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Manns A, Torregrossa H, Mahdjoub S, Gomajee R, Melchior M, El-Khoury Lesueur F. Do Determinants of Smoking Cessation and Relapse Differ between Men and Women? Data from a French National Study. Subst Use Misuse 2023; 59:167-176. [PMID: 37813814 DOI: 10.1080/10826084.2023.2267106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
Introduction: There is limited understanding of different predictors of smoking cessation success (SCS) among women and men, despite well-documented differences in smoking behavior.Methods: Using data from DePICT (Description des Perceptions, Images, et Comportements liés au Tabagisme), a national survey of French adults which recruited 2377 regular and former smokers we investigated whether major determinants of SCS differed by sex. Factors associated with unsuccessful vs. No successful quit attempt; vs. SCS were studied using multivariate multinomial logistic regression analyses stratified by sex.Results: Women and men share some determinants of SCS including no cannabis use, living in a nonsmoker household and importance giving to being a nonsmoker. However, no e-cigarette use, low-to-moderate alcohol consumption, early smoking initiation, and higher education were associated with SCS only among women. No use of nicotine replacement, having family members who smoke, family opinion on smoking and current employment, were associated with SCS only among men. Neutral or negative friends' opinion on smoking or living with a smoker were associated with unsuccessful smoking attempts among men.Conclusions: Our results show differences between determinants of SCS according to sex, which highlights the importance of developing tailored interventions that account for sex/gender differences in smoking cessation.
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Affiliation(s)
- Aurélia Manns
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Hugo Torregrossa
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Sarah Mahdjoub
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Ramchandar Gomajee
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Maria Melchior
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
| | - Fabienne El-Khoury Lesueur
- Department of Social Epidemiology, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, IPLESP, Paris, France
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Lin B, Xie L, Xie X, Yan Y, Zhang L, Xiao L. Predictors for quitting smoking in smoking cessation clinics among female smokers in China. Tob Induc Dis 2023; 21:26. [PMID: 36819959 PMCID: PMC9936604 DOI: 10.18332/tid/159132] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 12/26/2022] [Accepted: 01/09/2023] [Indexed: 02/19/2023] Open
Abstract
INTRODUCTION The number of cessation clinics in China have been increasing ever since the Chinese government supported the establishment of smoking cessation clinics (SCCs) in each province in 2014. Many studies have examined smoking cessation behaviors among male smokers, but few of female smokers. This study aimed to understand female smokers' quitting behaviors in SCCs and identify predictors of successful cessation. METHODS This study used data of the SCCs Platform in China from 2018 to 2020. The self-reported 7-day point prevalence of abstinence rate (PPAR) at 1 month and at 3 months follow-up and the continuous abstinence rate (CAR) at 3 months follow-up are reported based on smokers' characteristics and intention to treat analysis. A multiple logistic regression model was used to identify predictors of continuous abstinence at 3 months follow-up. RESULTS The 7-day PPAR of female outpatients in SCCs was 29.20% at 1 month follow-up and 28.36% at 3 months follow-up. The CAR at 3 months follow-up was 19.88%. Female smokers who were prepared to quit within 7 days (AOR=2.86; 95% CI: 1.53-5.32), today (AOR=4.01; 95% CI: 2.35-6.85), had started to quit (AOR=7.11; 95% CI: 4.12-12.27), and used a combination of counseling and drugs (AOR=2.41; 95% CI: 1.73-3.35) were more likely to quit smoking. Associated with lower quitting rates were: living in the central region of China (AOR=0.47; 95% CI: 0.31-0.73) and the west region (AOR=0.48; 95% CI: 0.31-0.73); being aged 30-39 years (AOR=0.39; 95% CI: 0.23-0.64), and 40-49 years (AOR=0.41; 95% CI:0.24-0.69); being unemployed (AOR=0.64; 95% CI: 0.45-0.91); having a fair perceived health status at the first visit (AOR=0.65; 95% CI: 0.47-0.91) and a poor one (AOR=0.37; 95% CI: 0.21-0.64); having a moderate nicotine dependence (AOR=0.64; 95% CI: 0.44-0.92) and a severe one (AOR=0.50; 95% CI: 0.34-0.72). CONCLUSIONS In our study, the region of residence, age, employment, perceived health status, Fagerström test for nicotine dependence (FTND), readiness to quit, and intervention model were independent predictors of quitting for female smokers. Improving the motivation to quit, providing intensive psychological interventions and equipping SCCs with cessation medication would assist female smokers to quit.
