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Meijer E, Van den Putte B, Gebhardt WA, Van Laar C, Bakk Z, Dijkstra A, Fong GT, West R, Willemsen MC. A longitudinal study into the reciprocal effects of identities and smoking behaviour: Findings from the ITC Netherlands Survey. Soc Sci Med 2018; 200:249-257. [PMID: 29321102 DOI: 10.1016/j.socscimed.2017.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/21/2017] [Accepted: 12/07/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although it has been found that identity constructs related to smoking are associated with changes in smoking behaviour, the direction of causal associations is as yet unclear. This study aims to clarify the nature and direction of these associations. METHODS In this longitudinal study we examined the reciprocal relations between identity constructs (i.e., smoker self-identity, quitter self-identity and smoker group-identity), intention to quit and smoking and quitting behaviour among a sample of 1036 smokers and ex-smokers, using cross-lagged structural equation modelling. Moreover, we tested whether these relations differed by socio-economic status (SES). RESULTS Identity and smoking behaviour were reciprocally related in that in intention to quit and smoking behaviour consistently predicted identity change, and identity predicted (changes in) intentions to quit and smoking behaviour. Behaviour appears more important for identity change than identity for behaviour change. Furthermore, quitter self-identity appears more important than smoker self- and group-identity. Relationships did not differ significantly between SES-groups. The findings were replicated using a cross-validation sample. CONCLUSION Results imply that changing smoking behaviour may be a vehicle to change smoking-related identity. Moreover, strengthening identification with quitting is more crucial for quit success than decreasing smoker identities. The finding that behaviour may be more important for identity than vice versa, if replicated, may call for additions to identity theories.
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Affiliation(s)
- E Meijer
- Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands; Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - B Van den Putte
- University of Amsterdam, Amsterdam School of Communication Research, Amsterdam, The Netherlands; Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands
| | - W A Gebhardt
- Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands.
| | - C Van Laar
- Social and Cultural Psychology, University of Leuven, Leuven, Belgium.
| | - Z Bakk
- Section of Methodology and Statistics, Department of Psychology, Leiden University, Leiden, The Netherlands
| | - A Dijkstra
- Department of Social Psychology, University of Groningen, Groningen, The Netherlands
| | - G T Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Canada
| | - R West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - M C Willemsen
- Department of Health Promotion, CAPHRI, Maastricht University, Maastricht, The Netherlands; Dutch Alliance for a Smoke Free Society, The Hague, The Netherlands
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Triandafilidis Z, Ussher JM, Perz J, Huppatz K. Young Australian women's accounts of smoking and quitting: a qualitative study using visual methods. BMC WOMENS HEALTH 2018; 18:5. [PMID: 29301518 PMCID: PMC5755039 DOI: 10.1186/s12905-017-0500-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/19/2017] [Indexed: 11/21/2022]
Abstract
Background Although the overall rate of smoking in Australia continues to decline, the rate of decline has begun to slow. Rates of smoking among young women in Australia have been a particular concern, which has led to the development of targeted public health campaigns. Poststructuralist theory has successfully been used in research to explore the way in which young women experience smoking. However, there is an absence of poststructuralist analysis of young women’s experiences of quitting. This study aims to address this gap. Methods We carried out 27 interviews with young Australian women smokers and ex-smokers. Eighteen of those women then participated in a photography activity and follow-up interviews. A Foucauldian discourse analysis of the data was conducted. Results Through our analysis, we identified three discourses: ‘The irresponsibility of smoking: Quitting as responsible’, ‘The difficulties of quitting: Smoking as addictive’, and ‘Making a decision to quit: Smoking as a choice’. In relation to these discourses, participants took up contradictory positions of responsibility and resistance, addiction and agency. Taking up these positions had implications for young women’s subjectivity, and the way they engaged with tobacco controls and cessation support. Conclusions The analysis highlights the complex and contradictory nature of young women’s experiences with smoking and quitting. The study’s findings are considered in relation to the improvement of tobacco control policies and cessation support programmes targeted at young women.
