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Andrews M, Cooper N, Mattan BD, Carreras-Tartak J, Paul AM, Strasser AA, Henriksen L, Falk EB. Causal effects of point-of-sale cigarette promotions and subjective social status on cigarette craving: a randomised within-person experiment. Tob Control 2023:tc-2023-058069. [PMID: 37949653 PMCID: PMC11082063 DOI: 10.1136/tc-2023-058069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/17/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Cigarette smoking continues to be a leading cause of preventable deaths in the USA, in part because the USA has not adopted the WHO Framework Convention on Tobacco Control. One way the tobacco industry counteracts tobacco control policies is by heavily advertising cigarettes at the point of sale in retailers (eg, at the cash register) and by offering discounts on cigarettes. DESIGN A within-subject experimental design with adults who smoke cigarettes daily (n=281) investigated whether: (1) exposure to images of cigarette promotions in an online experiment is associated with greater cigarette craving relative to viewing images of non-smoking cues, and (2) if exposure to images of point-of-sale cigarette promotions with a discount (vs without) increases cigarette craving. The study also examined how participants' subjective social status (compared with others in the USA) relates to cigarette craving after exposure to images of cigarette promotions with and without a discount. RESULTS In an online experiment, exposure to images of smoking cues, including point-of-sale cigarette promotions, elicited greater craving relative to non-smoking cues (all p<0.001). In addition, images of promotions with a discount elicited higher levels of craving compared with those without a discount (b=0.09, p=0.001). Although participants with a higher (vs lower) subjective social status craved cigarettes less overall (b=-0.12, p=0.012), there was no difference in their craving between images of promotions with and without a discount, while craving was higher for images of promotions with a discount than without for participants with higher subjective social status (b=0.06, p=0.021). CONCLUSION Viewing images of point-of-sale cigarette promotions can causally increase cravings to smoke, which may also apply to real-world retail settings that display cigarette promotions. Restricting point-of-sale promotions generally, and discounts specifically, could help reduce cigarette smoking and address tobacco use disparities in the USA.
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Affiliation(s)
- Mary Andrews
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nicole Cooper
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Bradley D Mattan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - José Carreras-Tartak
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alexandra M Paul
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Andrew A Strasser
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lisa Henriksen
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA
| | - Emily B Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Wharton Marketing Department, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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2
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de Hoog N, van Dinther S, Bakker E. Socioeconomic Status and Health-Compromising Behaviour: Is it All About Perception? EUROPES JOURNAL OF PSYCHOLOGY 2021; 16:498-513. [PMID: 33680195 PMCID: PMC7909503 DOI: 10.5964/ejop.v16i3.1840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 01/01/2020] [Indexed: 12/04/2022]
Abstract
Socioeconomic status (SES) is associated with many health issues and health-compromising behaviour (HCB). Most research is based on objective indicators of SES, even though subjective SES, someone’s perception of their social standing, is also related to health. Moreover, perceptions of health and HCB might also be of importance. Therefore, this study examined the relationship between both objective and subjective SES and perceived health and HCB respectively, and the role of perceptions of HCB. 326 respondents completed measures of objective and subjective SES, perceived health, HCB and perceptions of HCB. Results showed objective and subjective SES were related to perceived health. Only subjective SES was related to HCB, while for objective SES a moderating effect of perceiving HCB as typically high or low SES was found. Not only objective SES, but especially perceptions of SES and HCB are associated with someone feeling healthy and engaging in HCB. Health interventions should try to tackle perceptions of SES and HCB, either by invalidating current SES related perceptions or by emphasizing new healthy perceptions.
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Affiliation(s)
- Natascha de Hoog
- Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands
| | - Susanne van Dinther
- Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands
| | - Esther Bakker
- Faculty of Psychology, Open University of the Netherlands, Heerlen, the Netherlands
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Nollen NL, Ahluwalia JS, Sanderson Cox L, Okuyemi K, Lawrence D, Samuels L, Benowitz NL. Assessment of Racial Differences in Pharmacotherapy Efficacy for Smoking Cessation: Secondary Analysis of the EAGLES Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2032053. [PMID: 33464316 PMCID: PMC7816102 DOI: 10.1001/jamanetworkopen.2020.32053] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/04/2020] [Indexed: 01/02/2023] Open
Abstract
Importance Understanding Black vs White differences in pharmacotherapy efficacy and the underlying reasons is critically important to reducing tobacco-related health disparities. Objective To compare pharmacotherapy efficacy and examine variables to explain Black vs White differences in smoking abstinence. Design, Setting, and Participants This study is a secondary analysis of the Evaluating Adverse Events in a Global Smoking Cessation Study (EAGLES) double-blind, placebo-controlled, randomized clinical trial, which took place at clinical trial centers, academic centers, and outpatient clinics in 29 states in the US. US Black and White smokers who smoked 10 or more cigarettes per day with and without psychiatric comorbidity were enrolled between November 2011 and January 2015. Data analysis was performed from July 2019 to January 2020. Interventions Participants were randomized (1:1:1:1) in a double-blind, triple-dummy, placebo- and active-controlled (nicotine patch) trial of varenicline and bupropion for 12 weeks with follow-up through week 24. Main Outcomes and Measures Biochemically verified continuous cigarette abstinence rate (CAR) from weeks 9 to 24. Baseline, postbaseline treatment, and safety characteristics were examined as variables to explain race differences in abstinence. Results Of the 1065 Black smokers enrolled, 255 were randomized to receive varenicline, 259 received bupropion, 286 received nicotine replacement therapy (NRT [ie, nicotine patch]), and 265 received placebo. Among the 3044 White smokers enrolled, 778 were randomized to receive varenicline, 769 received bupropion, 738 received NRT, and 759 received placebo. Participants were predominantly female (614 Black [57.7%] and 1786 White [58.7%] women) and heavy smokers (mean [SD] cigarettes per day, 18.2 [7.9] for Black and 20.0 [7.5] for White smokers), with a mean (SD) age of 47.2 (11.2) years for Black and 46.5 (12.7) years for White participants. Treatment and race were associated with CAR for weeks 9 to 24. The CAR was 4.9% lower for Black vs White participants (odds ratio [OR], 0.53; 95% CI, 0.41-0.69; P < .001); differences were found across all treatments. Pooling psychiatric and nonpsychiatric cohorts, varenicline (OR, 2.63; 95% CI, 1.90-3.63; P < .001), bupropion (OR, 1.75; 95% CI, 1.25-2.46; P = .001), and NRT (OR, 1.52; 95% CI, 1.07-2.16; P = .02) had greater efficacy than placebo for White participants. Only varenicline (OR, 2.63; 95% CI, 1.26-5.48; P = .01) had greater efficacy than placebo for Black participants. Baseline, postbaseline, and safety characteristics differed by race, but these variables did not eliminate the association of race with CAR. Black participants had 49% reduced odds of CAR for weeks 9 to 24 compared with White participants in the adjusted model (OR, 0.51; 95% CI, 0.39-0.66; P < .001). Conclusions and Relevance Black and White smokers achieved the highest rate of abstinence while taking varenicline, suggesting that it is the best first-line therapy for these groups. However, Black smokers were less responsive to all therapies, including placebo. Understanding variables (eg, socioeconomic or biological) beyond those may lead to improved treatment outcomes for Black smokers. Trial Registration ClinicalTrials.gov Identifier: NCT01456936.
