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Walters KJ, Emery NN, Thrul J, Tomko RL, Gray KM, McClure EA. Temporal associations linking alcohol and cannabis use to cigarette smoking in young adults engaged in a tobacco cessation and relapse monitoring study. Addict Behav 2024; 149:107902. [PMID: 37924584 PMCID: PMC10842007 DOI: 10.1016/j.addbeh.2023.107902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
Young adulthood remains a developmental period in which cigarette smoking initiation and progression to dependence and regular use is common. Moreover, co-use of alcohol and/or cannabis with tobacco is common in this age group and may have detrimental effects on tobacco use rates and cessation outcomes. Although young adults are interested in quitting smoking, achieving abstinence remains difficult, even with evidence-based treatment strategies. Understanding proximal associations between other substance use (e.g., alcohol and cannabis) and smoking may have important treatment implications. This exploratory analysis investigated the role of alcohol and/or cannabis use in contributing to smoking events on the same day or next day among young adults engaged in a smoking cessation and relapse monitoring study. We used ecological momentary assessment (EMA) data from 43 young adults (ages 18-25; 932 observations) who smoked cigarettes daily and agreed to participate in a 5-week study that included a 2-day smoking quit attempt and provision of tobacco treatment in the form of nicotine replacement therapy, brief cessation counseling, and financial incentives for abstinence (incentives were provided only during the 2-day quit attempt). We tested multilevel time-series models of daily associations between alcohol use, cannabis use, and smoking. Consistent with hypotheses, days on which participants were more likely to drink alcohol predicted increased likelihood of smoking the next day (OR = 2.27, p =.003). This effect was significant after controlling for both the one-day lagged effect of smoking (i.e., autoregression) and the concurrent (i.e., same day) effects of drinking and cannabis use. Although there was a positive concurrent effect of cannabis use on smoking (OR = 12.86, p =.003), the one-day lagged effect of cannabis use and the concurrent effect of drinking was not significant, contrary to hypotheses. Results indicate that alcohol use presents a potential threat to successful smoking cessation that extends to the following day. This suggests a risk-window in which treatment could be supplemented with just-in-time interventions and extending the focus on co-use to include this lagged impact on cessation outcomes.
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Affiliation(s)
- Kyle J Walters
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Noah N Emery
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Johannes Thrul
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA; Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Rachel L Tomko
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA; Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
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Klaver SJ, Dvorak RD, De Leon AN, Burr EK, Leary AV, Hayden ER, Peterson R, Allen Q, Gwaltney CJ. Support for incentive-sensitization theory in adolescent ad libitum smokers using ecological momentary assessment. Exp Clin Psychopharmacol 2024; 32:27-34. [PMID: 37384458 PMCID: PMC10755077 DOI: 10.1037/pha0000669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The incentive-sensitization theory (IST) has emerged as a potentially useful theory in explaining substance addiction. IST postulates that the prolonged use of a substance can alter neural systems that are often involved in incentive motivation and reward processes, leading to an increased "sensitization" to the substance and associated stimuli. However, this increased sensitization is thought to mediate only the individual's craving of the substance (e.g., their "wanting"), not their enjoyment of the substance (e.g., their "liking"), a process that may involve unconscious implicit changes in cognitive networks linked to specific substances. Consequently, IST may better explain the real-world dissonance reported for individuals who want to accomplish long-term substance cessation but fail to do so, a phenomenon that is common in adolescent smokers. Thus, the present study aimed to examine the principles of IST in a sample of 154 adolescent ad libitum smokers (Mage = 16.57, SDage = 1.12, 61.14% male) utilizing ecological momentary assessment. Data were analyzed utilizing a multilevel structural equation model examining changes in positive affect (PA), negative affect (NA), and stress from Time 1 (T1) and Time 2 (T2) as a function of smoking and tested the influence of implicit cognition (specifically, implicit attitudes about smoking [Implicit Association Test (IAT)]) on these associations. Consistent with the principles of IST, results found a modest significant negative association between smoking status at T1 and PA at T2 (B = -0.11, p = .047). This association was further moderated by IAT (B = -0.19, p = .029) and was particularly potentiated at high levels of IAT (B = -0.44, p < .001), compared to low (B = -0.05, p = .663) or mean levels of IAT (B = -0.25, p = .004). Findings from this study provide additional support to the principles underlying IST and indicate that, in adolescents, smoking may result in thwarted PA indicative of a transition from "liking" toward "wanting," and this is especially pronounced among those with stronger implicit smoking cognitions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Bitar S, Collonnaz M, O'Loughlin J, Kestens Y, Ricci L, Martini H, Agrinier N, Minary L. A Systematic Review of Qualitative Studies on Factors Associated With Smoking Cessation Among Adolescents and Young Adults. Nicotine Tob Res 2024; 26:2-11. [PMID: 37648287 DOI: 10.1093/ntr/ntad167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/02/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVE To summarize findings from qualitative studies on factors associated with smoking cessation among adolescents and young adults. DATA SOURCES We searched Pubmed, Psychinfo, CINAHL, Embase, Web of Science, and SCOPUS databases, as well as reference lists, for peer-reviewed articles published in English or French between January 1, 2000, and November 18, 2020. We used keywords such as adolescents, determinants, cessation, smoking, and qualitative methods. STUDY SELECTION Of 1724 records identified, we included 39 articles that used qualitative or mixed methods, targeted adolescents and young adults aged 10-24, and aimed to identify factors associated with smoking cessation or smoking reduction. DATA EXTRACTION Two authors independently extracted the data using a standardized form. We assessed study quality using the National Institute for Health and Care Excellence checklist for qualitative studies. DATA SYNTHESIS We used an aggregative meta-synthesis approach and identified 39 conceptually distinct factors associated with smoking cessation. We grouped them into two categories: (1) environmental factors [tobacco control policies, pro-smoking norms, smoking cessation services and interventions, influence of friends and family], and (2) individual attributes (psychological characteristics, attitudes, pre-quitting smoking behavior, nicotine dependence symptoms, and other substances use). We developed a synthetic framework that captured the factors identified, the links that connect them, and their associations with smoking cessation. CONCLUSIONS This qualitative synthesis offers new insights on factors related to smoking cessation services, interventions, and attitudes about cessation (embarrassment when using cessation services) not reported in quantitative reviews, supplementing limited evidence for developing cessation programs for young persons who smoke. IMPLICATIONS Using an aggregative meta-synthesis approach, this study identified 39 conceptually distinct factors grouped into two categories: Environmental factors and individual attributes. These findings highlight the importance of considering both environmental and individual factors when developing smoking cessation programs for young persons who smoke. The study also sheds light on self-conscious emotions towards cessation, such as embarrassment when using cessation services, which are often overlooked in quantitative reviews. Overall, this study has important implications for developing effective smoking cessation interventions and policies that address the complex factors influencing smoking behavior among young persons.
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Affiliation(s)
- Sarah Bitar
- Université de Lorraine, APEMAC, Nancy, France
| | | | - Jennifer O'Loughlin
- École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, QC, Canada
| | - Yan Kestens
- École de Santé Publique de l'Université de Montréal (ESPUM), Montreal, QC, Canada
- Centre de recherche du CHUM (CRCHUM), Université de Montréal, Montreal, QC, Canada
| | - Laetitia Ricci
- Université de Lorraine, APEMAC, Nancy, France
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Hervé Martini
- Service de Médecine L/ Addictologie CHRU de Nancy, Hôpitaux de Brabois - Bâtiment Philippe Canton, Rue du Morvan, Vandœuvre-lès-Nancy, France
| | - Nelly Agrinier
- Université de Lorraine, APEMAC, Nancy, France
- CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
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Walters KJ, Gray KM, Gex KS, McClure EA. The Role of Emotion Differentiation in the Association Between Momentary Affect and Tobacco/Nicotine Craving in Young Adults. Nicotine Tob Res 2023; 25:1261-1268. [PMID: 36610804 PMCID: PMC10256884 DOI: 10.1093/ntr/ntad001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/13/2022] [Accepted: 01/03/2023] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Tobacco/nicotine use is commonly initiated during adolescence or young adulthood, which increases the likelihood of continued use into adulthood and related adverse health outcomes. Despite interest in cessation, achieving and maintaining abstinence is difficult among this population. Cravings are often a barrier to abstinence, which have been associated with intensity of affect at the moment level. Emotion differentiation involves the ability to distinguish between discrete emotion states, and previous work suggests it may moderate the effect of momentary affect on craving, which has never been explored among young adults who are smoking or vaping nicotine. AIMS AND METHODS In a sample of young adults (N = 37, observations = 2020, ages 18-25, 51% female, and 78% white) interested in quitting smoking or vaping, we used real-time, naturalistic data capture via mobile phones to examine the interaction of momentary affect and trait emotion differentiation on nicotine craving. Participants were prompted with four surveys per day for 35 days and asked to make a 48-h quit attempt on day 7. RESULTS Multilevel models showed moments of higher-than-average momentary negative affect (NA; b = 0.39, p < .001), and positive affect (PA; b = 0.26, p = .001) were associated with greater levels of craving. NA emotion differentiation significantly moderated the associations between PA and craving (b = -0.63, p = .031) and NA and craving (b = -0.67, p = .003). CONCLUSIONS Findings from this exploratory analysis suggest that for young adults engaging in a nicotine quit attempt, greater ability to differentiate NA weakens the momentary association between intense affect and craving. IMPLICATIONS Results of this study show that the ability to differentiate between discrete emotional experiences may protect young adults against nicotine craving during moments of intense affective experience. These preliminary findings suggest that emotion differentiation, a modifiable construct, could be an important treatment target for individuals engaged in treatment for nicotine dependence.
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Affiliation(s)
- Kyle J Walters
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Kathryn S Gex
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA
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Tsikrika S, Dai S, Dilektasli A, Katsaounou P, Dagli E. Challenges and perspectives of tobacco cessation in special groups of patients and populations. Breathe (Sheff) 2023; 19:220224. [PMID: 37645019 PMCID: PMC10461735 DOI: 10.1183/20734735.0224-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 06/27/2023] [Indexed: 08/31/2023] Open
Abstract
During the first 2 years of the coronavirus disease 2019 pandemic, health systems worldwide were put under extreme pressure, and healthcare professionals had to manage unprecedented health crises as well as provide healthcare services to an increased number of patients. Therefore, public health policies with respect to smoking and education of the general population regarding the harmful effects of active and second-hand smoking may not have received adequate attention during this period. More specifically, certain subpopulations suffering from chronic diseases may not have received adequate information about the effects of smoking on the course and outcome of their disease; high-level, evidence-based pharmaceutical therapies; and the potential for follow-up. However, adequate education and awareness regarding short- and long-term health benefits from smoking cessation for the general population as well as special subgroups remains of utmost importance. Healthcare professionals should understand that it is only through high-quality evidence and results from independent studies that they will be able to provide their expertise and scientific knowledge concerning newer tobacco products and their effects on human health.
