Smit, E.S.; Hoving, C.; Schelleman-Offermans, K.; West, R.; de Vries, H.
Introduction: Despite their positive motivation to quit, many smokers do not attempt to quit or relapse soon after their quit attempt. This study investigated the predictors of successful and unsuccessful quit attempts among smokers motivated to quit smoking. Methods: We conducted secondary data
Hughes, John R; Callas, Peter W
The incidence of quit attempts is often used to measure the effects of tobacco control interventions. Many surveys of quit attempts require that the attempt last ≥24 hr, presumably to provide a more objective definition and to eliminate less serious attempts; however, this criterion may bias outcomes by excluding the more dependent quitters who cannot stop for 1 day despite a serious quit attempt. We examined the 2003 and the 2006-2007 Tobacco Use Supplements to the Current Population Survey to determine the prevalence of quit attempts that did and did not last 24 hr, both in the last 12 months and in one's lifetime among current daily smokers. We also tested the hypothesis that those unable to quit for 24 hr were the more dependent smokers. Requiring quit attempts to last 24 hr excluded 6%-17% of smokers who stated they made a quit attempt. Whether smokers who could not quit for more than 24 hr were more dependent varied across survey, recall duration, and measure. We conclude restricting quit attempts to those who have quit for 24 hr underestimates the prevalence of attempts. Whether those unable to quit for 24 hr are the more dependent smokers is unclear. Empirical tests of whether the addition of a 24-hr criterion increases reliability or validity are needed.
Full Text Available Introduction: Cigarette smoking is the leading preventable cause of premature deaths in the U.S., accounting for approximately 443,000 deaths annually. Although smoking prevalence in recent decades has declined substantially among all racial/ethnic groups, disparities in smoking-related behaviors among racial/ethnic groups continue to exist. Two of the goals of Healthy People 2020 are to reduce smoking prevalence among adults to 12% or less and to increase smoking cessation attempts by adult smokers from 41% to 80%. Our study assesses whether correlates of quit attempts vary by race/ethnicity among adult (≥18 years smokers in the U.S. Understanding racial/ethnic differences in how both internal and external factors affect quit attempts is important for targeting smoking-cessation interventions to decrease tobacco-use disparities. Methods: We used 2003 Tobacco Use Supplement to the Current Population Survey (CPS data from 16,213 adults to examine whether the relationship between demographic characteristics, smoking behaviors, smoking policies and having made a quit attempt in the past year varied by race/ethnicity. Results: Hispanics and persons of multiple races were more likely to have made a quit attempt than whites. Overall, younger individuals and those with >high school education, who smoked fewer cigarettes per day and had smoked for fewer years were more likely to have made a quit attempt. Having a smoke-free home, receiving a doctor’s advice to quit, smoking menthol cigarettes and having a greater time to when you smoked your first cigarette of the day were also associated with having made a quit attempt. The relationship between these four variables and quit attempts varied by race/ethnicity; most notably receiving a doctor’s advice was not related to quit attempts among Asian American/Pacific Islanders and menthol use among whites was associated with a lower prevalence of quit attempts while black menthol users were more likely
Zhao, Luhua; Song, Yang; Xiao, Lin; Palipudi, Krishna; Asma, Samira
China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers. The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation analyses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking-related variables affected making a quit attempt. An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15-24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables. Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers. Copyright © 2015 Elsevier Inc. All rights reserved.
Zhao, Luhua; Song, Yang; Xiao, Lin; Palipudi, Krishna; Asma, Samira
Background China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers. Methods The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation anal yses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking related variables affected making a quit attempt. Results An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15–24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables. Conclusion Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers. PMID:26441296
Daniel A. Gundersen
Full Text Available Objective. Examine the association between English language proficiency (ELP and immigrant generation and having made a cigarette smoking quit attempt in the past 12 months among Latinos. Examine if gender moderates the association between acculturation and quit attempts. Methods. Latino past year smokers from the 2003 and 2006/07 Tobacco Use Supplement to the Current Population Survey were analyzed. Logistic regression was used to examine the association between quit attempt and ELP and immigrant generation, controlling for demographics and smoking characteristics. Results. Latinos with poor ELP were more likely to have made a quit attempt compared to those with good ELP (adjusted odds ratio [AOR]=1.22, confidence interval [CI]: 1.02–1.46 after controlling for demographic and smoking characteristics. First (AOR=1.21, CI: 1.02–1.43 and second generation immigrants (AOR=1.36, CI: 1.12–1.64 were more likely than third generation immigrants to have made a quit attempt in the past 12 months. Conclusion. Quit behaviors are shaped by differences in language ability and generational status among Latinos. This underscores the need to disaggregate Latinos beyond racial/ethnic categories to identify subgroup differences relevant for smoking and smoking cessation behaviors in this population.
Wrighting, Quentaxia; Businelle, Michael S; Kendzor, Darla E; LeBlanc, Hannah; Reitzel, Lorraine R
Cigarette purchasing patterns may be linked with greater readiness to make a quit attempt and more quit attempts among domiciled samples. However, little is known about the cigarette purchasing patterns of homeless smokers or their potential relations to quitting intention and behaviors. This study redressed this gap among a convenience sample of homeless adult smokers from a large shelter in Dallas, Texas. Participants (N = 207; Mage = 43; 71.5% male) smoked ≥100 cigarettes over the lifetime and endorsed current daily smoking. Variables assessed included cigarette dependence (time to first cigarette of the day), monthly income, quantity of cigarettes most recently purchased, average money spent on cigarettes weekly, readiness/motivation to quit smoking, and the number intentional quit attempts lasting ≥24h in the past year. Regression analyses were conducted to characterize associations of cigarette purchasing patterns with readiness to quit and quit attempts controlling for sex, age, cigarette dependence, and income. Most participants purchased cigarettes by the pack (61.4%), and more than half the sample spent ≤$20 on cigarettes per week. Results indicated that spending less money per week on cigarettes was associated with greater readiness to quit (P = .016), even when controlling for income, cigarette dependence, and other covariates. Stratified analyses indicated that this association was significant only for homeless smokers reporting no regular monthly income. Homeless daily smokers with no reported income who spend little money on cigarettes may make particularly apt targets for cessation interventions due to potential associations with quitting motivation. Adults who are homeless smoke at greater rates and quit at lower rates than domiciled adults, leading to significant smoking-related health disparities among this group. Findings suggest that cigarette purchasing patterns are linked with readiness to quit smoking among smokers who are homeless
Shin, Sanghyuk S; Moreno, Patricia Gonzalez; Rao, Smriti; Garfein, Richard S; Novotny, Thomas E; Strathdee, Steffanie A
Injection drug use and cigarette smoking are major global health concerns. Limited data exist regarding cigarette smoking behavior and quit attempts among injection drug users (IDUs) in low- and middle-income countries to inform the development of cigarette smoking interventions. We conducted a cross-sectional study to describe cigarette smoking behavior and quit attempts among IDUs in Tijuana, Mexico. IDUs were recruited through community outreach and administered in-person interviews. Multivariable Poisson regression models were constructed to determine prevalence ratios (PRs) for quit attempts. Of the 670 participants interviewed, 601 (89.7%) were current smokers. Of these, median number of cigarettes smoked daily was 10; 190 (31.6%) contemplated quitting smoking in the next 6 months; 132 (22.0%) had previously quit for ≥1 year; and 124 (20.6%) had made a recent quit attempt (lasting ≥1 day during the previous 6 months). In multivariable analysis, recent quit attempts were positively associated with average monthly income (≥3,500 pesos [US$280] vs. <1,500 pesos [US$120]; PR = 2.30; 95% CI = 1.57-3.36), smoking marijuana (PR = 1.38; 95% CI = 1.01-2.90), and smoking heroin (PR = 1.85; 95% CI = 1.23-2.78), and they were negatively associated with number of cigarettes smoked daily (PR = 0.96; 95% CI = 0.94-0.98). One out of 5 IDUs attempted to quit cigarette smoking during the previous 6 months. Additional research is needed to improve the understanding of the association between drug use patterns and cigarette smoking quit attempts, including the higher rate of quit attempts observed among IDUs who smoke marijuana or heroin compared with IDUs who do not smoke these substances.
Skov-Ettrup, Lise Skrubbeltrang; Egan, Kia Kejlskov; Dalum, Peter
Smokers who wish to quit may refrain from doing so if they expect to experience more stress after haven given up. We test if stress-related expectations about smoking cessation are associated with quit attempts and abstinence among smokers who are motivated to quit. The study included 1809 daily...... after 3, 8 and 14 months. We found that the association between expecting to be more stressed if giving up smoking differed between participants who had previously attempted to quit and those who had not: In participants who previously attempted to quit (47%), expecting to be more stressed......, expectations about stress were not associated with abstinence. Results indicate that expectations about stress in relation to smoking cessation are an important determinant of cessation in smokers who previously attempted to quit. Addressing stress and how to handle stressful situations may increase...
van den Putte, B.; Yzer, M.C.; Willemsen, M.C.; de Bruijn, G.J.
Objective: To examine the effect of two types of self-identity on attempts to quit smoking: self-identity in terms of smoking and self-identity in terms of quitting. Design: A prospective survey among an initial sample of 3,411 smokers. Smoking history variables and psychosocial variables from the
Erblich, Joel; Michalowski, Alexandra
Poor inhibitory control has been shown to be an important predictor of relapse to a number of drugs, including nicotine. Indeed, smokers who exhibit higher levels of impulsivity are thought to have impaired regulation of urges to smoke, and previous research has suggested that impulsivity may moderate cue-induced cigarette cravings. To that end, we conducted a study to evaluate the interplay between failed smoking cessation, cue-induced craving, and impulsivity. Current smokers (n=151) rated their cigarette cravings before and after laboratory to exposure to smoking cues, and completed questionnaires assessing impulsivity and previous failed quit attempts. Findings indicated that shorter duration of previous failed quit attempts was related to higher cue-induced cigarette craving, especially among smokers with higher levels of impulsivity. Results underscore the importance of considering trait impulsivity as a factor in better understanding the management of cue-induced cravings. Copyright © 2015 Elsevier Ltd. All rights reserved.
Ussher, Michael; Kakar, Geetanjali; Hajek, Peter; West, Robert
It is not known how well motivation to stop smoking predicts abstinence in a clinical sample relative to the most widely used measure of cigarette dependence. A secondary analysis was conducted from a trial with 864 smokers making quit attempt. Fagerström Test of Cigarette Dependence (FTCD), Heaviness of Smoking Index (HSI), and motivation to stop smoking (composite of determination to quit and importance of quitting) were measured at baseline. Continuous smoking abstinence, validated by expired-air carbon monoxide, was assessed at 4weeks, 6months and 12months post-quit date. FTCD, HSI, non-HSI items in FTCD, and motivation were assessed as predictors of abstinence. In multiple-logistic regressions, controlling for age, gender and medication use, lower scores for FTCD, HSI and non-HSI all significantly predicted abstinence at all follow-ups, while motivation did not predict abstinence at any time. Likelihood ratio tests showed that the FTCD contributed most to the model at 4weeks and 6months; at 12months FTCD and non-HSI equally contributed most to the model. At 4weeks and 6months, predictions were improved by combining HSI and non-HSI components, compared with using these components alone. Cigarette dependence, measured by the FTCD, or by its HSI or non-HSI components, predicts both short-term and medium-term outcomes of attempts to stop smoking in treatment-seeking smokers involved in a clinical trial, whereas strength of motivation to stop predicts neither. Both the HSI and non-HSI components may be considered as briefer alternatives to the full FTCD. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.
Full Text Available Abstract Background Although the current Clinical Practice Guideline recommend Motivational Interviewing for use with smokers not ready to quit, the strength of evidence for its use is rated as not optimal. The purpose of the present study is to address key methodological limitations of previous studies by ensuring fidelity in the delivery of the Motivational Interviewing intervention, using an attention-matched control condition, and focusing on unmotivated smokers whom meta-analyses have indicated may benefit most from Motivational Interviewing. It is hypothesized that MI will be more effective at inducing quit attempts and smoking cessation at 6-month follow-up than brief advice to quit and an intensity-matched health education condition. Methods/Design A sample of adult community resident smokers (N = 255 who report low motivation and readiness to quit are being randomized using a 2:2:1 treatment allocation to Motivational Interviewing, Health Education, or Brief Advice. Over 6 months, participants in Motivational Interviewing and Health Education receive 4 individual counseling sessions and participants in Brief Advice receive one brief in-person individual session at baseline. Rigorous monitoring and independent verification of fidelity will assure the counseling approaches are distinct and delivered as planned. Participants complete surveys at baseline, week 12 and 6-month follow-up to assess demographics, smoking characteristics, and smoking outcomes. Participants who decide to quit are provided with a self-help guide to quitting, help with a quit plan, and free pharmacotherapy. The primary outcome is self-report of one or more quit attempts lasting at least 24 hours between randomization and 6-month follow-up. The secondary outcome is biochemically confirmed 7-day point prevalence cessation at 6-month follow-up. Hypothesized mediators of the presumed treatment effect on quit attempts are greater perceived autonomy support and
O'Connor, Richard J; Heckman, Bryan W; Adkison, Sarah E; Rees, Vaughan W; Hatsukami, Dorothy K; Bickel, Warren K; Cummings, K Michael
The cigarette purchase task (CPT) is a method that can be used to assess the relative value of cigarettes. Based on cigarettes purchased across a price range, five derived metrics (Omax, Pmax, breakpoint, intensity, and elasticity) can assess cigarette demand. A study with adolescent smokers found that these could be reduced to two latent factors: persistence (price insensitivity) and amplitude (volumetric consumption). We sought to replicate this structure with adult smokers and examine how these variables relate to cessation efforts. Web-based survey conducted in 2014 among adult (18 years and above) current daily cigarette smokers (N = 1194). Participants completed the CPT, Fagerstrom Test for Nicotine Dependence (FTND), reported past-year quit attempts, and future quit intentions. We included published scales assessing perceived prevalence of smoking, social reactivity, smoker identity, and risk perception. Our analysis supported two latent variables, persistence and amplitude, which correlated positively with FTND. Persistence was correlated with several psychosocial factors and was higher among those intending to quit very soon, but did not vary by number of past-year quit attempts. Amplitude differed across quit attempts and intention (p intention (OR = 0.76, p = 0.001). Persistence and amplitude factors characterized CPT data in adults, discriminated known groups (e.g., smokers by intentions to quit), and were positively associated with nicotine dependence. Factor scores also appear to relate to certain psychosocial factors, such as smoker identity and perceptions of risk. Future research should examine the predictive validity of these constructs.
Reitzel, Lorraine R; Langdon, Kirsten J; Nguyen, Nga T; Zvolensky, Michael J
Financial strain, defined as an unfavorable asset-to-needs ratio, has been associated with reduced odds of smoking cessation in the context of a structured clinical study providing cessation assistance. This study reports on a secondary data analysis that assessed the association of financial strain and biochemically-verified smoking abstinence within a structured clinical study of smokers making a self-guided cessation attempt. Participants (N=58; 65.5% men) were enrolled in a study about anxiety sensitivity and smoking cessation whereby they were instructed to initiate a self-guided quit attempt. Relations between financial strain and biochemically-verified smoking abstinence on the quit day and at Days 3, 7, 14, 28, and 90 post-quit were assessed using generalized estimating equations controlling for age, sex, race, education, partner status, pre-quit cigarettes smoked per day, and time. Associations between financial strain and abstinence in the whole sample were marginal (aOR=.94, 95% CI=.87-1.01, observations=293; p=.07). However, sex was a significant moderator: greater financial strain was associated with lower odds of abstinence for men (aOR=.90, 95% CI=.80-1.00, observations=201; p=.05), but not women (aOR=1.05, 95% CI=.91-1.21, observations=92; p=.48). Results indicated that financial strain was associated with lower odds of cessation among men undergoing a self-guided quit attempt in the context of a structured clinical study. These data suggest that financial strain may be an important socioeconomic determinant of smoking cessation and support its relevance for better understanding socioeconomic-based smoking-related health disparities. Future work may benefit by exploring sex-specific models of financial strain in the context of smoking cessation. Copyright © 2015 Elsevier Ltd. All rights reserved.