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Affiliation(s)
- Zoi Triandafilidis
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia.
| | - Jane M Ussher
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
| | - Kate Huppatz
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
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Smith AL, Carter SM, Dunlop SM, Freeman B, Chapman S. Revealing the complexity of quitting smoking: a qualitative grounded theory study of the natural history of quitting in Australian ex-smokers. Tob Control 2017; 27:568-576. [DOI: 10.1136/tobaccocontrol-2017-053919] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/28/2017] [Accepted: 10/03/2017] [Indexed: 11/03/2022]
Abstract
ObjectiveTo explore the quitting histories of Australian ex-smokers in order to develop an understanding of the varied contribution of smoking cessation assistance (either pharmacotherapy or professionally mediated behavioural support) to the process of quitting.DesignQualitative grounded theory study; in-depth interviews.Participants37 Australian adult ex-smokers (24–68 years; 15 men, 22 women) who quit in the past 6–24 months.ResultsAlthough participants’ individual quitting histories and their overall experiences of quitting were unique, when the 37 quitting histories were compared it was clear two experiences were common to almost all participants: almost no one quit at their first quit attempt and almost everyone started out quitting unassisted. Furthermore, distinct patterns existed in the timing and use of assistance, in particular the age at which assistance was first used, how some participants were resolutely uninterested in assistance, and how assistance might have contributed to the process of successful quitting even if not used on the final quit attempt. Importantly, three patterns in use of assistance were identified: (1) only ever tried to quit unassisted (n=13); (2) started unassisted, tried assistance but reverted back to unassisted (n=13); (3) started unassisted, tried assistance and quit with assistance (n=11). For most participants, insight into what quitting would require was only gained through prior quitting experiences with and without assistance. For a number of participants, interest in assistance was at its lowest when the participant was most ready to quit.ConclusionQuitting should be viewed as a process drawing on elements of assisted and unassisted quitting rather than a stand-alone event that can be labelled as strictly assisted or unassisted.
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McCarthy MJ, Craddock WS, Acquavita SP, Black K. A mixed-methods study of smoking attitudes and behaviors among dual-smoker stroke survivor-caregiver dyads. J Health Psychol 2016; 23:1659-1667. [PMID: 27638738 DOI: 10.1177/1359105316667797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Although cigarette smoking is a major contributor to continued health problems after stroke, the majority of stroke survivors do not quit smoking. This may be due in part to the high rate of smoking among committed partners of stroke survivors. This study investigated the experiences of 11 dual-smoker stroke survivor-caregiver dyads, identifying themes which may be useful for understanding this entrenched population: managing the addiction as a dyad; conflicting feelings about whether smoking is an individual versus mutual concern; and dyad-level barriers and facilitators of quitting. We also present specific cessation strategies that dual-smoker dyads participating in the study described.
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Abstract
Contemporary ideals of health and nutrition conspire to render the consumption of chocolate and similar snacks problematic. Individuals who self-define as ‘chocoholics’ therefore present an ideal opportunity to investigate how ostensibly unhealthy acts are defined, defended and maintained within a health-conscious climate. This article reports on an interview-based study with five self-professed chocoholics. A Foucauldian form of discourse analysis was applied to the interview transcripts and four main discourses identified: chocolate as dirty and dangerous; chocolate as pleasure; self-surveillance; and addiction. The function of such discourses in terms of upholding the moral status of these individuals is discussed.
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Peel E, Parry O, Douglas M, Lawton J. Taking the Biscuit? A Discursive Approach to Managing Diet in Type 2 Diabetes. J Health Psychol 2016; 10:779-91. [PMID: 16176956 DOI: 10.1177/1359105305057313] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Adopting and maintaining a healthy diet is pivotal to diabetic regimens. Behavioural research has focused on strategies to modify/maintain healthy behaviours; thus ‘compliance’ and ‘ noncompliance’ are operationalized by researchers. In contrast, discursive psychology focuses on the actions different accounts accomplish—in this case regarding diets. Using thematic discourse analysis, we examine dietary management talk in repeat-interviews with 40 newly diagnosed type 2 diabetes patients. Women in our study tended to construct dietary practices as an individual concern, while men presented food consumption as a family matter. Participants accounted for ‘cheating’ in complex ways that aim to accomplish, for instance, a compliant identity. Discursive psychology may facilitate fluidity in our understandings of dietary management, and challenge fixed notions of ‘compliant’ and ‘non-compliant’ diabetes patients.
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Affiliation(s)
- Elizabeth Peel
- Department of Psychology, Life and Health Sciences, Aston University, Birmingham, UK.