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Affiliation(s)
- Nicole L. Nollen
- Department of Population Health, University of Kansas School of Medicine, Kansas City
| | - Jasjit S. Ahluwalia
- Alpert Medical School, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
- Alpert Medical School, Department of Medicine, Brown University School of Public Health, Providence, Rhode Island
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas School of Medicine, Kansas City
| | - Kolawole Okuyemi
- Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City
| | | | | | - Neal L. Benowitz
- Department of Medicine, Bioengineering, and Therapeutic Sciences, University of California, San Francisco
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4
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Otto MW, Zvolensky MJ, Rosenfield D, Hoyt DL, Witkiewitz K, McKee SA, Bickel WK, Smits JAJ. A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults. Health Psychol 2020; 39:815-825. [PMID: 32833483 PMCID: PMC8489738 DOI: 10.1037/hea0000858] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Low income and low educational attainment are among the strongest predictors of both smoking prevalence and lapse (i.e., return) to smoking after cessation attempts. Treatment refinement is limited by inadequate knowledge of the specific lapse- or relapse-relevant vulnerabilities characteristic of populations that should be the target of treatment. In the context of a randomized clinical trial design, we describe an experimental medicine approach for evaluating the role of 2 specific lapse-relevant targets relative to the higher stress characteristic of low-socioeconomic contexts: low distress tolerance and low working memory capacity. Furthermore, we use an innovative approach for understanding risk of smoking lapse in smokers undergoing a quit attempt to examine candidate mechanistic targets assessed not only during nicotine use, but also during the conditions smokers will face upon a cessation attempt-during stressful nicotine-deprivation windows. This study is designed to show the incremental value of assessments during deprivation windows, in part because of the way in which specific vulnerabilities are modified by, and interact with, the heightened stress and withdrawal symptoms inherent to nicotine-deprivation states. Specifically, the study is designed to evaluate whether a novel mindfulness intervention (mindfulness combined with interoceptive exposure) can improve upon existing mindfulness interventions and extend therapeutic gains to the modification of mechanistic targets assessed in high-stress or negative affectivity contexts. The overall goal is to validate mechanistic targets and associated interventions for the purpose of expanding treatment options for at-risk smokers. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University
| | | | | | - Danielle L. Hoyt
- Department of Psychological and Brain Sciences, Boston University
| | | | - Sherry A. McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519
| | - Warren K. Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute
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5
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Nollen NL, Mayo MS, Sanderson Cox L, Benowitz NL, Tyndale RF, Ellerbeck EF, Scheuermann TS, Ahluwalia JS. Factors That Explain Differences in Abstinence Between Black and White Smokers: A Prospective Intervention Study. J Natl Cancer Inst 2020; 111:1078-1087. [PMID: 30657926 DOI: 10.1093/jnci/djz001] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/03/2018] [Accepted: 01/02/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Black-white differences in smoking abstinence are not well understood. This trial sought to confirm previously reported differences in quitting between blacks and whites and to identify factors underlying this difference. METHODS During enrollment, 224 black and 225 white low-income smokers were stratified on race and within race on age and sex to ensure balance on these factors known to impact abstinence. The intervention included varenicline for 12 weeks and six guideline-based smoking cessation counseling sessions. The primary endpoint was cotinine-verified 7-day point prevalence smoking abstinence at week 26. A priori socioeconomic, smoking, treatment process (eg, treatment utilization, side effects, withdrawal relief), psychosocial, and biological factors were assessed to investigate race differences in abstinence. Unadjusted odds ratios (OR) were used to compare abstinence between blacks and whites. Adjusted odds ratios from logistic regression models were used to examine predictors of abstinence. All statistical tests were two-sided. RESULTS Blacks were less likely to achieve abstinence at week 26 (14.3% vs 24.4%, OR = 0.51, 95% confidence interval [CI] = 0.32 to 0.83, P = .007). Utilizing best subsets logistic regression, five factors associated with race jointly predicted abstinence: home ownership (yes/no, OR = 3.03, 95% CI = 1.72 to 5.35, P < .001), study visits completed (range = 0-6, OR = 2.81, 95% CI = 1.88 to 4.20, P < .001), income (household member/$1000, OR = 1.03, 95% CI = 1.01 to 1.06, P = .02), plasma cotinine (per 1 ng/mL, OR = 0.997, 95% CI = 0.994 to 0.999, P = .002), and neighborhood problems (range = 10-30, OR = 0.88, 95% CI = 0.81 to 0.96, P = .003). CONCLUSIONS The race difference in abstinence was fully explained by lack of home ownership, lower income, greater neighborhood problems, higher baseline cotinine, and higher visit completion, which were disproportionately represented among blacks. Findings illuminate factors that make it harder for blacks in the United States to quit smoking relative to whites and provide important areas for future studies to reduce tobacco-related health disparities.