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Affiliation(s)
- Bingliang Lin
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Li Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Xiaoyun Xie
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Yongfu Yan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Luge Zhang
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Lin Xiao
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
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Castello S, Darker C, Vance J, Dougall N, Bauld L, Hayes CB. The We Can Quit2 Smoking Cessation Trial: Knowledge Exchange and Dissemination Following a Community-Based Participatory Research Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042333. [PMID: 35206521 PMCID: PMC8872427 DOI: 10.3390/ijerph19042333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/28/2022] [Accepted: 02/11/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND 'We Can Quit2' pilot randomised controlled trial determined the feasibility [of conducting a community-based trial of We Can Quit, a peer-delivered stop-smoking programme (group support, combination nicotine replacement therapy (NRT), and tailored individual support) for women living in socioeconomically disadvantaged areas in Ireland. Lessons from a knowledge exchange (KE) workshop that reengaged trial stakeholders are presented. METHODS The trial dissemination plan included invitation of community, regional and national stakeholders (n = 176) to a KE interactive workshop, who received an accessible brief beforehand. Trial findings were presented. Enhancements to community engagement, participants' recruitment and retention, and policy priorities arising from the research were discussed. Field notes and responses to a post-event anonymous questionnaire were analysed using thematic content analysis. RESULTS Workshop attendees (41/176, 23%) recommended: dedicated additional time to engage community stakeholders; social prescribing pathways to enhance recruitment; more adaptation of trial-related information and assistance in completion of data forms for low literacy individuals; encouraging women to join healthy community programmes to facilitate retention and sustainability; removal of barriers to access NRT; and ongoing provision of cessation services tailored to disadvantaged groups. CONCLUSIONS The findings are relevant to the implementation of other community-based health interventions for disadvantaged groups, to policy makers and to service providers.
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Affiliation(s)
- Stefania Castello
- Public Health & Primary Care, Institute of Population Health, Trinity College Dublin, D24DH74 Dublin, Ireland; (S.C.); (C.D.)
| | - Catherine Darker
- Public Health & Primary Care, Institute of Population Health, Trinity College Dublin, D24DH74 Dublin, Ireland; (S.C.); (C.D.)
| | - Joanne Vance
- Community Programmes, Irish Cancer Society, D04VX65 Dublin, Ireland;
| | - Nadine Dougall
- School of Health and Social Care, Edinburgh Napier University, Edinburgh EH11 4BN, UK;
| | - Linda Bauld
- Usher Institute and SPECTRUM Consortium, College of Medicine and Veterinary Science, University of Edinburgh, Edinburgh EH16 4TJ, UK;
| | - Catherine B. Hayes
- Public Health & Primary Care, Institute of Population Health, Trinity College Dublin, D24DH74 Dublin, Ireland; (S.C.); (C.D.)
- Correspondence:
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Youn JH, Shin S. The experience of continued smoking after stroke in Korean males: A qualitative study. Nurs Open 2021; 8:2750-2759. [PMID: 33704928 PMCID: PMC8363419 DOI: 10.1002/nop2.851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 01/26/2021] [Accepted: 02/17/2021] [Indexed: 01/25/2023] Open
Abstract
AIM This study aimed to identify the nature and meaning of continued smoking in male stroke patients based on a deep understanding of their lived experiences. DESIGN Phenomenological qualitative methodology. METHODS In total, 10 male stroke patients participated in this study. We used purposive sampling for recruitment. Data collection was performed through in-depth interviews and analysis through van Manen's methodology. RESULTS Five essential themes were derived from the analyses and described participants' experiences with continued smoking, as follows: "Natural relapse into smoking," "Behaving like a healthy person," "Believing that smoking will not be a problem," "Finding consolation in smoking behaviour," and "Consoling oneself by the rationalization of smoking behaviour." CONCLUSION The results showcased the need for the development of a smoking cessation educational programme tailored for male stroke patients who have perceptions towards being "like healthy people" after early recovery and who think that smoking is not a problematic behaviour. Participants' reports underpinned the necessity for these programmes to have contents focused on the transformation of patients' awareness toward their own health status.
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Affiliation(s)
- Jung Hee Youn
- Division of Nursing, Ewha Seoul Hospital, Seoul, Republic of Korea
| | - Sujin Shin
- College of Nursing, Ewha Womans University, Seoul, Republic of Korea
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Jayakumar N, Chaiton M, Zhang B, Selby P, Schwartz R. Sex Differences in Use of Smoking Cessation Services and Resources: A Real-World Study. Tob Use Insights 2020; 13:1179173X20901500. [PMID: 32030067 PMCID: PMC6977215 DOI: 10.1177/1179173x20901500] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/20/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives: Smoking cessation interventions with sex considerations have been found to effectively increase cessation rates. However, evidence is limited and weak. This study examined sex differences in the use of smoking cessation services or resources among Ontario adults. Methods: Data are from the Smokers’ Panel, an ongoing online survey of Ontario adult smokers and recent quitters. The analysis included 1009 male and 1765 female participants. Bivariate analysis was used to examine differences in sociodemographic characteristics and smoking-related variables by use of cessation services/resources. Logistic regression was then used to identify sociodemographic characteristics and smoking-related variables associated with the use of cessation services/resources. Results: The analysis shows that there were significant sex differences in the use of individual interventions. Female participants were more likely to use nicotine patch (63% vs 58%; adjusted odds ratio, AOR: 1.39, 95% confidence interval [CI]: 1.16-1.67), varenicline (29% vs 24%; AOR: 1.37, 95% CI: 1.13-1.66), Smokers’ Helpline phone (14% vs 10%; AOR: 1.39, 95% CI: 1.07-1.79), Smokers’ Helpline online (27% vs 21%; AOR 1.43, 95% CI: 1.18-1.74), self-help materials (23% vs 16%; AOR: 1.81 95% CI: 1.46-2.26), and alternative methods (23% vs 19%; AOR: 1.40, 95% CI: 1.14-1.73) compared with male participants, after adjusting for covariates. Conclusion: Consistent with other findings, the study shows sex differences in the use of smoking cessation services or resources among adult smokers. Women are more likely to use recommended cessation resources such as nicotine patch, varenicline, and Smokers’ Helpline than men. Health professionals should use this increased willingness to help female smokers quit. However, men may be underserved and more men-specific interventions need to be developed and evaluated.