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Abdullah ASM, Ho LM, Kwan YH, Cheung WL, McGhee SM, Chan WH. Promoting Smoking Cessation Among the Elderly. J Aging Health 2016; 18:552-64. [PMID: 16835389 DOI: 10.1177/0898264305281104] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To assess the predictors of smoking cessation and intention to quit among the Chinese elderly smokers. Design: A cross-sectional survey of elderly smokers. Setting: Shamsuipo district, Hong Kong. Subject: A total of 1,318 elderly were interviewed (response rate = 83%). Measures: A structured questionnaire was used for data collection. The questionnaire sought information on the subject's sociodemographic background and smoking habits. The predictors for successful quitting and intention to quit were assessed by chi-square tests and multiple logistic regression. Results: Of the respondents, 20.2% were current smokers, 25.4% were ex-smokers, and 54.4% were never smokers. Of the smoker (current and ex-smokers) respondents, 55.7% (335/601) had successfully quit at the time of enumeration. The predictors of quitting were living with others, receiving assistance for mobility, being nondrinkers, smoking for shorter duration, and smoking more cigarettes per day. Having health problems in the past, smoking for shorter duration, and smoking fewer cigarettes per day were predictors of intention to quit smoking. Conclusion:The study identified several predictors of successful quitting that could help improve the provision of current smoking cessation services. Population-based smoking cessation programs, especially those targeted to elderly, should take these predictors into consideration in the design of interventions.
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Hansen EC, Nelson MR. Staying a smoker or becoming an ex-smoker after hospitalisation for unstable angina or myocardial infarction. Health (London) 2016; 21:461-477. [DOI: 10.1177/1363459316644493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of our study was to better understand processes of ongoing smoking or smoking cessation (quitting) following hospitalisation for myocardial infarction or unstable angina (acute cardiac syndromes). In-depth interviews were used to elicit participants’ stories about ongoing smoking and quitting. In total, 18 interviews with smokers and 14 interviews with ex-smokers were analysed. Our findings illustrate the complex social nature of smoking practices including cessation. We found that smoking cessation following hospitalisation for acute cardiac syndromes is to some extent a performative act linked to ‘doing health’ and claiming a new identity, that of a virtuous ex-smoker in the hope that this will prevent further illness. For some ex-smokers hospitalisation had facilitated this shift, acting as a rite of passage and disrupting un-contemplated habits. Those participants who continued to smoke had often considered quitting or had even stopped smoking for a short period of time after hospitalisation; however, they did not undergo the identity shift described by ex-smokers and smoking remained firmly entrenched in their sense of self and the pattern of their daily lives. The ongoing smokers described feeling ashamed and stigmatised because of their smoking and felt that quitting was impossible for them. Our study provides an entry point into the smokers’ world at a time when their smoking has become problematised and highly visible due to their illness and when smoking cessation or continuance carries much higher stakes and more immediate consequences than might ordinarily be the case.
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Meijer E, Gebhardt WA, Dijkstra A, Willemsen MC, Van Laar C. Quitting smoking: The importance of non-smoker identity in predicting smoking behaviour and responses to a smoking ban. Psychol Health 2015; 30:1387-409. [PMID: 25959600 DOI: 10.1080/08870446.2015.1049603] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We examined how 'smoker' and 'non-smoker' self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e., the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban. DESIGN Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers. MAIN OUTCOME MEASURES Intention to quit, quit attempts and 'rejecting', 'victimizing', 'socially conscious smoking' and 'active quitting' responses to the smoking ban. RESULTS Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES. CONCLUSION Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.
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Affiliation(s)
- Eline Meijer
- a Health, Medical and Neuropsychology , Leiden University , Leiden , The Netherlands
| | - Winifred A Gebhardt
- a Health, Medical and Neuropsychology , Leiden University , Leiden , The Netherlands
| | - Arie Dijkstra
- b Department of Social Psychology , University of Groningen , Groningen , The Netherlands
| | - Marc C Willemsen
- c Department of Health Promotion , CAPHRI, Maastricht University , Maastricht , The Netherlands.,d Alliantie Nederland Rookvrij , The Hague , The Netherlands
| | - Colette Van Laar
- e Social and Cultural Psychology , University of Leuven , Leuven , Belgium
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Cuc A, Sobell LC, Sobell MB, Ruiz JJ, Voluse A. Autobiographical narratives can be used with confidence to collect information about ex-smokers' reasons for quitting smoking. Subst Use Misuse 2014; 49:1326-31. [PMID: 24712296 DOI: 10.3109/10826084.2014.901385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although autobiographical narratives (ABNs) provide rich descriptions of how people change addictive behaviors, psychometric evaluations of such reports are rare. 27 ex-smokers who had quit for 1 to 5 years were interviewed twice about why they quit. Participants' ABN reasons for why they quit smoking were compared with their answers on the Reasons For Quitting (RFQ) scale and found to be similar. Ex-smokers' ABNs are reliably reported for number and types of reasons given for quitting. Reasons ex-smokers gave in their ABNs were similar to their RFQ subscale answers. ABNs, a qualitative measure of quitting smoking, captured more information about how people quit smoking than quantitative scales.