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6
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Carl E, Liskiewicz A, Rivard C, Alberico R, Belal A, Mahoney MC, Quisenberry AJ, Bickel WK, Sheffer CE. Dosing parameters for the effects of high-frequency transcranial magnetic stimulation on smoking cessation: study protocol for a randomized factorial sham-controlled clinical trial. BMC Psychol 2020; 8:42. [PMID: 32357940 PMCID: PMC7193364 DOI: 10.1186/s40359-020-00403-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 04/05/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Despite the considerable success of comprehensive tobacco control efforts, tobacco use remains one of the greatest preventable causes of death and disease today. Over half of all smokers in the US make quit attempts every year, but over 90% relapse within 12 months, choosing the immediate reinforcement of smoking over the long-term benefits of quitting. Conceptual and empirical evidence supports continued investigation of high frequency repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex in reducing relapse and decreasing cigarette consumption. While this evidence is compelling, an optimal dosing strategy must be determined before a long-term efficacy trial can be conducted. The goal of this study is to determine a dosing strategy for 20 Hz rTMS that will produce the best long-term abstinence outcomes with the fewest undesirable effects. METHODS This is a fully crossed, double-blinded, sham-controlled, 3x2x2 randomized factorial study. The three factors are duration (stimulation days: 8, 12, and 16); intensity (900 or 1800 pulses per day); and sham control. Participants (n = 258) will consist of adults (18-65) who are motivated to quit smoking cigarettes and who will be followed for 6 months post-quit. Outcomes include latency to relapse, point prevalence abstinence rates, delay discounting rates, cognitive-behavioral skills acquisition, and multiple measures of potential undesirable effects that impact participant compliance. DISCUSSION This study integrates existing theoretical concepts and methodologies from neuropsychology, behavioral economics, brain stimulation, clinical psychology, and the evidence-based treatment of tobacco dependence in the development of a promising and innovative approach to treat tobacco dependence. This study will establish an optimal dosing regimen for efficacy testing. Findings are expected to have a significant influence on advancing this approach as well as informing future research on clinical approaches that combine rTMS with other evidence-based treatments for tobacco dependence and perhaps other addictions. TRIAL REGISTRATION Clinical Trials NCT03865472 (retrospectively registered). The first participant was fully enrolled on November 26, 2018. Registration was posted on March 7, 2019.
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Affiliation(s)
- Ellen Carl
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA.
| | | | - Cheryl Rivard
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | - Ronald Alberico
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | - Ahmed Belal
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | - Martin C Mahoney
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | | | - Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA, 24016, USA
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7
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Alexander AC, Olurotimi O, Hébert ET, Ra CK, Businelle MS, Kendzor DE. Subjective social status is indirectly associated with short-term smoking cessation through nicotine withdrawal symptoms. J Health Psychol 2020; 26:2320-2329. [PMID: 32191140 DOI: 10.1177/1359105320911432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
This study used data collected from a smoking cessation program (N = 146) to evaluate whether subjective social status was indirectly associated with smoking cessation through nicotine withdrawal symptoms. Findings indicated that subjective social status was indirectly associated with smoking cessation through withdrawal symptoms, specifically through anger and anxiety symptoms. People with lower subjective social status reported more withdrawal symptoms, particularly symptoms related to anger and anxiety, shortly after a quit attempt, and as such, were less likely to achieve smoking abstinence. Findings from this study provide insight into why socioeconomically disadvantaged adults are less likely to remain abstinent after a quit attempt.
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8
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Vinci C, Guo L, Spears CA, Li L, Correa-Fernández V, Etcheverry PE, Lam CY, Hoover DS, Wetter DW. Socioeconomic indicators as predictors of smoking cessation among Spanish-Speaking Mexican Americans. ETHNICITY & HEALTH 2019; 24:841-853. [PMID: 28859518 PMCID: PMC5832556 DOI: 10.1080/13557858.2017.1373074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 08/21/2017] [Indexed: 05/16/2023]
Abstract
Objective: Smoking-related illnesses are the leading cause of death among Latinos, and within this ethnic group, Mexican Americans are the largest subgroup in the U.S. Understanding the factors associated with successful smoking cessation could inform interventions for this population. Although socioeconomic status (SES) is a powerful predictor of cessation outcomes in the general U.S. population, it has generally been a poor predictor of quitting smoking among Latinos. Within a sample of Spanish-speaking Mexican Americans (n = 199), this study examined a broad array of objective and subjective indicators of SES (i.e. income, education, employment, subjective social status, financial strain, insurance status) as predictors of smoking cessation. Design: Data for the current study came from a longitudinal cohort study examining the pathways linking the social determinants of health with smoking cessation. Generalized estimating equation modeling examined the association of each predictor variable with smoking abstinence across quit day, and the 3 and 26-weeks post-quit time points. Results: Results indicated that both low financial strain and insurance status predicted an increased likelihood of abstinence when controlling for covariates in the intention-to-treat analyses (p = .02 and p = .01, respectively). However, these models only approached significance in the multiple imputation analyses (all ps > .05). Other indicators of SES (i.e. income, education, employment) that have been predictive of cessation in other populations were not predictive of abstinence in this sample. Conclusions: These findings suggest that SES may indeed influence smoking cessation among Spanish-speaking Mexican Americans similarly to its influence in other populations, but that capturing the construct of SES may require assessing a broader range of SES indicators. Specifically, low financial strain and having insurance predicted a greater likelihood of achieving smoking abstinence, whereas other indicators of SES (i.e. income, education) were not predictive.
