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Castro Y, Leija A, Guerra ZC, Londoño T, Heydarian NM, Correa-Fernández V. Improving Spanish translations of tobacco dependence measures using cognitive interviewing. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:8-16. [PMID: 35050814 PMCID: PMC10642076 DOI: 10.1080/00952990.2021.1998514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Cognitive interviewing is the practice of systematically collecting feedback about survey items from members of the priority population, with the goal of identifying and rectifying problems to increase the comprehensibility of the survey. Evidence is limited on the extent to which this method of pretesting improves survey items. OBJECTIVE The current study examined the utility of incorporating cognitive interviewing to improve the Spanish translations of two measures of tobacco dependence. METHODS Items from the Spanish versions of the Wisconsin Inventory of Smoking Dependence Motives (68 items) and Nicotine Dependence Syndrome Scale (19 items) were subjected to cognitive interviews with Spanish-speaking smokers. Problematic items were revised based on participant feedback and re-assessed in a second round of interviews (N = 23, 78.3% male; 21.7% female). RESULTS Twenty-three of the 87 items demonstrated comprehension problems, and 67 items elicited at least one problem report. Number of problems were significantly fewer pre- vs. post-revision (t [90] = 6.55, p < .001). CONCLUSIONS In combination with standard translation procedures, cognitive interviewing with the priority population appears to be a useful method for ensuring comprehensible and relevant item content.
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Affiliation(s)
- Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas at Austin
| | | | - Zully C. Guerra
- Steve Hicks School of Social Work, The University of Texas at Austin
| | - Tatiana Londoño
- Steve Hicks School of Social Work, The University of Texas at Austin
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Londoño T, Moore JR, Guerra ZC, Heydarian NM, Castro Y. The contribution of positive affect and loneliness on readiness and self-efficacy to quit smoking among Spanish-speaking Mexican American smokers. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2022; 48:110-119. [PMID: 34932409 PMCID: PMC10763704 DOI: 10.1080/00952990.2021.1998513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The existing research on affective and interpersonal determinants of smoking cessation largely under-represents minority smokers, such as Latinos. OBJECTIVE The current study examined associations between affective and interpersonal factors with intermediary smoking cessation variables among Mexican-American smokers (N = 290; 60% male). METHODS Measures of positive and negative affect, social support, and loneliness were each examined for associations with measures of motivational readiness to quit smoking, and smoking abstinence self-efficacy. Significant predictors were entered into models simultaneously to examine their unique associations. Covariates included gender, age, and educational attainment. RESULTS Negative affect (b = .68, SE b = .14, p < .001) and loneliness (b = .20, SE b = .09, p < .05) were independently associated with motivation. Negative affect (b = .20, SE b = .06, p < .01) and positive affect (b = .34 SE b = .07, p < .001) were independently associated with self-efficacy. In the final models, only negative affect was associated with motivation (b = .68, SE b = .17, p < .001); whereas negative (b = .17, SE b = .06, p < .01) and positive (b = . 32, SE b = .07, p < .001) affect were associated with self-efficacy. CONCLUSION Results highlight the importance of resilience factors (e.g., positive affect) among Mexican-American smokers. Cessation interventions regularly target negative affect among smokers; additional focus on positive affect in cessation interventions with this population may be warranted.
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Affiliation(s)
- Tatiana Londoño
- Steve Hicks School of Social Work, The University of Texas, Austin, TX, USA
| | - John R Moore
- Steve Hicks School of Social Work, The University of Texas, Austin, TX, USA
| | - Zully C Guerra
- Steve Hicks School of Social Work, The University of Texas, Austin, TX, USA
| | | | - Yessenia Castro
- Steve Hicks School of Social Work, The University of Texas, Austin, TX, USA
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Barcelona de Mendoza V, Damio G. Evaluation of a culturally appropriate peer coaching program for smoking cessation. Public Health Nurs 2019; 35:541-550. [PMID: 30596399 DOI: 10.1111/phn.12542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 06/07/2018] [Accepted: 07/13/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the effectiveness of a peer coaching smoking cessation program in a high-risk Medicaid population. DESIGN AND SAMPLE In this manuscript, we present an evaluation of a pilot program. Participants (N = 138) were recruited out of a larger smoking cessation program administered statewide and funded by the Center for Medicare and Medicaid Services. The participant sample was diverse, with 52% self-identifying as White, 39% as Black, and 56% Latino ethnicity (any race). METHODS Motivational interviewing techniques were utilized by peer coaches in clinical and community settings to achieve smoking cessation using face-to-face, telephone, and text/email encounters over a period of 6 months. RESULTS There was a statistically significant increase in the number of participants who had quit smoking from program enrollment to discharge (5.1%-18.5%, p = 0.02). Number of peer coaching encounters predicted quitting in program participants. CONCLUSIONS This study adds to the literature that community-based smoking cessation services led by peer coaches can be effective in a diverse, high-risk population.