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Affiliation(s)
- Navitha Jayakumar
- Ontario Tobacco Research Unit, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Michael Chaiton
- Ontario Tobacco Research Unit, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Michael Chaiton, Ontario Tobacco Research Unit, 155 College Street, Toronto, ON M5T 3M7, Canada.
| | - Bo Zhang
- Ontario Tobacco Research Unit, Toronto, ON, Canada
| | - Peter Selby
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Robert Schwartz
- Ontario Tobacco Research Unit, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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Lima Passos V, Crutzen R, Feder JT, Willemsen MC, Lemmens P, Hummel K. Dynamic, data-driven typologies of long-term smoking, cessation, and their correlates: Findings from the International Tobacco Control (ITC) Netherlands Survey. Soc Sci Med 2019; 235:112393. [PMID: 31302376 DOI: 10.1016/j.socscimed.2019.112393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 05/24/2019] [Accepted: 06/29/2019] [Indexed: 01/04/2023]
Abstract
RATIONALE Efforts towards tobacco control are numerous, but relapse rates for smoking cessations remain high. Behavioral changes necessary for continuous cessation appear complex, variable and subject to social, biological, psychological and environmental determinants. Currently, most cessation studies concentrate on short-to midterm behavioral changes. Besides, they use fixed typologies, thereby failing to capture the temporal changes in smoking/cessation behaviors, and its determinants. OBJECTIVE To obtain long-term, data-driven longitudinal patterns or profiles of smoking, cessation, and related determinants in a cohort of adult smokers, and to investigate their dynamic links. METHODS The dataset originated from the International Tobacco Control (ITC) Netherlands Project, waves 2008 to 2016. Temporal dynamics of smoking/cessation, psychosocial constructs, and time-varying determinants of smoking were extracted with Group-Based Trajectory Modeling technique. Their associations were investigated via multiple regression models. RESULTS Substantial heterogeneity of smoking and cessation behaviors was unveiled. Most respondents were classified as persistent smokers, albeit with distinct levels of consumption. For a minority, cessation could be sustained between 1 and 8 years, while others showed relapsing or fluctuating smoking behavior. Links between smoking/cessation trajectories with those of psychosocial and sociodemographic variables were diverse. Notably, changes in two variables were aligned to behavioral changes towards cessation: decreasing number of smoking peers and attaining a higher self-perceived control. CONCLUSION The unveiled heterogeneity of smoking behavior over time and the varied cross-dependencies between smoking data-driven typologies and those of underlying risk factors underscore the need of individually tailored approaches for motivational quitting.
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Affiliation(s)
- Valéria Lima Passos
- Department of Methodology and Statistics, Maastricht University, CAPHRI Care and Public Health Research Institute, Peter Debyeplein, 1, 6229, HA, Maastricht, the Netherlands.
| | - Rik Crutzen
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Johannes T Feder
- Department of Methodology and Statistics, Maastricht University, CAPHRI Care and Public Health Research Institute, Peter Debyeplein, 1, 6229, HA, Maastricht, the Netherlands.
| | - Marc C Willemsen
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P. Debyeplein 1, 6229, HA, Maastricht, the Netherlands.
| | - Paul Lemmens
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P. Debyeplein 1, 6229, HA, Maastricht, the Netherlands.