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Affiliation(s)
- Christine Vinci
- Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Lin Guo
- Corona LLC, Southborough, MA, USA
| | - Claire A. Spears
- Division of Health Promotion & Behavior, Georgia State University, School of Public Health, Atlanta, GA, USA
| | - Liang Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Paul E. Etcheverry
- Department of Psychology, Southern Illinois University Carbondale, Carbondale, IL, USA
| | - Cho Y. Lam
- Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Diana S. Hoover
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David W. Wetter
- Population Health Sciences, University of Utah, Salt Lake City, UT, USA
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9
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Quisenberry AJ, Pittman J, Goodwin RD, Bickel WK, D'Urso G, Sheffer CE. Smoking relapse risk is increased among individuals in recovery. Drug Alcohol Depend 2019; 202:93-103. [PMID: 31325822 PMCID: PMC6685745 DOI: 10.1016/j.drugalcdep.2019.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The prevalence of cigarette smoking among individuals with a history of substance use disorders (SUDs) remains up to four times higher than those without a history of SUDs. More than half of individuals who attain sustained remission from SUDs will die of tobacco-related diseases. The aim of this secondary data analysis was to compare the risk for smoking relapse among smokers with no history of SUDs and smokers in recovery from SUDs after multi-component, cognitive-behavioral treatment for tobacco dependence. METHODS Participants were randomized to receive 6 sessions of multicomponent cognitive-behavioral therapy (adapted for lower socioeconomic groups or standard), 8 weeks of nicotine patches, and were followed for 6 months in the parent randomized clinical trial. Participants passed a urine drug test prior to enrollment. Recovery was assessed at baseline by self-report to the question, "Do consider yourself in recovery from drugs or alcohol?" Relapse was defined as any smoking for 7 consecutive days. RESULTS Participants were primarily lower SES and identified as racial and/or ethnic minorities. Cox proportional hazards models revealed that the risk of smoking relapse following tobacco dependence treatment was greater among smokers in long-term (HR: 1.44; 95% CI: 1.01, 2.05) and short-term (HR: 1.98; 95% CI: 1.30, 3.03) recovery than for smokers with no history of SUDs. CONCLUSIONS Our findings indicate that smokers in recovery from SUDs have 1.5-2 times the risk of relapse than smokers with no history of SUDs. More effective relapse prevention interventions are needed for this vulnerable, high-risk group of smokers.
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Affiliation(s)
- Amanda J Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14203, United States.
| | - Jami Pittman
- College of Liberal Arts & Sciences, Wayne State University, 4841 Cass Avenue, Detroit, MI, 48201, United States
| | - Renee D Goodwin
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, United States; Institute of Implementation in Population Health, The City University of New York, 55 West 125th Street, New York, New York, 10027, United States
| | - Warren K Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, 2 Riverside Circle, Roanoke, VA, 24016, United States
| | - Giordano D'Urso
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Christine E Sheffer
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Elm and Carlton Streets, Buffalo, NY, 14203, United States
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10
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Piña JA, Namba MD, Leyrer-Jackson JM, Cabrera-Brown G, Gipson CD. Social Influences on Nicotine-Related Behaviors. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 140:1-32. [DOI: 10.1016/bs.irn.2018.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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11
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Zvolensky MJ, Paulus DJ, Langdon KJ, Robles Z, Garey L, Norton PJ, Businelle MS. Anxiety sensitivity explains associations between anxious arousal symptoms and smoking abstinence expectancies, perceived barriers to cessation, and problems experienced during past quit attempts among low-income smokers. J Anxiety Disord 2017; 48:70-77. [PMID: 28024913 PMCID: PMC5476482 DOI: 10.1016/j.janxdis.2016.12.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 11/07/2016] [Accepted: 12/15/2016] [Indexed: 11/23/2022]
Abstract
Disproportionately more smokers report low-income and mental health problems relative to non-smokers. Low-income smokers may use smoking to alleviate negative emotional states resulting from exposure to multiple stressors. Yet, little work has been devoted to elucidating mechanisms that may explain the association between negative emotional states and smoking-related processes among low-income smokers. The present study sought to address this gap by examining anxiety sensitivity, a transdiagnostic factor related to both anxiety and smoking, as a potential mediator for the influence of anxiety symptoms on smoking-related processes, including threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), perceived barriers for cessation, and problems experienced during past quit attempts. Participants included treatment-seeking daily cigarette smokers (n=101; 68.3% male; Mage=47.1; SD=10.2). Results indicated that anxiety symptoms exerted a significant indirect effect through anxiety sensitivity for threat-related smoking abstinence expectancies (somatic symptoms and harmful consequences), perceived barriers for cessation, and problems experienced during past quit attempts. The present results provide empirical support that anxiety sensitivity may be an underlying mechanism that partially explains the relation between anxiety symptoms and smoking processes among low-income treatment-seeking smokers. Findings broaden current theoretical understanding of pathways through which anxiety symptoms contribute to maladaptive smoking processes and cognitions among socioeconomically disadvantaged smokers.