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Affiliation(s)
- Alex Cuc
- 1Nova Southeastern University, Center for Psychological Studies, 3301 College Avenue, Ft Lauderdale, USA
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Park ER, Streck JM, Gareen IF, Ostroff JS, Hyland KA, Rigotti NA, Pajolek H, Nichter M. A qualitative study of lung cancer risk perceptions and smoking beliefs among national lung screening trial participants. Nicotine Tob Res 2014; 16:166-73. [PMID: 23999653 PMCID: PMC3934998 DOI: 10.1093/ntr/ntt133] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 07/22/2013] [Indexed: 11/13/2022]
Abstract
INTRODUCTION The National Comprehensive Cancer Network and the American Cancer Society recently released lung screening guidelines that include smoking cessation counseling for smokers undergoing screening. Previous work indicates that smoking behaviors and risk perceptions of the National Lung Screening Trial (NLST) participants were relatively unchanged. We explored American College of Radiology Imaging Network (ACRIN)/NLST former and current smokers' risk perceptions specifically to (a) determine whether lung screening is a cue for behavior change, (b) elucidate risk perceptions for lung cancer and smoking-related diseases, and (c) explore postscreening behavioral intentions and changes. METHODS A random sample of 35 participants from 4 ACRIN sites were qualitatively interviewed 1-2 years postscreen. We used a structured interview guide based on Health Belief Model and Self-Regulation Model constructs. Content analyses were conducted with NVivo 8. RESULTS Most participants endorsed high-risk perceptions for lung cancer and smoking-related diseases, but heightened concern about these risks did not appear to motivate participants to seek screening. Risk perceptions were mostly attributed to participants' heavy smoking histories; former smokers expressed greatly reduced risk. Lung cancer and smoking-related diseases were perceived as very severe although participants endorsed low worry. Current smokers had low confidence in their ability to quit, and none reported quitting following their initial screen. CONCLUSIONS Lung screening did not appear to be a behavior change cue to action, and high-risk perceptions did not translate into quitting behaviors. Cognitive and emotional dissonance and avoidance strategies may deter engagement in smoking behavior change. Smoking cessation and prevention interventions during lung screening should explore risk perceptions, emotions, and quit confidence.
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Affiliation(s)
- Elyse R. Park
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
- Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA
| | - Joanna M. Streck
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
| | - Ilana F. Gareen
- Center for Statistical Sciences and the Department of Epidemiology, Brown University School of Medicine, Providence, RI
| | - Jamie S. Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Kelly A. Hyland
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
| | - Nancy A. Rigotti
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
- Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, MA
- Department of Medicine, Harvard Medical School, Boston, MA
| | - Hannah Pajolek
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA
| | - Mark Nichter
- School of Anthropology, University of Arizona, Tuscon, AZ
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Murray J, Fenton G, Honey S, Bara AC, Hill KM, House A. A qualitative synthesis of factors influencing maintenance of lifestyle behaviour change in individuals with high cardiovascular risk. BMC Cardiovasc Disord 2013; 13:48. [PMID: 23829636 PMCID: PMC3716917 DOI: 10.1186/1471-2261-13-48] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 06/28/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Management of cardiovascular risk factors includes commitment from patients to adhere to prescribed medications and adopt healthy lifestyles. Unfortunately many fail to take up and maintain the four key healthy behaviours (not smoking, having a balanced diet, limiting alcohol consumption and being more active). Five factors (beliefs, knowledge, transport and other costs, emotions, and friends and family support) are known to predict uptake of lifestyle behaviour change. The key factors influencing maintenance of healthy lifestyles are not known but would be helpful to support the development of relapse prevention programmes for this population. Our review aimed to clarify the main patient perceived factors thought to influence maintenance of changed healthy lifestyles. METHODS We performed a systematic review of qualitative observational studies and applied the principles of content synthesis and thematic analysis to extract reported factors (barriers and facilitators) considered by individuals to be influential in maintaining changed healthy lifestyle behaviours. Factors were then organised into an existing framework of higher order categories which was followed by an analysis of the interrelationships between factors to identify key themes. RESULTS Twenty two studies met our inclusion criteria. Participants reported barriers and facilitators within 13 categories, the majority of which were facilitators. The most commonly reported influences were those relating to social support (whether provided formally or informally), beliefs (about the self or the causes and management of poor health, and the value of maintaining lifestyle behaviours), and other psychological factors (including attitude, thinking and coping styles, and problem solving skills). Physical activity was the most commonly investigated behaviour in four categories, but overall, the main barriers and facilitators were related to a range of behaviours. Through analysis of the interrelationships between factors within categories, 'social support', 'education and knowledge', and 'beliefs and emotions' were all considered key themes. CONCLUSIONS Our review suggests that for the most part, factors that influence lifestyle change are also important for maintaining healthy behaviours. This indicates that addressing these barriers and facilitators within lifestyle support programmes would also be of value in the longer-term.
