoking not previously identified. Helping smokers increase their PWB may benefit them beyond promoting cessation and contribute to a flourishing society. These results warrant further investigation of PWB and smoking, and support the continued evaluation of PWB-boosting components in smoking cessation treatments.

Passive smoking is associated with cognitive and emotional impairment in adolescent girls

It is well established that smoking is associated with impaired mental health and sleep problems. However, the possible effects of passive smoking on cognitive and emotional characteristics have not previously been evaluated in adolescents. We investigated the association between passive smoking and cognitive and emotional function, and sleep patterns in 940 adolescent girls. The girls were divided into two groups [305 exposed subjects and 635 non-exposed subjects (the controls)]. The passive smokers had a significantly lower cognitive function and higher depression, aggression, and insomnia scores compared to the control group (P < 0.05). No significant difference was detected with respect to day-time sleepiness and sleep apnea. Logistic regression analyses showed that the passive smokers were more likely than the controls to have cognitive impairments, depressive mood, aggressive behavior, and insomnia. Adolescent passive smokers had significant differences in their cognitive abilities and emotional function.

Major depression and secondhand smoke exposure

BACKGROUND

Epidemiological studies have consistently linked smoking to poor mental health. Among non-smokers, some studies have also reported associations between secondhand smoke exposure and psychological symptoms. However, an association between secondhand smoke exposure and depressive disorders has not been well established.

METHODS

This analysis used cross-sectional data from a series of 10 population surveys conducted in Canada between 2003 and 2013. The surveys targeted the Canadian household population, included a brief structured interview for past year major depressive episode (MDE) and included items assessing secondhand smoke exposure. We used two-stage individual-level random-effects meta-regression to synthesize results from these surveys.

RESULTS

Over the study interval, about 20% of non-smokers reported substantial exposure to secondhand smoke. In this group, the pooled annual prevalence of MDE was 6.1% (95% CI 5.3-6.9) compared to 4.0% (95% CI 3.7-4.3) in non-smokers without secondhand smoke exposure. The crude odds ratio was 1.5 (95% CI 1.4-1.7). With adjustment for a set of potential confounding variables the odds ratio was unchanged, 1.4 (95% CI 1.2 - 1.6).

CONCLUSIONS

These results provide additional support for public health measures aimed at reducing secondhand smoke exposure. A causal connection between secondhand smoke exposure and MDEs cannot be confirmed due to the cross-sectional nature of the data. Longitudinal studies are needed to establish temporal sequencing.

Link between healthy lifestyle and psychological well-being in Lithuanian adults aged 45-72: a cross-sectional study

OBJECTIVE

This study uses a cross-sectional study design to analyse the connection between psychological well-being (PWB) and components of a healthy lifestyle in the Lithuanian population aged 45-72. The purpose of our study is to establish the links between PWB and lifestyle factors such as physical activity, smoking, alcohol consumption and dietary patterns in people above the age of 44.

PARTICIPANTS

A stratified sample of 10 940 urban citizens aged 45-72 years were randomly selected from the National Population Register. The response rate was 65%.

METHODS

PWB was evaluated by using a Control Autonomy Self-realization and Pleasure (CASP-12) questionnaire. The standard questionnaire included questions regarding the respondent's sociodemographic, socioeconomic and social status. The lifestyle questionnaire evaluated behavioural factors as smoking status, alcohol consumption, nutrition habits and physical activity. Objective measurements of cardiovascular disease (CVD) risk factors were taken.

RESULTS

Adjusted for sociodemographic, socioeconomic, social and biological CVD risk factors, the probability of higher PWB increased for physically active men and women and male former smokers. Higher PWB was directly associated with consumption of fresh vegetables and fruits. Responders who consumed potatoes, meat, boiled vegetables and eggs less frequently than average were more likely to have higher PWB. A direct association was ascertained between PWB and consumption of chicken and fish, as well as an inverse association between PWB and consumption of sweets in women.

CONCLUSIONS

Healthy lifestyle education efforts should focus on increasing physical activity, controlling smoking and improving diversity in healthy food consumption including the consumption of fresh vegetables and fruits, particularly among older adults with lower PWB.