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Affiliation(s)
| | - Siyu Dai
- Department of Paediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Asli Dilektasli
- Department of Pulmonary Medicine, Bursa Uludag University, Bursa, Turkey
| | - Paraskevi Katsaounou
- National and Kapodistrian University of Athens, 1st Department of Critical Care and Pulmonary Medicine, Evaggelismos Hospital, Athens, Greece
| | - Elif Dagli
- Marmara and Acibadem University, Istanbul, Turkey
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Dai H. Prevalence and Factors Associated With Youth Vaping Cessation Intention and Quit Attempts. Pediatrics 2021; 148:peds.2021-050164. [PMID: 34408090 DOI: 10.1542/peds.2021-050164] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study sought to examine the prevalence and factors associated with youth vaping cessation behaviors. METHODS Current (past 30-day) electronic-cigarette (e-cigarette) users from the 2020 National Youth Tobacco Survey (n = 1660, typically aged 11-18 years) were analyzed to examine the prevalence of youth intention to quit vaping, past-year quit attempts, and the frequency of quit attempts. Multivariable logistic or linear regressions were performed to assess the correlates with youth vaping cessation behaviors. RESULTS In 2020, 53.4% of current e-cigarette users reported intention to quit vaping and 67.4% reported having tried to quit vaping. Intention to quit was lower among female individuals (versus male individuals, adjusted odds ratio [aOR] = 0.7, P = .0004), users of a modifiable system (versus disposable e-cigarettes, aOR = 0.4, P = .0204), and dual or poly users (versus sole e-cigarette use, aOR = 0.7, P = .0144). e-cigarette harm perception was positively associated with intention to quit (aOR = 2.2, P < .0001) and past-year quit attempts (aOR = 1.6, P = .0037). Reasons for e-cigarette use were related to cessation behaviors. Adolescents who vaped because of curiosity had higher odds of past-year quit attempts (aOR = 1.4, P = .0306), whereas users to disguise vaping had a lower likelihood of intention to quit (aOR=0.4, P < .0001) and past-year quit attempts (aOR = 0.7, P = .0126). The average number of past-year quit attempts was 5.3, and it was lower among female individuals (versus male individuals), users of e-cigarettes with prefilled pods or cartridges (versus disposable e-cigarettes), and those with nicotine cravings (versus no nicotine craving). CONCLUSIONS Intention to quit vaping and past-year quit attempts are prevalent among US adolescent e-cigarette users. The study findings inform the development of multifaceted vaping cessation programs to take sex, e-cigarette devices, vaping reasons and patterns, harm perception, and nicotine dependence into account.
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Affiliation(s)
- Hongying Dai
- College of Public Health, University of Nebraska Medical Center, University of Nebraska, Omaha, Nebraska
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Wang L, Chen J, Leung LT, Ho SY, Lam TH, Wang MP. Use patterns of cigarettes and alternative tobacco products and socioeconomic correlates in Hong Kong secondary school students. Sci Rep 2021; 11:17253. [PMID: 34446733 PMCID: PMC8390664 DOI: 10.1038/s41598-021-96452-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/06/2021] [Indexed: 02/07/2023] Open
Abstract
Smoking is a major cause of health inequities. However, sociodemographic differences in adolescent tobacco use are unclear. In a territory-wide school-based anonymous survey in 2018/19, we investigated tobacco use and sociodemographic correlates in 33,991 students (mean age 14.8 ± 1.9 years) in Hong Kong. Tobacco use prevalence and current-ever use ratios by sociodemographic factors were calculated. Generalised linear mixed models were used in association analyses. Current use was highest for cigarettes (3.2%), closely followed by alternative tobacco products (3.0%). Current-ever use ratios were highest for heated tobacco products (HTPs, 0.60), followed by nicotine e-cigarettes (0.52), waterpipe (0.51), and cigarettes (0.35). Use prevalence and current-ever use ratios of all products showed curvilinear relations with perceived family affluence (P values < 0.01), being highest in the richest families. Tobacco use was also associated with more senior grades, the lowest parental education, and boys, but current-ever use ratios of HTPs and waterpipe were higher in girls (P values < 0.05). The results suggested that adolescent ever users of nicotine-containing alternative tobacco products were more likely to keep using them than cigarettes, and the richest adolescents were at the highest risks of tobacco use. Diverse tobacco control measures are needed to improve health equity, especially on alternative tobacco products.
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Affiliation(s)
- Lijun Wang
- grid.194645.b0000000121742757School of Public Health, University of Hong Kong, Hong Kong, People’s Republic of China
| | - Jianjiu Chen
- grid.194645.b0000000121742757School of Public Health, University of Hong Kong, Hong Kong, People’s Republic of China ,grid.21729.3f0000000419368729Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Lok Tung Leung
- grid.194645.b0000000121742757School of Public Health, University of Hong Kong, Hong Kong, People’s Republic of China
| | - Sai Yin Ho
- grid.194645.b0000000121742757School of Public Health, University of Hong Kong, Hong Kong, People’s Republic of China
| | - Tai Hing Lam
- grid.194645.b0000000121742757School of Public Health, University of Hong Kong, Hong Kong, People’s Republic of China
| | - Man Ping Wang
- grid.194645.b0000000121742757School of Nursing, University of Hong Kong, Hong Kong, People’s Republic of China
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Vallata A, O'Loughlin J, Cengelli S, Alla F. Predictors of Cigarette Smoking Cessation in Adolescents: A Systematic Review. J Adolesc Health 2021; 68:649-657. [PMID: 33191057 DOI: 10.1016/j.jadohealth.2020.09.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 09/09/2020] [Accepted: 09/18/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To update a systematic review published in 2012 that identified predictors of cigarette smoking cessation among adolescents. METHODS The PubMed and Web of Science databases were searched for relevant articles published between September 2010 and January 2018, using the following keywords: smoking OR tobacco OR cessation; quit OR stop; longitudinal OR prospective OR cohort. Our search identified 3,399 articles. Inclusion criteria included longitudinal studies (intervention and cohort studies) evaluating cigarette smoking cessation in young people (aged 10-24 years). After screening, in total, 34 articles were included in the review. RESULTS In total, 63 predictors of smoking cessation among adolescents were identified, with 36 new predictors that were not identified in the previous review: nine sociodemographic factors, 13 psychosocial factors, five behavioral factors, 19 social influences factors, eight smoking related variables, six environmental factors, 2 health related variables, and one genetic factor. CONCLUSIONS To increase the probability of successful smoking cessation, strategies targeting young smokers should consider both individual and environmental predictors of cessation.
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Affiliation(s)
- Amandine Vallata
- Bordeaux Research Center for Population Health - BPH, U1219 Inserm, University of Bordeaux, Bordeaux, France.
| | | | | | - François Alla
- Bordeaux Research Center for Population Health - BPH, U1219 Inserm, University of Bordeaux, Bordeaux, France
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Tran TPT, Park J, Park E, Shin SH, Paek YJ, Kim YH, Lim MK. Effect of Additional Motivational Interviewing on Smoking Abstinence for 1-Year among Korean Adolescents: Results from A Comparative Retrospective Study in Quitline. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218025. [PMID: 33142682 PMCID: PMC7662252 DOI: 10.3390/ijerph17218025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the effect of additional motivational enhancement through telephone-based counseling on short- and long-term smoking abstinence among Korean adolescents. METHODS A comparative retrospective study was conducted based on the longitudinal follow up in Quitline from 2010 to 2017. A total of 533 and 178 adolescent smokers voluntarily participated in the 1-year quitting counseling only (group A, who were ready to quit) and the additional 4-week motivational interviewing before 1-year quitting counseling (group B, who were ambivalent about quitting), respectively. The outcomes were self-reported continuous abstinence at 30-day, 6-month, and 1-year follow up. Logistic regression was applied to estimate the effect of potential factors, including motivational enhancement, on cessation outcome. RESULTS At baseline, adolescents in group B had a lower motivation to quit than those in group A (p < 0.001). The successful quit rates at 30-day, 6-month, and 1-year follow up were 37.2%, 12.8%, and 11.4% in group A and 33.7%, 15.2%, and 11.2% in group B, respectively. After adjusting factors as appropriate, successful quit rates in group B were not significantly different from the rates in group A. Higher self-efficacy increased the successful quit rate at 30-day, 6-month, and 1-year follow up, similar in subgroup analysis by gender. Never-drinking showed significant association with 30-day successful quit in the whole population and among boys. The lower number of smoking triggers was associated with an increased 30-day successful quit rate among boys only. CONCLUSIONS Counseling for motivational enhancement could be a promising approach for better quitting outcomes. Improving self-efficacy and eliminating smoking triggers should be continuously strengthened during the quitting process.
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Affiliation(s)
- Thi Phuong Thao Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
| | - Jinju Park
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
| | - Eunjung Park
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
| | - Sang Hwa Shin
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
| | - Yu-Jin Paek
- Department of Family Medicine, Health Promotion Center, Hallym University Sacred Heart Hospital, Anyang 14068, Korea;
| | - Yun Hee Kim
- Department of Nursing, Pukyong National University, Busan 48513, Korea;
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
- Correspondence: ; Tel.: +82-31-920-2016; Fax: +82-31-920-2929
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Minary L, Agrinier N, Dugas EN, Sylvestre MP, O'Loughlin J. The Natural Course of Cigarette Smoking among Adolescent Daily Smokers in France and Quebec. Tob Use Insights 2020; 13:1179173X20943549. [PMID: 32922106 PMCID: PMC7446263 DOI: 10.1177/1179173x20943549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 06/25/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: To describe the natural course of cigarette smoking and nicotine dependence (ND) over 1-year in daily smokers ages 15 to 17 living in different social contexts. Method: Cigarette smoking and ND indicators were measured at baseline and 3- and 12-months thereafter among 95 daily smokers with a total of 123 observations from the Nicotine Dependence in Teens (NDIT) Study in Quebec, Canada, and in 111 daily smokers from the TABagisme chez les ADOlescents (TABADO) Study in Lorraine, France. Results: NDIT and TABADO participants initiated smoking a mean (SD) of 3.9 (1.6) and 3.7 (2.0) years prior to baseline, respectively. Despite baseline differences in age, sex, age at initiation, number of cigarettes smoked per day and social context, 85% of participants in both samples reported cravings and responded “yes” to “felt like you really need a cigarette”. Mean (SD) number of cigarettes smoked per day increased from 9.4 (8.1) to 11.8 (8.0) over 1 year in NDIT (adjusted mean difference (95% CI) = 2.4 (0.8, 3.0)), and from 11.5 (6.5) to 13.5 (6.7) in TABADO (adjusted mean difference (95% CI) = 2.0 (0.8, 3.1)). However, most ND indicators in both samples were stable over time and cessation was infrequent. Conclusion: Despite notable differences across samples, the natural course of cigarettes smoked per day, ND symptoms and cessation was similar, suggestive of an underlying biologic rather than social process. To quit, adolescents who smoke daily will likely need (pharmacologic) intervention to counter the biological mechanisms underpinning ND, as well as complementary strategies targeting the social context such as creating social environments favoring cessation success.