| | - Karin Hummel
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
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Robinson JD, Versace F, Engelmann JM, Cui Y, Gilbert DG, Waters AJ, Gritz ER, Cinciripini PM. Attentional bias to smoking and other motivationally relevant cues is affected by nicotine exposure and dose expectancy. J Psychopharmacol 2016; 30:627-40. [PMID: 27097731 PMCID: PMC5858186 DOI: 10.1177/0269881116642879] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We investigated the effects of acute nicotine dose and expected dose on attentional bias (AB) to smoking and affective cues in overnight nicotine-deprived smokers (n=51; 24 women) using a balanced placebo design, which counterbalanced given nicotine dose (Given-NIC vs. Given-DENIC) with instructed nicotine dose expectancy (Told-NIC vs. Told-DENIC). Before and after smoking a study cigarette, smokers completed a vigilance task where they pressed buttons to every third consecutive even or odd digit, while ignoring intermittent smoking, pleasant, unpleasant, and neutral picture distracters. We examined the early posterior negativity (EPN) and late positive potential (LPP) components of the event-related potentials (ERPs) to the distracters, reaction time (RT) to the target digits, and ratings of the study cigarettes. The EPN was sensitive to both given and instructed nicotine dose, while the instructed dose moderated the impact of given dose for the LPP. The RT metrics were sensitive to given but not to instructed dose. The effects of given dose on ratings following cigarette smoking (e.g. enjoyment) were moderated by the instructed dose. The ERP findings suggest that the anticipated effects of nicotine improve attention much like receiving actual nicotine.
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Affiliation(s)
- Jason D Robinson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Francesco Versace
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center and Oklahoma Tobacco Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Jeffery M Engelmann
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yong Cui
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - David G Gilbert
- Department of Psychology, Southern Illinois University, Carbondale, IL, USA
| | - Andrew J Waters
- Department of Medical & Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Ellen R Gritz
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Paul M Cinciripini
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Scott-Sheldon LAJ, Lantini R, Jennings EG, Thind H, Rosen RK, Salmoirago-Blotcher E, Bock BC. Text Messaging-Based Interventions for Smoking Cessation: A Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2016; 4:e49. [PMID: 27207211 PMCID: PMC4893152 DOI: 10.2196/mhealth.5436] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 02/17/2016] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Tobacco use is one of the leading preventable global health problems producing nearly 6 million smoking-related deaths per year. Interventions delivered via text messaging (short message service, SMS) may increase access to educational and support services that promote smoking cessation across diverse populations. OBJECTIVE The purpose of this meta-analysis is to (1) evaluate the efficacy of text messaging interventions on smoking outcomes, (2) determine the robustness of the evidence, and (3) identify moderators of intervention efficacy. METHODS Electronic bibliographic databases were searched for records with relevant key terms. Studies were included if they used a randomized controlled trial (RCT) to examine a text messaging intervention focusing on smoking cessation. Raters coded sample and design characteristics, and intervention content. Summary effect sizes, using random-effects models, were calculated and potential moderators were examined. RESULTS The meta-analysis included 20 manuscripts with 22 interventions (N=15,593; 8128 (54%) women; mean age=29) from 10 countries. Smokers who received a text messaging intervention were more likely to abstain from smoking relative to controls across a number of measures of smoking abstinence including 7-day point prevalence (odds ratio (OR)=1.38, 95% confidence interval (CI)=1.22, 1.55, k=16) and continuous abstinence (OR=1.63, 95% CI=1.19, 2.24, k=7). Text messaging interventions were also more successful in reducing cigarette consumption relative to controls (d+=0.14, 95% CI=0.05, 0.23, k=9). The effect size estimates were biased when participants who were lost to follow-up were excluded from the analyses. Cumulative meta-analysis using the 18 studies (k=19) measuring abstinence revealed that the benefits of using text message interventions were established only after only five RCTs (k=5) involving 8383 smokers (OR=1.39, 95% CI=1.15, 1.67, P<.001). The inclusion of the subsequent 13 RCTs (k=14) with 6870 smokers did not change the established efficacy of text message interventions for smoking abstinence (OR=1.37, 95% CI=1.25, 1.51, P<.001). Smoking abstinence rates were stronger when text messaging interventions (1) were conducted in Asia, North America, or Europe, (2) sampled fewer women, and (3) recruited participants via the Internet. CONCLUSIONS The evidence for the efficacy of text messaging interventions to reduce smoking behavior is well-established. Using text messaging to support quitting behavior, and ultimately long-term smoking abstinence, should be a public health priority.
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Affiliation(s)
- Lori A J Scott-Sheldon
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States.