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Affiliation(s)
| | - Grace Damio
- Hispanic Health Council, Hartford, Connecticut
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Jalali-Farahani S, Amiri P, Khalili-Chelik A, Karimi M, Azizi F. Association between Smoking and Perceived Social Support among Tehranian Adults: Tehran Lipid and Glucose Study. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2018. [DOI: 10.21859/jech.5.2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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An Interdisciplinary Response to a Tobacco Cessation Case Vignette. J Smok Cessat 2017. [DOI: 10.1017/jsc.2016.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction:Tobacco use is a chronic, relapsing condition. While there are proven cessation medications and counselling treatments, uptake of available aids is poor and smokers often do not have access to evidence-based services.Aims:The Association for the Treatment of Tobacco Use and Dependence (ATTUD) is an organisation of tobacco treatment specialists (TTSs) representing a wide array of disciplines and healthcare settings. This case vignette was intended to provide a clinical example of an interdisciplinary approach to tobacco use treatment.Methods:ATTUD Interdisciplinary Committee members representing tobacco-cessation experts from five professions were asked to respond to the same composite case vignette detailing key areas of clinical consideration and treatment.Results/Findings:While there were common treatment themes across professions, each provider also offered a unique treatment perspective addressing different facets of the patient's complex care needs, including attention to other chronic illnesses, mental illnesses, and preventive services. Expert responses highlighted that different treatment approaches across a continuum of healthcare settings are complementary.Conclusions:Responses to this vignette support the need to address tobacco use from an interdisciplinary approach. Existing chronic care and patient-centred models should be utilised to ensure that tobacco users receive a sufficient range of cessation services.
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Hou LS, Du XD, Li JJ, Zhu P, Yan PJ, Zhan FY, Zhou MK, Zhu CR. Long-term trends and predictors of smoking behaviors among men following first-ever ischemic stroke. ACTA ACUST UNITED AC 2017; 37:446-452. [DOI: 10.1007/s11596-017-1755-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/10/2017] [Indexed: 11/29/2022]
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Powell J, Newhouse N, Martin A, Jawad S, Yu LM, Davoudianfar M, Locock L, Ziebland S. A novel experience-based internet intervention for smoking cessation: feasibility randomised controlled trial. BMC Public Health 2016; 16:1156. [PMID: 27835953 PMCID: PMC5106834 DOI: 10.1186/s12889-016-3821-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 11/04/2016] [Indexed: 12/04/2022] Open
Abstract
Background The internet is frequently used to share experiences of health and illness, but this phenomenon has not been harnessed as an intervention to achieve health behaviour change. The aim of this study was to determine the feasibility of a randomised trial assessing the effects of a novel, experience-based website as a smoking cessation intervention. The secondary aim was to measure the potential impact on smoking behaviour of both the intervention and a comparator website. Methods A feasibility randomised controlled single-blind trial assessed a novel, experience-based website containing personal accounts of quitting smoking as a cessation intervention, and a comparator website providing factual information. Feasibility measures including recruitment, and usage of the interventions were recorded, and the following participant-reported outcomes were also measured: Smoking Abstinence Self-Efficacy Questionnaire, the single-item Motivation to Stop Scale, self-reported abstinence, quit attempts and health status outcomes. Eligible smokers from two English regions were entered into the trial and given access to their allocated website for two weeks. Results Eighty-seven smokers were randomised, 65 completed follow-up (75 %). Median usage was 15 min for the intervention, and 5 min for the comparator (range 0.5–213 min). Median logins for both sites was 2 (range 1–20). All participant-reported outcomes were similar between groups. Conclusions It was technically feasible to deliver a novel intervention harnessing the online sharing of personal experiences as a tool for smoking cessation, but recruitment was slow and actual use was relatively low, with attrition from the trial. Future work needs to maximize engagement and to understand how best to assess the value of such interventions in everyday use, rather than as an isolated ‘dose of information’. Trial registration ISRCTN29549695 DOI 10.1186/ISRCTN29549695. Registered 17/05/2013.