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Affiliation(s)
- Michael J Zvolensky
- University of Houston, Department of Psychology, Houston, TX, United States; The University of Texas MD Anderson Cancer Center, Department of Behavioral Science, Houston, TX, United States.
| | - Daniel J Paulus
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Kirsten J Langdon
- Rhode Island Hospital, Department of Psychiatry, Providence, RI, United States
| | - Zuzuky Robles
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Lorra Garey
- University of Houston, Department of Psychology, Houston, TX, United States
| | - Peter J Norton
- Monash University, School of Psychological Sciences, Melbourne, Victoria, Australia
| | - Michael S Businelle
- University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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12
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Castro Y. Determinants of Smoking and Cessation Among Latinos: Challenges and Implications for Research. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2016; 10:390-404. [PMID: 27672402 DOI: 10.1111/spc3.12256] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Tobacco is a significant burden to individual and public health, and disparities exist among Latino smokers with respect to use and cessation. Although the prevalence of smoking is lower for Latinos than for non-Latino Whites and the general U.S. population, numerous health disparities exist within the population of Latino smokers. Much is known about determinants of smoking and cessation but the vast majority of this knowledge is based on research with non-Latino White smokers. This results in at least two important challenges in tobacco research among Latino smokers: (i) demonstrating the generalizability of known determinants of smoking and cessation, and; (ii) identifying culturally relevant variables that influence smoking and cessation among Latinos. An argument for increased research in these areas is presented with a review of existing research among Latino smokers that demonstrates these needs. Research is summarized that suggests socioeconomic position, depressive symptomatology, physical dependence, and gender function differently as determinants of smoking and cessation among Latinos compared with the general population of smokers. Research is also reviewed that suggests the promise of acculturation, acculturative stress, and discrimination as culturally relevant determinants of smoking and cessation. Research and practice implications are discussed, and specific areas for future research are offered.
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Sheffer CE, Mackillop J, Fernandez A, Christensen D, Bickel WK, Johnson MW, Panissidi L, Pittman J, Franck CT, Williams J, Mathew M. Initial examination of priming tasks to decrease delay discounting. Behav Processes 2016; 128:144-52. [PMID: 27179761 PMCID: PMC4942247 DOI: 10.1016/j.beproc.2016.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/10/2016] [Accepted: 05/10/2016] [Indexed: 11/19/2022]
Abstract
Steep discounting of delayed rewards is linked with a variety of unhealthy behaviors that contribute to the major causes of preventable death and disease. Growing evidence suggests that decreases in delay discounting contribute to healthier preferences. This study sought to provide preliminary evidence for the viability of developing a brief priming task to reduce delay discounting in a large, diverse group of individuals. Participants (n=1,122) were randomized to one of three conditions: Future Focus (FF), Present Focus (PF), and Non-Temporal Focus (NTF) intended respectively to decrease, increase, or have no effect on delay discounting. Participants then completed the Monetary Choice Questionnaire, a brief assessment of delay discounting rate. Participants randomized to FF exhibited significantly lower discounting rates than those randomized to PF or NTF conditions. Race, Hispanic background, social self-monitoring, education, and cigarette smoking also accounted for a significant amount of variance in the discounting model. These findings provide support for the development of a brief priming intervention that might be examined in clinical or public health contexts to decrease discounting and support healthy choices.
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Affiliation(s)
- Christine E Sheffer
- Sophie Davis School of Biomedical Education / CUNY Medical School, 160 Convent Ave, City College of New York, United States.
| | - James Mackillop
- Peter Boris Centre for Addictions Research, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada, x39492, Canada.
| | - Arislenia Fernandez
- Department of Psychology, Harris Hall Suite 14, City College of New York, United States
| | - Darren Christensen
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada.
| | - Warren K Bickel
- Advanced Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, United States.
| | - Matthew W Johnson
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224-6823, United States.
| | - Luana Panissidi
- Department of Psychology, Harris Hall Suite 14, City College of New York, United States
| | - Jami Pittman
- Department of Psychology, Harris Hall Suite 14, City College of New York, United States
| | - Christopher T Franck
- Virginia Tech University, Virginia Tech Department of Statistics, 403E Hutcheson Hall, Blacksburg, VA 24061, United States.
| | - Jarrett Williams
- Department of Psychology, Harris Hall Suite 14, City College of New York, United States
| | - Merlin Mathew
- Department of Psychology, Harris Hall Suite 14, City College of New York, United States
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Nollen NL, Cox LS, Yu Q, Ellerbeck EF, Scheuermann TS, Benowitz NL, Tyndale RF, Mayo MS, Ahluwalia JS. A clinical trial to examine disparities in quitting between African-American and White adult smokers: Design, accrual, and baseline characteristics. Contemp Clin Trials 2016; 47:12-21. [PMID: 26667382 PMCID: PMC4818177 DOI: 10.1016/j.cct.2015.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 11/24/2015] [Accepted: 12/03/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND African-Americans smoke fewer cigarettes per day than Whites but experience greater smoking attributable morbidity and mortality. African-American-White differences may also exist in cessation but rigorously designed studies have not been conducted to empirically answer this question. METHODS/DESIGN Quit2Live is, to our knowledge, the first head-to-head trial designed with the primary aim of examining African-American-White disparities in quitting smoking. Secondary aims are to identify mechanisms that mediate and/or moderate the relationship between race and quitting. The study is ongoing. Study aims are accomplished through a 5-year prospective cohort intervention study designed to recruit equal numbers of African-Americans (n=224) and Whites (n=224) stratified on age (<40, ≥40) and gender, key factors known to impact cessation, and all within a restricted income range (≤400% federal poverty level). All participants will receive 12 weeks of varenicline in combination with smoking cessation counseling. The primary outcome is cotinine-verified 7-day point prevalence abstinence from smoking at week 26. Secondary outcomes are cotinine-verified 7-day point prevalence abstinence from smoking at weeks 4 and 12. DISCUSSION Findings from Quit2Live will not only address if African-American-White disparities in quitting smoking exist but, more importantly, will examine mechanisms underlying the difference. Attention to proximal, modifiable mechanisms (e.g., adherence, response to treatment, depression, stress) maximizes Quit2Live's potential to inform practice. Findings will provide an empirically-derived approach that will guide researchers and clinicians in identifying specific factors to address to improve cessation outcomes and reduce tobacco-related morbidity and mortality in African-American and White smokers. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT01836276.