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Affiliation(s)
- Jenni Murray
- Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK
| | - Grania Fenton
- Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK
| | - Stephanie Honey
- Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK
| | - Ana Claudia Bara
- Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK
| | - Kate Mary Hill
- Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK
| | - Allan House
- Academic Unit of Psychiatry and Behavioural Sciences, Leeds Institute of Health Sciences, The University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK
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Kim SK, Park JH, Lee JJ, Lee SB, Kim TH, Han JW, Youn JC, Jhoo JH, Lee DY, Kim KW. Smoking in elderly Koreans: prevalence and factors associated with smoking cessation. Arch Gerontol Geriatr 2012; 56:214-9. [PMID: 22995342 DOI: 10.1016/j.archger.2012.08.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 08/30/2012] [Indexed: 11/26/2022]
Abstract
The aims of this study were to investigate the prevalence of smoking and to explore the factors associated with smoking cessation. 1118 Koreans were randomly sampled from the residents aged 65 years or older living in Seongnam, Korea. Structured face-to-face interviews with neurological and physical examinations were conducted to the 714 respondents. A current smoker was defined as a person who had been smoking at least one cigarette per day for 1 year, and a past smoker as a person who used to smoke but had not smoked in the past 1 year. Nicotine dependence was defined as having the Fagerström Test for Nicotine Dependence (FTND) score of 4 or higher. Age- and gender-standardized prevalence of ever smoker, past smoker and current smoker among the elderly Koreans aged 65 and over were estimated to be 36.3% (95% CI=32.7-39.8), 24.4% (95% CI=21.2-27.5) and 11.9% (95% CI=9.5-14.3), respectively. Current smokers were much more prevalent in men (23.3%) than in women (3.9%), but did not decline with advancing age in both genders. 36.0% (21 men, 10 women) of the current smokers were nicotine-dependent. The smokers with depression or alcohol use disorder (AUD) were less likely and those who were educated more or inhaled smoke more deeply were more likely to quit smoking. Thus, smoking is common in the elderly men, and treatments of depression and AUD may be helpful in increasing smoking cessation rate among elderly Koreans.
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Affiliation(s)
- Shin Kyum Kim
- Yangsan Neuropsychiatry Hospital, 91 Moraedeul 1-gil, 626-310 Yangsan-si, Republic of Korea
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Rollins E, Terrion JL. Explorations of Self-Efficacy: Personal Narratives as Qualitative Data in the Analysis of Smoking Cessation Efforts. J Smok Cessat 2012. [DOI: 10.1375/jsc.5.1.57] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AbstractResearch has found that an individual's perceived self-efficacy, supported by goals and the acceptance of potential obstacles, has the ability to assist in behaviour modification. By examining the narratives of cardiovascular patients undergoing smoking cessation counselling, this study highlights factors that individuals communicate in their narratives regarding changes to self-efficacy throughout the process of smoking cessation. Narrative analysis is used to establish those factors that cardiovascular patients assert to be the motivating or impeding factors in their smoking cessation efforts, particularly in relation to their initial readiness to quit smoking. The study's findings illustrate the social, physical and psychological barriers and motivating factors that exist for cardiovascular patients in the process of quitting smoking. The current study supplements past research illustrating that in-hospital programs are among the most influential smoking intervention strategies because they can be tailored to each patient's specific health problems and personal and social circumstances. The study concludes that the relationship formed between patients and intervention specialists can assist in raising an individual's self-efficacy to end an addictive behaviour.