Buckner, Julia D; Langdon, Kirsten J; Jeffries, Emily R; Zvolensky, Michael J
Despite evidence of a strong and consistent relation between smoking and elevated social anxiety, strikingly little empirical work has identified mechanisms underlying the smoking-social anxiety link. Persons with elevated social anxiety may rely on smoking to cope with more severe nicotine withdrawal and post-quit negative mood states; yet, no known studies have investigated the relation of social anxiety to withdrawal severity. The current study examined the relation of social anxiety to post-quit nicotine withdrawal severity among 51 (33.3% female, Mage = 34.6) community-recruited smokers during the first two weeks following an unaided (i.e., no treatment) cessation attempt. Ecological momentary assessment was used to collect multiple daily ratings of withdrawal and negative mood states. Baseline social anxiety was related to increases in negative affect during the monitoring period and remained significantly related to post-quit withdrawal after controlling for negative affect, gender, lapses, and substance use. Persons with elevated social anxiety experience more severe post-quit withdrawal symptoms and increases in negative affect during a cessation attempt and may therefore benefit from intervention and treatment strategies geared toward helping them learn to cope with withdrawal and negative affect to improve cessation rates among these vulnerable smokers.
Siahpush, Mohammad; Shaikh, Raees A.; Smith, Danielle; Hyland, Andrew; Cummings, K. Michael; Sikora Kessler, Asia; Dodd, Michael D.; Carlson, Les; Meza, Jane; Wakefield, Melanie
The aim was to assess the association of exposure to point-of-sale (POS) tobacco marketing with quit attempt and quit success in a prospective study of smokers in the United States. Data were collected via telephone-interview on exposure to POS tobacco marketing, sociodemographic and smoking-related variables from 999 smokers in Omaha, Nebraska, in the United States. Exposure to POS tobacco marketing was measured by asking respondents three questions about noticing pack displays, advertisements, and promotions in their respective neighborhoods stores. These three variables were combined into a scale of exposure to POS tobacco marketing. About 68% of the respondents participated in a six-month follow-up phone interview and provided data on quit attempts and smoking cessation. At the six-month follow-up, 39.9% of respondents reported to have made a quit attempt, and 21.8% of those who made a quit attempt succeeded in quitting. Exposure to POS marketing at baseline was not associated with the probability of having made a quit attempt as reported at the six-month follow-up (p = 0.129). However, higher exposure to POS marketing was associated with a lower probability of quit success among smokers who reported to have attempted to quit smoking at six-month follow-up (p = 0.006). Exposure to POS tobacco marketing is associated with lower chances of successfully quitting smoking. Policies that reduce the amount of exposure to POS marketing might result in higher smoking cessation rates. PMID:26861379
Full Text Available The aim was to assess the association of exposure to point-of-sale (POS tobacco marketing with quit attempt and quit success in a prospective study of smokers in the United States. Data were collected via telephone-interview on exposure to POS tobacco marketing, sociodemographic and smoking-related variables from 999 smokers in Omaha, Nebraska, in the United States. Exposure to POS tobacco marketing was measured by asking respondents three questions about noticing pack displays, advertisements, and promotions in their respective neighborhoods stores. These three variables were combined into a scale of exposure to POS tobacco marketing. About 68% of the respondents participated in a six-month follow-up phone interview and provided data on quit attempts and smoking cessation. At the six-month follow-up, 39.9% of respondents reported to have made a quit attempt, and 21.8% of those who made a quit attempt succeeded in quitting. Exposure to POS marketing at baseline was not associated with the probability of having made a quit attempt as reported at the six-month follow-up (p = 0.129. However, higher exposure to POS marketing was associated with a lower probability of quit success among smokers who reported to have attempted to quit smoking at six-month follow-up (p = 0.006. Exposure to POS tobacco marketing is associated with lower chances of successfully quitting smoking. Policies that reduce the amount of exposure to POS marketing might result in higher smoking cessation rates.
Siahpush, Mohammad; Shaikh, Raees A; Smith, Danielle; Hyland, Andrew; Cummings, K Michael; Kessler, Asia Sikora; Dodd, Michael D; Carlson, Les; Meza, Jane; Wakefield, Melanie
The aim was to assess the association of exposure to point-of-sale (POS) tobacco marketing with quit attempt and quit success in a prospective study of smokers in the United States. Data were collected via telephone-interview on exposure to POS tobacco marketing, sociodemographic and smoking-related variables from 999 smokers in Omaha, Nebraska, in the United States. Exposure to POS tobacco marketing was measured by asking respondents three questions about noticing pack displays, advertisements, and promotions in their respective neighborhoods stores. These three variables were combined into a scale of exposure to POS tobacco marketing. About 68% of the respondents participated in a six-month follow-up phone interview and provided data on quit attempts and smoking cessation. At the six-month follow-up, 39.9% of respondents reported to have made a quit attempt, and 21.8% of those who made a quit attempt succeeded in quitting. Exposure to POS marketing at baseline was not associated with the probability of having made a quit attempt as reported at the six-month follow-up (p = 0.129). However, higher exposure to POS marketing was associated with a lower probability of quit success among smokers who reported to have attempted to quit smoking at six-month follow-up (p = 0.006). Exposure to POS tobacco marketing is associated with lower chances of successfully quitting smoking. Policies that reduce the amount of exposure to POS marketing might result in higher smoking cessation rates.
Sweitzer, Maggie M; Geier, Charles F; Denlinger, Rachel; Forbes, Erika E; Raiff, Bethany R; Dallery, Jesse; McClernon, F J; Donny, Eric C
Tobacco smoking is associated with dysregulated reward processing within the striatum, characterized by hypersensitivity to smoking rewards and hyposensitivity to non-smoking rewards. This bias toward smoking reward at the expense of alternative rewards is further exacerbated by deprivation from smoking, which may contribute to difficulty maintaining abstinence during a quit attempt. We examined whether abstinence-induced changes in striatal processing of rewards predicted lapse likelihood during a quit attempt supported by contingency management (CM), in which abstinence from smoking was reinforced with money. Thirty-six non-treatment-seeking smokers participated in two functional MRI (fMRI) sessions, one following 24-h abstinence and one following smoking as usual. During each scan, participants completed a rewarded guessing task designed to elicit striatal activation in which they could earn smoking and monetary rewards delivered after the scan. Participants then engaged in a 3-week CM-supported quit attempt. As previously reported, 24-h abstinence was associated with increased striatal activation in anticipation of smoking reward and decreased activation in anticipation of monetary reward. Individuals exhibiting greater decrements in right striatal activation to monetary reward during abstinence (controlling for activation during non-abstinence) were more likely to lapse during CM (p reward. These results are consistent with a growing number of studies indicating the specific importance of disrupted striatal processing of non-drug reward in nicotine dependence and highlight the importance of individual differences in abstinence-induced deficits in striatal function for smoking cessation.
Yasin, S M; Moy, F M; Retneswari, M; Isahak, M; Koh, D
Many smokers attempt to quit smoking, but very few succeed. To identify the timing and risk factors involved in smoking relapse. We conducted a prospective cohort study among staff in two public universities in Malaysia. Behavioural therapy with free nicotine replacement therapy was given as treatment. Participants were followed up for 6 months. Relapse was defined as returning to smoking after having quit for at least 24 h. Of 185 smokers who volunteered to participate, 120 achieved at least 24-h abstinence, and 80% of these relapsed within 2 months. Compared to participants who attended a single smoking cessation session, participants who attended three sessions had a lower likelihood of relapse within 6 months of quitting. In contrast, smokers with a much longer exposure to cigarette smoking in the workplace (>3 h per week) had a greater chance of relapse compared to those with no exposure. Frequent attendance at clinic sessions and less exposure to other people smoking in the workplace can potentially reduce the likelihood of relapse among smokers who have recently quit.
Bacio, Guadalupe A; Guzman, Iris Y; Shapiro, Jenessa R; Ray, Lara A
The prevalence of smoking across racial/ethnic groups has declined over the years, yet racial health disparities for smoking persist. Studies indicate that non-Hispanic Black smokers attempt to quit smoking more often compared to non-Hispanic White smokers but are less successful at doing so. Research suggests that motives to quit smoking differ by race, however, less is known about the role of motives to smoke in explaining racial differences in attempts to quit smoking. This study examined whether smoking motives accounted for the differential rates in quit attempts between non-Hispanic Black (n=155) and non-Hispanic White (n=159) smokers. Data were culled from a larger study of heavy-drinking smokers. The Wisconsin Index of Smoking Dependence Motives (WISDM) assessed motives to smoke. As expected, Black and White smokers reported similar smoking patterns, yet Black smokers reported higher rates of failed attempts to quit smoking than White smokers. Findings indicated that Black, compared to White, smokers endorsed lower scores in the negative reinforcement, positive reinforcement, and taste WISDM subscales and scores in these subscales mediated the relationship between race and quit attempts. In this study, Blacks, compared to Whites, endorsed lower motives to smoke, which are generally associated with successful quit attempts, yet they experienced more failed attempts to quit smoking. This study demonstrates racial health disparities at the level of smoking motives and suggests that Black smokers remain vulnerable to failed quit attempts despite reporting lower motives to smoke. Published by Elsevier Ltd.
Liles, Sandy; Hovell, Melbourne F; Matt, Georg E; Zakarian, Joy M; Jones, Jennifer A
This study explored predictors of smoking quit attempts in a sample of low-income smoking mothers who participated in a randomized trial of a 6-month, 14-session counseling intervention to decrease their children's secondhand smoke exposure (SHSe) and eliminate smoking. Measures were taken at baseline and at 3, 6, 12, and 18 months on 150 mothers who exposed their children (aged or = 10 cigarettes/week in the home. Reported 7-day quits were verified by saliva cotinine or urine anabasine and anatabine levels. There were few quits longer than 6 months. Mothers in the counseling group reported more 24-hr quits (p = .019) and more 7-day quits (p = .029) than controls. Multivariate modeling revealed that having quit for at least 24 hr in the year prior to baseline and the number of alternative cessation methods ever tried were predictive of the longest quit attempt during the 18-month study. Mothers in the counseling group who at baseline felt SHSe posed a health risk for their children or who at baseline had more permissive home smoking policies had longer quit attempts. Results confirm that attempts to quit smoking predict additional quit attempts. This suggests that practice may be necessary for many people to quit smoking permanently. Findings of interaction analyses suggest that participant factors may alter the effects of treatment procedures. Failure to account for or employ such factors in the analysis or design of community trials could confound the results of intervention trials.
Pasquereau, Anne; Guignard, Romain; Andler, Raphaël; Nguyen-Thanh, Viêt
There is conflicting evidence that use of e-cigarettes promotes cessation in regular smokers, but contrasting findings may be due to differing definitions of vaping. The aim was to assess whether regular use of e-cigarettes while smoking is associated with subsequent smoking cessation. Baseline internet survey with outcomes measured at 6-month follow-up. All French metropolitan territory. A total of 2057 smokers aged 15-85 years were recruited through an access panel and responded to a 6-month follow-up: 1805 exclusive tobacco smokers and 252 dual users (tobacco plus regular e-cigarette users) at baseline. The three outcomes assessed at 6 months were: a minimum 50% reduction in the number of cigarettes smoked per day, quit attempts of at least 7 days and smoking cessation of at least 7 days at the time of follow-up. Logistic regressions were performed to model the three outcomes according to regular e-cigarette use at baseline, adjusted for socio-economic variables and smoking behaviours. Baseline dual users were more likely than baseline exclusive tobacco smokers to have halved cigarette consumption [25.9 versus 11.2%, P e-cigarette regularly are more likely to try to quit smoking and reduce their cigarette consumption during the next 6 months. It remains unclear whether regular e-cigarette users are also more likely to stop smoking. © 2017 Society for the Study of Addiction.
Buckner, Julia D; Zvolensky, Michael J; Ecker, Anthony H
There is little research that has sought to identify factors related to quit success and failure among cannabis users. The current study examined affective, cognitive, and situational factors related to cannabis use among current cannabis users undergoing a voluntary, self-guided quit attempt. The sample consisted of 30 (33% female) current cannabis users, 84% of whom evinced a current cannabis use disorder. Ecological momentary assessment was used to collect multiple daily ratings of cannabis withdrawal, negative affect, peer cannabis use, reasons for use, and successful coping strategies over two weeks. Findings from generalized linear models indicated that cannabis withdrawal and positive and negative affect were significantly higher during cannabis use than non-use episodes. Additionally, when negative and positive affect were entered simultaneously, negative affect, but not positive affect, remained significantly related to use. Participants were significantly more likely to use in social situations than when alone. When participants were in social situations, they were significantly more likely to use if others were using. Participants tended to use more behavioral than cognitive strategies to abstain from cannabis. The most common reason for use was to cope with negative affect. Overall, these novel findings indicate that cannabis withdrawal, affect (especially negative affect), and peer use play important roles in cannabis use among self-quitters. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Daniel F Mackay
Full Text Available OBJECTIVES: In Scotland, legislation was implemented in March 2006 prohibiting smoking in all wholly or partially enclosed public spaces. We investigated the impact on attempts to quit smoking and smoking prevalence. METHODS: We performed time series models using Box-Jenkins autoregressive integrated moving averages (ARIMA on monthly data on the gross ingredient cost of all nicotine replacement therapy (NRT prescribed in Scotland in 2003-2009, and quarterly data on self-reported smoking prevalence between January 1999 and September 2010 from the Scottish Household Survey. RESULTS: NRT prescription costs were significantly higher than expected over the three months prior to implementation of the legislation. Prescription costs peaked at £1.3 million in March 2006; £292,005.9 (95% CI £260,402.3, £323,609, p<0.001 higher than the monthly norm. Following implementation of the legislation, costs fell exponentially by around 26% per month (95% CI 17%, 35%, p<0.001. Twelve months following implementation, the costs were not significantly different to monthly norms. Smoking prevalence fell by 8.0% overall, from 31.3% in January 1999 to 23.7% in July-September 2010. In the quarter prior to implementation of the legislation, smoking prevalence fell by 1.7% (95% CI 2.4%, 1.0%, p<0.001 more than expected from the underlying trend. CONCLUSIONS: Quit attempts increased in the three months leading up to Scotland's smoke-free legislation, resulting in a fall in smoking prevalence. However, neither has been sustained suggesting the need for additional tobacco control measures and ongoing support.
Mackay, Daniel F.; Haw, Sally; Pell, Jill P.