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Affiliation(s)
| | - Nelly Agrinier
- Université de Lorraine, APEMAC, Nancy, France.,CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy, France
| | - Erika N Dugas
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Sylvestre
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada
| | - Jennifer O'Loughlin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada
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Treloar Padovano H, Merrill JE, Colby SM, Kahler CW, Gwaltney CJ. Affective and Situational Precipitants of Smoking Lapses Among Adolescents. Nicotine Tob Res 2020; 22:492-497. [PMID: 30624745 DOI: 10.1093/ntr/ntz002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 01/07/2019] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Most adolescent smokers report a desire to quit, and many have made several unsuccessful quit attempts; however, when adolescents attempt to quit, they often resume smoking quickly. This ecological study aimed to (1) characterize affective and situational precipitants of smoking lapses among adolescents and (2) explore the moderating influence of nicotine dependence severity on lapse precipitants. METHODS Adolescent daily smokers (n = 166; ages 14-18 years) completed electronic diaries of cigarettes smoked, craving and affective states, and situational variables on handheld computers in their natural environment for 2 weeks following an unassisted quit attempt. On average, adolescents were moderately nicotine dependent (Modified Fagerström Tolerance Questionnaire [mFTQ] score = 4.9; SD = 1.6). RESULTS Craving was a significant episodic cue for lapse and stable influence on lapse, relating to 44% and 15% increased odds of lapse, respectively. High-arousal affective states-regardless of valence-were associated with 12%-13% increased odds of lapse. Low-arousal positive affective states were associated with 17% decreased odds of lapse. A 1-unit difference in a teen's mFTQ score related to 27% increased odds of lapse, but dependence severity did not moderate proximal lapse influences. CONCLUSIONS This report provides some of the first ecological data characterizing adolescent smoking lapses following a quit attempt. As in prior work with teens, lapses were nearly universal and quickly followed the quit attempt. Specific situational and affective contexts of smoking lapses for adolescents were implicated, indicating the need for cessation interventions to address craving and high-arousal affective states as precipitators of lapse in this high-risk group. IMPLICATIONS This report provides some of the first ecological data characterizing smoking lapses among teens attempting to quit smoking on their own. Like adults, adolescents face many barriers when making quit attempts. The present work provides ecological data to suggest that the experience of heightened arousal in teens' daily lives interferes with their efforts to quit smoking. Thus, this work highlights the importance of affective dysregulation, or amplitude of emotional feelings, for teen smoking lapses. Moment-to-moment fluctuation in craving was also implicated as a dynamic precipitator of smoking lapse in this high-risk group.
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Affiliation(s)
- Hayley Treloar Padovano
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI.,Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Jennifer E Merrill
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI.,Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Chad J Gwaltney
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
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12
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Abstract
Hidradenitis suppurativa (HS) can have devastating impacts on quality of life (QoL), especially during adolescence when patients face unique challenges related to self-esteem, body-image, and sexual maturation. Many teenage HS patients also experience social challenges related to school, relationships, and employment that may require physician intervention. Strategies for comprehensive management of this special group include addressing low medication adherence, screening for comorbidities, and recommending practical lifestyle modifications to reduce disease flares. Herein, we review the impact of HS on adolescent patients and provide practical recommendations to minimize effects on the adolescent life course.
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Affiliation(s)
- Erin Collier
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Vivian Y Shi
- Department of Medicine, Division of Dermatology, University of Arizona, Tucson, AZ, USA
| | - Jennifer L Hsiao
- Department of Medicine, Division of Dermatology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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13
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Aljandaleh H, Bolze C, El-Khoury Lesueur F, Melchior M, Mary-Krause M. Factors Associated with Electronic Cigarette Use among Young Adults: The French "Trajectoires EpidéMiologiques en POpulation" (TEMPO) Cohort Study. Subst Use Misuse 2020; 55:964-972. [PMID: 31997695 DOI: 10.1080/10826084.2020.1717534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background: Electronic cigarettes (e-cigarettes) are sold in France since 2010 and have rapidly become popular. However, factors associated with e-cigarette use among young adults are not well known. Methods: We used data from the 2015 French TEMPO community based cohort study, restricted to current and former smokers with data on e-cigarette use (n = 368 adults, 23-41 years). Participants completed a self-administered questionnaire including information on family status, educational attainment, occupation and type of work contract, health problems, alcohol and cannabis use, electronic cigarette use, as well as perceptions of e-cigarettes. Use of traditional tobacco was assessed in 2011 and 2015. Data were analyzed using logistic regression models. Results: Among current and former smokers, 26.9% reported lifetime e-cigarettes use and 15.2% current use. Factors associated with lifetime use were: low socioeconomic position (OR = 2.2; 95% CI = 1.2-4.2), traditional cigarette use (OR associated with smoking in 2011 and 2015 = 13.1; 95% CI = 5.2-32.6) and positive perceptions of e-cigarettes (OR = 4.4; 95% CI = 2.4-8.1) as well as asthma (OR = 2.1; 95% CI = 0.9-4.9) and overweight/obesity (OR = 2.5, 95% CI = 0.9-6.9). Factors associated with current use were traditional cigarette smoking (OR associated with smoking in 2011 and 2015 = 3.9; 95% CI= 1.3-12.2) and positive perceptions of e-cigarettes (OR =4.4; 95% CI = 2.3-8.4). Conclusions: Young adults who use e-cigarettes tend to persist in smoking traditional cigarettes. The conditions under which e-cigarette use can help individuals quit traditional tobacco products remain to be elucidated.
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Affiliation(s)
- Hala Aljandaleh
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
| | - Camille Bolze
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
| | - Fabienne El-Khoury Lesueur
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
| | - Murielle Mary-Krause
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), Equipe de Recherche en Epidémiologie Sociale (ERES), Paris, France
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14
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Komiyama M, Takahashi Y, Tateno H, Mori M, Nagayoshi N, Yonehara H, Nakasa N, Haruki Y, Hasegawa K. Support for Patients Who Have Difficulty Quitting Smoking: A Review. Intern Med 2019; 58:317-320. [PMID: 30210111 PMCID: PMC6395133 DOI: 10.2169/internalmedicine.1111-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Smoking cessation plays a crucial role in reducing preventable morbidity and mortality. However, some smokers find smoking cessation difficult, despite receiving treatment. This includes heavy smokers with chronic obstructive pulmonary disease, smokers with a psychiatric disorder, and female and underage smokers. This review article describes smoking cessation approaches for patients who find it difficult to quit smoking.
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Affiliation(s)
- Maki Komiyama
- Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
| | - Yuko Takahashi
- Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
| | - Hiroki Tateno
- Department of Internal Medicine, Saitama City Hospital, Japan
| | - Masahiro Mori
- Department of Surgery, National Hospital Organization Chiba Medical Center, Japan
| | | | | | - Naoko Nakasa
- Health Support Center, Matsue Memorial Hospital, Japan
| | - Yuko Haruki
- Health Support Center, Matsue Memorial Hospital, Japan
| | - Koji Hasegawa
- Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
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15
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AlAbdullah H, AlFahid AS, AlQarni A, Nazir MA. Impact of Oral Health Educational Intervention on Smoking among Male Adolescents. Contemp Clin Dent 2019; 10:502-506. [PMID: 32308328 PMCID: PMC7150572 DOI: 10.4103/ccd.ccd_863_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the impact of oral health educational intervention on smoking among male Saudi adolescents. METHODS This study included participants from male public high schools (10-12-grade students) in Dammam, Dhahran, and Al Khobar, Saudi Arabia, between March 2018 and May 2018. Multistage random sampling was used to recruit the students. The participants received two sessions of oral health educational intervention, which was based on educating the adverse effects of smoking on oral health. A pilot-tested questionnaire was used to collect preintervention and postintervention data. McNemar's test was performed for statistical analysis. RESULTS There were 432 participants in the study with a mean age of 10.18 ± 8.44 years. The prevalence of smoking was 31.7% in the preintervention stage. Over half the participants (60.6%) had family history of smoking. There was no reduction in smoking prevalence after the educational intervention. A significant improvement in the awareness about the effects of smoking on oral health was observed after the intervention (P < 0.05). The proportion of smokers willing to quit smoking significantly increased from 34.3% in the preintervention stage to 55.5% in postintervention stage (P = 0.021). Similarly, the percentage of smokers willing to join smoking cessation program increased after the intervention. CONCLUSION There was a significant improvement in the awareness about the effects of smoking on oral health. The study found significantly higher percentage of adolescents willing to quit smoking after oral health educational interventions. The smoking cessation campaigns should include the education of adverse effects of smoking on oral health.
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Affiliation(s)
- Hassan AlAbdullah
- Dental Interns, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali Sadeq AlFahid
- Dental Interns, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulaziz AlQarni
- Dental Interns, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Muhammad Ashraf Nazir
- Department of Preventive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,Address for correspondence: Dr. Muhammad Ashraf Nazir, Department of Preventive Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, P. O. Box 1982, Dammam 31441, Saudi Arabia. E-mail:
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16
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Hors-Fraile S, Malwade S, Spachos D, Fernandez-Luque L, Su CT, Jeng WL, Syed-Abdul S, Bamidis P, Li YCJ. A recommender system to quit smoking with mobile motivational messages: study protocol for a randomized controlled trial. Trials 2018; 19:618. [PMID: 30413176 PMCID: PMC6230227 DOI: 10.1186/s13063-018-3000-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 10/17/2018] [Indexed: 12/27/2022] Open
Abstract
Background Smoking cessation is the most common preventative for an array of diseases, including lung cancer and chronic obstructive pulmonary disease. Although there are many efforts advocating for smoking cessation, smoking is still highly prevalent. For instance, in the USA in 2015, 50% of all smokers attempted to quit smoking, and only 5–7% of them succeeded – with slight deviation depending on external assistance. Previous studies show that computer-tailored messages which support smoking abstinence are effective. The combination of health recommender systems and behavioral-change theories is becoming increasingly popular in computer-tailoring. The objective of this study is to evaluate patients’s smoking cessation rates by means of two randomized controlled trials using computer-tailored motivational messages. A group of 100 patients will be recruited in medical centers in Taiwan (50 patients in the intervention group, and 50 patients in the control group), and a group of 1000 patients will be recruited on-line (500 patients in the intervention group, and 500 patients in the control group). The collected data will be made available to the public in an open-source data portal. Methods Our study will gather data from two sources. The first source is a clinical pilot in which a group of patients from two Taiwanese medical centers will be randomly assigned to either an intervention or a control group. The intervention group will be provided with a mobile app that sends motivational messages selected by a recommender system that takes the user profile (including gender, age, motivations, and social context) and similar users’ opinions. For 6 months, the patients’ smoking activity will be followed up, and confirmed as “smoke-free” by using a test that measures expired carbon monoxide and urinary cotinine levels. The second source will be a public pilot in which Internet users wanting to quit smoking will be able to download the same mobile app as used in the clinical pilot. They will be randomly assigned to a control group that receives basic motivational messages or to an intervention group, that receives personalized messages by the recommender system. For 6 months, patients in the public pilot will be assessed periodically with self-reported questionnaires. Discussion This study will be the first to use the I-Change behavioral-change model in combination with a health recommender system and will, therefore, provide relevant insights into computer-tailoring for smoking cessation. If our hypothesis is validated, clinical practice for smoking cessation would benefit from the use of our mobile solution. Trial registration ClinicalTrials.gov, ID: NCT03108651. Registered on 11 April 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3000-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Santiago Hors-Fraile
- Universidad de Sevilla, Seville, Spain.,Maastricht University, Maastricht, The Netherlands
| | - Shwetambara Malwade
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan
| | | | | | - Chien-Tien Su
- School of Public Health, Taipei Medical University, Taipei, Taiwan
| | | | - Shabbir Syed-Abdul
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan. .,Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
| | | | - Yu-Chuan Jack Li
- International Center for Health Information Technology (ICHIT), Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.,TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei, Taiwan
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17
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McClure EA, Tomko RL, Carpenter MJ, Treiber FA, Gray KM. Acceptability and compliance with a remote monitoring system to track smoking and abstinence among young smokers. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 44:561-570. [PMID: 29737885 PMCID: PMC6059983 DOI: 10.1080/00952990.2018.1467431] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/11/2017] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Similar to adult smokers, quit attempts among younger smokers almost inevitably result in relapse. Unlike adults, less is known about the process of relapse in this younger age group. A technology-based remote monitoring system may allow for detailed and accurate characterization of smoking and abstinence and would help to improve cessation strategies. OBJECTIVES This study describes a mobile system that captures smoking using breath carbon monoxide (CO) and real-time self-reports of smoking behavior. Compliance, feasibility, acceptability, and accuracy of the system were measured during a quit attempt and subsequent monitoring period. METHODS The mobile application (My Mobile Monitor, M3) combined breath CO with ecological momentary assessment, delivered via smartphone. Participants (N = 16; 75% female) were daily smokers between the ages of 19 and 25, who used the app for 11 days during which they agreed to make a quit attempt. Acceptability, compliance, and abstinence were measured. RESULTS Participants averaged 22.3 ± 2.0 years old and smoked an average of 13.0 ± 6.1 cigarettes per day. Overall session compliance was 69% and during the quit attempt, 56% of participants abstained from smoking for at least 24 hours. Agreement between self-reported smoking compared to breath CO was generally high, when available for comparison, though underreporting of cigarettes was likely. CONCLUSION This study demonstrates feasibility of a remote monitoring app with younger smokers, though improvements to promote compliance are needed. Remote monitoring to detect smoking and abstinence represents a step forward in the improvement of cessation strategies, but user experience and personalization are vital.