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Hansen EC, Nelson MR. How cardiac patients describe the role of their doctors in smoking cessation: a qualitative study. Aust J Prim Health 2011; 17:268-73. [PMID: 21896263 DOI: 10.1071/py10082] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 02/18/2011] [Indexed: 11/23/2022]
Abstract
This article reports a qualitative study investigating patients' experiences of ongoing smoking or smoking cessation after hospitalisation for an acute coronary syndrome (myocardial infarction or unstable angina) and describes how study participants spoke about the role of their doctors in smoking cessation. We invited individuals who had been admitted to an Australian public hospital in 2005 with a discharge diagnosis of an acute cardiac syndrome and who were smokers at the time of their hospitalisation to participate. Participants underwent a semi-structured interview and ongoing smokers also completed a 'stages of change' questionnaire. In total, 35 participants were interviewed, including 14 who were no longer smoking at least 12 months after their admission and 21 who were. Findings gave insight into the ways that cardiac patients perceive smoking cessation advice from their doctors, the perceived stigma of smoking and how lay understandings about smoking and smoking cessation emphasise the role of choice and individual responsibility. Our findings also indicate considerable scope for GPs and other doctors to offer better smoking cessation support to patients with established cardiovascular disease, particularly after a period of hospitalisation when the majority are highly motivated to stop smoking.
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Affiliation(s)
- Emily C Hansen
- School of Sociology and Social Work, University of Tasmania, Hobart, Tas. 7001, Australia.
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Abstract
Bladder cancer is common in the UK. Of all the aetiological factors associated with the development of the disease, cigarette smoking is the most important, in industrialized countries. It is estimated that 60% of all bladder cancers result from smoking. The management of bladder cancer is governed by specific guidelines. Superficial cancers are managed surgically with transurethral resection, while more aggressive tumours are managed with cystectomy (removal of the bladder). Additional treatment includes cytotoxic therapy with intravesical chemotherapy and immunotherapy agents. However, while treatments may be effective in reducing tumour recurrence, the side effects of treatments on the individual's quality of life can be devastating. This paper seeks to provide an overview of bladder cancer, namely how the disease presents and is subsequently treated. The role of smoking is discussed in relation to the development of bladder cancer. Also, whether health promotion and education are effective in increasing the individual's awareness of the dangers of smoking are explored.
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Anderson B, Naish W. Bladder cancer and smoking. Part 4: efficacy of health promotion. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2008; 17:1340-1344. [PMID: 19060816 DOI: 10.12968/bjon.2008.17.21.31741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This is the last of a four-part series on bladder cancer and smoking. Part 1 presented an overview of bladder cancer and the role of smoking in its development (Anderson and Naish, 2008a), part 2 discussed diagnosis and management of bladder cancer (Anderson and Naish, 2008b) and part 3 examined perceptions and beliefs related to smoking and health (Anderson and Naish, 2008c). Part 4 examines evidence for the efficacy of health promotional measures in helping people to stop smoking. It aims to provide an insight into whether health education and health promotion increase awareness of the impact of smoking on health and wellbeing, and whether a person's subsequent behaviour changes enough for them to stop smoking. Finally, it discusses the role of the healthcare professional in helping people to achieve this objective.
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Affiliation(s)
- Beverley Anderson
- Epsom and St Helier University Hospitals NHS Trust, St Helier Hospital, Surrey, UK
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Hansen EC, Walters J, Baker RW. Explaining chronic obstructive pulmonary disease (COPD): perceptions of the role played by smoking. SOCIOLOGY OF HEALTH & ILLNESS 2007; 29:730-49. [PMID: 17714340 DOI: 10.1111/j.1467-9566.2007.01013.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
There are few studies that investigate how people personally affected by a chronic disease associated with cigarette smoking account for their illness. Chronic obstructive pulmonary disease (COPD) is a respiratory condition largely caused by cigarette smoking. In order to better understand how people diagnosed with COPD view the relationship between cigarette smoking and their illness we conducted semi-structured interviews with 19 participants. We found a widespread scepticism among our respondents about medical attempts to link their illness with cigarette smoking, and doubts about whether their illness was in fact COPD at all. Only four participants described smoking as the principal reason why they had developed breathing problems. Most participants gave multi-causal accounts that emphasised explanatory factors such as a familial tendency to respiratory illness or workplace exposure to pollution. Our findings have relevance for the development of smoking cessation interventions for people with COPD.
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Affiliation(s)
- Emily C Hansen
- Discipline of General Practices, School of Medicine, University of Tasmania, Tasmania, Australia.
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