Objectives In Scotland, legislation was implemented in March 2006 prohibiting smoking in all wholly or partially enclosed public spaces. We investigated the impact on attempts to quit smoking and smoking prevalence. Methods We performed time series models using Box-Jenkins autoregressive integrated moving averages (ARIMA) on monthly data on the gross ingredient cost of all nicotine replacement therapy (NRT) prescribed in Scotland in 2003–2009, and quarterly data on self-reported smoking prevalence between January 1999 and September 2010 from the Scottish Household Survey. Results NRT prescription costs were significantly higher than expected over the three months prior to implementation of the legislation. Prescription costs peaked at £1.3 million in March 2006; £292,005.9 (95% CI £260,402.3, £323,609, p<0.001) higher than the monthly norm. Following implementation of the legislation, costs fell exponentially by around 26% per month (95% CI 17%, 35%, p<0.001). Twelve months following implementation, the costs were not significantly different to monthly norms. Smoking prevalence fell by 8.0% overall, from 31.3% in January 1999 to 23.7% in July–September 2010. In the quarter prior to implementation of the legislation, smoking prevalence fell by 1.7% (95% CI 2.4%, 1.0%, p<0.001) more than expected from the underlying trend. Conclusions Quit attempts increased in the three months leading up to Scotland's smoke-free legislation, resulting in a fall in smoking prevalence. However, neither has been sustained suggesting the need for additional tobacco control measures and ongoing support. PMID:22110585
El Ansari, W.; Stock, C.
Objectives: This study assessed the associations between socio-demographic, health and wellbeing variables (independent variables) and daily smoking, attempts to quit smoking, and agreement with smoking ban (dependent variables). Methods: Data from 3,706 undergraduate students were collected from...... degree; and, students who reported binge drinking. Conversely, daily smoking was less likely among students who rated their health as very good/excellent, those who ate >= 5 portions of fruit or vegetables, and those who had never taken illicit drugs. Previous attempt/s to quit smoking were more likely...... of occasional smokers. About every second smoker (55%) had attempted to quit smoking. Almost 45% of the whole sample agreed or strongly agreed with implementing a total smoking ban on campus. Daily smoking was more likely among students with not sufficient income, students whose fathers had at least a bachelor...
Attempt Quit Smoking 24+ Hours is defined as a person 18 years of age or older who must have reported smoking at least 100 cigarettes in his/her life, and now does not smoke at all but it has been less than 365 days since completely stopped smoking cigarettes, or now smoke everyday or some days but reported that have made attempt of quitting for more than 24 hours in the past 12 months.
Scheuermann, Taneisha S; Nollen, Nicole L; Luo, Xianghua; Cox, Lisa Sanderson; Ahluwalia, Jasjit S
Ethnic and racial differences in smoking patterns and behaviors have been well documented and most African American and Latino smokers are nondaily or light smokers. However, differences within smoking levels are understudied. Our primary aim was to determine whether there are racial and ethnic differences among African American, Latino, and White nondaily, light daily, and moderate to heavy daily smokers on (1) perceived health risk reduction, (2) intentions to quit, and (3) past year quit attempts. Smokers were recruited through an online research panel for a cross-sectional survey (n = 2376). Sampling quotas were used to obtain equal numbers of African American, Latino, and White nondaily and daily smokers. African American (59.6%) and Latino (54%) nondaily smokers were more likely than White nondaily smokers (45%) to currently limit their cigarettes per day (cpd) as a perceived health risk reduction strategy (p smokers were more likely than Latino and White nondaily smokers (p smokers (15%) were more likely than either Latinos (7.8%) or Whites (8.5%) to intend to quit in the next 30 days (p smokers were more likely than Whites (49%) to have made a quit attempt in the past year (p smokers. Racial and ethnic group differences were more pronounced among nondaily smokers compared to light daily smoker and moderate to heavy daily smokers. Smoking level is an important consideration in understanding racial and ethnic variation in perceived health risk reduction and cessation-related behaviors.
Madewell, Zachary J; Figueiredo, Valeska Carvalho; Harbertson, Judith; Pérez, Ramona L; Novotny, Thomas
The objectives of this research were to evaluate whether there was an association between seeing an actor smoke in telenovelas, Brazilian films, or international films, and trying to quit and quitting among adult Brazilian smokers. Data from 39,425 participants in the Global Adult Tobacco Survey were used. Quit ratio (former smoker/former smoker + ever smoker) and proportions of current, former, and never smokers were calculated. Multivariable weighted regression was used to determine significant associations between quitting smoking and exposure to telenovelas and films. For current smokers, the odds of trying to quit were significantly higher among those who saw an actor smoking in a Brazilian film. Those who believed smoking caused serious illness and had rules in the home prohibiting smoking were significantly more likely to have tried to quit or had quit smoking. Exposure to smoking in the media may be different in adults than adolescents. Influential factors for trying to quit and quitting are rules prohibiting smoking at home, belief that smoking causes serious illness, and hearing about dangers of smoking in media.
Turk, Tahir; Newton, Fiona; Choudhury, Sohel; Islam, Md Shafiqul
Tobacco use contributes to an estimated 14.6% of male and 5.7% of female deaths in Bangladesh. We examine the determinants of tobacco-related quit attempts among Bangladeshis with and without awareness of the synergized "People Behind the Packs" (PBTP) communication campaign used to support the introduction of pack-based graphic warning labels (GWLs) in 2016. Data from 1,796 adults were collected using multistage sampling and a cross-sectional face-to-face survey. Analyses used a normalized design weight to ensure representativeness to the national population of smokers within Bangladesh. For the overall sample, the multivariable logistic regression model revealed quit attempts were associated with having seen the pack-based GWLs, recalling ≥1 PBTP campaign message, higher levels of self-efficacy to quit, and recognizing more potential side-effects associated with using tobacco products. Conversely, the likelihood of quitting attempts were lower among dual tobacco users (relative to smokers) and those using tobacco at least daily (vs. less than daily). The hierarchical multivariable logistic regression model among those aware of ≥1 PBTP campaign message indicated quitting attempts were positively associated with recalling more of the campaign messages and discussing them with others. This national evaluation of pack-based GWLs and accompanying PBTP campaign within Bangladesh supports the efficacy of using synergized communication messages when introducing such labels. That quit attempts are more likely among those discussing PBTP campaign messages with others and recalling more PBTP campaign messages highlights the importance of ensuring message content is both memorable and engaging.
Minami, Haruka; Bloom, Erika Litvin; Reed, Kathleen M. Palm; Hayes, Steven C.; Brown, Richard A.
Recent smoking cessation studies have shown that decreasing experiential avoidance (EA) (i.e., tendency to reduce or avoid internal distress) improves success, but to date none have examined the moderating effect of EA on the role of specific internal distress in smoking cessation. This study examined whether pre-quit general EA (Acceptance & Action Questionnaire) and smoking-specific EA (Avoidance and Inflexibility Scale) moderated the relations between four measures of post-quit internal distress (depressive symptoms, negative affect, physical withdrawal symptoms, craving), and smoking. Participates: 40 adult smokers who participated in a randomized controlled trial of Distress Tolerance treatment for smokers with a history of early lapse. Results: Multilevel models showed that pre-quit smoking-specific EA, but not general EA, significantly moderated the relationship between all measures of internal distress, except craving, and smoking over 13 weeks post-quit. When examined over 26 weeks, these relations remained unchanged for all, but the moderating effect became trend-level for depressive symptoms. Significant associations between post-quit internal distress and smoking were found only in those with high pre-quit smoking-specific EA. Moreover, pre-quit smoking-specific EA did not predict post-quit levels or changes in internal distress, suggesting that decreasing smoking-specific EA pre-quit may not reduce internal distress, but may instead reduce smoking risk in response to such distress during a quit attempt. Conclusions: Results mainly supported hypothesized relations, but only for smoking-specific EA. Smoking cessation interventions focusing on EA reduction may especially benefit those vulnerable to greater post-quit depressive and withdrawal symptoms, and those who smoke to regulate aversive internal states. PMID:25347023
Smoking cigarettes is a factor which increases the risk of developing many diseases, especially of the circulatory and respiratory systems. Quitting smoking is an essential element of prophylaxis and therapy. The effectiveness of treating the syndrome of nicotine addiction mostly depends on the motivation to give up the habit. The study aimed at evaluating the motivation and the strength of nicotine addiction as well as the factor which motivates smokers for giving up the habit. Sixty-two smokers were included in the study. There were 31 males and 31 females. The mean age of the study subjects was 47.26 ± 14.45. The study was performed using the author-made survey (including for example questions regarding sociodemographic data and motives for quitting smoking), Fagerström Tolerance Questionnaire (for analyzing degree of nicotine addiction) and Schneider Motivation Test (to evaluate the degree of motivation to quit smoking). Thirty-seven subjects out of the total number of 62 were the least addicted to nicotine. They were highly motivated to give up the habit of smoking. The mean value of motivation depended on the level of education of the subjects and was 7.71-8.50 scores. Health concerns were the reasons to make a decision to quit smoking for the majority of the subjects. Health concern is the most common reason for giving up the habit of smoking. The relationship between the motivation to quit smoking and the sex of the subjects was not observed.
Davis, Kevin C; Duke, Jennifer; Shafer, Paul; Patel, Deesha; Rodes, Robert; Beistle, Diane
Measures of perceived effectiveness (PE) of ads have been validated to predict changes in cognitive precursors of quit attempts, but a relationship between PE and actual quit attempts has not been shown in population-based studies. We analyzed smokers' PE ratings of ads from the national Tips From Former Smokers (Tips) campaign to (1) establish the validity of PE in predicting quit attempts in a large, nationally representative sample of smokers; (2) identify behavioral and demographic correlates of PE among respondents; and (3) examine whether PE is influenced by matching the race/ethnicity of ad participants with that of the ad viewer. We used survey data from two waves (baseline and follow-up) of a longitudinal online cohort of adult U.S. cigarette smokers. Respondents were shown one or more of 14 Tips campaign ads and were asked to assess each ad in terms of PE. We used multivariate models to estimate the association between baseline PE and prospective quit attempts; cross-sectional associations between PE and various respondent characteristics, including race/ethnicity, desire to quit, and health conditions; and the association between race/ethnicity of respondents and Tips ad participants. Higher PE at baseline was associated with increased odds of a quit attempt at follow-up. Higher PE scores were associated with non-Hispanic black race, Hispanic ethnicity, higher desire to quit, presence of a chronic health condition, and presence of a mental health condition. There was no relationship between PE scores and matched race/ethnicity of the respondent and Tips ad participants. This is the first study to demonstrate an association between PE scores for antismoking ads and prospective quit attempts in a large, nationally representative sample of smokers. Our findings also provide strong evidence that racial/ethnic minority subpopulations, including non-Hispanic blacks and Hispanics, react more favorably to Tips campaign ads irrespective of race/ethnicity of
Wakefield, M. A.; Spittal, M. J.; Yong, H-H.; Durkin, S. J.; Borland, R.
Objective: To assess the extent to which intensity and timing of televised anti-smoking advertising emphasizing the serious harms of smoking influences quit attempts. Methods: Using advertising gross rating points (GRPs), we estimated exposure to tobacco control and nicotine replacement therapy (NRT) advertising in the 3, 4-6, 7-9 and 10-12 months…
Buckner, Julia D.; Langdon, Kirsten J.; Jeffries, Emily R.; Zvolensky, Michael J.
Despite evidence of a strong and consistent relation between smoking and elevated social anxiety, strikingly little empirical work has identified mechanisms underlying the smoking-social anxiety link. Persons with elevated social anxiety may rely on smoking to cope with more severe nicotine withdrawal and post-quit negative mood states; yet, no known studies have investigated the relation of social anxiety to withdrawal severity. The current study examined the relation of social anxiety to po...
Full Text Available Abstract Background Smoking is a significant women's health issue. Examining smoking behaviors among occupational groups with a high prevalence of women may reveal the culture of smoking behavior and quit efforts of female smokers. The purpose of this study was to examine how smoking and quitting characteristics (i.e., ever and recent quit attempts among females in the occupation of nursing are similar or different to those of women in the general population. Methods Cross-sectional data from the Tobacco Use Supplement of the Current Population Survey 2006/2007 were used to compare smoking behaviors of nurses (n = 2, 566 to those of non-healthcare professional women (n = 93, 717. Smoking characteristics included years of smoking, number of cigarettes, and time to first cigarette with smoking within the first 30 minutes as an indicator of nicotine dependence. Logistic regression models using replicate weights were used to determine correlates of ever and previous 12 months quit attempts. Results Nurses had a lower smoking prevalence than other women (12.1% vs 16.6%, p p = 0.0002; but not in the previous 12 months (42% vs 43%, p = 0.77. Among those who ever made a quit attempt, nurses who smoked within 30 minutes of waking, were more likely to have made a quit attempt compared to other women (OR = 3.1, 95% CI: 1.9, 5.1. When considering quit attempts within the last 12 months, nurses whose first cigarette was after 30 minutes of waking were less likely to have made a quit attempt compared to other females (OR = 0.69, 95% CI: 0.49, 0.98. There were no other significant differences in ever/recent quitting. Conclusions Smoking prevalence among female nurses was lower than among women who were not in healthcare occupations, as expected. The lack of difference in recent quit efforts among female nurses as compared to other female smokers has not been previously reported. The link between lower level of nicotine dependence, as reflected by the longer
Park, Eun-Ja; Park, Susan; Cho, Sung-il; Kim, Yeol; Seo, Hong Gwan; Driezen, Pete; Quah, Anne C K; Fong, Geoffrey T
We assess the cigarette price that would motivate smokers to quit. We also explore the factors associated with the required price, including exposures to non-tax tobacco control policies. Cross-sectional analysis was conducted on data from 1257 male smokers, who participated in either Wave 2 or 3 of the ITC Korea Survey. Information was obtained on what cigarette price per pack would make them try to quit ('price to quit'). Tobit regression on log-transformed price and logistic regression on non-quitting were conducted to identify associated factors. The median price to quit was KRW5854 (US$5.31)/pack, given the current price of KRW2500 (US$2.27)/pack. Younger age, higher education, lack of concern about the health effects of smoking, lack of quit attempts and more cigarettes consumed per day were related to a higher price needed for a quit attempt. Exposures to combinations of non-tax policies were significantly associated with lower price levels to be motivated to quit. Considering the large price increase required for quit attempts, tax policy needs to be combined with other policies, particularly for certain groups, such as heavy smokers. Strengthening non-tax policies is likely to facilitate greater responsiveness to tax policy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
El Ansari, Walid; Labeeb, Shokria; Kotb, Safaa; Yousafzai, Mohammad T; El-Houfey, Amira; Stock, Christiane
Smoking among university students represents a formidable and global public health challenge. We assessed the associations between socio-demographic, health and wellbeing variables as independent variables, with daily smoking, attempts to quit smoking, and agreement with smoking ban as dependent variables. A sample of 3258 undergraduate students from eleven faculties at Assiut University, Assiut, Egypt, completed a general health questionnaire. Overall daily or occasional smoking in last three months prior to the survey was about 9% (8% occasional and 1% daily smokers), and smoking was generally more prevalent among males (male=17%, female=0.6%, P non-smoking policies on university premises, as well as regular up-to-date information on, and the periodic/yearly monitoring of tobacco use by university students employing standardised data collection instruments and reference periods. In addition, it would be valuable to develop campus-based educational/ awareness campaigns designed to counteract tobacco advertisement directed towards young people in Middle East countries. Otherwise, the danger could be that the current relatively low smoking prevalence among university students may escalate in the future.