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Affiliation(s)
- Erin A. McClure
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Rachel L. Tomko
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Matthew J. Carpenter
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Frank A. Treiber
- College of Medicine, Medical University of South Carolina, Charleston, SC, USA
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M. Gray
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
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18
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Braverman Bronstein A, Lomelín Gascón J, Eugenio González CI, Barrientos-Gutierrez T. Environmental Tobacco Exposure and Urinary Cotinine Levels in Smoking and Nonsmoking Adolescents. Nicotine Tob Res 2018; 20:523-526. [PMID: 28582526 DOI: 10.1093/ntr/ntx124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 05/30/2017] [Indexed: 11/14/2022]
Abstract
Objective We aimed to evaluate the association between environmental tobacco smoke (ETS) exposure and urinary cotinine levels in current adolescent smokers and nonsmokers. The secondary objective was to explore the association between ETS exposure and nicotine dependence in adolescent smokers. Methods Using the results from a validation study for the 2012 Global Youth Tobacco Survey in Mexico, we quantified urinary cotinine levels in adolescent smokers and nonsmokers. We fitted a multivariate regression model to assess the association between household exposure to ETS and cotinine levels in adolescent smokers and nonsmokers. In addition, using the questionnaire's answers for morning cravings, we fitted a multivariate Poisson regression model to explore the association between household ETS exposure and nicotine dependence in adolescent smokers. Results For each day of household ETS exposure, cotinine levels increase by 5% in adolescent smokers compared to a 2% increase in nonsmokers, adjusting for the number of cigarettes smoked per week, age and sex (exp(β) 1.05; 95% confidence interval [CI] [1.00, 1.10]; p = .041). Morning cravings increase 11% for each day of household ETS exposure adjusting for the number of cigarettes smoked per week, age and sex (prevalence ratio [PR] 1.11; 95% CI [0.99, 1.25]; p = .064). Conclusions There is an association between ETS exposure and cotinine levels, and ETS may contribute to nicotine dependence in adolescent smokers. If confirmed, avoiding ETS exposure could prove helpful for addiction control and quitting in adolescents. Implications Evidence suggests that ETS increases cotinine levels in nonsmokers and adult smokers. However, no study has explored the association between ETS exposure and cotinine levels and addiction in adolescent smokers. This paper provides evidence of an association between ETS exposure and cotinine levels in adolescent smokers: each day of environmental tobacco smoke exposure at home increased cotinine levels by 5% among smokers. In addition, morning cravings in adolescent smokers increased 11% for every day of ETS exposure. ETS exposure is a significant source of nicotine for adolescent smokers and could play an important role in addiction.
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Affiliation(s)
- Ariela Braverman Bronstein
- National Institute of Public Health, Center for Population Health Research, Departament of Reproductive Health, Cuernavaca, Mexico
| | - Julieta Lomelín Gascón
- National Institute of Public Health, Center for Population Health Research, Departament of Reproductive Health, Cuernavaca, Mexico.,School of Public Health, Boston University, Boston, MA
| | | | - Tonatiuh Barrientos-Gutierrez
- National Institute of Public Health, Center for Population Health Research, Departament of Reproductive Health, Cuernavaca, Mexico
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19
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Fanshawe TR, Halliwell W, Lindson N, Aveyard P, Livingstone‐Banks J, Hartmann‐Boyce J. Tobacco cessation interventions for young people. Cochrane Database Syst Rev 2017; 11:CD003289. [PMID: 29148565 PMCID: PMC6486118 DOI: 10.1002/14651858.cd003289.pub6] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Most tobacco control programmes for adolescents are based around prevention of uptake, but teenage smoking is still common. It is unclear if interventions that are effective for adults can also help adolescents to quit. This is the update of a Cochrane Review first published in 2006. OBJECTIVES To evaluate the effectiveness of strategies that help young people to stop smoking tobacco. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group's Specialized Register in June 2017. This includes reports for trials identified in CENTRAL, MEDLINE, Embase and PsyclNFO. SELECTION CRITERIA We included individually and cluster-randomized controlled trials recruiting young people, aged under 20 years, who were regular tobacco smokers. We included any interventions for smoking cessation; these could include pharmacotherapy, psycho-social interventions and complex programmes targeting families, schools or communities. We excluded programmes primarily aimed at prevention of uptake. The primary outcome was smoking status after at least six months' follow-up among those who smoked at baseline. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of candidate trials and extracted data. We evaluated included studies for risk of bias using standard Cochrane methodology and grouped them by intervention type and by the theoretical basis of the intervention. Where meta-analysis was appropriate, we estimated pooled risk ratios using a Mantel-Haenszel fixed-effect method, based on the quit rates at six months' follow-up. MAIN RESULTS Forty-one trials involving more than 13,000 young people met our inclusion criteria (26 individually randomized controlled trials and 15 cluster-randomized trials). We judged the majority of studies to be at high or unclear risk of bias in at least one domain. Interventions were varied, with the majority adopting forms of individual or group counselling, with or without additional self-help materials to form complex interventions. Eight studies used primarily computer or messaging interventions, and four small studies used pharmacological interventions (nicotine patch or gum, or bupropion). There was evidence of an intervention effect for group counselling (9 studies, risk ratio (RR) 1.35, 95% confidence interval (CI) 1.03 to 1.77), but not for individual counselling (7 studies, RR 1.07, 95% CI 0.83 to 1.39), mixed delivery methods (8 studies, RR 1.26, 95% CI 0.95 to 1.66) or the computer or messaging interventions (pooled RRs between 0.79 and 1.18, 9 studies in total). There was no clear evidence for the effectiveness of pharmacological interventions, although confidence intervals were wide (nicotine replacement therapy 3 studies, RR 1.11, 95% CI 0.48 to 2.58; bupropion 1 study RR 1.49, 95% CI 0.55 to 4.02). No subgroup precluded the possibility of a clinically important effect. Studies of pharmacotherapies reported some adverse events considered related to study treatment, though most were mild, whereas no adverse events were reported in studies of behavioural interventions. Our certainty in the findings for all comparisons is low or very low, mainly because of the clinical heterogeneity of the interventions, imprecision in the effect size estimates, and issues with risk of bias. AUTHORS' CONCLUSIONS There is limited evidence that either behavioural support or smoking cessation medication increases the proportion of young people that stop smoking in the long-term. Findings are most promising for group-based behavioural interventions, but evidence remains limited for all intervention types. There continues to be a need for well-designed, adequately powered, randomized controlled trials of interventions for this population of smokers.
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Affiliation(s)
- Thomas R Fanshawe
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - William Halliwell
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - Nicola Lindson
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
| | - Paul Aveyard
- University of OxfordNuffield Department of Primary Care Health SciencesOxfordUK
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20
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Sanders A, Robinson C, Taylor SC, Post SD, Goldfarb J, Shi R, Hunt YM, Augustson EM. Using a Media Campaign to Increase Engagement With a Mobile-Based Youth Smoking Cessation Program. Am J Health Promot 2017; 32:1273-1279. [PMID: 28925292 DOI: 10.1177/0890117117728608] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To describe the impact of the National Cancer Institute's promotion of its youth smoking cessation program, Smokefree Teen (SFT). DESIGN We provide a description of campaign strategies and outcomes as a means to engage a teen audience in cessation resources using a cost-effective approach. SETTING The campaign occurred nationally, using traditional (TV and radio), online, and social media outreach. PARTICIPANTS Ads targeted adolescent smokers (aged 14-17). The baseline population was 42 586 and increased to 464 357 during the campaign. MEASURES Metrics used to assess outcomes include (1) visits to SFT website from traditional and online ads, (2) cost to get an online ad clicked (cost-per-click), and (3) SmokefreeTXT program enrollments during the 8-week campaign period. ANALYSIS We conducted a quantitative performance review of all tactics. RESULTS The SFT campaign achieved an online ad click-through rate of 0.33%, exceeding industry averages of 0.15%. Overall, web traffic to teen.smokefree.gov increased by 980%, and the online cost-per-click for ads, including social media actions, was approximately $1 as compared with $107 for traditional ads. Additionally, the campaign increased the SmokefreeTXT program teen sign-ups by 1334%. CONCLUSION The campaign increased engagement with evidence-informed cessation resources for teen smokers. Results show the potential of using multiple, online channels to help increase engagement with core resources.