Secondhand smoke exposure and mental health in adults: a meta-analysis of cross-sectional studies

PURPOSE

Previous studies assessing secondhand smoke (SHS) and risk of mental health problems have yielded inconsistent results. We performed a meta-analysis to statistically assess the association between SHS exposure, depressive symptoms and psychological distress among adults.

METHODS

A systematically search of Pubmed (1946-2015) and EMBASE (1976-2015) was conducted and supplemented by bibliographies of all retrieved articles to find additional relevant citations. Odds ratios (OR) and associated 95 % confidence interval (CI) of each eligible study were extracted and pooled in our meta-analysis.

RESULTS

A total of 11 studies comprising 86,739 participants met the inclusion criteria. A random-effect model was used in meta-analysis since considerable heterogeneity was expected. Our results indicate that SHS exposure was significantly associated with depressive symptoms (OR 1.60, 95 % CI 1.35-1.90) and psychological distress (OR 1.32, 95 % CI 1.11-1.56).

CONCLUSION

Exposure to SHS among non-smoker is associated with depressive symptoms and psychological distress, emphasizing the significance of reducing SHS exposure at a population level.

Tobacco consumption and positive mental health: an epidemiological study from a positive psychology perspective

Background

Positive mental health (PMH) is much more than the absence of mental illnesses. For example, PMH explains that to be happy or resilient can drive us to live a full life, giving us a perception of well-being and robustness against everyday problems. Moreover, PMH can help people to avoid risky behaviours like tobacco consumption (TC). Our hypothesis was that PMH is negatively associated with TC, and this association differs across rural, urban and migrant populations.

Methods

A cross-sectional study was conducted using the PERU MIGRANT Study’s dataset, including rural population from the Peruvian highlands (n = 201), urban population from the capital city Lima (n = 199) and migrants who were born in highlands but had to migrated because of terrorism (n = 589). We used an adapted version of the 12-item Global Health Questionnaire to measure PMH. The outcome was TC, measured as lifetime and recent TC. Log-Poisson robust regression, performed with a Maximum Likelihood method, was used to estimate crude prevalence ratios (PR) and 95 % confidence intervals (95%CI), adjusted by sex, age, family income and education which were the confounders. The modelling procedure included the use of LR Test, Akaike information criteria (AIC) and Bayesian information criteria (BIC).

Results

Cumulative occurrence of tobacco use (lifetime TC) was 61.7 % in the rural group, 78 % in the urban group and 76.2 % in rural-to-urban migrants. Recent TC was 35.3 % in the rural group, 30.7 % in the urban group and 20.5 % in rural-to-urban migrants. After adjusting for confounders, there was evidence of a negative association between PMH and lifetime TC in the rural group (PR = 0.93; 95%CI: 0.87–0.99), and a positive association between PMH and recent TC in migrants (PR = 1.1; 95%CI: 1.0–1.3).

Conclusions

PMH was negatively associated with TC in rural participants only. Urbans exhibited just a similar trend, while migrants exhibited the opposite one. This evidence represents the first step in the route of knowing the potential of PMH for fighting against TC. For rural populations, this study supplies new information that could support decisions about prevention programmes and psychotherapy for smoking cessation. However, more research in the topic is needed.

Electronic supplementary material

The online version of this article (doi:10.1186/s40359-016-0130-7) contains supplementary material, which is available to authorized users.

Association of second-hand smoke exposure at home with psychological distress in the Spanish adult population

INTRODUCTION

Second-hand smoke (SHS) exposure has been associated with increased risks of respiratory and heart diseases. However, little is known about the potential effects of SHS on psychological distress. The aim of this study is to examine the association of SHS exposure at home with psychological distress in Spain.

METHODS

A cross-sectional survey about SHS exposure, socio-demographic and health related variables, and psychological distress, measured with the 12-item version of the General Health Questionnaire (GHQ-12) with a cut-off score ≥ 3, was conducted from 2011-2012 among a representative sample of the adult population (aged ≥ 15 years) of Spain. From the total sample (n = 21,007), we used the subsample of never-smokers (n = 11,214). We computed the odds ratios (OR) and their 95% confidence intervals (95% CI) for scoring ≥ 3 on the GHQ by means of unconditional multiple logistic regression models adjusted for sex and age.