Cano, Miguel Ángel; Lam, Cho Y; Chen, Minxing; Adams, Claire E; Correa-Fernández, Virmarie; Stewart, Diana W; McClure, Jennifer B; Cinciripini, Paul M; Wetter, David W
Ecological momentary assessment was used to examine associations between negative affect, positive smoking outcome expectancies, and smoking urge during the first 7 days of a smoking quit attempt. Participants were 302 female smokers who enrolled in an individually tailored smoking cessation treatment study. Multilevel mediation analysis was used to examine the temporal relationship among the following: (a) the effects of negative affect and positive smoking outcome expectancies at 1 assessment point (e.g., time j) on smoking urge at the subsequent time point (e.g., time j + 1) in Model 1; and, (b) the effects of negative affect and smoking urge at time j on positive smoking outcome expectancies at time j + 1 in Model 2. The results from Model 1 showed a statistically significant effect of negative affect at time j on smoking urge at time j + 1, and this effect was mediated by positive smoking outcome expectancies at time j, both within- and between-participants. In Model 2, the within-participant indirect effect of negative affect at time j on positive smoking outcome expectancies at time j + 1 through smoking urge at time j was nonsignificant. However, a statistically significant indirect between-participants effect was found in Model 2. The findings support the hypothesis that urge and positive smoking outcome expectancies increase as a function of negative affect, and suggest a stronger effect of expectancies on urge as opposed to the effect of urge on expectancies.
Hitchman, Sara C; Fong, Geoffrey T; Zanna, Mark P; Thrasher, James F; Laux, Fritz L
Smokers who inhabit social contexts with a greater number of smokers may be exposed to more positive norms toward smoking and more cues to smoke. This study examines the relation between number of smoking friends and changes in number of smoking friends, and smoking cessation outcomes. Data were drawn from Wave 1 (2002) and Wave 2 (2003) of the International Tobacco Control (ITC) Project Four Country Survey, a longitudinal cohort survey of nationally representative samples of adult smokers in Australia, Canada, United Kingdom, and United States (N = 6,321). Smokers with fewer smoking friends at Wave 1 were more likely to intend to quit at Wave 1 and were more likely to succeed in their attempts to quit at Wave 2. Compared with smokers who experienced no change in their number of smoking friends, smokers who lost smoking friends were more likely to intend to quit at Wave 2, attempt to quit between Wave 1 and Wave 2, and succeed in their quit attempts at Wave 2. Smokers who inhabit social contexts with a greater number of smokers may be less likely to successfully quit. Quitting may be particularly unlikely among smokers who do not experience a loss in the number of smokers in their social context.
Lüscher, Janina; Stadler, Gertraud; Ochsner, Sibylle; Rackow, Pamela; Knoll, Nina; Hornung, Rainer; Scholz, Urte
Social support receipt from one's partner is assumed to be beneficial for successful smoking cessation. However, support receipt can have costs. Recent research suggests that the most effective support is unnoticed by the receiver (i.e., invisible). Therefore, this study examined the association between everyday levels of dyadic invisible emotional and instrumental support, daily negative affect, and daily smoking after a self-set quit attempt in smoker-non-smoker couples. Overall, 100 smokers (72.0% men, mean age M = 40.48, SD = 9.82) and their non-smoking partners completed electronic diaries from a self-set quit date on for 22 consecutive days, reporting daily invisible emotional and instrumental social support, daily negative affect, and daily smoking. Same-day multilevel analyses showed that at the between-person level, higher individual mean levels of invisible emotional and instrumental support were associated with less daily negative affect. In contrast to our assumption, more receipt of invisible emotional and instrumental support was related to more daily cigarettes smoked. The findings are in line with previous results, indicating invisible support to have beneficial relations with affect. However, results emphasize the need for further prospective daily diary approaches for understanding the dynamics of invisible support on smoking cessation. Statement of contribution What is already known on this subject? Social support receipt from a close other has proven to have emotional costs. According to current studies, the most effective social support is unnoticed by the receiver (i.e., invisible). There is empirical evidence for beneficial effects of invisible social support on affective well-being. What does this study add? Confirming benefits of invisible social support for negative affect in a health behaviour change setting Providing first evidence for detrimental effects of invisible social support on smoking. © 2015 The British Psychological Society.
Differences in Quit Attempts and Cigarette Smoking Abstinence Between Whites and African Americans in the United States: Literature Review and Results From the International Tobacco Control US Survey.
Kulak, Jessica A; Cornelius, Monica E; Fong, Geoffrey T; Giovino, Gary A
While cigarette smoking prevalence is declining among US adults, quit rates may differ between white and African American smokers. Here, we summarize the literature on smoking cessation behaviors in whites and African Americans across four study designs and report the findings of new analyses of International Tobacco Control (ITC) US Survey cohort data. We reviewed 32 publications containing 39 relevant analyses that compared quit attempts and abstinence between US whites and African Americans. Two additional longitudinal analyses were conducted on 821 white and 76 African American cigarette smokers from Waves 7 and 8 of the ITC US Survey (mean follow-up = 19 months). Of 17 total analyses of quit attempts, nine (including the ITC US Survey) observed that African American smokers were more likely than whites to attempt to quit during a given year; seven found no differences. Whites were more likely than African Americans to be abstinent in five of six retrospective cohort analyses and in two of five considered community- and population-based cohort studies. Four of these 11 analyses, including one from the ITC US Survey, found no differences. Of 11 population- or community-based analyses, all seven that found significant differences indicated that whites were more likely to quit than African Americans. These findings, combined with the similar results from population-based birth cohort analyses, support the conclusion that white smokers are more likely to quit than African American smokers. Efforts to encourage and support quitting among all tobacco users remain a priority. This article provides a review of the literature on smoking cessation among African American and white smokers, and adds new analyses that compare quit attempts and abstinence between US African Americans and whites. Results demonstrate a clear distinction between the findings of cross-sectional and retrospective cohort studies with those of cohort studies. Reasons for these differences merit
Subramony, Deepak Prem; Molenda, Michael; Betrus, Anthony K.; Thalheimer, Will
Critics have been attempting to debunk the mythical retention chart at least since 1971. The earliest critics, David Curl and Frank Dwyer, were addressing just the retention data. Beginning around 2002, a new generation of critics has taken on the illegitimate combination of the retention chart and Edgar Dale's Cone of Experience--the corrupted…
Cho, Yoo Jin; Thrasher, James F; Yong, Hua-Hie; Szklo, André Salem; O'Connor, Richard J; Bansal-Travers, Maansi; Hammond, David; Fong, Geoffrey T; Hardin, James; Borland, Ron
Cigarette pack health warning labels can elicit negative emotions among smokers, yet little is known about how these negative emotions influence behavior change. Guided by psychological theories emphasizing the role of emotions on risk concern and behavior change, we investigated whether smokers who reported stronger negative emotional responses when viewing warnings reported stronger responses to warnings in daily life and were more likely to try to quit at follow-up. We analyzed data from 5439 adult smokers from Australia, Canada, Mexico, and the US, who were surveyed every four months from September 2012 to September 2014. Participants were shown warnings already implemented on packs in their country and reported negative emotional responses (i.e., fear, disgust, worry), which were averaged (range = 1 to 9). Country-stratified logistic and linear generalized estimating equations were used to analyze the effect of negative emotional responses on self-reported responses to warnings in daily life (i.e., attention, risk concern, avoidance of warnings, forgoing planned cigarettes) and quit attempts at follow-up. Models were adjusted for socio-demographic and smoking-related characteristics, survey wave, and the number of prior surveys answered. Smokers who reported stronger negative emotions were more likely to make quit attempts at follow-up (Adjusted ORs ranged from 1.09 [95% CI 1.04 to 1.14] to 1.17 [95% CI 1.12 to 1.23]; p negative emotions. This relationship was mediated through attention to warnings and behavioral responses to warnings. There was no significant interaction of negative emotions with self-efficacy or nicotine dependence. Negative emotions elicited by warnings encourage behavior change, promoting attention to warnings and behavioral responses that positively predict quit attempts. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
Lee, Sungkyu; Grana, Rachel A; Glantz, Stanton A
As elsewhere, in South Korea electronic cigarettes (e-cigarettes) are marketed, in part, as a smoking cessation aid. We assessed the prevalence of e-cigarette use among Korean adolescents and the relationship between e-cigarette use and current (past 30-day) smoking, cigarettes/day, attempts to quit conventional cigarettes, and ceasing to use cigarettes. Data from the 2011 Korean Youth Risk Behavior Web-based Survey of 75,643 students aged 13-18 years were analyzed with logistic regression. A total of 9.4% (8.0% ever-dual users who were concurrently using e-cigarettes and smoking conventional cigarettes and 1.4% ever-e-cigarette only users) of Korean adolescents have ever used e-cigarettes and 4.7% were current (past 30-day) e-cigarette users (3.6% dual users and 1.1% e-cigarettes only). After adjusting for demographics, current cigarette smokers were much more likely to use e-cigarettes than were nonsmokers. Among current cigarette smokers, those who smoked more frequently were more likely to be current e-cigarette users. The odds of being an e-cigarette user were 1.58 times (95% confidence interval, 1.39-1.79) higher among students who had made an attempt to quit than for those who had not. It was rare for students no longer using cigarettes to be among current e-cigarette users (odds ratio, .10; confidence interval, .09-.12). Some Korean adolescents may be responding to advertising claims that e-cigarettes are a cessation aid: those who had made an attempt to quit were more likely to use e-cigarettes but less likely to no longer use cigarettes. E-cigarette use was strongly associated with current and heavier cigarette smoking. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Berg, Carla J.; Swan, Deanne W.; Kegler, Michelle C.; Fredrick, George; Daniel, Sandra
Introduction The objective of this study was to examine the cumulative effect of smoke-free policies and social support for smoking cessation in the home, at church, and at work on smoking levels and quit attempts in the context of a community-based study of rural African Americans and whites in the Southeast. Methods We conducted a baseline survey to assess sociodemographics, smoking behavior, level of social support for smoking cessation, and smoke-free policies at home, church, and work. W...
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.
Zvolensky, Michael J; Paulus, Daniel J; Langdon, Kirsten J; Robles, Zuzuky; Garey, Lorra; Norton, Peter J; Businelle, Michael S
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; M age =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. Copyright © 2016 Elsevier Ltd. All rights reserved.
Williams, David M.; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J.; Monti, Peter M.; Emerson, Jessica
Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)—an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants’ natural environments. PMID:24246818
Williams, David M; Ussher, Michael; Dunsiger, Shira; Miranda, Robert; Gwaltney, Chad J; Monti, Peter M; Emerson, Jessica
Aerobic exercise has been proposed as a stand-alone or adjunct smoking cessation treatment, but findings have been mixed. Laboratory studies have shown that individual exercise sessions lead to decreases in withdrawal symptoms and cigarette cravings, but findings are limited by lack of follow-up and artificial settings. On the other hand, smoking cessation treatment RCTs have generally failed to show positive effects of exercise on smoking cessation, but have been plagued by poor and/or unverified compliance with exercise programs. This paper describes the rationale and design for Quit for Health (QFH)--an RCT designed to determine the efficacy of aerobic exercise as an adjunct smoking cessation treatment among women. To overcome limitations of previous research, compliance with the exercise (and wellness contact control) program is incentivized and directly observed, and ecological momentary assessment is used to examine change over time in withdrawal symptoms and cigarette cravings in participants' natural environments. Copyright © 2013 Elsevier Inc. All rights reserved.
... half of the people who don't quit smoking will die of smoking-related problems. Quitting smoking is important for your health. Soon after you ... they succeed. There are many ways to quit smoking. Some people stop "cold turkey." Others benefit from ...
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Minami, Haruka; Frank, Brandon E; Bold, Krysten W; McCarthy, Danielle E
To assess whether individuals trying to quit smoking who have high depressive symptoms (HD), compared with low depressive symptoms (LD): (1) report more frequent stressful events (SEs), (2) are more likely to smoke after SEs, (3) experience greater acute or persistent changes in affect after an SE, and (4) are at greater risk of smoking following affective changes. Smoking cessation data were analyzed using multi-level path modeling to examine the moderating effects of depressive symptoms on relations among SEs, subsequent affect, and smoking. An academic research center in Central New Jersey, USA. Seventy-one adult treatment-seeking daily smokers recruited from 2010 to 2012. Baseline depressive symptoms [HD: Center for Epidemiological Studies Depression Scale (CES-D) ≥ 16 versus LD: CES-D affect, and smoking assessed during 21 days post-quit. Multi-level models indicated that HD smokers were more likely than LD smokers to report stressful events [odds ratio (OR) = 2.323, P = 0.009], but had similar post-stress acute affective changes (negative affect: b = -0.117, P = 0.137, positive affect: b = 0.020, P = 0.805). Only HD smokers reported increased negative affect (NA) (b = 0.199, P = 0.030) and decreased positive affect (PA) up to 12 hours later (b = -0.217, P = 0.021), and greater lapse risk up to 24 hours after an SE (OR = 3.213, P = 0.017). The persistence of elevated NA and suppressed PA was partially explained by increased odds of subsequent SEs among HD smokers. However, the heightened stress-lapse association over 24 hours found in HD smokers was not fully explained by sustained aversive affect or subsequent SEs. Depressed and non-depressed smokers trying to quit appear to experience similar acute affective changes following stress: however, depressed smokers experience higher rates of exposure to stress, longer-lasting post-stress affective disturbance and greater risk of smoking lapse 12-24 hours after a stressful event
Full Text Available Abstract Background The estimated number of cigarette smokers in the world is 1.3 billion, expected to rise to 1.7 billion by 2025, with 10 million smokers living in the U.K. Smoking is the leading, preventable death-cause worldwide, being responsible for almost 650,000 deaths in the E.U. annually. A combination of pharmacological interventions, including nicotine replacement therapy, bupropion and varenicline, and behavioural support is the most effective approach to smoking cessation. However, even the best methods have high relapse rates of approximately 75% within 6 months. Electronic (or “e-“ cigarettes use battery power to disperse a solution that usually contains propylene glycol or glycerine, water, flavouring and nicotine. E-cigarettes have become the most popular smoking cessation aid in England, however, information on their effects on cardiovascular function is limited and contradictory. As e-cigarettes are not solely nicotine-based products, existing research exploring the effects of nicotine on the cardio-vasculature provides only limited information, while their extensive uptake urges the need of evidence to inform the general public, smokers and policy-makers. Methods This is a pragmatic, 3-group, randomised, assessor-blinded, single-centre trial exploring the cardiovascular physiological effects of the use of e-cigarettes (nicotine-free and nicotine-inclusive, assessed separately combined with behavioural support as a smoking cessation method in comparison to the combination of NRT and behavioural support. The primary outcome will be macro-vascular function, determined by a Flow Mediated Dilatation ultrasound assessment, 6 months following participants’ “quit date”. Discussion Participants will be assessed at baseline, 3 days following their self-determined “quit date”, at intervention end (3 months and 6 months following their “quite date”. Findings are expected to give an indication of the cardiovascular
Klonizakis, Markos; Crank, Helen; Gumber, Anil; Brose, Leonie S
The estimated number of cigarette smokers in the world is 1.3 billion, expected to rise to 1.7 billion by 2025, with 10 million smokers living in the U.K. Smoking is the leading, preventable death-cause worldwide, being responsible for almost 650,000 deaths in the E.U. annually. A combination of pharmacological interventions, including nicotine replacement therapy, bupropion and varenicline, and behavioural support is the most effective approach to smoking cessation. However, even the best methods have high relapse rates of approximately 75% within 6 months. Electronic (or "e-") cigarettes use battery power to disperse a solution that usually contains propylene glycol or glycerine, water, flavouring and nicotine. E-cigarettes have become the most popular smoking cessation aid in England, however, information on their effects on cardiovascular function is limited and contradictory. As e-cigarettes are not solely nicotine-based products, existing research exploring the effects of nicotine on the cardio-vasculature provides only limited information, while their extensive uptake urges the need of evidence to inform the general public, smokers and policy-makers. This is a pragmatic, 3-group, randomised, assessor-blinded, single-centre trial exploring the cardiovascular physiological effects of the use of e-cigarettes (nicotine-free and nicotine-inclusive, assessed separately) combined with behavioural support as a smoking cessation method in comparison to the combination of NRT and behavioural support. The primary outcome will be macro-vascular function, determined by a Flow Mediated Dilatation ultrasound assessment, 6 months following participants' "quit date". Participants will be assessed at baseline, 3 days following their self-determined "quit date", at intervention end (3 months) and 6 months following their "quite date". Findings are expected to give an indication of the cardiovascular effects of e-cigarettes both in the short- and in the medium-term period
... of dying from cancer goes down. Your blood pressure goes down. Your pulse and blood oxygen level return to normal. If you have children, you can help them be healthier by quitting smoking. Children whose parents smoke around them are at higher risk for ...