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Affiliation(s)
- Amy Sanders
- 1 Digital Strategy Group, ICF International, Fairfax, VA, USA
| | - Cendrine Robinson
- 2 Tobacco Control Research Branch, The National Cancer Institute, Rockville, MD, USA
| | - Shani C Taylor
- 1 Digital Strategy Group, ICF International, Fairfax, VA, USA
| | | | | | - Rui Shi
- 3 Tobacco Center of Regulatory Science, University of Maryland School of Public Health, College Park, MD, USA
| | - Yvonne M Hunt
- 2 Tobacco Control Research Branch, The National Cancer Institute, Rockville, MD, USA
| | - Erik M Augustson
- 2 Tobacco Control Research Branch, The National Cancer Institute, Rockville, MD, USA
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21
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Burris JL, Riley E, Puleo GE, Smith GT. A longitudinal study of the reciprocal relationship between ever smoking and urgency in early adolescence. Drug Alcohol Depend 2017; 178:519-526. [PMID: 28719886 PMCID: PMC5555077 DOI: 10.1016/j.drugalcdep.2017.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/18/2017] [Accepted: 06/03/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Among early adolescents in the United States (U.S.), the prevalence of cigarette smoking is at its lowest level in recent decades. Nonetheless, given the risks of smoking in early development, it remains critically important to study both risk factors for smoking and risks from smoking. This longitudinal study with U.S. early adolescents examines smoking initiation and tests a model of reciprocal prediction between ever smoking and the personality trait of urgency (i.e., mood-based impulsivity), a trait that increases risk for multiple forms of dysfunction. METHODS Participants (n=1906; 90% 10-11 years old, 50% female, 39% racial minorities at baseline) completed questionnaires 1-2 times per year starting in 5th grade and ending in 9th grade. Structural equation modeling allowed tests of bidirectional relationships between ever smoking and urgency controlling for pubertal status and negative affect at each wave. RESULTS Incidence of ever smoking increased from 5% to 27% over time, with current smoking around 5% at the last wave. Urgency at each wave predicted ever smoking at the next wave above and beyond covariates and prior smoking (all p<0.01). Likewise, with one exception, ever smoking predicted an increase in urgency at the subsequent wave above and beyond covariates and prior urgency (all p<0.05). CONCLUSION Results show that risk for smoking increases with higher levels of urgency and urgency increases secondary to engagement in smoking. Future work should therefore explore urgency as a point of prevention for smoking and smoking cessation as a means to mitigate mood-based impulsivity.
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Affiliation(s)
- Jessica L. Burris
- Department of Psychology and Markey Cancer Center, University of Kentucky, Lexington, KY, USA, University of Kentucky, 206 Combs Cancer Research Building, Lexington, KY 40536-0096, USA;
| | - Elizabeth Riley
- Department of Psychology, University of Kentucky, 171 Funkhouser Dr., Lexington, KY 40506-0044, USA.
| | - Gabriella E. Puleo
- Department of Psychology, University of Kentucky, Lexington, KY, USA, University of Kentucky, 171 Funkhouser Dr., Lexington, KY 40506-0044, USA;
| | - Gregory T. Smith
- Department of Psychology, University of Kentucky, Lexington, KY, USA, University of Kentucky, 105 Kastle Hall, Lexington, KY 40506-0044, USA;
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Attitudes and interest in technology-based treatment and the remote monitoring of smoking among adolescents and emerging adults. J Smok Cessat 2017; 12:88-98. [PMID: 28580019 DOI: 10.1017/jsc.2015.15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Despite the public health relevance of smoking in adolescents and emerging adults, this group remains understudied and underserved. High technology utilization among this group may be harnessed as a tool for better understanding of smoking, yet little is known regarding the acceptability of mobile health (mHealth) integration. METHODS Participants (ages 14-21) enrolled in a smoking cessation clinical trial provided feedback on their technology utilization, perceptions, and attitudes; and interest in remote monitoring for smoking. Characteristics that predicted greater technology acceptability for smoking treatment were also explored. RESULTS Participants (N=87) averaged 19 years old and were mostly male (67%). Technology utilization was high for smart phone ownership (93%), Internet use (98%), and social media use (94%). Despite this, only one-third of participants had ever searched the Internet for cessation tips or counseling (33%). Participants showed interest in mHealth-enabled treatment (48%) and felt that it could be somewhat helpful (83%). Heavier smokers had more favorable attitudes toward technology-based treatment, as did those with smartphones and unlimited data. CONCLUSIONS Our results demonstrate high technology utilization, favorable attitudes towards technology, and minimal concerns. Technology integration among this population should be pursued, though in a tailored fashion, to accomplish the goal of providing maximally effective, just-in-time interventions.
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Affiliation(s)
- Grace Kong
- Yale School of Medicine, New Haven CT, USA.
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Khattab AM, AbdelFattah EB, Abozahra AKEA. Study of smoking habit among soldiers in Cairo Security Forces Hospital. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2017. [DOI: 10.1016/j.ejcdt.2016.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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DiFranza JR. Can tobacco dependence provide insights into other drug addictions? BMC Psychiatry 2016; 16:365. [PMID: 27784294 PMCID: PMC5081932 DOI: 10.1186/s12888-016-1074-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/17/2016] [Indexed: 11/10/2022] Open
Abstract
Within the field of addiction research, individuals tend to operate within silos of knowledge focused on specific drug classes. The discovery that tobacco dependence develops in a progression of stages and that the latency to the onset of withdrawal symptoms after the last use of tobacco changes over time have provided insights into how tobacco dependence develops that might be applied to the study of other drugs.As physical dependence on tobacco develops, it progresses through previously unrecognized clinical stages of wanting, craving and needing. The latency to withdrawal is a measure of the asymptomatic phase of withdrawal, extending from the last use of tobacco to the emergence of withdrawal symptoms. Symptomatic withdrawal is characterized by a wanting phase, a craving phase, and a needing phase. The intensity of the desire to smoke that is triggered by withdrawal correlates with brain activity in addiction circuits. With repeated tobacco use, the latency to withdrawal shrinks from as long as several weeks to as short as several minutes. The shortening of the asymptomatic phase of withdrawal drives an escalation of smoking, first in terms of the number of smoking days/month until daily smoking commences, then in terms of cigarettes smoked/day.The discoveries of the stages of physical dependence and the latency to withdrawal raises the question, does physical dependence develop in stages with other drugs? Is the latency to withdrawal for other substances measured in weeks at the onset of dependence? Does it shorten over time? The research methods that uncovered how tobacco dependence emerges might be fruitfully applied to the investigation of other addictions.
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Affiliation(s)
- Joseph R. DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
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Heffner JL, Kealey KA, Marek PM, Bricker JB, Ludman EJ, Peterson AV. Proactive telephone counseling for adolescent smokers: Comparing regular smokers with infrequent and occasional smokers on treatment receptivity, engagement, and outcomes. Drug Alcohol Depend 2016; 165:229-35. [PMID: 27344195 PMCID: PMC4948586 DOI: 10.1016/j.drugalcdep.2016.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/31/2016] [Accepted: 06/15/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Adolescent smoking cessation efforts to date have tended to focus on regular smokers. Consequently, infrequent and occasional smokers' receptivity and response to smoking cessation interventions is unknown. To address this gap, this study examines data from the Hutchinson Study of High School Smoking-a randomized trial that examined the effectiveness of a telephone-delivered smoking cessation intervention for a large, population-based cohort of adolescent smokers proactively recruited in an educational setting. METHODS The study population included 1837 proactively identified high school smokers. Intervention receptivity, engagement, and outcomes were examined among adolescent infrequent (1-4days/month) and occasional (5-19days/month) smokers and compared with regular smokers (20 or more days/month). RESULTS With regard to treatment receptivity, intervention recruitment did not differ by smoking frequency. For engagement, intervention completion rates were higher for infrequent smokers (80.5%) compared with occasional (63.8%) and regular smokers (61.5%, p<0.01). Intervention effect sizes were not statistically different across groups. CONCLUSIONS Adolescent infrequent and occasional smokers are at least as receptive to a proactively delivered smoking cessation intervention as regular smokers and can benefit just as much from it. Including these adolescent smokers in cessation programs and research-with the goal of interrupting progression of smoking before young adulthood-should help reduce the high smoking prevalence among young adults.
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Affiliation(s)
- Jaimee L Heffner
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States.
| | - Kathleen A Kealey
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Patrick M Marek
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States; Department of Psychology, University of Washington, Seattle, WA, United States
| | | | - Arthur V Peterson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, United States; Department of Biostatistics, University of Washington, Seattle, WA, United States
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Mohamed A, Shaker A, Ragab M, Ghoneim A. Study of pharmacotherapy role in smoking cessation giving an insight into the frequency of smoking among Zagazig University Hospitals’ staff in 2013. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2016. [DOI: 10.1016/j.ejcdt.2016.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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O'Loughlin JL, Sylvestre MP, Dugas EN, Karp I. Predictors of the occurrence of smoking discontinuation in novice adolescent smokers. Cancer Epidemiol Biomarkers Prev 2016; 23:1090-101. [PMID: 24895443 DOI: 10.1158/1055-9965.epi-13-0869] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND While long-term cessation is an outcome of interest in adult smokers, little is known about discontinuing smoking in adolescent smokers. The objective was to identify the predictors of the occurrence of smoking discontinuation in novice smokers. METHODS Data were available for 620 adolescent smokers participating in a longitudinal study on the natural course of nicotine dependence. Data on smoking discontinuation (i.e., stopping smoking for ≥12 consecutive months) were collected in 20 cycles over five years from grade 7 to 11 (1999-2005). Data on 37 potential predictors representing a wide range of demographic, psychosocial, health, lifestyle, smoking-related, and context-related characteristics were collected once, 2 to 3 times, or 20 times. Pooled logistic regression was used to test the association between each potential predictor and smoking discontinuation, adjusting for potential confounders. RESULTS Forty percent of 620 participants discontinued smoking during follow up. Male sex [OR (95% confidence interval), 1.8 (1.3-2.4)], age [1.3 (1.1-1.5)], cigarette package warnings [0.6 (0.5-0.9)], team sports participation [1.4 (1.1-1.9)], family stress [0.7 (0.6-1.0)], worrying about weight [0.6 (0.5-0.9)], overweight [0.7 (0.5-1.0)], illicit drugs use [0.5 (0.4-0.7)], tolerance [0.6 (0.4-1.0)], and other nicotine dependence symptoms [1.0 (0.9-1.0)] were statistically significantly associated with smoking discontinuation. CONCLUSIONS Both individual and context-level factors were associated with smoking discontinuation. IMPACT Programs and policy targeting novice adolescent smokers may be more effective if factors associated with long-term smoking discontinuation are taken into consideration. In particular, young smokers may need help with dependence symptoms, body weight issues, family functioning, and polysubstance use. Cigarette package warnings may be effective in helping adolescents discontinue smoking. Cancer Epidemiol Biomarkers Prev; 23(6); 1090-101. ©2014 AACR.