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Affiliation(s)
- Nicole L Nollen
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas, United States.
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas, United States.
| | - Qing Yu
- Department of Biostatistics, University of Kansas School of Medicine, Kansas City, Kansas, United States.
| | - Edward F Ellerbeck
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas, United States.
| | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas, United States.
| | - Neal L Benowitz
- Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, San Francisco, California, United States; Department of Medicine, University of California, San Francisco, San Francisco, California, United States; Department of Bioengineering, University of California, San Francisco, San Francisco, California, United States; Department of Therapeutic Sciences, University of California, San Francisco, San Francisco, California, United States.
| | - Rachel F Tyndale
- Center for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada.
| | - Matthew S Mayo
- Department of Biostatistics, University of Kansas School of Medicine, Kansas City, Kansas, United States.
| | - Jasjit S Ahluwalia
- Department of Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, United States.
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Garey L, Reitzel LR, Kendzor DE, Businelle MS. The Potential Explanatory Role of Perceived Stress in Associations Between Subjective Social Status and Health-Related Quality of Life Among Homeless Smokers. Behav Modif 2015; 40:303-24. [PMID: 26530474 DOI: 10.1177/0145445515612396] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Homeless individuals smoke at high rates relative to the general population and are at heightened risk of tobacco-related illnesses and poor health-related quality of life (HRQoL). Homeless smokers also report low subjective social status (SSS) or perceived social standing relative to others. SSS may contribute to poor HRQoL, potentially through perceived stress. The current study examined the role of perceived stress in the association of SSS and HRQoL among 227 (70.9% male, Mage = 43.2) homeless smokers. Participants completed self-report measures of SSS, perceived stress, and HRQoL. Perceived stress partially explained the relation between SSS (United States and Community) and HRQoL in covariate-adjusted analyses. Results suggested that perceived stress is a pathway through which SSS contributes to HRQoL among homeless smokers. Findings broaden current understanding of the impact of social disadvantage and perceived stress on HRQoL among homeless smokers.
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Affiliation(s)
| | | | - Darla E Kendzor
- The University of Texas Southwestern Medical Center, Dallas, TX, USA The University of Texas School of Public Health, Dallas, TX, USA
| | - Michael S Businelle
- The University of Texas Southwestern Medical Center, Dallas, TX, USA The University of Texas School of Public Health, Dallas, TX, USA
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16
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McGovern P, Nazroo JY. Patterns and causes of health inequalities in later life: a Bourdieusian approach. SOCIOLOGY OF HEALTH & ILLNESS 2015; 37:143-60. [PMID: 25601070 DOI: 10.1111/1467-9566.12187] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study explores the relationship between social class and health change in older people in a path analysis, using data from the English Longitudinal Study of Ageing (n = 6241) in a Bourdieusian theoretical framework. Bourdieu drew a distinction between the occupational characteristics by which people are classified and the secondary properties of class that relate to lifestyle (economic, cultural and social capitals). Our path model includes both occupational and secondary characteristics of objective social class as well as a measure of subjective social class. We investigate the effects of the predictors on change in three health outcomes (self-rated health, number of symptoms of depression and number of difficulties with the activities of daily living). The analysis adds to Bourdieusian research by showing how the effects of objective social class on health are partially mediated by perceived social status. It also adds to substantive research on the relationship between class and health by suggesting that class-related health inequalities do persist for older people, even for those who are not in paid employment. It suggests that a large amount of the effect of occupation on the health of older people is not direct but indirect; through their personal wealth and lifestyle.
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Affiliation(s)
- Pauline McGovern
- Cathie Marsh Institute for Social Research, School of Social Science, University of Manchester
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17
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Vassilev I, Rogers A, Sanders C, Cheraghi-Sohi S, Blickem C, Brooks H, Kapadia D, Reeves D, Doran T, Kennedy A. Social status and living with a chronic illness: an exploration of assessment and meaning attributed to work and employment. Chronic Illn 2014; 10:273-90. [PMID: 24486894 DOI: 10.1177/1742395314521641] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Traditional measures of social status are predicated on position in the labour market. There has been less attention directed to the meanings of social position for people with a long-term condition whose relationship to employment is precarious. Previous research has demonstrated that the MacArthur scale is capable of capturing contextualised aspects of social status, which makes it a useful tool for exploring changes in meaning. AIMS The paper explores the meanings and experiences of social status of people living with a long-term condition with particular reference to employment status. METHODS A sample of 300 participants was drawn from diabetes and chronic heart disease registers of General Practices in North West England. A cross-sectional survey with nested qualitative interviews was used in collecting and analysing the data. FINDINGS Having financial independence and participating in valued activities are more important for people with chronic illness than power and status mediated through the labour market. Income and the lack and loss of employment were given a central role in respondents' narratives reflecting the absence of acceptable alternative routes through which social status for those with a long-term condition can realistically be rebuilt outside of participation in the labour market. CONCLUSION Social participation, where people with chronic illness feel valued and of tangible utility to other people, might offer some opportunities for rebuilding social status outside the labour market. Chronic illness management interventions need to focus on improving people's engagement with such activities.