Ismail, Tengku Alina Tengku; Jalil, Rohana Abdul; Wan Ishak, Wan Rosli; Hamid, Noor Fadzlina; Wan Nik, Wan Suriati; Jan Mohamed, Hamid Jan; Mohd, Nor Haslina; Arifin, Wan Nor; Mohamed, Wan Mohd Izani Wan; Ibrahim, Mohd Ismail; Ismail, Rohaida; Hassim, Tengku Fatimatul Tengku; Aris, Tahir; Wan Muda, Wan Manan
A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program. Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed. The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors. Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.
Rachamallu, Vivekananda; Song, Michael M; Liu, Haiying; Giles, Charles L; McMahon, Terry
Obsessive-compulsive disorder (OCD) is a distressing and often debilitating disorder characterized by obsessions, compulsions, or both that are time-consuming and cause impairment in social, occupational, or other areas of functioning. There are many published studies reporting higher risk of suicidality in OCD patients, as well as studies describing increased risk of suicidality in OCD patients with other comorbid psychiatric conditions such as major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Existing case reports on OCD with suicide as the obsessive component describe patients with long standing diagnosis of OCD with suicidal ideations or previous suicide attempts. This report describes the case of a 28-year-old male, who works as a first responder, who presented with new onset symptoms characteristic of MDD and PTSD, with no past history of OCD or suicidality who developed OCD with suicidal obsessions. Differentiating between suicidal ideation in the context of other psychiatric illnesses and suicidal obsessions in OCD is critical to ensuring accurate diagnosis and timely provision of most appropriate treatment. The combination of exposure and response prevention therapy and pharmacotherapy with sertraline and olanzapine was effective in helping the patient manage the anxiety and distress stemming from the patient's OCD with suicidal obsession.
Toolkit No. 7 All About Quitting Smoking Are you ready to quit smoking? You can find a way to do it. Once you’ve quit, you’ll feel healthier ... ve quit. What are the benefits of quitting smoking? You’ve probably already heard that smoking is ...
Helgason Asgeir R
Full Text Available Abstract Aims To describe the prevalence and intensity of different symptoms in relation to tobacco abstinence. To explore latent dimensions between symptoms in smokers trying to quit. Design A cross sectional study using a questionnaire to retrospectively assess symptoms over a period of 12 months. Setting Swedish telephone quitline, a nationwide free of charge service. Participants All 741 individuals who had called the quitline and signed up for smoking cessation treatment between February 2000 to November 2001 and reported to have been smoke free for at least 24 hours during the previous 12 month period from first contact. Measurements Assessments were made by self-report, and abstinence was defined as "not a single puff of smoke during the last week". A factor analysis approach where individual items aggregate into factors was used to explore the relationship between the different symptoms. Findings High intensity of symptoms related to unsuccessful quitting attempts and included craving, irritability, apprehension/anxiety, difficulties concentrating, restlessness, depression/depressed mood, and insomnia. The factor loadings of all 17 symptoms resulted in three factors with factor 1, psychological being the most important. High scores on this factor relates to unsuccessful quitting attempts. Using Nicotine Replacement Therapy (NRT for 5 weeks or longer, reduced symptoms included in factor 1. The other two factors were factor 2 physiological and factor 3 neurological. Conclusion Symptoms that are psychological and/or neurological in nature are interrelated and appear to be the most significant obstacles for successful quitting attempts in a population-based setting. These symptoms may be successfully treated with NRT.
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Balmford, James; Swift, Elena; Borland, Ron
Planning before quitting smoking is widely believed to be beneficial and is usually recommended in cessation counseling, but there is little evidence on the efficacy of specific planning activities. Using data from 1140 respondents who reported quit attempts at Wave 8 of the ITC 4-Country Survey, we analyzed use of 8 specific planning strategies before (5) and after (3) implementation of a quit attempt, in relation to cessation outcomes, delay in implementation of the attempt, and recent quitting history. Most participants reported some planning both before and after quitting, even among those reporting quitting 'spontaneously.' Younger smokers, those who cut down before quitting, and users of stop-smoking medication were more likely to report planning. Those who planned prequit were also more likely to plan postquit. Unexpectedly, we found no clear benefit of planning on short-term (1 month) cessation outcomes, whereas one prequit strategy (practicing not smoking) was negatively related to outcome. There was evidence for a predicted moderating effect of recent quitting experience on planning for the prequit task 'practice replacement strategies.' This predicted quit success among those with multiple quit attempts in the past year, but failure among those without. This finding suggests that the quality of planning may be critical. More research, particularly on the moderating effect of quit experience, and where measures of planning are collected before outcomes become evident, is needed before clear recommendations can be made on the utility of various forms of planning for the success of quit attempts.
Full Text Available Abstract Background The majority of Polish smokers declare their will to quit smoking and many of them attempt to quit. Although morbidity and mortality from tobacco-related diseases are among the highest in the world, there is a lack of comprehensive cessation support for smokers. We aimed to investigate how Poles, including the medically ill, cope with quitting cigarettes and what their motivations to quit are. Methods Convenience sampling was used for the purpose of the study. Individuals attending several health care units were screened for a history of quit attempts. Ex-smokers were defined as smoking previously at least one cigarette/day but who have no longer been smoking for at least one month. Attempts at quitting were defined as abstaining from cigarettes for at least one day. Data on socio-demographics, tobacco use, quitting behaviors and reasons to quit from 618 subjects (385 ex- and 233 current smokers who fulfilled these criteria were collected with the use of a questionnaire. For the comparison of proportions, a chi-square test was used. Results In the entire study population, 77% of smokers attempted to quit smoking on their own and a similar proportion of smokers (76% used the cold turkey method when quitting. Current smokers were more likely than former smokers to use some form of aid (p = 0.0001, mainly nicotine replacement therapy (68%. The most important reasons for quitting smoking were: general health concern (57%, personal health problems (32% and social reasons (32%. However, 41% of smokers prompted to quitting by personal health problems related to tobacco smoking did not see the link between the two. A small proportion of ex-smokers (3% abstaining from cigarettes for longer than a year were not confident about their self-efficacy to sustain abstinence further. Conclusion The majority of Polish smokers, including patients with tobacco-related diseases, attempt to quit without smoking cessation assistance, thus there is
Sieminska, Alicja; Buczkowski, Krzysztof; Jassem, Ewa; Lewandowska, Katarzyna; Ucinska, Romana; Chelminska, Marta
The majority of Polish smokers declare their will to quit smoking and many of them attempt to quit. Although morbidity and mortality from tobacco-related diseases are among the highest in the world, there is a lack of comprehensive cessation support for smokers. We aimed to investigate how Poles, including the medically ill, cope with quitting cigarettes and what their motivations to quit are. Convenience sampling was used for the purpose of the study. Individuals attending several health care units were screened for a history of quit attempts. Ex-smokers were defined as smoking previously at least one cigarette/day but who have no longer been smoking for at least one month. Attempts at quitting were defined as abstaining from cigarettes for at least one day. Data on socio-demographics, tobacco use, quitting behaviors and reasons to quit from 618 subjects (385 ex- and 233 current smokers) who fulfilled these criteria were collected with the use of a questionnaire. For the comparison of proportions, a chi-square test was used. In the entire study population, 77% of smokers attempted to quit smoking on their own and a similar proportion of smokers (76%) used the cold turkey method when quitting. Current smokers were more likely than former smokers to use some form of aid (p = 0.0001), mainly nicotine replacement therapy (68%). The most important reasons for quitting smoking were: general health concern (57%), personal health problems (32%) and social reasons (32%). However, 41% of smokers prompted to quitting by personal health problems related to tobacco smoking did not see the link between the two. A small proportion of ex-smokers (3%) abstaining from cigarettes for longer than a year were not confident about their self-efficacy to sustain abstinence further. The majority of Polish smokers, including patients with tobacco-related diseases, attempt to quit without smoking cessation assistance, thus there is a need for a broader professional help for them. There is
Vangeli, E; West, R
Reasons for quitting smoking and triggers that finally precipitate a quit attempt are not necessarily the same thing. We sought to assess variation in reported triggers of attempts to stop smoking as a function of age, gender and socioeconomic status. Cross-sectional household survey in England. A total of 2441 smokers and ex-smokers aged 16 and over, who reported making at least one serious quit attempt in the last 12 months, were recruited. The main outcome measure was participants' responses to the question "What finally triggered your most recent quit attempt?". Respondents selected from a list of options or specified a trigger not on the list. In the event, smokers typically reported as triggers similar factors as have previously been reported as "reasons". "A concern about future health problems" (28.5%) was the most commonly cited trigger followed by "health problems I had at the time" (18%) and then "a decision that smoking was too expensive" (12.2%). The most common external trigger was advice from a health professional (5.6%). Future health concern was more common in smokers with higher socioeconomic status (SES), whereas cost and current health problems were more often cited by lower SES smokers. Younger smokers were more likely to report their quit attempt being triggered by a TV advertisement while older smokers were more likely to cite advice from a health professional. Concern about future health problems was cited less often by 16 to 24 year olds and those aged 65+ than those aged 25 to 64 years. There are significant differences in reported triggers for quit attempts as a function of sociodemographic factors. Most notably, smokers with higher SES are more likely to report concern about future health whereas those from lower SES are more likely to cite cost and current health problems.
Full Text Available This study uses longitudinal data from the International Tobacco Control Southeast Asia (ITC-SEA Thailand survey to explore patterns and predictors of successful quitting among Thai adult smokers as a function of time quit. A cohort of a representative sample of 2000 smokers was surveyed four times from 2005 to 2009. A sample of 1533 individuals provided data for at least one of the reported analyses. Over the four years of follow-up, 97% made attempts to quit. Outcomes were successful quitting/relapse: (a quit attempts of at least one month (short-term relapse, 43% (57% remaining quit; (b surviving at least six months (medium-term (31%; (c relapse between one and six months (45%; (d having continuously quit between Waves 3 and 4 (sustained abstinence (14%; and (e relapse from six months on (44% compared to those who continuously quit between Waves 3 and 4 (56%. Predictors for early relapse (<1 month differ from longer-term relapse. Age was associated with reduced relapse over all three periods, and was much stronger for longer periods of abstinence. Cigarette consumption predicted relapse for short and medium terms. Self-assessed addiction was predictive of early relapse, but reversed to predict abstinence beyond six months. Previous quit history of more than one week was predictive of early abstinence, but became unrelated subsequently. Self-efficacy was strongly predictive of abstinence in the first month but was associated with relapse thereafter. Some determinants of relapse change with time quit, but this may be in somewhat different to patterns found in the West.
Background Previous cross-sectional research has suggested single cigarettes could either promote or inhibit consumption. The present study aimed to assess the effects of single cigarette availability and consumption on downstream quit behavior. Methods We analyzed population-based, longitudinal data from adult smokers who participated in the 2008 and 2010 administrations of the International Tobacco Control Policy Evaluation Survey in Mexico. Results At baseline, 30% of smokers saw single cigarettes for sale on a daily basis, 17% bought singles at their last purchase, and 7% bought singles daily. Smokers who most frequently purchased singles, both in general and specifically to control their consumption, were no more likely to attempt to quit over the 14 month follow-up period than those who did not purchase singles. Frequency of buying singles to reduce consumption had a non-monotonic association with being quit at followup. The odds of being quit was only statistically significant when comparing those who had not bought singles to reduce consumption with those who had done so on a more irregular basis (AOR = 2.30; 95% CI 1.19, 4.45), whereas those who did so more regularly were no more likely to be quit at followup. Frequency of self-reported urges to smoke upon seeing singles for sale was unassociated with either quit attempts or being quit at followup. Conclusions These results suggest that the relationship between singles consumption and quit behavior is complex, with no clear evidence that singles either promote or inhibit downstream quit behavior. PMID:21352526
Full Text Available Abstract Background Previous cross-sectional research has suggested single cigarettes could either promote or inhibit consumption. The present study aimed to assess the effects of single cigarette availability and consumption on downstream quit behavior. Methods We analyzed population-based, longitudinal data from adult smokers who participated in the 2008 and 2010 administrations of the International Tobacco Control Policy Evaluation Survey in Mexico. Results At baseline, 30% of smokers saw single cigarettes for sale on a daily basis, 17% bought singles at their last purchase, and 7% bought singles daily. Smokers who most frequently purchased singles, both in general and specifically to control their consumption, were no more likely to attempt to quit over the 14 month follow-up period than those who did not purchase singles. Frequency of buying singles to reduce consumption had a non-monotonic association with being quit at followup. The odds of being quit was only statistically significant when comparing those who had not bought singles to reduce consumption with those who had done so on a more irregular basis (AOR = 2.30; 95% CI 1.19, 4.45, whereas those who did so more regularly were no more likely to be quit at followup. Frequency of self-reported urges to smoke upon seeing singles for sale was unassociated with either quit attempts or being quit at followup. Conclusions These results suggest that the relationship between singles consumption and quit behavior is complex, with no clear evidence that singles either promote or inhibit downstream quit behavior.
Jeong, Michelle; Tan, Andy; Brennan, Emily; Gibson, Laura; Hornik, Robert C.
This study examined the role of interpersonal communication in the context of a mass media anti-smoking campaign. Specifically, it explored whether conversations about campaign ads and/or about quitting mediated campaign exposure effects on two quitting behaviors (sought help to quit and tried to quit smoking completely), as well as the relationship between ad-related and quitting-related conversations. Data were collected prior to the campaign and monthly for 16 months during the campaign through cross-sectional telephone surveys among a sample of 3277 adult Philadelphian smokers. Follow-up interviews were conducted among 877 participants three months after their first survey. Cross-sectional and longitudinal mediation models with bootstrap procedures assessed the indirect effects of campaign exposure on outcomes through conversations, and of conversations about ads on outcomes through conversations about quitting. In addition, lagged regression analyses tested the causal direction of associations between the variables of interest. The results partially support hypotheses that conversations about quitting mediate campaign effects on quitting-related behaviors, and, in line with previous research, that conversations about the ads have indirect effects on quitting-related behaviors by triggering conversations about quitting. These findings demonstrate the importance of considering interpersonal communication as a route of campaign exposure effects when evaluating and designing future public health campaigns. PMID:26147367
Female workers are traditionally viewed as more likely to quit, to be absent and to take more days of absence than male workers, and this gender difference is widely used as an important explanation for the gender wage gap and other labour market differences between men and women. This study documents the gender differences in quits and absenteeism in Canada and attempts to assess whether the traditional view is still valid today. The study found that Canadian women's quitting behaviour chang...