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Affiliation(s)
- Jennifer L O'Loughlin
- Authors' Affiliations: Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montréal, and Institut national de santé publique du Québec, Montreal, Quebec, CanadaAuthors' Affiliations: Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montréal, and Institut national de santé publique du Québec, Montreal, Quebec, CanadaAuthors' Affiliations: Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montréal, and Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Marie-Pierre Sylvestre
- Authors' Affiliations: Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montréal, and Institut national de santé publique du Québec, Montreal, Quebec, CanadaAuthors' Affiliations: Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montréal, and Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Erika N Dugas
- Authors' Affiliations: Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montréal, and Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Igor Karp
- Authors' Affiliations: Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montréal, and Institut national de santé publique du Québec, Montreal, Quebec, CanadaAuthors' Affiliations: Centre de recherche CHUM, Department of Social and Preventive Medicine, University of Montréal, and Institut national de santé publique du Québec, Montreal, Quebec, Canada
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Yurasek AM, Robinson LA, Parra G. Ethnic and Gender differences in Strategies Used by Adolescents when Attempting to Quit or Reduce Smoking. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2016; 25:252-259. [PMID: 27917033 PMCID: PMC5127445 DOI: 10.1080/1067828x.2015.1014613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Few adolescent smoking cessation programs have been able to match the success rate found in adult programs. The current study identified smoking cessation strategies used by adolescents and whether strategies differed as a function of ethnic, gender, or individual smoking-level. Participants were 136 high school students who made an attempt to quit or reduce their smoking. Logistic regressions revealed that individuals making an actual quit attempt and African American adolescents used cessation strategies presumed to be more effective. Adolescents are more likely to use informal cessation methods and may need to be provided with more information on effective quit strategies.
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Affiliation(s)
- Ali M. Yurasek
- University of Memphis
- Center for Alcohol and Addiction Studies
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Are you in or out? Recruitment of adolescent smokers into a behavioral smoking cessation intervention. Addict Behav 2015; 45:150-5. [PMID: 25678303 PMCID: PMC4373965 DOI: 10.1016/j.addbeh.2015.01.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 01/17/2015] [Accepted: 01/21/2015] [Indexed: 02/04/2023]
Abstract
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.
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Pbert L, Farber H, Horn K, Lando HA, Muramoto M, O'Loughlin J, Tanski S, Wellman RJ, Winickoff JP, Klein JD. State-of-the-art office-based interventions to eliminate youth tobacco use: the past decade. Pediatrics 2015; 135:734-47. [PMID: 25780075 DOI: 10.1542/peds.2014-2037] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2015] [Indexed: 11/24/2022] Open
Abstract
Tobacco use and tobacco smoke exposure are among the most important preventable causes of premature disease, disability, and death and therefore constitute a major pediatric health concern. The pediatric primary care setting offers excellent opportunities to prevent tobacco use in youth and to deliver cessation-related treatment to youth and parents who use tobacco. This report updates a "state-of-the-art" article published a decade ago on office-based interventions to address these issues. Since then there has been marked progress in understanding the nature, onset, and trajectories of tobacco use and nicotine addiction in youth with implications for clinical practice. In addition, clinicians need to remain abreast of emerging nicotine delivery systems, such as electronic cigarettes, that may influence uptake or continuation of smoking. Although evidence-based practice guidelines for treating nicotine addiction in youth are not yet available, research continues to build the evidence base toward that goal. In the interim, practical guidelines are available to assist clinicians in addressing nicotine addiction in the pediatric clinical setting. This article reports current practices in addressing tobacco in pediatric primary care settings. It reviews our increasing understanding of youth nicotine addiction, summarizes research efforts on intervention in the past decade and additional research needed going forward, and provides practical guidelines for pediatric health care providers to integrate tobacco use prevention and treatment into their clinical practice. Pediatric providers can and should play an important role in addressing tobacco use and dependence, both in the youth they care for and in parents who use tobacco.
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Affiliation(s)
| | - Harold Farber
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas
| | - Kimberly Horn
- Department of Prevention and Community Health, The George Washington University, Washington, District of Columbia
| | - Harry A Lando
- Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota
| | - Myra Muramoto
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, Arizona
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Susanne Tanski
- Department of Pediatrics, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire
| | - Robert J Wellman
- Department of Family Medicine and Community Health University of Massachusetts Medical School, Worcester, Massachusetts
| | | | - Jonathan D Klein
- Julius B. Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, Illinois
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Abstract
INTRODUCTION The age of starting the habit of smoking, one of the top causes of many illnesses, is usually in the period of adolescence. This study was conducted to determine students' smoking status and to explore their desire to quit and their experiences during the cessation process. METHODS This descriptive study was performed with 934 adolescents between the ages of 14 and 20 years at a vocational high school located in Istanbul, Turkey. The data were collected by using a survey form. RESULTS The mean age of the adolescents was 16.38 ± 1.12 years. Among the adolescents, 90.3% were male. Of the group, 29.9% reported that they had smoked at least once, and 12.1% of the participants smoked regularly. Among the students who smoked, 80% reported that they wanted to quit smoking. Among the smokers, 55.2% reported that they tried to quit smoking but could only stop smoking for a period of between 1 day and 1 month at maximum (71.4%). A group of 68.9% reported that they wanted to quit because they were afraid of getting sick in the future, 28.8% indicated economic reasons to quit smoking, and 24.2% reported that they wanted to stop smoking because they did not want to damage the environment. CONCLUSION More than half of the smokers among the students had tried to stop smoking, but most of them had failed to quit. These results indicate that schools need programs for the cessation and the prevention of smoking.
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Roberts ME, Bidwell LC, Colby SM, Gwaltney CJ. With others or alone? Adolescent individual differences in the context of smoking lapses. Health Psychol 2015; 34:1066-75. [PMID: 25664557 DOI: 10.1037/hea0000211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Although a great deal of adolescent smoking research has investigated predictors of initiation, much less has focused on predictors of lapsing during a quit attempt. In particular, the role of social context may deserve greater attention in models of adolescent smoking cessation. Therefore, the present investigation aimed to use ecological momentary assessment (EMA) to examine individual differences in social lapsing--the extent to which lapses occur around others versus when alone. METHODS Analyses focused on 179 adolescent smokers (aged 14-18 years) engaged in an unassisted quit attempt. There were 2 general EMA assessment intervals: prequit (1 week) and postquit (2 weeks). Participants reported every time that they smoked a cigarette and at random, nonsmoking times; in each assessment, participants responded to questions about their current environment, behaviors, and psychological state. A 3-month follow-up assessed longer-term smoking-related outcomes. RESULTS Consistent with other adolescent research, the overall rate of lapsing was very high (93%). Social lapsing rates were likewise high (among those who lapsed, 73% reported their first lapse was social), but they also varied continuously across individuals. We computed a social lapsing coefficient for each youth and found that it related to smoking factors at baseline (e.g., lower smoking intensity and dependence) and follow-up (e.g., lower cotinine levels). CONCLUSIONS These results suggest that higher rates of social lapsing are associated with being a lighter, less dependent smoker and having better eventual cessation prospects. Findings provide evidence that accounting for variability in social lapsing may improve theory and treatment.
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Camenga DR, Cavallo DA, Kong G, Morean ME, Connell CM, Simon P, Bulmer SM, Krishnan-Sarin S. Adolescents' and Young Adults' Perceptions of Electronic Cigarettes for Smoking Cessation: A Focus Group Study. Nicotine Tob Res 2015; 17:1235-41. [PMID: 25646346 DOI: 10.1093/ntr/ntv020] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 01/17/2015] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Research has shown that adults perceive that electronic cigarettes (e-cigarettes) are effective for smoking cessation, yet little is known about adolescents and young adults' perceptions of e-cigarettes for quitting cigarette smoking. This study describes middle, high school, and college students' beliefs about, and experiences with, e-cigarettes for cigarette smoking cessation. METHODS We conducted 18 focus groups (n = 127) with male and female cigarette smokers and nonsmokers in 2 public colleges, 2 high schools, and 1 middle school in Connecticut between November 2012 and April 2013. Participants discussed cigarette smoking cessation in relation to e-cigarettes. Verbatim transcripts were analyzed using thematic analysis. RESULTS All participants, regardless of age and smoking status, were aware that e-cigarettes could be used for smoking cessation. College and high school participants described different methods of how e-cigarettes could be used for smoking cessation: (a) nicotine reduction followed by cessation; (b) cigarette reduction/dual use; and (c) long-term exclusive e-cigarette use. However, overall, participants did not perceive that e-cigarette use led to successful quitting experiences. Participants described positive attributes (maintenance of smoking actions, "healthier" alternative to cigarettes, and parental approval) and negative attributes (persistence of craving, maintenance of addiction) of e-cigarettes for cessation. Some college students expressed distrust of marketing of e-cigarettes for smoking cessation. CONCLUSIONS Adolescent and young adult smokers and nonsmokers perceive that there are several methods of using e-cigarettes for quitting and are aware of both positive and negative aspects of the product. Future research is needed to determine the role of e-cigarettes for smoking cessation in this population.
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Affiliation(s)
- Deepa R Camenga
- Department of Pediatrics, Yale School of Medicine, New Haven, CT
| | - Dana A Cavallo
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Grace Kong
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Meghan E Morean
- Department of Psychiatry, Yale School of Medicine, New Haven, CT; Department of Psychology, Oberlin College, Oberlin, OH
| | | | - Patricia Simon
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | - Sandra M Bulmer
- Department of Public Health, Southern Connecticut State University, New Haven, CT
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Bowes L, Chollet A, Fombonne E, Melchior M. Psychological, social and familial factors associated with tobacco cessation among young adults. Eur Addict Res 2015; 21:153-159. [PMID: 25832118 DOI: 10.1159/000367691] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 08/18/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The younger individuals quit smoking, the greater the health benefits. We studied the role of adolescent and concurrent psychological, social and familial factors in successful tobacco cessation in a general population sample of French young adults. METHODS Our data came from participants of the TEMPO cohort study and their parents (members of the GAZEL cohort study) in France. Among regular smokers (n = 678), Cox proportional hazards models were used to estimate hazard ratios of self-reported tobacco cessation of at least 12 months in relation to individual and socioenvironmental variables. RESULTS On average, participants (mean: 28.9 years) smoked for 10.51 years (SD = 5.9); the majority had attempted to quit smoking at least once (59.5%). In multiple regression analyses, cannabis use in the preceding year and recent financial difficulties were both negatively associated with successful smoking cessation. Conversely, living with a partner and, for women only, recent pregnancy or childbirth were associated with an increased likelihood of tobacco cessation. CONCLUSIONS This study highlights the importance of young adults' cannabis use, family situation and socioeconomic context with regard to their smoking behavior. Physicians and public health decision makers aiming to decrease the burden of tobacco smoking should take into consideration these social and behavioral factors.
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Hoeppner BB, Kahler CW, Gwaltney CJ. Relationship between momentary affect states and self-efficacy in adolescent smokers. Health Psychol 2014; 33:1507-17. [PMID: 25020151 PMCID: PMC4250296 DOI: 10.1037/hea0000075] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Relapse to smoking after making a quit attempt is both common and rapid in adolescent smokers. Momentary self-efficacy (SE)-that is, momentary shifts in one's confidence in the ability to abstain from smoking-predicts the occurrence and timing of relapse among adolescent smokers. Therefore, it is important to identify factors that are associated with changes in momentary SE early in a quit attempt. This study examined the relationship between affect states (including positive, negative, and nicotine withdrawal states) and momentary SE at various stages of a quit attempt. METHOD Adolescent daily smokers interested in making a quit attempt (n = 202) completed ecological momentary assessments (EMA) each day for 1 week leading up to and 2 weeks after a quit attempt. In each assessment, they reported current SE and affect state. RESULTS RESULTS of linear mixed models indicated that most of the examined affect states were related to momentary SE. Contrary to expectation, they were related to momentary SE both immediately before and after the quit attempt. Moderation effects were observed for select affect states, where higher baseline SE was related to lower momentary SE in the presence of increasing negative high activation, boredom, and difficulty concentrating. CONCLUSIONS Our findings suggest that both positive and negative affect states are related to SE, and that thereby positive affect enhancement may be a promising, underutilized treatment target.