RESULTS

In the subsample, 9.7% (n = 1,090) responded that they were exposed to SHS at home. The prevalence of subjects scoring ≥ 3 on the GHQ was higher for the sample exposed to SHS (22.7%) than for the non-exposed sample (18.9%; OR: 1.39; CI: 1.19-1.62). This association was also present when stratified for sex, age, marital status, socio-economic status, perceived general health, presence of any chronic disease, and alcohol intake.

CONCLUSIONS

Exposure to SHS at home is associated with psychological distress. Further investigation is necessary to determine if this association is causal. Avoiding SHS exposure at home could have beneficial effects on psychological distress.

Voluntary smoking bans at home and in the car and smoking cessation, obesity, and self-control

This study of female former and current smokers assessed the associations between voluntary smoking bans at home and in the car and smoking cessation, obesity, and self-control. Data from self-reported female smokers (N = 194) who were in a community-based random cohort at four points in time, from 1983 to 2009, were analyzed. These female participants (M age = 63.7 yr.) were given self-administered questionnaires. Analyses showed that complete smoking bans at home and in the car were positively associated with a greater likelihood of smoking cessation. Complete smoking bans at home and in the car were positively associated with greater self-control. Public health policies should focus on the positive health effects of smoking bans on smoking cessation and greater self-control.

Current smoking and secondhand smoke exposure and depression among Korean adolescents: analysis of a national cross-sectional survey

OBJECTIVES

To examine the association between cigarette smoke exposure and depression among Korean adolescents using the seventh Korea Youth Risk Behavior Web-based Survey (KYRBWS).

DESIGN

Cross-sectional study.

SETTING

A nationally representative sample of middle and high school students across South Korea.

PARTICIPANTS

75 643 eligible participants across the country.

PRIMARY OUTCOME MEASURES

Current smoking, secondhand smoke exposure and depression.

METHODOLOGY

Data were analysed from a nationally representative survey of 75 643 participants (37 873 men and 37 770 women). Data were gathered on extensive information including current smoking, secondhand smoke exposure and depression in adolescence. Multiple logistic regression analysis was used to estimate the association between current smoking, secondhand smoke exposure and depression in Korean adolescents.

RESULTS

Among those who had never smoked, secondhand smoke exposure was positively associated with depression in male and female adolescents in a dose-response relation (OR 1.27, OR 1.52 in males; OR 1.25, OR 1.72 in females). Similar associations were observed among currently smoking men and women in a dose-response manner (OR 1.29, OR 1.55 in males; OR 1.22, OR 1.41 in females). These significant trends were consistently observed even after adjustments.

CONCLUSIONS

We suggested that current smoking and secondhand smoke exposure were positively associated with depression in male and female adolescents. Efforts to encourage no smoking and no secondhand smoke exposure will be established for adolescents.

Individuality and contextual influences on drug dependence: a 15-year Prospective longitudinal study of adolescents from Harlem

In this 15-year longitudinal study the authors investigated individual and contextual factors that predispose adolescents from a disadvantaged urban area to drug dependence in adulthood. Adolescents were recruited from schools serving East Harlem in New York City. Of the 838 participants followed to adulthood, 59% were women, 55% were African American, and 45% were Puerto Rican. Self-report data were obtained on externalizing and internalizing problems, substance use, and contextual influences across adolescence and young adulthood. Drug dependence was assessed in adulthood. Multivariate logistic regressions of drug dependence were performed on the whole sample and separately by gender. Each of the domains was associated with adult drug dependence. Although mean gender differences were found, most associations of risk factors with drug dependence did not vary significantly by gender. Treating externalizing and internalizing problems, reducing substance use, and providing coping skills for adverse contextual influences in adolescence and young adulthood may reduce the likelihood of becoming drug dependent in adulthood.

What are candidate biobehavioral mechanisms underlying the association between secondhand smoke exposure and mental health?

There is a consistent positive and significant association between secondhand smoke exposure and mental health outcomes in the literature. There are potential genetic and behavioral confounders (e.g., psychological stress, maternal depression, and family functioning) were discussed, as well as potential causal neurobiological pathways (e.g., dopamine system). Further neurobiological research to establish causal pathways is needed as well as the integration of positive observational findings into clinical and public health prevention practices.