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Cowie, Genevieve A; Swift, Elena; Partos, Timea; Borland, Ron
Among Australian smokers, to examine associations between cigarette brand switching, quitting activity and possible causal directions by lagging the relationships in different directions. Current smokers from nine waves (2002 to early 2012) of the ITC-4 Country Survey Australian dataset were surveyed. Measures were brand switching, both brand family and product type (roll-your-own versus factory-made cigarettes) reported in adjacent waves, interest in quitting, recent quit attempts, and one month sustained abstinence. Switching at one interval was unrelated to concurrent quit interest. Quit interest predicted switching at the following interval, but the effect disappeared once subsequent quit attempts were controlled for. Recent quit attempts more strongly predicted switching at concurrent (OR 1.34, 95%CI=1.18-1.52, pbrand switching does not affect subsequent quitting. Brand switching does not appear to interfere with quitting. © 2015 Public Health Association of Australia.
Wellman, Robert J; O'Loughlin, Erin K; Dugas, Erika N; Montreuil, Annie; Dutczak, Hartley; O'Loughlin, Jennifer
Although most young adult smokers want to quit smoking, few can do so successfully. Increased understanding of reasons to quit in this age group could help tailor interventions, but few studies document reasons to quit in young adults or examine reasons to quit by smoker characteristics. In 2011-12, 311 current smokers (age 22-28, M=24.1; 48.9% male, 51.1% female; 50.4% daily smokers) from the Nicotine Dependence in Teens Study completed the Adolescent Reasons for Quitting scale. We assessed differences in the importance of 15 reasons to quit by sex, education, smoking frequency, quit attempt in the past year, perceived difficulty in quitting, and motivation to quit. We also examined differences between participants who discounted the importance of long-term health risks and those who acknowledged such risks. Concerns about getting sick or still smoking when older were considered very important by >70% of participants. Median scores were higher among daily smokers, those who had tried to quit or who expressed difficulty quitting, and those with strong motivation to quit. Discounters (14.5% of participants) were primarily nondaily, low-consumption smokers. Their Fagerström Test for Nicotine Dependence scores did not differ from non-discounters', and 11% (vs. 35.7% of non-discounters) were ICD-10 tobacco dependent. Novel smoking cessation interventions are needed to help young adult smokers quit by capitalizing on their health concerns. Discounters may need educational intervention to better understand the impact of even "light" smoking on their health before or in conjunction with quit interventions. Copyright © 2017 Elsevier Ltd. All rights reserved.
Dunlop, Sally M; Cotter, Trish; Perez, Donna
The authors investigated the potential for antismoking advertising to generate interpersonal pressure on smokers to quit using the Cancer Institute NSW's Tobacco Tracking Survey, a telephone tracking survey of adult smokers conducted throughout the year with approximately 50 interviews per week (N = 5,448). The survey includes questions relating to recently broadcast antismoking advertisements, including whether smokers have received pressure from family and friends as a result of their seeing the advertisements. The authors conducted multivariate logistic regression analyses to predict: (a) receiving ad-stimulated interpersonal pressure; and (b) quitting outcomes. All analyses controlled for smoker characteristics and potential exposure to the advertisements. Compared with ads coded as having a low level of emotion (by independent coders), ads coded as highly emotional were more likely to have generated interpersonal pressure. Ad-stimulated interpersonal pressure was associated with an increased likelihood of recent quit attempts and with salient quitting thoughts, with a greater effect on quitting thoughts for interpersonal pressure generated by highly and moderately emotional ads. These results support previous research suggesting that highly emotional antismoking ads with personal stories or graphic imagery are effective in promoting smoking cessation, and these results help to identify communication processes that contribute to the ads' success.
Smith, Andrea L; Carter, Stacy M; Dunlop, Sally M; Freeman, Becky; Chapman, Simon
To explore the quitting histories of Australian ex-smokers in order to develop an understanding of the varied contribution of smoking cessation assistance (either pharmacotherapy or professionally mediated behavioural support) to the process of quitting. Qualitative grounded theory study; in-depth interviews. 37 Australian adult ex-smokers (24-68 years; 15 men, 22 women) who quit in the past 6-24 months. Although participants' individual quitting histories and their overall experiences of quitting were unique, when the 37 quitting histories were compared it was clear two experiences were common to almost all participants: almost no one quit at their first quit attempt and almost everyone started out quitting unassisted. Furthermore, distinct patterns existed in the timing and use of assistance, in particular the age at which assistance was first used, how some participants were resolutely uninterested in assistance, and how assistance might have contributed to the process of successful quitting even if not used on the final quit attempt. Importantly, three patterns in use of assistance were identified: (1) only ever tried to quit unassisted (n=13); (2) started unassisted, tried assistance but reverted back to unassisted (n=13); (3) started unassisted, tried assistance and quit with assistance (n=11). For most participants, insight into what quitting would require was only gained through prior quitting experiences with and without assistance. For a number of participants, interest in assistance was at its lowest when the participant was most ready to quit. Quitting should be viewed as a process drawing on elements of assisted and unassisted quitting rather than a stand-alone event that can be labelled as strictly assisted or unassisted. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Patten, Christi A; Clinic, Mayo; Goggin, Kathy; Harris, Kari Jo; Richter, Kimber; Williams, Karen; Decker, Paul A; Clinic, Mayo; Bradley-Ewing, Andrea; Catley, Delwyn
Research examining relationships between social support and smoking cessation has paid little attention to non-treatment seeking smokers and not considered the role of autonomy support for fostering quitting motivation. This study examined if autonomy support received from family and friends was associated with quitting motivation and making a quit attempt among diverse smokers with varying levels of quitting motivation. Demographic characteristics associated with autonomy support were explored. Participants (N=312) responded to advertisements seeking smokers "not quite ready to quit," and were primarily Black, low-income, and unemployed. Most (255) enrolled in a clinical trial of smoking cessation induction strategies (treatment sample). An additional 57 not meeting the trial eligibility criteria of low quitting motivation enrolled for baseline assessments only. Participants completed baseline measures of autonomy support received from friends and autonomous quitting motivation. In the treatment sample, quit attempts were assessed at 6-months follow-up. Females reported higher levels than males of autonomy support from friends (p=0.003). Participants with a high school diploma/GED reported higher levels of support from family (pautonomy support scores were significantly, albeit weakly, associated with autonomous quitting motivation. Autonomy support was not associated with making a quit attempt. Support from family and friends may promote autonomous reasons to quit among diverse smokers. Research is needed to assess the role of social support in the pre-quitting phases among racial and socio-economically diverse populations.
Shaheen, Kanwal; Oyebode, Oyinlola; Masud, Haleema
Smoking is highly prevalent in Pakistan claiming the lives of over 100,000 individuals every year. A significant proportion of smokers (24.7%) make an attempt to quit each year but 97.4% fail to quit successfully. Little is known about the reasons for, and experiences of, failed quit attempts. This study was carried out to explore the experiences of young male smokers in quitting smoking in the twin cities of Pakistan METHOD: A qualitative study was carried out using a phenomenological approach in Rawalpindi and Islamabad. A total of 11 participants were interviewed. All study participants were male and had made at least one quit attempt. Study participants were a mix of smokers who failed to quit smoking, intermittent smokers and successful quitters. Streubert's (1991) method of phenomenology was followed during data analysis. The experiences of smokers while smoking "the smoking phase" have major effects on their journey towards quitting smoking. The smoking phase consists of three major stages: contact with initial smoking stimuli, the journey from first puff to enjoying smoking and then finally smoking becoming part of life. However, the journey towards quitting smoking is not as simple as the journey towards becoming a smoker. Instead, smokers get trapped in three overlapping cycles of smoking and quit attempts: smoking & forced quitting, smoking & intentional quitting, and smoking & intermittent smoking before successful quitting. Breaking the cycle is not easy in the presence of trapping factors (addiction, high availability, easy affordability, conducive social setup and low perceived risks of smoking). Three factors play a major role in breaking these cycles which are strong will power, continuous peer support and avoidance of smokers' company. A young smoker, during his experience of quitting smoking gets entrapped in several overlapping cycles of smoking & quit attempts before successful quitting. There are known entrapping factors as well as factors
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Metse, Alexandra P; Wiggers, John; Wye, Paula; Moore, Lyndell; Clancy, Richard; Wolfenden, Luke; Freund, Megan; Van Zeist, Tara; Stockings, Emily; Bowman, Jenny A
Persons with a mental illness are less likely to be successful in attempts to quit smoking. A number of smoking and environmental characteristics have been shown to be related to quitting behaviour and motivation of smokers generally, however have been less studied among smokers with a mental illness. This study aimed to report the prevalence of smoking characteristics and a variety of physical and social environmental characteristics of smokers with a mental illness, and explore their association with quitting behaviour and motivation. A cross-sectional descriptive study was undertaken of 754 smokers admitted to four psychiatric inpatient facilities in Australia. Multivariable logistic regression analyses were undertaken to explore the association between smoking and environmental characteristics and recent quitting behaviour and motivation. Participants were primarily daily smokers (93 %), consumed >10 cigarettes per day (74 %), and highly nicotine dependent (51 %). A third (32 %) lived in a house in which smoking was permitted, and 44 % lived with other smokers. The majority of participants believed that significant others (68-82 %) and health care providers (80-91 %) would be supportive of their quitting smoking. Reflecting previous research, the smoking characteristics examined were variously associated with quitting behaviour and motivation. Additionally, participants not living with other smokers were more likely to have quit for a longer duration (OR 2.02), and those perceiving their psychiatrist to be supportive of a quit attempt were more likely to have had more quit attempts in the past six months (OR 2.83). Modifiable characteristics of the physical and social environment, and of smoking, should be considered in smoking cessation interventions for persons with a mental illness.
Although the percentage adolescent smokers in the Netherlands has gradually decreased over the past years, the number of daily smokers is still increasing rapidly, from 12% of 16-year-olds to 27% of 19-year-olds. Adolescents often make quit attempts within a very short period after taking up
Valdivia, Mario; Silva, Daniel; Sanhueza, Félix; Cova, Félix; Melipillán, Roberto
Suicide mortality rates are increasing among teenagers. To study the prevalence and predictive factors of suicide attempts among Chilean adolescents. A random sample of 195 teenagers aged 16 ± 1 years (53% males) answered an anonymous survey about their demographic features, substance abuse, the Osaka suicidal ideation questionnaire, Smilksten familial Apgar. Beck hopelessness scale, Beck depression scale and Coppersmith self-esteem inventory. Twenty five percent of respondents had attempted suicide at least in one occasion during their lives. These attempts were significantly associated with female gender, absent parents, family dysfunction, drug abuse, smoking, low self-esteem, hopelessness, depression and recent suicidal ideation. A logistic regression analysis accepted female gender, smoking and recent suicidal ideation as significant independent predictors of suicide attempt. Suicide attempted is common among teenagers and its predictors are female sex, smoking and previous suicidal ideation.
Sheahan, Sharon L; Free, Teresa A
It is estimated that 20%-50% of adult smokers reside with children, and the majority of these smokers (70%) continue to smoke inside their homes despite the adverse health effects of second hand smoke (SHS) for their children (Centers for Disease Control and Prevention, 1997). Smoking is more prevalent among parents with lower incomes and less education (U.S. Surgeon General's Report, 2002a). Young persons, ages 20-40 in the family child-rearing stage, are more likely to be smokers. However, they usually have less time and financial resources for quitting smoking. To prevent the adverse health effects of SHS for children, pediatric nurses must provide parents with accurate information on affordable smoking cessation education resources. Evidenced-based smoking cessation guidelines, the cost and efficacy of prescription and over-the-counter (OTC) pharmacological aids, and essential counseling tips for parents are reviewed.
Full Text Available Abstract Background Social and community service organisations (SCSOs are non-government, not-for-profit organisations that provide welfare services to disadvantaged individuals. SCSOs hold considerable potential for providing smoking cessation support to disadvantaged smokers. This study aimed to establish the prevalence of smoking, interest in quitting and interest in receiving cessation support amongst clients accessing SCSOs. Methods Clients seeking financial or material assistance from three SCSOs in NSW, Australia, between February and October 2010 were invited to complete a 60-item general health touch screen computer survey. This included questions about smoking status, past quit attempts and interest in receiving support to quit smoking from SCSO staff. Results A total of 552 clients were approached to participate during the study period, of which 383 provided consent and completed the survey (69% consent rate. Daily smoking was reported by 53.5% of participants. Occasional smoking (non-daily smoking was reported by a further 7.9% of participants. Most participants had tried to quit smoking in the past (77% and had made an average of two quit attempts (SD = 3.2 lasting longer than 24 hours in the previous 12 months. More than half of all participants (52.8% reported that they would like help from SCSO staff to quit smoking. For those interested in receiving help, the preferred types of help were access to free NRT (77%, cash rewards (52% and non-cash rewards (47% for quitting, and to receive support and encouragement from SCSO staff to quit (45%. Conclusions Smoking rates among clients accessing SCSO are substantially higher than the general population rate of 15.1%. A substantial proportion of clients are interested in quitting and want support from the SCSO to do so.
Bottorff, Joan L; Oliffe, John L; Sarbit, Gayl; Sharp, Paul; Caperchione, Cristina M; Currie, Leanne M; Schmid, Jonathan; Mackay, Martha H; Stolp, Sean
Men continue to smoke cigarettes in greater numbers than women. There is growing evidence for the value of developing targeted, men-centered health promotion programs. However, few smoking cessation interventions have been designed for men. A gender-specific website, QuitNow Men, was developed based on focus group interview findings, stakeholder feedback, and evidence-based cessation strategies. The website was designed to incorporate a masculine look and feel through the use of images, direct language, and interactive content. Usability experts and end-users provided feedback on navigation and functionality of the website prior to pilot testing. The objectives of the pilot study were to describe (1) men's use and evaluations of the interactive resources and information on the QuitNow Men website, and (2) the potential of QuitNow Men to engage men in reducing and quitting smoking. A one-group, pretest-posttest study design was used. Men who were interested in quitting were recruited and invited to use the website over a 6-month period. Data were collected via online questionnaires at baseline, 3-month, and 6-month follow-up. A total of 117 men completed the baseline survey. Over half of those (67/117, 57.3%) completed both follow-up surveys. At baseline, participants (N=117) had been smoking for an average of 24 years (SD 12.1) and smoked on average 15 cigarettes a day (SD 7.4). The majority had not previously used a quit smoking website (103/117, 88.0%) or websites focused on men's health (105/117, 89.7%). At the 6-month follow-up, the majority of men used the QuitNow Men website at least once (64/67, 96%). Among the 64 users, 29 (43%) reported using the website more than 6 times. The men using QuitNow Men agreed or strongly agreed that the website was easy to use (51/64, 80%), the design and images were appealing (42/64, 66%), they intended to continue to use the website (42/64, 66%), and that they would recommend QuitNow Men to others who wanted to quit (46
Full Text Available Abstract Background The aim of the study was, despite the special characteristics of prisons, to identify the features which led prisoners who attended the Smoking Cessation Centre at the Kassavetia Detention Centre in Volos (region of Thessaly, in the central part of mainland Greece to quit smoking. Methods Personal interviews with 204 male prisoners irrespective of smoking habitus over the period June 2008 to December 2010 were obtained. Information about medical history, history of tobacco use and addiction to narcotic use was obtained and imprisonment status was recorded. Pharmaceutical treatment (Varenicline and counselling or only counselling were suggested as alternative strategies to them in order to help quit smoking. SPSS v15.0 software was employed, descriptive statistics were used, and a X2 independence test and Student’s t-test were performed. Results Of the sample examined, 75.5% (154 were smokers. They were mainly Greeks (51.5%, single (53.4% and had not gratuated from a high school (secondary education level (70.6%. 59.75% begun smoking early ( ≤14 years of age and 64.9% were highly addicted according to Fagerstrom Tolerance Questionnaire. 74% (114 of all smokers at the prison attended the Smoking Cessation Centre. Of them, 30.7% were able to quit smoking at 3 months but 1 year later there were 20.2% ex-smokers. The key characteristics of those who were able to be ex-smokers were a change in smoking habits (decreased compared to when free (p = .001, previous attempts to quit (while incarcerated and in general (p = .001, average dependence levels (p Conclusions Average dependence, a past free of addictive substance abuse and a better environment of daily living for certain prisoners (as far as the number of cellmates was concerned had a catalytic impact on prisoners finally managed to quit smoking.