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Affiliation(s)
- John Powell
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Nikki Newhouse
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Angela Martin
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sena Jawad
- Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Ly-Mee Yu
- Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Mina Davoudianfar
- Primary Care Clinical Trials Unit, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Louise Locock
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Sue Ziebland
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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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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LaChance H, Cioe PA, Tooley E, Colby SM, O'Farrell TJ, Kahler CW. Behavioral couples therapy for smoking cessation: A pilot randomized clinical trial. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2015; 29:643-52. [PMID: 25642582 PMCID: PMC4768739 DOI: 10.1037/adb0000051] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Behavioral couples therapy (BCT) has been found to improve long-term abstinence rates in alcohol- and substance-dependent populations but has not been tested for smoking cessation. This pilot study examined the feasibility and acceptability of BCT for smoking-discordant couples. Forty-nine smokers (smoking >10 cigarettes/day) with nonsmoking partners were randomized to receive a couples social support (BCT-S) intervention or an individually delivered, standard smoking cessation treatment (ST). The couples were married or had been cohabiting for at least 1 year, with partners who had never smoked or had not used tobacco in 1 year. Both treatments included 7 weekly sessions and 8 weeks of nicotine replacement therapy. Participants were followed for 6 months posttreatment. The Partner Interaction Questionnaire was used to measure perceived smoking-specific partner support. Participants were 67% male and 88% White. Biochemically verified cessation rates were 40.9%, 50%, and 45% in BCT-S and 59.1%, 50%, and 55% in ST at end of treatment, after 3 month, and after 6 months, respectively, and did not differ significantly between treatment conditions at any time point. Perceived smoking-specific partner support at posttreatment did not significantly differ between treatment groups. Results of this pilot study do not provide support for the efficacy of BCT in smoking-discordant couples.
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Affiliation(s)
| | - Patricia A Cioe
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University
| | - Erin Tooley
- Center for Behavioral and Preventative Medicine, Warren Alpert Medical School, Brown University
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University
| | | | - Christopher W Kahler
- Center for Alcohol and Addiction Studies, School of Public Health, Brown University
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Hemsing N, Greaves L, Poole N. Tobacco Cessation Interventions for Underserved Women. JOURNAL OF SOCIAL WORK PRACTICE IN THE ADDICTIONS 2015; 15:267-287. [PMID: 27226783 PMCID: PMC4867857 DOI: 10.1080/1533256x.2015.1054231] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 04/09/2015] [Accepted: 05/14/2015] [Indexed: 06/05/2023]
Abstract
Despite high rates of smoking among some subgroups of women, there is a lack of tailored interventions to address smoking cessation among women. We identify components of a women-centered approach to tobacco cessation by analyzing 3 bodies of literature: sex and gender influences in tobacco use and addiction; evidence-based tobacco cessation guidelines; and best practices in delivery of women-centered care. Programming for underserved women should be tailored, build confidence and increase motivation, integrate social justice issues and address inequities, and be holistic and comprehensive. Addressing the complexity of women's smoking and tailoring appropriately could help address smoking among subpopulations of women.
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Affiliation(s)
- Natalie Hemsing
- Research Associate, British Columbia Centre of Excellence for Women’s Health, Vancouver, British Columbia, Canada
| | - Lorraine Greaves
- Senior Investigator, British Columbia Centre of Excellence for Women’s Health, Vancouver, British Columbia, Canada
| | - Nancy Poole
- Director, British Columbia Centre of Excellence for Women’s Health, Vancouver, British Columbia, Canada
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Burns RJ, Rothman AJ, Fu SS, Lindgren B, Joseph AM. The relation between social support and smoking cessation: revisiting an established measure to improve prediction. Ann Behav Med 2015; 47:369-75. [PMID: 24222508 DOI: 10.1007/s12160-013-9558-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although social support is an integral element in smoking cessation, the literature presents mixed findings regarding the type(s) of social support that are most helpful. The Partner Interaction Questionnaire (PIQ) is commonly used to measure social support in this context. PURPOSE We explored the possibility that more nuanced distinctions between items on the PIQ than what is customarily used could improve the prediction of cessation. METHODS Baseline PIQ responses of smokers enrolled in a cessation program was submitted to an exploratory factor analysis. Emergent factors were used to predict cessation at several time points. RESULTS Four factors emerged, which differed from the two subscales that are typically used. The four-factor version predicted cessation; the two-factor version did not. CONCLUSIONS Identifying the types of social support that predict smoking cessation depend on our ability to measure social support. More nuanced measures will likely clarify the role of social support in cessation.