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Affiliation(s)
- Ivaylo Vassilev
- Greater Manchester Collaboration for Leadership in Applied Health Research and Care, University of Manchester, Manchester, UK Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Caroline Sanders
- Greater Manchester Collaboration for Leadership in Applied Health Research and Care, University of Manchester, Manchester, UK Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Sudeh Cheraghi-Sohi
- Greater Manchester Collaboration for Leadership in Applied Health Research and Care, University of Manchester, Manchester, UK Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Christian Blickem
- Greater Manchester Collaboration for Leadership in Applied Health Research and Care, University of Manchester, Manchester, UK Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Helen Brooks
- Greater Manchester Collaboration for Leadership in Applied Health Research and Care, University of Manchester, Manchester, UK School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK
| | - Dharmi Kapadia
- Greater Manchester Collaboration for Leadership in Applied Health Research and Care, University of Manchester, Manchester, UK
| | - David Reeves
- Greater Manchester Collaboration for Leadership in Applied Health Research and Care, University of Manchester, Manchester, UK Centre for Primary Care, Institute of Population Health, University of Manchester, Manchester, UK
| | - Tim Doran
- Department of Health Sciences, University of York, York, UK
| | - Anne Kennedy
- Greater Manchester Collaboration for Leadership in Applied Health Research and Care, University of Manchester, Manchester, UK Faculty of Health Sciences, University of Southampton, Southampton, UK
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18
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Abstract
PURPOSE OF REVIEW Subjective social status (SSS) predicts health outcomes above and beyond traditional objective measures of social status, such as education, income and occupation. This review summarizes and integrates recent findings on SSS and health. RECENT FINDINGS Current studies corroborate associations between low SSS and poor health indicators by extending previous findings to further populations and biological risk factors, providing meta-analytic evidence for adolescents and by demonstrating that negative affect may not confound associations between SSS and self-rated health. Recent findings also highlight the relevance of SSS changes (e.g. SSS loss in immigrants) and the need to consider cultural/ethnical differences in psychological mediators and associations between SSS and health. SUMMARY SSS is a comprehensive measure of one's social position that is related to several poor health outcomes and risk factors for disease. Future investigation, particularly prospective studies, should extend research on SSS and health to further countries/ethnic groups, also considering additional psychological and biological mediators and dynamic aspects of SSS. Recently developed experimental approaches to manipulate SSS may also be promising.
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19
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Reitzel LR, Kendzor DE, Cao Y, Businelle MS. Subjective Social Status Predicts Quit-Day Abstinence among Homeless Smokers. Am J Health Promot 2014; 29:43-5. [DOI: 10.4278/ajhp.130228-arb-88] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose. Smoking prevalence is alarmingly high among the homeless. Few studies have focused on predictors of smoking abstinence in this population. Subjective social status, a person's ranking of their own social standing relative to others in the United States or in their own self-defined communities, has predicted smoking cessation among domiciled smokers in analyses adjusted for objective socioeconomic status and other demographic variables. This study examined if subjective social status predicted quit-day abstinence among homeless smokers making a quit attempt. Design. Longitudinal study using self-reported survey data. Setting. Transitional homeless shelter in Dallas, Texas. Subjects. A total of 57 homeless smokers enrolled in a cessation program. Measures. Predictors were the Subjective Social Status-U.S (SSS-U.S.) and the Subjective Social Status-Community (SSS-Community) ladders measured 1 week pre quit. Covariates were sociodemographics and tobacco dependence measured 1 week pre quit. The outcome was self-reported and biochemically verified smoking abstinence on the quit day. Analysis. Covariate-adjusted logistic regression models. Results. Higher rankings on the SSS-U.S. ladder, but not the SSS-Community ladder, predicted abstinence on the quit day (p = .005). Conclusion. Lower rankings on the SSS-U.S. ladder predicted increased risk of relapse on the quit day or the inability to quit at all. The SSS-U.S. ladder might be useful in identifying homeless smokers needing additional preparation and intervention before initiating a quit attempt.
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20
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Reitzel LR, Buchanan TS, Nguyen N, Ahluwalia JS. Associations of subjective social status with nondaily and daily smoking. Am J Health Behav 2014; 38:245-53. [PMID: 24629553 DOI: 10.5993/ajhb.38.2.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To explore associations between subjective social status (SSS) and smoking level among 2274 adult current smokers. METHODS Associations were investigated using a covariate-adjusted proportional odds cumulative logit model. Moderation (via race/ethnicity or sex) and mediation (via depressive symptoms, social/emotional support, or life satisfaction) were explored in additional models. RESULTS Higher SSS was associated with greater likelihood of nondaily versus light daily or moderate/ heavy daily smoking (p = .017). Life satisfaction partially mediated the association of SSS and smoking level (p = .003). CONCLUSIONS Higher SSS was associated with greater likelihood of nondaily relative to light daily or moderate to heavy smoking, potentially via greater life satisfaction. Additional studies are needed to confirm these findings.
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Affiliation(s)
- Lorraine R Reitzel
- Department of Educational Psychology, College of Education, University of Houston, Houston, Department of Health Disparities Research at The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Taneisha S Buchanan
- Center for Health Equity and Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Nga Nguyen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jasjit S Ahluwalia
- Center for Health Equity, University of Minnesota Medical School, Minneapolis, MN, USA
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21
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Meyers JL, Cerdá M, Galea S, Keyes KM, Aiello AE, Uddin M, Wildman DE, Koenen KC. Interaction between polygenic risk for cigarette use and environmental exposures in the Detroit Neighborhood Health Study. Transl Psychiatry 2013; 3:e290. [PMID: 23942621 PMCID: PMC3756291 DOI: 10.1038/tp.2013.63] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 06/04/2013] [Accepted: 07/10/2013] [Indexed: 01/31/2023] Open
Abstract
Cigarette smoking is influenced both by genetic and environmental factors. Until this year, all large-scale gene identification studies on smoking were conducted in populations of European ancestry. Consequently, the genetic architecture of smoking is not well described in other populations. Further, despite a rich epidemiologic literature focused on the social determinants of smoking, few studies have examined the moderation of genetic influences (for example, gene-environment interactions) on smoking in African Americans. In the Detroit Neighborhood Health Study (DNHS), a sample of randomly selected majority African American residents of Detroit, we constructed a genetic risk score (GRS), in which we combined top (P-value <5 × 10(-7)) genetic variants from a recent meta-analysis conducted in a large sample of African Americans. Using regression (effective n=399), we first tested for association between the GRS and cigarettes per day, attempting to replicate the findings from the meta-analysis. Second, we examined interactions with three social contexts that may moderate the genetic association with smoking: traumatic events, neighborhood social cohesion and neighborhood physical disorder. Among individuals who had ever smoked cigarettes, the GRS significantly predicted the number of cigarettes smoked per day and accounted for ~3% of the overall variance in the trait. Significant interactions were observed between the GRS and number of traumatic events experienced, as well as between the GRS and average neighborhood social cohesion; the association between genetic risk and smoking was greater among individuals who had experienced an increased number of traumatic events in their lifetimes, and diminished among individuals who lived in a neighborhood characterized by greater social cohesion. This study provides support for the utility of the GRS as an alternative approach to replication of common polygenic variation, and in gene-environment interaction, for smoking behaviors. In addition, this study indicates that environmental determinants have the potential to both exacerbate (traumatic events) and diminish (neighborhood social cohesion) genetic influences on smoking behaviors.