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Minian N, Penner J, Voci S, Selby P. Woman focused smoking cessation programming: a qualitative study. BMC Womens Health 2016; 16:17. [PMID: 26971306 PMCID: PMC4788944 DOI: 10.1186/s12905-016-0298-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 03/09/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Several studies of smoking cessation programs in clinical settings have revealed poorer outcomes for women compared to men, including counselling alone or in combination with pharmacotherapy. The objective of the current study was to explore treatment and program structure needs and preferences among female clients in a specialized smoking cessation clinic in an academic mental health and addiction health science centre in order to inform program design so that it meets the needs of female clients. METHODS Four focus groups were conducted with current and former female clients (n = 23, mode age range = 50-59 years old, 56.5% were still smoking and 43.5% had quit) who had registered for outpatient smoking cessation treatment. Questions were designed to examine what aspects of the services were helpful and what changes they would like to see to better assist them and other women with quitting smoking. A thematic analysis of the raw data (audio recordings and notes taken during the focus groups) was conducted using a phenomenological theoretical framework. RESULTS Themes that emerged indicated that females trying to quit smoking are best supported if they have choice from a variety of services so that treatment can be individualized to meet their specific needs; psychosocial support is provided both one-one-one with health care professionals and by peers in support groups; free pharmacotherapy is available to eliminate financial barriers to use; women-specific educational topics and support groups are offered; the clinic is accessible with evening/weekend hours, options to attend a local clinic, and childcare availability; and communication about clinic services and operation are clear, readily available, and regularly updated. CONCLUSIONS An ideal smoking cessation program for women includes a women's centred approach with sufficient variety and choice, free pharmacotherapy, non-judgmental support, accessible services and clear communication of program options and changes. Findings may suggest an actionable list of adaptations that can be adopted by other clinics providing smoking cessation services to women.
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Affiliation(s)
- Nadia Minian
- />Addictions Program, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, ON M6J 1H4 Canada
| | - Jessica Penner
- />Addictions Program, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, ON M6J 1H4 Canada
| | - Sabrina Voci
- />Addictions Program, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, ON M6J 1H4 Canada
| | - Peter Selby
- />Addictions Program, Centre for Addiction and Mental Health, 100 Stokes Street, Toronto, ON M6J 1H4 Canada
- />Department of Family and Community Medicine, University of Toronto, 500 University Avenue, Toronto, ON M5G 1V7 Canada
- />Department of Psychiatry, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8 Canada
- />Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7 Canada
- />Ontario Tobacco Research Unit, 155 College Street, Toronto, ON M5T 3M7 Canada
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Abstract
This integrative review provides an overview of nicotine dependence measures used with perinatal women and an evaluation of their psychometric properties. Fifty-five articles that met inclusion and exclusion criteria were identified from five different databases. Most of the studies used the Fagerström Test for Nicotine Dependence (FTND). Other approaches included diagnostic tests, the Wisconsin Inventory of Smoking Dependence Motives (WISDM), the Tobacco Dependence Screener, and single-item measures. This review indicated that the FTND may not be the best option for measuring nicotine dependence in this population. The WISDM is a newer instrument that has excellent psychometric properties and captures nonnicotinic dimensions of nicotine dependence relevant to women. Future research is needed to assess its reliability in the perinatal population. Other recommendations from this review include the use of biomarker validation, thorough psychometric reporting on nicotine dependence instruments, and the use of multiple instruments to maximize comparability between nicotine dependence instruments.
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Wray JM, Gray KM, McClure EA, Carpenter MJ, Tiffany ST, Saladin ME. Gender differences in responses to cues presented in the natural environment of cigarette smokers. Nicotine Tob Res 2015; 17:438-42. [PMID: 25762753 DOI: 10.1093/ntr/ntu248] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Although the evidence is mixed, female smokers appear to have more difficulty quitting smoking than male smokers. Craving, stress, and negative affect have been hypothesized as potential factors underlying gender differences in quit rates. METHODS In the current study, the cue-reactivity paradigm was used to assess craving, stress, and negative affect in response to cues presented in the natural environment of cigarette smokers using ecological momentary assessment. Seventy-six daily smokers (42% female) responded to photographs (smoking, stress, and neutral) presented 4 times per day on an iPhone over the course of 2 weeks. RESULTS Both smoking and stress cues elicited stronger cigarette craving and stress responses compared to neutral cues. Compared with males, females reported higher levels of post-stress cue craving, stress, and negative affect, but response to smoking cues did not differ by gender. DISCUSSION Findings from this project were largely consistent with results from laboratory-based research and extend previous work by measuring response to cues in the natural environment of cigarette smokers. This study extends previous cue reactivity ecological momentary assessment research by using a new platform and by measuring response to stress cues outside of the laboratory. Findings from this project highlight the importance of addressing coping in response to stress cues in clinical settings, especially when working with female smokers.