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Affiliation(s)
- Rachel J Burns
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN, 55455, USA,
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Tooley EM, Busch A, McQuaid EL, Borrelli B. Structural and Functional Support in the Prediction of Smoking Cessation in Caregivers of Children with Asthma. Behav Med 2015; 41:203-10. [PMID: 24911559 PMCID: PMC4261041 DOI: 10.1080/08964289.2014.931274] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Caregivers of children with asthma smoke at rates similar to the general population. Research on the relative importance of structural or functional social support in smoking cessation has been mixed. Participants were smokers (N = 154) who were caregivers of children with asthma. Both functional (Interpersonal Support Evaluation List) and structural social support (living with another smoker, partner status, and the proportion of smoking friends) were measured at baseline. Participants received an asthma-education and smoking cessation intervention based on Motivational Interviewing. Biochemically-verified abstinence was assessed at six months post treatment. Results indicated that functional support predicted smoking abstinence even when controlling for relevant covariates and structural support (OR = .896, p = .025). Exploratory analyses revealed that this effect was driven primarily by the self-esteem ISEL subscale. Smoking cessation that focuses on building general functional support, particularly self-esteem support, may be beneficial for smoking cessation in caregivers of children with asthma.
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Affiliation(s)
- Erin M. Tooley
- Postdoctoral NIH Research Fellow, The Warren Alpert Medical School of Brown University and The Miriam Hospital, Program in Nicotine and Tobacco
| | - Andrew Busch
- Assistant Professor of Psychiatry and Human Behavior and The Miriam Hospital, Program in Nicotine and Tobacco, The Warren Alpert Medical School of Brown University and The Miriam Hospital
| | - Elizabeth L. McQuaid
- Associate Professor of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University and Rhode Island Hospital
| | - Belinda Borrelli
- Professor of Psychiatry and Human Behavior, The Warren Alpert Medical School of Brown University and The Miriam Hospital, Program in Nicotine and Tobacco
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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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Cokkinides VE, Bandi P, Siegel RL, Jemal A. Cancer-related risk factors and preventive measures in US Hispanics/Latinos. CA Cancer J Clin 2012; 62:353-63. [PMID: 22987448 DOI: 10.3322/caac.21155] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In this article, we provide prevalence data on major cancer-related risk factors, early detection testing, and vaccination among Hispanics using nationally representative surveys. Compared with non-Hispanic whites, Hispanic adults are less likely to be current smokers (13% vs 22%) or frequent alcohol drinkers, but they are more likely to be obese (32% vs 26%) and to have lower levels of mammography use within the past year (46% vs 51%), colorectal screening as per recommended intervals (47% vs 61%), and Papanicolaou (Pap) test use within the past 3 years (74% vs 79%). Within the Hispanic population, the prevalence of these risk factors and early detection methods substantially vary by country of origin. For example, Cuban men (20.7%) and Puerto Rican men (19%) had the highest levels of current smoking than any other Hispanic subgroups, while Mexican women had the lowest levels of mammogram use (44%) and Pap test use (71%). Hispanic migrants have a higher prevalence of hepatitis B virus and Helicobacter pylori, which cause liver and stomach cancer, respectively. Among Hispanic adolescents, tobacco use (eg, 20.8% use of any tobacco products), alcohol use (42.9%), and obesity (23.2%) remain highly prevalent risk factors. Although 56% of Hispanic adolescents initiate human papillomavirus vaccination, only 56% of them completed the 3-dose series. Differences in risk factors and early detection testing among Hispanic groups should be considered in clinical settings and for cancer control planning.
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The Relationship between Smoking and Depression Post-Acute Coronary Syndrome. CURRENT CARDIOVASCULAR RISK REPORTS 2011; 5:510-518. [PMID: 22384285 DOI: 10.1007/s12170-011-0198-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The purpose of the current paper is to review research on the relationship between smoking cessation and depressed mood post-Acute Coronary Syndrome (Myocardial infarction or unstable angina; ACS). Emerging evidence regarding the effect of anhedonia-a specific subcomponent of mood disturbance characterized by reduced pleasure-on post-ACS outcomes is also discussed. There is strong evidence that depression prospectively predicts post-ACS relapse to smoking. Weaker evidence suggests that smoking at the time of ACS is related to post-ACS depression. Bupropion is a particularly promising treatment for this population because of its smoking cessation and anti-depressant effects. Future research should focus on the relative risk of using nicotine replacement therapies post-ACS, the efficacy of bupropion for smoking cessation and depression reduction in post-ACS patients, the role of anhedonia in post-ACS smoking cessation, and the development and testing of integrated behavioral treatments (smoking cessation plus interventions targeting mood management) for ACS patients.
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