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Affiliation(s)
- Bettina B. Hoeppner
- Center for Addiction Medicine, Massachusetts General Hospital, Harvard Medical School, Boston MA 02114, USA
| | - Christopher W. Kahler
- Department of Behavioral and Social Sciences and the Center for Alcohol and Addiction Studies, Box GS121-4, Brown School of Public Health, Providence, RI 02912, USA
| | - Chad J. Gwaltney
- Department of Behavioral and Social Sciences and the Center for Alcohol and Addiction Studies, Box GS121-4, Brown School of Public Health, Providence, RI 02912, USA
- ERT, Inc., Philadelphia, PA, 19103
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Lydon DM, Wilson SJ, Child A, Geier CF. Adolescent brain maturation and smoking: what we know and where we're headed. Neurosci Biobehav Rev 2014; 45:323-42. [PMID: 25025658 PMCID: PMC4451244 DOI: 10.1016/j.neubiorev.2014.07.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 05/30/2014] [Accepted: 07/03/2014] [Indexed: 11/22/2022]
Abstract
Smoking is a leading cause of mortality and morbidity worldwide. Smoking initiation often occurs during adolescence. This paper reviews and synthesizes adolescent development and nicotine dependence literatures to provide an account of adolescent smoking from onset to compulsive use. We extend neurobiological models of adolescent risk-taking, that focus on the interplay between incentive processing and cognitive control brain systems, through incorporating psychosocial and contextual factors specific to smoking, to suggest that adolescents are more vulnerable than adults to cigarette use generally, but that individual differences exist placing some adolescents at increased risk for smoking. Upon smoking, adolescents are more likely to continue smoking due to the increased positive effects induced by nicotine during this period. Continued use during adolescence, may be best understood as reflecting drug-related changes to neural systems underlying incentive processing and cognitive control, resulting in decision-making that is biased towards continued smoking. Persistent changes following nicotine exposure that may underlie continued dependence are described. We highlight ways that interventions may benefit from a consideration of cognitive-neuroscience findings.
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Affiliation(s)
- David M Lydon
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, 315 Health and Human Development - East, University Park, PA 16802, United States.
| | - Stephen J Wilson
- Department of Psychology, The College of the Liberal Arts, The Pennsylvania State University, 311 Moore Building, University Park, PA 16802, United States
| | - Amanda Child
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, 315 Health and Human Development - East, University Park, PA 16802, United States
| | - Charles F Geier
- Department of Human Development and Family Studies, College of Health and Human Development, The Pennsylvania State University, 315 Health and Human Development - East, University Park, PA 16802, United States
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Young adults who smoke cigarettes and marijuana: analysis of thoughts and behaviors. Addict Behav 2014; 39:77-84. [PMID: 24090626 DOI: 10.1016/j.addbeh.2013.08.035] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 08/05/2013] [Accepted: 08/30/2013] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Smoking both cigarettes and marijuana is increasingly common among young adults, yet little is known about use patterns, motivations, or thoughts about abstinence. In a U.S. sample, this study explored young adults' severity of cigarette and marijuana co-use, quit attempts, and thoughts about use. METHODS Young adults age 18-to-25 who had smoked at least one cigarette in the past 30 days completed an anonymous online survey. RESULTS Of 1987 completed surveys, 972 participants reported both past-month cigarette and marijuana use (68% male, 71% Caucasian, mean age 20.4 years [SD=2.0]). Frequency of use, temptations to use, measures of dependence, decisional balance, and past-year quit attempts were associated across the two substances (all p<.05), but not motivation to quit. Relative to marijuana, participants reported greater desire and a later stage of change for quitting cigarettes and were more likely to endorse a cigarette abstinence goal, yet they had lower expectancy of success with quitting cigarettes and with staying quit (all p<.001). CONCLUSIONS Cigarette and marijuana use, temptations to use, and pros/cons of using were related in this young adult sample. Differences in motivation and thoughts about abstinence, however, suggest that young adults may be more receptive to interventions for tobacco than marijuana use. Use patterns and cognitions for both substances should be considered in prevention and intervention efforts.
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García-Rodríguez O, Secades-Villa R, Flórez-Salamanca L, Okuda M, Liu SM, Blanco C. Probability and predictors of relapse to smoking: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend 2013; 132:479-85. [PMID: 23570817 PMCID: PMC3723776 DOI: 10.1016/j.drugalcdep.2013.03.008] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 03/11/2013] [Accepted: 03/12/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND The goal of this study was to estimate rates of relapse to smoking in the community and to identify predictors of relapse. METHODS Data were drawn from the Waves 1 and 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Logistic regression analyses were used to estimate the probability of relapse at Wave 2 among individuals who were abstinent at Wave 1 given length of abstinence as well as the presence of several sociodemographic, psychopathologic and substance use-related variables at Wave 1. RESULTS The risk for relapse among individuals who had been abstinent for 12 months or less at the baseline assessment was above 50%. Among individuals who had been abstinent for over a year, risk of relapse decreased hyperbolically as a function of time, and stabilized around 10% after 30 years of abstinence. Although several sociodemographic, psychopathologic and tobacco-related variables predicted relapse in univariate analyses, only younger age at cessation and shorter duration of abstinence independently predicted risk of relapse in multivariable analyses. CONCLUSIONS The first year after a quit attempt constitutes the period of highest risk for relapse. Although the risk for relapse decreases over time, it never fully disappears. Furthermore, younger age at smoking cessation also increases the risk for relapse. This information may help develop more targeted and effective relapse prevention programs.
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Affiliation(s)
- Olaya García-Rodríguez
- Department of Psychology, University of Oviedo, 33003 Oviedo, Spain; New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
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Tzilos GK, Strong DR, Abrantes AM, Ramsey SE, Brown RA. Quit intention as a predictor of quit attempts over time in adolescents with psychiatric disorders. Am J Addict 2013; 23:84-89. [PMID: 23898867 DOI: 10.1111/j.1521-0391.2013.12067.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Revised: 01/15/2013] [Accepted: 02/19/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Rates of smoking among adolescents with psychiatric comorbidity are high, despite the well-known health risks. The current longitudinal study examined patterns of quitting behavior in adolescent smokers with psychiatric comorbidity. METHODS The study evaluated 191 inpatient adolescents who had been enrolled in a randomized controlled trial of motivational interviewing versus brief advice for smoking cessation, and assessed their intentions to quit smoking. RESULTS Rates of quit attempts at post-hospital, 1-month, and 6-month assessments were 23%, 17%, and 17%, respectively. Adolescents who reported an intention to quit smoking (43%) were significantly more likely to report a quit attempt, regardless of psychiatric symptoms, cognitive factors, or substance use. CONCLUSIONS Intention to quit smoking appears to translate to substantial quit behavior, even in a high-risk adolescent population that may otherwise be viewed as uninterested in quitting, suggesting the need to proactively connect this population with adequate services and follow-up support. (Am J Addict 2013;XX:1-6).
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Affiliation(s)
- Golfo K Tzilos
- Center for Alcohol and Addiction Studies, Providence, Rhode Island; Alpert Medical School of Brown University, Providence, Rhode Island
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Abstract
BACKGROUND/OBJECTIVES Cigarette smoking remains the leading cause of preventable death in the United States with the vast majority of adult smokers starting prior to the age of 18. Despite the public health relevance and implications of studying smoking in adolescents, little is known about the initiation of quit attempts, the process of relapse, and the most efficacious treatment interventions in this high-risk and underserved population. Issues such as retention in research studies and accuracy of self-reports have prompted investigators to explore innovative technology-based systems to integrate into treatment studies and services delivery. METHODS This paper will review the remote monitoring of smoking through means of ecological momentary assessment, biochemical verification of smoking verified through video capture, physiological monitoring, and mobile-delivered interventions using self-reported smoking outcomes in adolescents, when applicable. RESULTS Use of remote monitoring methods in adolescent smokers has been limited thus far, though monitoring technology in adults has shown promise for understanding relapse and delivering treatment interventions. CONCLUSIONS Comprehensive technology-based systems that do not rely primarily on self-report to monitor smoking would be a highly fruitful and innovative avenue to explore with adolescent smokers. Technology integration holds great promise to improve health-related research, treatment delivery, cost-effectiveness, and just-in-time interventions, but its novelty comes with unique problems and concerns to be carefully considered.
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Affiliation(s)
- Erin A McClure
- Medical University of South Carolina, Charleston, SC, USA
| | - Kevin M Gray
- Medical University of South Carolina, Charleston, SC, USA
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Spyratos DG, Pelagidou DT, Chloros D, Haidich AB, Karetsi E, Koubaniou C, Konstantopoulos S, Gourgoulianis K, Sichletidis LT. Smoking among adolescents in Northern Greece: a large cross-sectional study about risk and preventive factors. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2012; 7:38. [PMID: 22963755 PMCID: PMC3511804 DOI: 10.1186/1747-597x-7-38] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Accepted: 08/26/2012] [Indexed: 11/25/2022]
Abstract
Background The aim of the present study was to investigate epidemiological data about cigarette smoking in relation with risk and preventive factors among Greek adolescents. Methods We randomly selected 10% of the whole number of schools in Northern Greece (133 schools, 18,904 participants were included). Two anonymous questionnaires (smoker's and non-smoker's) were both distributed to all students so they selected and filled in only one. A parental signed informed consent was obtained using an informative leaflet about adolescent smoking. Results The main findings of the study were: a) 14.2% of the adolescents (mean age+/−SD: 15.3+/−1.7 years) reported regular smoking (24.1% in the age group 16–18 years), b) 84.2% of the current smokers reported daily use, c) students who live in urban and semirural areas smoke more frequently than those in rural areas, d) students in technically oriented schools smoke twice as frequent compared to those in general education, e) risk factors for smoking: male gender, low educational level of parents, friends who smoke (OR: 10.01, 95%CI: 8.53-11.74, p<0.001), frequent visits to internet cafes (OR:1.53, 95%CI: 1.35-1.74, p<0.001), parents, siblings (OR:2.24, 95%CI: 1.99-2.51, p<0.001) and favorite artist (OR:1.18, 95%CI: 1.04-1.33, p=0.009) who smoke, f) protective factors against smoking: participation in sports (OR:0.59, 95%CI: 0.53-0.67, p<0.001), watching television (OR:0.74, 95%CI 0.66-0.84, p<0.001) and influence by health warning messages on cigarette packets (OR:0.42, 95%CI: 0.37, 0.48, p<0.001). Conclusions Even though prevalence of cigarette smoking is not too high among Greek adolescents, frequency of everyday cigarette use is alarming. We identified many social and lifestyle risk and preventive factors that should be incorporated in a national smoking prevention program among Greek adolescents.