Hu, S C; Lanese, R R
An examination of the applicability of the theory of planned behavior (TPB) to the intention to quit smoking across workplaces was conducted. Subjects were randomly selected from three workplaces in southern Taiwan. Those from a large public steel-manufacturing company were used for model building, and those from two private auto-parts-manufacturing companies served to cross-validate the model. Eligible subjects were divided into three study samples: a learning sample and two test samples. Three predictors--priority of quitting, past behavior (measured as previous quit attempt), and habit (measured as nicotine dependence)--were added to the TPB model. The results of this study show that TPB based on the learning sample fit well in another sample from the same workplace but poorly in other workplaces. When priority of quitting and past behavior were added to the TPB model, prediction to other workplaces significantly improved. Habit had no significant contribution to the intention to quit in the TPB model. Detailed discussions of the results are provided.
Hoeppner, Bettina B; Hoeppner, Susanne S; Abroms, Lorien C
To determine the degree to which the observed benefit of Text2Quit was accounted for by psychosocial mechanisms derived from its quit smoking messaging versus from the use of extra-programmatic smoking cessation treatments and services. Prospective, multiple mediation model of a randomized controlled trial (RCT). United States nation-wide. A total of 409 adult daily smokers participated. Participants were, on average, 35 years of age, predominantly female (68%), white (79%), lacked a college degree (70%), had medium nicotine dependence (average Fagerström Nicotine Dependence Score score of 5.2) and more than half (62%) had made a previous quit attempt. Adult daily smokers browsing the web for smoking cessation support (n = 409; recruited 19 May2011-10 July 2012) were randomized to receive smoking cessation support via Text2Quit versus a smoking cessation material. Mediators (i.e. changes in psychosocial constructs of health behavior change, use of extra-programmatic treatment) were assessed at 1 month using single-item measures and outcome (i.e. self-reported 7-day point prevalence abstinence) at 6-month follow-up. Mediators accounted for 35% of the effect of Text2Quit on smoking cessation. Only psychosocial mechanisms had complete mediational paths, with increases in self-efficacy [b = 0.10 (0.06-0.15)], quitting know-how [b = 0.07 (0.03-0.11)] and the sense that someone cared [b = 0.06 (0.01-0.11)], partially explaining the conferred benefit of Text2Quit. Use of outside resources, including treatments promoted explicitly by Text2Quit, i.e. medication [b = 0.001 (-0.01 to 0.01), quitline [b = -0.002 (-0.01 to 0.04)], treatments and resources not promoted by Text2Quit, i.e. online forums [b = 0.01 (-0.01 to 0.04)] and self-help materials [b = -0.01 (-0.04 to 0.02)], did not have complete mediational paths. An interaction effect existed for medication use that suggested that for participants not using medication, Text2Quit conferred substantial
De Jesus, Stefanie; Prapavessis, Harry
A number of mechanisms have been proposed to explain how exercise attenuates cravings among temporarily abstinent smokers; however, research has presented mixed findings. The aim of this study was to further investigate the mechanistic role of positive and negative affect and cortisol in the exercise-craving reduction relationship. Adult smokers (N=110, male=56, M age=33.1, M cigarettes/day=15.4) provided baseline affective and cortisol data (T1). After an 18-h period of abstinence, participants were randomized to a passive sitting (PSG) or moderate exercise group (MEG; 40-68% of heart rate reserve) for 10min. Affect and cortisol data were also collected immediately before (T2) and after (T3) the condition. The smoking abstinence manipulation increased cravings (p<0.001, eta=0.40) and negative affect (p<0.001, eta=0.17), as well as decreased positive affect (p<0.001, eta=0.08) and cortisol (trending, p=0.07, η2=0.04). As expected, a significant reduction in cravings from T2 to T3 was found for MEG but not PSG (p<0.001, eta=0.25). Mediation was tested using Sobel and bootstrapping tests with residual change scores of mediators and cravings. Findings showed that both positive and negative affect, but not cortisol, mediated the relationship between exercise and cravings. Understanding the mechanisms by which exercise induces craving reductions will better allow researchers and healthcare professionals to infer causality and implement interventions guided by the processes that yield such desirable outcomes. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.
Abrantes, Ana M; Farris, Samantha G; Minami, Haruka; Strong, David R; Riebe, Deborah; Brown, Richard A
Aerobic exercise may improve smoking abstinence via reductions in craving and negative affect and increases in positive moods. Acute changes in craving and affect before and after structured exercise sessions have not been examined during the weeks prior to and following quit attempts nor has smoking status been examined in relation to these effects. Given that regular cigarette smoking can be perceived as affect enhancing and craving reducing, it is not known whether exercise could contribute additional affective benefit beyond these effects. Participants (N = 57; 68.4% women) were low-active daily smokers randomized to cessation treatments plus either group-based aerobic exercise (AE) or a health-education control (HEC). Mood, anxiety, and craving were assessed before and after each intervention session for each of the 12 weeks. Carbon monoxide (CO) breath samples ≤ 5ppm indicated smoking abstinence. During the prequit sessions, significantly greater decreases in anxiety following AE sessions relative to HEC sessions were observed. Changes in mood and craving were similar after AE and HEC sessions prior to quitting. Postquit attempt, significant reductions in craving and anxiety were observed after AE sessions but not following HEC. During the postquit period, positive mood increased following AE sessions relative to HEC only among individuals who were abstinence on that day. AE may be effective in acutely reducing anxiety prior to a quit attempt and both anxiety and craving following the quit attempt regardless of abstinence status. The mood-enhancing effects of AE may occur only in the context of smoking abstinence. The current findings underscore the importance of examining the acute effects of aerobic exercise prior to and after a cessation attempt and as a function of smoking status. Given the equivocal results from previous studies on the efficacy of exercise for smoking cessation, increasing our understanding of how aerobic exercise produces its
Christiansen, Erik; Jensen, Børge Frank
The Register for Suicide Attempts (RSA) is a product of the WHO research project "WHO/Euro Multicentre Study on Parasuicide", which, among other things, had the purpose of collecting data on suicide attempts from 13 European countries. Data is collected in order to calculate trends and identify...
Danaei, Mina; Palenik, Charles John; Abdollahifard, Gholamreza; Askarian, Mehrdad
A healthy lifestyle is important because of its long-term benefits; however, there is a paucity of information concerning health choices among Iranians. We evaluated personal health behaviors, attempts to change unhealthy behaviors, and factors affecting attempts at change. The design of this cross-sectional study was to assemble a representative cadre of >18-year-old adults in Shiraz, Iran, using a multistage cluster sampling technique. Validated questionnaires collected participant's demographic information, such as weight, height, cigarette smoking history, physical activity, and attempts at lifestyle changes during the previous year. To determine predictors of attempts to change unhealthy lifestyle and to identify confounders, we applied single and multivariable logistic regression methods, respectively. A confidence interval of 95% was calculated for each odds ratio. The prevalence of attempts to change unhealthy lifestyle was 42%, 64.8%, and 27.8%, respectively, for losing weight, being more physically active, and smoking cessation. Unemployment, low levels of education, and decreased socioeconomic status have important roles in attempts to change lifestyle conditions. Low socioeconomic status was a risk factor for quitting smoking. Occupation (unemployed/homemaker) and low level of education were two significant factors for being more physically active. The prevalence of inadequate physical activity and being overweight or obese was considerable in Shiraz, Iran. Attempts to change unhealthy lifestyle were less than ideal. Social determinants of health factors including unemployment and low levels of education and socioeconomic status play important roles in attempts to change current lifestyles.
Many people want to help their friends and loved ones quit smoking. But, they often don't know how. Here are 6 frequently asked questions about how to help someone quit smoking to help you get the information you need.
Resnicow, Ken; Zhou, Yan; Scheuermann, Taneisha S; Nollen, Nicole L; Ahluwalia, Jasjit S
Smokers who report quitting without prior planning have been shown to report longer abstinence compared with those who planned. Little is known about unplanned quitting (UQ) among U.S. smokers, minorities, or nondaily and light smokers. Using an online panel, we recruited equal numbers of Black, White, and Latino nondaily, light daily, and moderate/heavy daily smokers. Of the 1,127 who reported a past-year quit attempt, we queried whether it was planned and the maximum number of days abstinent. Overall, 38% reported that their last quit attempt was unplanned. The impact of planned versus unplanned quitting interacted with smoking level and race. Among White moderate/heavy smokers, mean days abstinent was 99 for those who reported an unplanned quit attempt compared with 60 days for those who reported a planned attempt (p = .02). Among Black moderate/heavy smokers, the mean days abstinent was higher among those whose last attempt was planned, 92 days, compared with 56 days among those whose last attempt was unplanned (p = .09). The pattern among Latinos resembled Whites but was not significant. Results remained after adjusting for confounds such as age, gender, education, income, time to first cigarette, and menthol use. There were no significant differences in abstinence by quit type for light or nondaily smokers. Future studies are needed to elucidate why UQ appears to have differential effectiveness across racial/ethnic groups and different levels of cigarette use. Research examining the impact of UQ on long-term quitting, which is not addressed here, is needed.
De Jesus, Stefanie; Prapavessis, Harry
Previous research has shown reductions in cigarette consumption during the pre-quit period of exercise-aided smoking cessation interventions. Smoking topography and sensation patterns during this period is unknown and may provide valuable insight into compensation and cessation readiness. Female smokers (N = 236, M age = 43, M cigarettes/day = 17.0) enrolled in an exercise-aided smoking cessation intervention self-reported daily cigarette use and cigarette sensory experiences. Breath carbon monoxide and smoking topography data were collected during the period leading up to the targeted quit date (i.e., baseline, week 1, and week 3), which was set for week 4. Repeated measures ANOVAs revealed that cigarette consumption (p smoking satisfaction (p exercise during the pre-quit period served as a conduit for facilitating behavioral and sensory harm reduction with cigarettes. Furthermore, the pattern of change observed between cigarette consumption and smoking topography does not support compensation. These findings imply that female smokers who exercise prior to a quit attempt are in a favourable state to achieve cessation. Copyright © 2018 Elsevier Ltd. All rights reserved.
Reitzel, Lorraine R; Kendzor, Darla E; Cao, Yumei; Businelle, Michael S
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. Longitudinal study using self-reported survey data. Transitional homeless shelter in Dallas, Texas. A total of 57 homeless smokers enrolled in a cessation program. 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. Higher rankings on the SSS-U.S. ladder, but not the SSS-Community ladder, predicted abstinence on the quit day (p = .005). 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.
... SOME GOALS Set short-term quitting goals and reward yourself when you meet them. Every day, put ... surgery - discharge Chronic obstructive pulmonary disease - adults - discharge Controlling your high blood pressure Deep vein thrombosis - discharge ...
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Omar A Al-Mohrej
Conclusions: We have looked at smoking cessation from a broader perspective, analysing different categories of the Saudi population. Social, religious and health reasons must be emphasised by counsellors assisting Saudi smokers to quit.
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Lundh, Lena; Alinaghizadeh, Hassan; Törnkvist, Lena; Gilljam, Hans; Galanti, Maria Rosaria
To test internal consistency and factor structure of a brief instrument called Trying to Quit smoking. The most effective treatment for patients with chronic obstructive pulmonary disease is to quit smoking. Constant thoughts about quitting and repeated quit attempts can generate destructive feelings and make it more difficult to quit. Development and psychometric testing of the Trying to Quit smoking scale. The Trying to Quit smoking, an instrument designed to assess pressure-filled states of mind and corresponding pressure-relief strategies, was tested among 63 Swedish patients with chronic obstructive pulmonary disease. Among these, the psychometric properties of the instrument were analysed by Exploratory Factor Analyses. Fourteen items were included in the factor analyses, loading on three factors labelled: (1) development of pressure-filled mental states; (2) use of destructive pressure-relief strategies; and (3) ambivalent thoughts when trying to quit smoking. These three factors accounted for more than 80% of the variance, performed well on the Kaiser-Meyer-Olkin (KMO) test and had high internal consistency.
Yasin, Siti Munira; Masilamani, Retneswari; Ming, Moy Foong; Koh, David; Zaki, Rafdzah Ahmad
Perceived risks and benefits of quitting smoking may be important factors in successful treatment. This study examined the association between initial perceived risks and benefits of quitting smoking and outcomes during a two month smoking cessation attempt. Participants (n = 185) were treatment-seeking smokers attending two smoking cessation clinics in Klang Valley, Malaysia. They received structured behavioral therapy and free Nicotine Replacement Therapy (NRT). Prior to treatment, a 12 item Perceived Risks and Benefits Questionnaire (PRBQ) was administered. This was used to assess the smoker's initial perceptions during their quit attempt. Participants were re-contacted at the end of two months to determine their smoking status. The results show participants intending to quit demonstrated a greater understanding of the benefits of quitting smoking than the risks of quitting. Those with a higher education level had a greater understanding of the benefits of quitting (p = 0.02). PRBQ items, such as perceived risks of quitting (ie weight gain, negative affect, social ostracism, loss of enjoyment and craving) were not associated with abstinence at two months. However, those who perceived a benefit of higher physical attraction post-cessation were less likely to have stopped smoking at two months (OR 0.18; 95% CI 0.08-0.45). Other perceived benefits at baseline, such as health, general well-being, self-esteem, finances and social approval, were not associated with smoking cessation at two months. The results suggest that in our study population, smokers' baseline perceptions of the benefits of cessation of smoking prior to therapy are not associated with quit results at two months. Counseling patients regarding the advantages and disadvantages of quitting may have changed their perceptions during quitting process and should be further explored in future studies.
Full Text Available Abstract Background Greece has the highest smoking rates (in the 15-nation bloc in Europe. The purpose of this study was to investigate Greek smokers' intention and appraisal of capability to quit employing the theoretical frameworks of Decisional Balance (DB and Cognitive Dissonance (CD. Methods A cross-sectional study including 401 Greek habitual smokers (205 men and 195 women, falling into four groups according to their intention and self-appraised capability to quit smoking was carried out. Participants completed a questionnaire recording their attitude towards smoking, intention and self appraised capability to quit smoking, socio-demographic information, as well as a DB and a CD scale. Results The most numerous group of smokers (38% consisted of those who neither intended nor felt capable to quit and these smokers perceived more benefits of smoking than negatives. DB changed gradually according to smokers' "readiness" to quit: the more ready they felt to quit the less the pros of smoking outnumbered the cons. Regarding relief of CD, smokers who intended but did not feel capable to quit employed more "excuses" compared to those who felt capable. Additionally smokers with a past history of unsuccessful quit attempts employed fewer "excuses" even though they were more frequently found among those who intended but did not feel capable to quit. Conclusion Findings provide support for the DB theory. On the other hand, "excuses" do not appear to be extensively employed to reduce the conflict between smoking and concern for health. There is much heterogeneity regarding smokers' intention and appraised capability to quit, reflecting theoretical and methodological problems with the distinction among stages of change. Harm reduction programs and interventions designed to increase the implementation of smoking cessation should take into account the detrimental effect of past unsuccessful quit attempts.