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Affiliation(s)
- Jennifer M Wray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC; University at Buffalo, State University of New York, Buffalo, NY
| | - Kevin M Gray
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Erin A McClure
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Matthew J Carpenter
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Stephen T Tiffany
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Michael E Saladin
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
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Chen D, Wu LT. Smoking cessation interventions for adults aged 50 or older: A systematic review and meta-analysis. Drug Alcohol Depend 2015; 154:14-24. [PMID: 26094185 PMCID: PMC4536122 DOI: 10.1016/j.drugalcdep.2015.06.004] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 05/31/2015] [Accepted: 06/02/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND The older population size has increased substantially, and a considerable proportion of older adults are cigarette smokers. Quitting smoking is associated with reduced health risk. This review is among the first to quantitatively assess the relative efficacy of types of cessation interventions for smokers aged ≥50 years. METHODS We conducted searches of the Cochrane Library, Embase, MEDLINE, and PsycINFO to identify smoking cessation studies on adults aged ≥50 years. Twenty-nine randomized clinical trials met the inclusion criteria. Three main types of interventions were identified. We analyzed relative cessation rates or Risk Ratios (RRs) between the type of intervention groups and the control group by fixed- and random-effects meta-analyses at the study level. We conducted a weighted least squares meta-regression of cessation rates on trial and sample characteristics to determine sources of outcome heterogeneity. RESULTS Fixed-effects analysis showed significant treatment effects for pharmacological (RR=3.18, 95% CI: 1.89-5.36), non-pharmacological (RR=1.80, 95% CI: 1.67-1.94), and multimodal interventions (RR=1.61, 95% CI: 1.41-1.84) compared with control group. Estimations based on meta-regression suggested that pharmacological intervention (mean point prevalence abstinence rate (PPA)=26.10%, CI: 15.20-37.00) resembled non-pharmacological (27.97%, CI: 24.00-31.94), and multimodal interventions (36.64%, CI: 31.66-41.62); and non-pharmacological and multimodal interventions had higher PPAs than the control group (18.80%, CI: 14.48-23.12), after adjusting for a number of trial and sample characteristics. CONCLUSIONS A small number of smoking cessation studies examined smokers aged ≥50 years. Additional research is recommended to determine smoking cessation efficacy for diverse older population groups (e.g., ethnic minorities).
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Affiliation(s)
- Danhong Chen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, BOX 3903, Durham, NC, 27710, USA.
| | - Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, BOX 3903, Durham, NC, 27710, USA; Center for Child and Family Policy, Duke University, Durham, NC, USA.
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Bottorff JL, Robinson CA, Sarbit G, Graham R, Kelly MT, Torchalla I. A Motivational, Gender-Sensitive Smoking Cessation Resource for Family Members of Patients With Lung Cancer. Oncol Nurs Forum 2015; 42:363-70. [PMID: 26148315 DOI: 10.1188/15.onf.42-04ap] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To gather feedback on an innovative gender-sensitive booklet that draws on emotional connections and relationship factors to motivate smoking cessation. RESEARCH APPROACH Qualitative, descriptive. SETTING Six provinces in Canada. PARTICIPANTS 30 family members of patients with lung cancer who were currently smoking or had recently quit. METHODOLOGIC APPROACH Parallel booklets for women and men were developed using language and images to emphasize family relationships and gender considerations to motivate smoking cessation. Participants were provided with the women's and men's versions of the resource, and they were asked to review the gender-specific version of the booklet that was relevant to them. Semistructured telephone interviews were conducted, and transcriptions were analyzed for themes. FINDINGS Three themes were evident in the data, including "new perspectives. CONCLUSIONS A gender-sensitive approach that focuses on relationship factors represents an acceptable way to engage relatives of patients with lung cancer in discussions to support smoking cessation. INTERPRETATION Approaches to supporting smoking cessation among relatives of patients diagnosed with lung cancer should draw on positive relationship bonds and caring connections to motivate cessation.
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Affiliation(s)
| | | | | | | | - Mary T Kelly
- Institute for Healthy Living and Chronic Disease Prevention at the University of British Columbia
| | - Iris Torchalla
- Centre for Health Evaluation and Outcome Sciences at St. Paul's Hospital in Vancouver, British Columbia, Canada
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Walitzer KS, Dearing RL, Barrick C, Shyhalla K. Tobacco smoking among male and female alcohol treatment-seekers: clinical complexities, treatment length of stay, and goal achievement. Subst Use Misuse 2015; 50:166-73. [PMID: 25313831 PMCID: PMC4431693 DOI: 10.3109/10826084.2014.962050] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Literature suggests that tobacco smoking among clients in alcohol treatment has important clinical implications, including poorer treatment outcome. Much of this literature, however, has been derived from research-based treatment samples that utilized stringent inclusion and exclusion criteria, limiting generalizability of findings. OBJECTIVE In order to further our understanding of the correlates of smoking among clients with alcohol problems, the present research examines tobacco smoking status at admission for 21,128 adult treatment seekers from 253 community outpatient substance abuse clinics across New York State. METHODS This sample includes tobacco smokers at admission (62%) and women (25%). Clinical complexities at admission (unemployment, lack of high school diploma/GED, criminal justice involvement, mental illness, polysubstance abuse) and length of treatment stay and alcohol-related goal achievement at discharge were assessed by clinic staff. RESULTS Mixed models revealed that tobacco smoking was significantly associated with all five clinical complexities; interactions with gender indicated that this association was stronger for women with regard to criminal justice involvement and polysubstance abuse. Also, these smokers evidenced shorter substance disorder treatment duration and were less likely to achieve alcohol-related treatment goals relative to their nonsmoking counterparts. CONCLUSIONS Admission tobacco smoking status of alcohol treatment seekers is an important client characteristic with regard to clinical presentation and treatment outcome. Our findings underscore the need to further our understanding of the complexities associated with smoking and especially as it pertains to female smokers.