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Affiliation(s)
- Dionisios G Spyratos
- Pulmonary Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Wang MP, Ho SY, Lo WS, Lam TH. Smoking family, secondhand smoke exposure at home, and quitting in adolescent smokers. Nicotine Tob Res 2012; 15:185-91. [PMID: 22547778 DOI: 10.1093/ntr/nts109] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION This study investigated the associations of smoking family and secondhand smoke (SHS) exposure at home with quit attempts and smoking cessation among adolescents. METHODS Students from 85 randomly selected secondary schools in Hong Kong were surveyed using an anonymous self-administered questionnaire on SHS exposure at home and outside the home in the past 7 days, quit attempts, smoking cessation, sociodemographic characteristics, and smoking status of family members and peers. Families with 1 or more smoking members (excluding the subject) were classified as smoking families and otherwise as nonsmoking families. Logistic regression yielded adjusted odds ratios (AORs) for quit attempts and smoking cessation in smoking families with or without SHS exposure at home compared with nonsmoking families. RESULTS Of 4,361 students who had smoked in the past 12 months, 70.3% were living with smokers and 52.8% were exposed to SHS at home. Compared with nonsmoking families, the AORs (95% CI) for making at least 1 quit attempt in the past 12 months were 0.80 (0.61-1.05) for 0 day, 0.80 (0.63-1.04) for 1-3 days, and 0.65 (0.50-0.86) for 4-7 days of SHS exposure at home. The corresponding AORs (95% CI) for smoking cessation were 0.58 (0.48-0.70), 0.45 (0.35-0.58), and 0.49 (0.41-0.60) (p for trend <.001). Any SHS exposure at home was associated with 28% and 53% lower odds of quit attempts and smoking cessation, respectively. CONCLUSIONS Living with smoker(s) and especially being exposed to SHS at home may hinder quit attempts and smoking cessation among Chinese adolescent smokers.
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Affiliation(s)
- Man Ping Wang
- School of Public Health, University of Hong Kong, Pokfulam, Hong Kong
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Wegmann L, Bühler A, Strunk M, Lang P, Nowak D. Smoking cessation with teenagers: the relationship between impulsivity, emotional problems, program retention and effectiveness. Addict Behav 2012; 37:463-8. [PMID: 22273584 DOI: 10.1016/j.addbeh.2011.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 11/09/2011] [Accepted: 12/15/2011] [Indexed: 12/14/2022]
Abstract
AIMS This study examines whether individual differences in impulsivity and emotional problems in adolescent smokers are related to initial smoking characteristics of participants, acceptance, retention and outcome of a school-based smoking cessation program. DESIGN The data was obtained from a feasibility study of a youth-specific, cognitive-behavioral and motivation enhancing program at 22 schools with 139 participating teenage smokers in Germany. A one-group-pre-posttest design was realized. MEASUREMENT Impulsivity levels were assessed by use of the impulsivity scale of the IVE ("Inventar zur Erfassung von Impulsivität, Risikoverhalten und Empathie", Stadler, Janke, & Schmeck, 2004). To evaluate the extent of emotional problems, the corresponding 5-items scale of the SDQ-Deu ("Strength and difficulties questionnaire", Klasen et al., 2000) was applied. Smoking behavior and acceptance of the program were assessed by students' self-reports. FINDINGS Acceptance and retention did not differ with regard to impulsivity and emotional problems, but initial smoking status did. Cessation rates varied with level of impulsivity: compared to non-impulsive participants, impulsive adolescents succeeded in quitting smoking less often. Emotional problems were not related to the rate of quitting. CONCLUSIONS Impulsive adolescents were similarly compliant to the offered cessation intervention as less impulsive smokers. In spite of their general positive evaluation, impulsive adolescents seem to benefit less from a smoking cessation program than their non-impulsive counterparts. Specific elements supporting impulsive teenage smokers in their goal to quit should be incorporated into youth-specific cessation programs.
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Lim MK, Kim HJ, Yun EH, Oh JK, Park EY, Shin SH, Jung BY, Park EC. Role of quit supporters and other factors associated with smoking abstinence in adolescent smokers: a prospective study on Quitline users in the Republic of Korea. Addict Behav 2012; 37:342-5. [PMID: 22133534 DOI: 10.1016/j.addbeh.2011.11.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 08/16/2011] [Accepted: 11/04/2011] [Indexed: 11/19/2022]
Abstract
The aim of this study elucidated the effectiveness of Quitline among adolescent smokers, as well as other factors associated with adolescent smoking cessation in the Republic of Korea. For 642 adolescent Quitline users aged 13-19 years, the information on demographic characteristics, smoking and cessation related factors, and cessation outcome was collected. Cox proportional hazard models were applied. 13.4% of boys and 6.6% of girls maintained smoking cessation for 1 year. Having a high level of self-efficacy had a preventive effect on relapse in both genders. Boys with parents or other family members as quit supporters, and boys with a higher number of past cessation attempts, were more likely to relapse. It was even more pronounced among boys who reported low self-efficacy. Relapse was increased with marginal significance among girls with parents or other family members as quit supporters. It is evident that Quitline is an effective way to encourage adolescent smoking cessation in Korea. Reinforcing self-efficacy and enhancing the cooperative behaviors of parents or other family member quit supporters could be additional contributors for maintaining cessation among adolescent smokers who want to quit.
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Affiliation(s)
- Min Kyung Lim
- National Cancer Control Institute, National Cancer Center, 323 Ilsan-ro, Goyang, Republic of Korea
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Kong G, Camenga D, Krishnan-Sarin S. Parental influence on adolescent smoking cessation: is there a gender difference? Addict Behav 2012; 37:211-6. [PMID: 22070852 DOI: 10.1016/j.addbeh.2011.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 09/08/2011] [Accepted: 10/17/2011] [Indexed: 11/28/2022]
Abstract
We examined the association of parental disapproval of adolescent smoking and parental smoking status, with past smoking quit behaviors among daily-smoking, high school-aged adolescents, and also tested whether these associations differ for boys and girls. Adolescent regular smokers (N=253) completed questions on smoking behaviors, past smoking cessation behaviors, parental disapproval of smoking, and parental smoking. Past smoking cessation behaviors were defined as "the number of quit attempts that lasted longer than 24 hours" and "the longest number of days of abstinence". Logistic regression analyses showed that for all adolescents, even having one smoking parent was associated with decreased odds of being abstinent for longer than 2 days. However, for girls, not having any smoking parents was associated with greater duration of abstinence (>2 weeks). Having both parents, compared with not having any parents disapprove of smoking, was associated with greater number of quit attempts in boys, but this effect was not found in girls. The results indicate that parents have a salient role in adolescent smoking cessation behaviors, and this association appears to be gender-specific. However, further research is needed to understand the mechanisms that explain gender differences in parental influence on adolescent smoking cessation behaviors.
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Affiliation(s)
- Grace Kong
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519, United States.
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Edvardsson I, Lendahls L, Andersson T, Ejlertsson G. The social environment is most important for not using snus or smoking among adolescents. Health (London) 2012. [DOI: 10.4236/health.2012.412184] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Myers MG, Gwaltney CJ, Strong DR, Ramsey SE, Brown RA, Monti PM, Colby SM. Adolescent first lapse following smoking cessation: situation characteristics, precipitants and proximal influences. Addict Behav 2011; 36:1253-60. [PMID: 21903332 PMCID: PMC3199975 DOI: 10.1016/j.addbeh.2011.07.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 06/02/2011] [Accepted: 07/29/2011] [Indexed: 11/19/2022]
Abstract
Despite increased attention to adolescent smoking cessation, little is known about adolescent relapse following a quit attempt. To address this issue, the present study was designed to provide initial information regarding the characteristics of adolescent lapses to smoking following abstinence. Included in the present study were 204 adolescent participants in four independent smoking cessation trials. For the full sample, participants averaged 15.99 (1.27) years of age; 56% were female and 78% were white. Lapse characteristics and precipitants were assessed using the Adolescent Smoking Relapse Review. Three domains of the lapse experience were assessed: lapse situation characteristics, precipitants of use in the situation, and proximal influences (i.e., potential precipitants occurring on the same day, prior to the lapse situation). Participant reports indicated that the modal lapse situation occurred in the evening while socializing with friends at home. Urges or cravings and social pressure were commonly endorsed as occurring in lapse situations. The most frequently reported proximal influence was desire for a cigarette, followed by abstinence-violation cognitions (okay to smoke occasionally, wanted to see what it would be like) and negative emotions. The findings indicate that a broad range of factors appear to influence adolescent smoking lapse and commend the value of incorporating content relevant to managing social and affective cues, strategies for inhibiting the prepotent response to ask for a cigarette, addressing cognitions regarding the difficulty of not smoking (i.e., cessation expectancies) and combating perceptions of the ability to smoke occasionally.
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Affiliation(s)
- Mark G Myers
- Psychology Service, Veteran Affairs San Diego Healthcare System/University of California, San Diego, Psychology 116B, VASDHS, 3350 La Jolla Village Drive, CA 92161, USA.
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Karp I, Paradis G, Lambert M, Dugas E, O'Loughlin J. A prognostic tool to identify adolescents at high risk of becoming daily smokers. BMC Pediatr 2011; 11:70. [PMID: 21834962 PMCID: PMC3199792 DOI: 10.1186/1471-2431-11-70] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 08/11/2011] [Indexed: 12/02/2022] Open
Abstract
Background The American Academy of Pediatrics advocates that pediatricians should be involved in tobacco counseling and has developed guidelines for counseling. We present a prognostic tool for use by health care practitioners in both clinical and non-clinical settings, to identify adolescents at risk of becoming daily smokers. Methods Data were drawn from the Nicotine Dependence in Teens (NDIT) Study, a prospective investigation of 1293 adolescents, initially aged 12-13 years, recruited in 10 secondary schools in Montreal, Canada in 1999. Questionnaires were administered every three months for five years. The prognostic tool was developed using estimated coefficients from multivariable logistic models. Model overfitting was corrected using bootstrap cross-validation. Goodness-of-fit and predictive ability of the models were assessed by R2, the c-statistic, and the Hosmer-Lemeshow test. Results The 1-year and 2-year probability of initiating daily smoking was a joint function of seven individual characteristics: age; ever smoked; ever felt like you needed a cigarette; parent(s) smoke; sibling(s) smoke; friend(s) smoke; and ever drank alcohol. The models were characterized by reasonably good fit and predictive ability. They were transformed into user-friendly tables such that the risk of daily smoking can be easily computed by summing points for responses to each item. The prognostic tool is also available on-line at http://episerve.chumontreal.qc.ca/calculation_risk/daily-risk/daily_smokingadd.php. Conclusions The prognostic tool to identify youth at high risk of daily smoking may eventually be an important component of a comprehensive tobacco control system.
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Affiliation(s)
- Igor Karp
- University of Montréal Hospital Research Centre (CRCHUM), Montreal, Quebec, Canada.
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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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