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Affiliation(s)
- J L Meyers
- Department of Epidemiology, Columbia University, New York, NY 10032, USA.
| | - M Cerdá
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - S Galea
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - K M Keyes
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - A E Aiello
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - M Uddin
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA,Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - D E Wildman
- Center for Molecular Medicine and Genetics, Wayne State University, Detroit, MI, USA
| | - K C Koenen
- Department of Epidemiology, Columbia University, New York, NY, USA
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22
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Camelo LDV, Giatti L, Barreto SM. Subjective social status, self-rated health and tobacco smoking: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). J Health Psychol 2013; 19:1388-99. [PMID: 23818507 DOI: 10.1177/1359105313490772] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Using baseline data from ELSA-Brasil (N = 15,105), we investigated whether subjective social status, measured using three 10-rung "ladders," is associated with self-rated health and smoking, independently of objective indicators of social position and depression symptoms. Additionally, we explored whether the magnitude of these associations varies according to the reference group. Subjective social status was independently associated with poor self-rated health and weakly associated with former smoking. The references used for social comparison did not change these associations significantly. Subjective social status, education, and income represent distinct aspects of social inequities, and the impact of each of these indicators on health is different.
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Affiliation(s)
| | - Luana Giatti
- Universidade Federal de Minas Gerais, Brazil Universidade Federal de Ouro Preto, Brazil
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23
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Abstract
Higher socioeconomic status smokers are more successful at smoking cessation. Few studies have investigated the prospective association between multiple measures of socioeconomic status and Hispanic smoking cessation. We assessed four measures to examine which predicted smoking cessation. Hispanics without debt had 18.5 times higher odds of 30-day cessation (odds ratio = 18.47, 95% confidence interval = 3.26-104.66, p < .01) and 11-fold increased odds of 7-day point prevalence abstinence (odds ratio = 11.32, 95% confidence interval = 2.45-52.24, p < .01) at 3-month follow-up. Yearly income, education, work status, money to see a doctor, and money for medications were not predictive of smoking cessation. Debt level may better measure socioeconomic inequities by capturing objective and subjective social status associated with Hispanic smoking cessation.
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Affiliation(s)
- Karl Chiang
- Mass Memorial Health Care and The University of Massachusetts Medical School, USA
| | - Belinda Borrelli
- Warren Alpert Medical School at Brown University and The Miriam Hospital
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24
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Reitzel LR, Nguyen N, Strong LL, Wetter DW, McNeill LH. Subjective social status and health behaviors among African Americans. Am J Health Behav 2013; 37:104-11. [PMID: 22943107 DOI: 10.5993/ajhb.37.1.12] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine associations of the US and community subjective social status (SSS) ladders with smoking status, at-risk drinking, fruit and vegetable intake, physical activity, and body mass index among 1467 church-going African American adults from a larger cohort study. METHODS Regression analyses, adjusted for sociodemographics, examined associations between SSS ladders and health behaviors. RESULTS The SSS-US ladder was significantly associated with fruit and vegetable consumption (p = .007) and physical activity (p = .005). The SSS-community ladder was not significantly associated with any health behaviors. CONCLUSIONS Among this sample of African Americans, the SSS-US ladder is more predictive of some health behaviors than is the SSS-community ladder.
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Affiliation(s)
- Lorraine R Reitzel
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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25
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Whembolua GL, Davis JT, Reitzel LR, Guo H, Thomas JL, Goldade KR, Okuyemi KS, Ahluwalia JS. Subjective social status predicts smoking abstinence among light smokers. Am J Health Behav 2012; 36:639-46. [PMID: 22584091 DOI: 10.5993/ajhb.36.5.6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To determine if community subjective social status (SSS) predicted smoking abstinence through 26 weeks postrandomization among 755 African American light smokers of low SES (socioeconomic status). METHODS Participants were enrolled in a double-blind, placebo-controlled, randomized clinical trial, which examined the efficacy of nicotine gum and counseling for smoking cessation. RESULTS Results indicated that SSS predicted smoking abstinence over time [P=.046; odds ratio (OR) =1.075 (1.001-1.155)] after adjusting for covariates. CONCLUSIONS Further research is needed to understand the effects of community SSS on smoking cessation among heavy smokers and other ethnic groups.
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Affiliation(s)
| | - Julia T. Davis
- University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Hongfei Guo
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Janet L. Thomas
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Kate R. Goldade
- Program in Health Disparities Research, Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Kola S. Okuyemi
- Program in Health Disparities Research, Director, Minnesota Center for Cancer Collaborations and Co-Director, Office of Community Engagement for Health, CTSI and Associate Professor, Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jasjit S. Ahluwalia
- Center for Health Equity, Director, Office of Interprofessional Career Development, Clinical and Translational Sciences Institute (CTSI), University of Minnesota Medical School, Minneapolis, MN, USA
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