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Affiliation(s)
- Kimberly S Walitzer
- Research Institute on Addictions, University at Buffalo , Buffalo, New York , USA
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Bottorff JL, Haines-Saah R, Kelly MT, Oliffe JL, Torchalla I, Poole N, Greaves L, Robinson CA, Ensom MHH, Okoli CTC, Phillips JC. Gender, smoking and tobacco reduction and cessation: a scoping review. Int J Equity Health 2014; 13:114. [PMID: 25495141 PMCID: PMC4297403 DOI: 10.1186/s12939-014-0114-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 11/08/2014] [Indexed: 11/10/2022] Open
Abstract
Considerations of how gender-related factors influence smoking first appeared over 20 years ago in the work of critical and feminist scholars. This scholarship highlighted the need to consider the social and cultural context of women's tobacco use and the relationships between smoking and gender inequity. Parallel research on men's smoking and masculinities has only recently emerged with some attention being given to gender influences on men's tobacco use. Since that time, a multidisciplinary literature addressing women and men's tobacco use has spanned the social, psychological and medical sciences. To incorporate these gender-related factors into tobacco reduction and cessation interventions, our research team identified the need to clarify the current theoretical and methodological interpretations of gender within the context of tobacco research. To address this need a scoping review of the published literature was conducted focussing on tobacco reduction and cessation from the perspective of three aspects of gender: gender roles, gender identities, and gender relations. Findings of the review indicate that there is a need for greater clarity on how researchers define and conceptualize gender and its significance for tobacco control. Patterns and anomalies in the literature are described to guide the future development of interventions that are gender-sensitive and gender-specific. Three principles for including gender-related factors in tobacco reduction and cessation interventions were identified: a) the need to build upon solid conceptualizations of gender, b) the importance of including components that comprehensively address gender-related influences, and c) the importance of promoting gender equity and healthy gender norms, roles and relations.
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Affiliation(s)
- Joan L Bottorff
- Institute for Healthy Living and Chronic Disease Prevention, University of British Columbia, 3333 University Way, Kelowna, BC, V1V 2V7, Canada. .,Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia.
| | - Rebecca Haines-Saah
- School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC, V6T 1Z3, Canada.
| | - Mary T Kelly
- School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC, V6T 1Z3, Canada.
| | - John L Oliffe
- School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC, V6T 1Z3, Canada.
| | - Iris Torchalla
- Centre for Health Evaluation and Outcome Sciences, Room 620, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
| | - Nancy Poole
- British Columbia Centre of Excellence for Women's Health, E311 - 4500 Oak Street, Box 48, Vancouver, BC, V6H 3N1, Canada.
| | - Lorraine Greaves
- British Columbia Centre of Excellence for Women's Health, E311 - 4500 Oak Street, Box 48, Vancouver, BC, V6H 3N1, Canada.
| | - Carole A Robinson
- School of Nursing, University of British Columbia, 3333 University Way, Kelowna, BC, V1V 1V7, Canada.
| | - Mary H H Ensom
- Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Chizimuzo T C Okoli
- College of Nursing, 315 College of Nursing Building, University of Kentucky, Lexington, KY, 40536-0232, USA.
| | - J Craig Phillips
- RGN 3249A, School of Nursing, University of Ottawa, Guidon Hall, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada.
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Matcham F, McNally L, Vogt F. A pilot randomized controlled trial to increase smoking cessation by maintaining National Health Service Stop Smoking Service attendance. Br J Health Psychol 2013; 19:795-809. [PMID: 24289715 DOI: 10.1111/bjhp.12078] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 10/16/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The National Health Service (NHS) Stop Smoking Service (SSS) is an extremely cost-effective method of enabling smoking cessation. However, the SSS is only used by a minority of smokers. Developing interventions to maintain service attendance may help to increase the number of quitters. This study pilots an intervention aimed at maintaining attendance by (1) increasing motivation to attend through a booklet providing evidence of service effectiveness and (2) strengthening the link between motivation to attend and attendance through forming an implementation intention. DESIGN A factorial randomized controlled trial. METHODS A total of 160 newly enrolled smokers at the Surrey NHS SSS were recruited and randomly assigned to one of four conditions: (1) standard care (SC), (2) SC + effectiveness booklet, (3) SC + implementation intention, and (4) SC + effectiveness booklet + implementation intention. The outcome measures included attendance at the SSS and the 4-week quit rate. RESULTS The booklet increased service attendance (OR = 2.93, p < .01, 95% CI = 1.45-5.93; Number Needed to Treat = 3.3) but had no impact on the 4-week quit rate (OR = 1.55, 95% CI = 0.75-3.21). Forming an implementation intention had no impact on service attendance or the 4-week quit rate. Attending the service was associated with a higher 4-week quit rate (ρ = 87.52, p < .001). CONCLUSIONS Presenting information about the effectiveness of the service improved service attendance. A larger trial now needs to evaluate whether this intervention can also increase the quit rate. STATEMENT OF CONTRIBUTION What is already known on this subject? The NHS Stop Smoking Service is an effective yet underused method of enabling smoking cessation. Low uptake levels may be due to smokers' misconception that the service will not improve their chances of quitting successfully. Improving smokers' perceptions of service efficacy may be valuable for maintaining service attendance, and subsequently improving smoking cessation levels in the United Kingdom. What does this study add? This pilot randomized controlled trial is the first to target service attendance rather than cessation levels. The results demonstrate that providing evidence of service efficacy in a simple icon array format can significantly improve service attendance.
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Affiliation(s)
- Faith Matcham
- Department of Psychological Medicine, Weston Education Centre, Institute of Psychiatry, King's College London, UK
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Targeting cessation: understanding barriers and motivations to quitting among urban adult daily tobacco smokers. Addict Behav 2013; 38:1639-42. [PMID: 23254211 DOI: 10.1016/j.addbeh.2012.09.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Revised: 09/17/2012] [Accepted: 09/24/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Many people continue to smoke tobacco products despite known negative health consequences, including increased risk of chronic disease and death. Disparities exist in rates of smoking and chronic disease, underscoring the importance of understanding the barriers and motivations to smoking cessation among vulnerable populations, such as socioeconomically disadvantaged people of color. METHODS This study uses data from a cross-sectional randomized household survey conducted in six low-income neighborhoods in New Haven, Connecticut, USA (N=1205). The objectives were to examine barriers and motivations to quitting smoking among daily tobacco smokers (31.6% of respondents) and sociodemographic differences in endorsement of barriers and motivations. RESULTS The two most common barriers to quitting were perceiving it to be too difficult and not wanting to quit. Financial costs, social support, and social influence were themes endorsed highly across both barriers and motivations to quitting. Sociodemographic differences were found, such as women and Black participants being more likely to be interested in a free quitline or quit website; women and Latinos being more likely to be afraid of gaining weight; and women, participants with less education, and older participants being more likely to be concerned about the cost of cessation products. CONCLUSIONS Understanding barriers and motivations to quitting among disadvantaged populations is crucial. Financial issues, social support, and social norms should be targeted in promoting cessation among disadvantaged, urban populations. Programs, interventions, and policies can also use research about specific barriers and motivations for sociodemographic sub-groups to be tailored, targeted, and more effective.
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Pulvers K, Hood A, Limas EF, Thomas MD. Female smokers show lower pain tolerance in a physical distress task. Addict Behav 2012; 37:1167-70. [PMID: 22658302 PMCID: PMC3389309 DOI: 10.1016/j.addbeh.2012.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 05/08/2012] [Accepted: 05/15/2012] [Indexed: 11/15/2022]
Abstract
Numerous studies have established a link between distress tolerance and smoking cessation outcomes. The present study examined whether smoking status affected physical distress tolerance, and considered this question separately for men and women. The sample was comprised of healthy adults, 56 smokers (63% male) and 58 nonsmokers (62% female). The pain stimulus was a cold pressor task. Outcome variables were seconds immersed in cold water when pain was first reported (threshold), and total seconds immersed in cold water (tolerance). Participants verbally reported their pain rating on a 0-100 scale after the task, and then completed the McGill Pain Questionnaire-Short Form. Smokers displayed lower pain tolerance than nonsmokers (p=.045), and women displayed lower pain tolerance than men (p=.017). Female smokers had significantly lower pain tolerance than other groups (p=.001). There were no significant differences in pain threshold or pain perception by smoking status or gender (p>.05). Lower physical distress tolerance could place female smokers at risk for difficulty in quitting smoking. This population needs additional research to better understand their unique pain experience and how physical distress tolerance impacts their smoking cessation outcomes.
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Affiliation(s)
- Kim Pulvers
- California State University San Marcos, USA.
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Salameh P, Khayat G, Waked M. Lower Prevalence of Cigarette and Waterpipe Smoking, But a Higher Risk of Waterpipe Dependence in Lebanese Adult Women Than in Men. Women Health 2012; 52:135-50. [DOI: 10.1080/03630242.2012.656885] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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20
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Torchalla I, Okoli CTC, Bottorff JL, Qu A, Poole N, Greaves L. Smoking Cessation Programs Targeted to Women: A Systematic Review. Women Health 2012; 52:32-54. [DOI: 10.1080/03630242.2011.637611] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Abstract
Smoking rates among and between men and women are in large part a reflection of the influence of gender and its intersections with other social factors including ethnicity, age, and social class that influence tobacco use and, ultimately, tobacco reduction and cessation. In this article, opportunities for developing and delivering gender-sensitive (programs addressing gender) and gender-specific (programs designed for men or women) interventions in the context of tobacco dependence treatment are discussed.
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