Burns, Emily K; Levinson, Arnold H
Nicotine replacement therapy (NRT) doubles successful quitting, but more than half of NRT users do not comply with optimal treatment regimens. From the 2005 Colorado state tobacco survey, quit attempters who utilized NRT (N=366) were analyzed in spring 2007. Descriptive and regression analyses were used to examine reasons for discontinuing NRT, length of time on NRT, and quit intentions. The reasons for discontinuing NRT were resuming smoking (34%), side effects (17%), NRT not helping with quitting (14%), quitting smoking (10%), and cost (5%). Poverty, age, and non-Latino minority status were associated with reasons for discontinuation other than quitting smoking. Having side effects was associated with a short duration of NRT use and 95% lower odds of intending to quit in the next month. In the first population-level study examining reasons for discontinuing NRT, general-population smokers who initiate NRT use when attempting to quit are highly likely to discontinue NRT prematurely. Age and culturally-appropriate medication management interventions may increase NRT compliance and improve cessation outcomes.
Bloom, Erika Litvin; Minami, Haruka; Brown, Richard A; Strong, David R; Riebe, Deborah; Abrantes, Ana M
Quitting smoking and aerobic exercise each improve health. Although smokers may be concerned that quitting smoking will reduce their quality of life (QOL), recent research has shown that cessation is associated with QOL benefits. Elements of smoking cessation interventions, such as exercise, may contribute to changes in QOL. However, it is unknown whether initiating exercise in the context of smoking cessation is associated with greater or different effects on QOL than smoking cessation alone. The current study is a secondary analysis of data from a randomized trial (n = 61) of an exercise intervention for smoking cessation. We hypothesized that smoking abstinence and engagement in exercise would have positive, additive effects on QOL at end-of-treatment, 6- and, 12-month follow-ups. Sedentary adult smokers were randomized to the exercise intervention or a health education control (HEC) group. Additionally, all participants received smoking cessation counseling and nicotine patches. Data were analyzed using actual engagement in exercise, rather than group assignment as a proxy for exercise engagement, because some HEC participants also began exercising. Abstinence was positively associated with higher total and physical health QOL at follow-up. Exercise was not associated with total QOL and only marginally associated with physical health QOL, but was positively related to overall sense of well-being. Emphasizing that smoking cessation is associated with higher QOL may help motivate smokers to initiate quit attempts.
Liao, Yanhui; Wu, Qiuxia; Tang, Jinsong; Zhang, Fengyu; Wang, Xuyi; Qi, Chang; He, Haoyu; Long, Jiang; Kelly, Brian C; Cohen, Joanna
Considering the extreme shortage of smoking cessation services in China, and the acceptability, feasibility and efficacy of mobile phone-based text message interventions for quitting smoking in other countries, here we propose a study of "the efficacy of mobile phone-based text message interventions ('Happy Quit') for smoking cessation in China". The primary objective of this proposed project is to assess whether a program of widely accessed mobile phone-based text message interventions ('Happy Quit') will be effective at helping people in China who smoke, to quit. Based on the efficacy of previous studies in smoking cessation, we hypothesize that 'Happy Quit' will be an effective, feasible and affordable smoking cessation program in China. In this single-blind, randomized trial, undertaken in China, about 2000 smokers willing to make a quit attempt will be randomly allocated, using an independent telephone randomization system that includes a minimization algorithm balancing for sex (male, female), age (19-34 or >34 years), educational level (≤ or >12 years), and Fagerstrom score for nicotine addiction (≤5, >5), to 'Happy Quit', comprising motivational messages and behavioral-change support, or to a control group that receives text messages unrelated to quitting. Messages will be developed to be suitable for Chinese. A pilot study will be conducted before the intervention to modify the library of messages and interventions. The primary outcome will be self-reported continuous smoking abstinence. A secondary outcome will be point prevalence of abstinence. Abstinence will be assessed at six time points (4, 8, 12, 16, 20 and 24 weeks post-intervention). A third outcome will be reductions in number of cigarettes smoked per day. The results will provide valuable insights into bridging the gap between need and services received for smoking cessation interventions and tobacco use prevention in China. It will also serve as mHealth model for extending the public
Scollo, Michelle; Hayes, Linda; Wakefield, Melanie
Deciding on an appropriate level for taxes on tobacco products is a critical issue in tobacco control. The aim of the present study was to describe the critical price points for packs for smokers of each pack size, to calculate what this would equate to in terms of price per stick, and to ascertain whether price points varied by age, socio-economic status and heaviness of smoking. In November 2011, 586 Victorian smokers of factory-made cigarettes were asked during a telephone survey about their usual brand, including the size and cost of their usual pack. They were also asked about use of illicit tobacco. Smokers estimated what price their preferred pack would need to reach before they would seriously consider quitting. Three-quarters of regular smokers of manufactured cigarettes could envisage their usual brand reaching a price at which they would seriously consider quitting. Analyses revealed that answers clustered around whole numbers, (AUD$15, $20, $25 and $30), with a median nominated price point of AUD$20 per pack. The median price point at which regular smokers would consider quitting was calculated to be 80 cents per stick, compared to the current median reported stick price of 60 cents.Of the smokers who nominated a price point, 60.1% indicated they would seriously consider quitting if the cost of their usual brand equated to 80 cents per stick or less; 87.5% would seriously consider quitting if sticks reached one dollar each. These results do suggest a potentially useful approach to setting taxes in Australia. If taxes can be set high enough to ensure that the cost of the smokers' preferred packs exceeds critical price points, then it seems likely that more people would seriously attempt to quit than if the price increased to a level even slightly below the price points. Our study suggests that a tax increase large enough to ensure that a typical pack of 25 cigarettes in Australia cost at least AUD$20 would prompt more than 60% of smokers able to nominate
Rosaz , Julie; Slonim , Robert; Villeval , Marie Claire
While peer effects have been shown to affect worker's productivity when workers are paid a fixed wage, there is little evidence on their influence on quitting decisions. This paper presents results from an experiment in which participants receive a piece-rate wage to perform a real-effort task. After completing a compulsory work period, the participants have the option at any time to continue working or quit. To study peer effects, we randomly assign participants to work alone or have one oth...
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Kennedy, May G; Genderson, Maureen Wilson; Sepulveda, Allison L; Garland, Sheryl L; Wilson, Diane Baer; Stith-Singleton, Rose; Dubuque, Susan
Pregnant African American women are at disproportionately high risk of premature birth and infant mortality, outcomes associated with cigarette smoking. Telephone-based, individual smoking cessation counseling has been shown to result in successful quit attempts in the general population and among pregnant women, but "quitlines" are underutilized. A social marketing campaign called One Tiny Reason to Quit (OTRTQ) promoted calling a quitline (1-800-QUIT-NOW) to pregnant, African American women in Richmond, Virginia, in 2009 and was replicated there 2 years later. The campaign disseminated messages via radio, interior bus ads, posters, newspaper ads, and billboards. Trained volunteers also delivered messages face-to-face and distributed branded give-away reminder items. The number of calls made from pregnant women in the Richmond area during summer 2009 was contrasted with (a) the number of calls during the seasons immediately before and after the campaign, and (b) the number of calls the previous summer. The replication used the same evaluation design. There were statistically significant spikes in calls from pregnant women during both campaign waves for both types of contrasts. A higher proportion of the calls from pregnant women were from African Americans during the campaign. A multimodal quitline promotion like OTRTQ should be considered for geographic areas with sizable African American populations and high rates of infant mortality.
report. The detail required for such a review would be unwieldy and would comsume inordinate amounts of time. The result of the document review will...attempts have been made at writing specific behavioral objectives (SBOs). These, however, have proven to be inadequate in that they are not stated in... behavioral terms (e.g., "will understand," "will have a knowledge of," etc.). C. Development of CRO/CRTs? In nearly all cases, ISD teams are just
Pokhrel, Pallav; Herzog, Thaddeus A
Despite the lack of clarity regarding their safety and efficacy as smoking cessation aids, electronic cigarettes (e-cigarettes) are commonly used to quit smoking. Currently, little is understood about why smokers may use e-cigarettes for help with smoking cessation compared with other, proven cessation aids. This study aimed to determine the reasons for wanting to quit cigarettes that are associated with the use of e-cigarettes for cessation help versus the use of conventional nicotine replacement therapy (NRT) products (e.g., gums). Cross-sectional, self-report data were obtained from 1,988 multiethnic current daily smokers (M age = 45.1, SD = 13.0; 51.3% women) who had made an average of 8.5 (SD = 18.7) lifetime quit attempts but were not currently engaged in a cessation attempt. Reasons for wanting to quit smoking were assessed by using the Reasons for Quitting scale. Path analyses suggested that among reasons for quitting cigarettes, "immediate reinforcement"-a measure of wanting to quit cigarettes for extrinsic reasons such as bad smell, costliness and untidiness-was significantly associated with having tried e-cigarettes for cessation help, and "concerns about health" was associated with having tried NRT-only use. E-cigarettes appear to provide an alternative "smoking" experience to individuals who wish to quit cigarette smoking because of the immediate, undesirable consequences of tobacco smoking (e.g., smell, ash, litter) rather than concerns about health. Provided that the safety of e-cigarette use is ensured, e-cigarettes may be effectively used to reduce tobacco exposure among smokers who may not want to quit cigarettes for intrinsic motivation. (c) 2015 APA, all rights reserved).
Full Text Available Background Emotional attachment to your brand of cigarettes or snus might imply a lower tendency to want to quit smoking or using snus. Aim: Investigate emotional attachment to the personal snus or cigarette pack, and its potential effect on quitting plans, among snus users and smokers. Methods A sample of 1625 smokers and 1626 snus users, aged 16-75, recruited from a web-panel, and weighted according to national statistics on smoking and snus use within gender, age and region. Mean age: 41 years, and 41% women. A principal component analysis showed that all positive feelings loaded on a single component, which was used in a multinomial adjusted regression, with a three-point quitting-plans variable as the dependent variable (no quitting plan, plan to quit during this month, plan to quit later. Adjustments were made for gender, age, education, tobacco product (cigarettes or snus, and last month quitting attempts. Results A relatively large minority (20-30% of smokers and snus users agreed fully or partly with statements expressing positive feelings related to buying and using their choice of tobacco brand. The exception was the statement “I like my current/regular pack”, which was endorsed by 65% of smokers and 75% of snus users. Adjusted multinomial regression showed that those who had less positive feelings related to their pack were more likely to have plans to quit tobacco within the next month (AOR=1.5, p< 0.001, or to have plans to quit at some later date (AOR=1.2, p< 0.001, than to have no quitting plans (ref. Other significant factors were gender and earlier quit attempts. Conclusions Emotional attachment to cigarette and snus brands and packages reduces the likelihood of having plans to quit tobacco, which might in turn result in lower actual quitting behaviour. Regulatory actions that reduce emotional attachment, e.g. standardised packaging, may potentially affect quitting behaviour.
Full Text Available Abstract Background It has been suggested that shame may be an important feature in suicidal behaviors. The disposition to react with shame, “shame-proneness”, has previously not been investigated in groups of attempted suicide patients. We examined shame-proneness in two groups of attempted suicide patients, one group of non-suicidal patients and one group of healthy controls. We hypothesized that the attempted suicide patients would be more shame-prone than non-suicidal patients and healthy controls. Methods The Test of Self-Conscious Affect (TOSCA, which is the most used measure of shame-proneness, was completed by attempted suicide patients (n = 175: 105 women and 3 men with borderline personality disorder [BPD], 45 women and 22 men without BPD, non-suicidal psychiatric patients (n = 162, and healthy controls (n = 161. The participants were convenience samples, with patients from three clinical research projects and healthy controls from a fourth research project. The relationship between shame-proneness and attempted suicide was studied with group comparisons and multiple regressions. Men and women were analyzed separately. Results Women were generally more shame-prone than men of the same participant group. Female suicide attempters with BPD were significantly more shame-prone than both female suicide attempters without BPD and female non-suicidal patients and controls. Male suicide attempters without BPD were significantly less shame-prone than non-suicidal male patients. In multiple regressions, shame-proneness was predicted by level of depression and BPD (but not by attempted suicide in female patients, and level of depression and non-suicidality in male patients. Conclusions Contrary to our hypothesis and related previous research, there was no general relationship between shame-proneness and attempted suicide. Shame-proneness was differentially related to attempted suicide in different groups of suicide attempters
Quitting smoking is a major challenge for many people. Seeking help and using proven techniques can improve your chances of quitting for good. In this podcast, Steve Babb discusses ways to successfully quit smoking.
Full Text Available Waterpipe smoking has been described as “the second global tobacco epidemic since the cigarette.” Both Middle Eastern ethnicity and having a friend of Middle Eastern ethnicity have been reported as significant predictors of waterpipe smoking. Addressing waterpipe smoking in this ethnic minority is essential to controlling this growing epidemic in the US. We investigated the predictors of an intention to quit waterpipe smoking by surveying 340 Arab American adults in the Houston area. Primary analyses were conducted using stepwise logistic regression. Only 27% of participants reported having an intention to quit waterpipe smoking. Intention to quit waterpipe smoking was significantly higher with history of cigar use, a prior attempt to quit, and not smoking when seriously ill and significantly lower with increasing age, medium cultural acceptability of using waterpipe among family, high cultural acceptability of using waterpipe among friends, longer duration of smoking sessions, and perceiving waterpipe smoking as less harmful than cigarettes. Educational programs that target Arab Americans in general, and specifically older adults, those who smoke waterpipe for more than 60 minutes, those whose family and friends approve waterpipe smoking, and those with no former attempts to quit, may be necessary to increase the intention to quit waterpipe smoking.
Full Text Available Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of self-harm. Such patients can be on the edge when there is an imbalance between risk factors (such as depression, insomnia, and psychosocial stressors and protective factors (like religious affiliation and family support. All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor.
Ellis, J.; Maiani, L.; Zumino, B.; Gaillard, M.K.
We describe attempts to construct a phenomenologically viable model which embeds a unified theory of strong, weak and electromagnetic interactions in an extended supergravity theory. Following Cremmer and Julia, we assume that the local unitary symmetry which they found for SO(N) supergravity theories is realized dynamically, and that the usual quarks, leptons, gauge bosons and Higgs scalars of the renormalizable gauge theory are composite states which appear point-like on a mass scale below the Planck mass. We argue that this picture leads uniquely to SO(8) (or SO(7)) supergravity with SU(5) as the grand unification gauge group. We find that conventional symmetry breaking schemes according to which particles acquire all allowed invariant masses at each stage of a step by step symmetry breakdown do not yield an acceptable particle spectrum. We argue that the original symmetries of the composite supermultiplet may break dynamically to an effective anomaly free renormalizable sub-theory, with the underlying supersymmetry serving at most to restrict the particle spectrum and to specify the couplings of the effective renormalizable Lagrangian at the Planck mass. Preliminary investigations suggest that this approach may be more promising
Meijer, Eline; Gebhardt, Winifred A; Dijkstra, Arie; Willemsen, Marc C; Van Laar, Colette
We examined how 'smoker' and 'non-smoker' self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e., the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban. Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers. Intention to quit, quit attempts and 'rejecting', 'victimizing', 'socially conscious smoking' and 'active quitting' responses to the smoking ban. Non-smoker identities are more important than smoker identities in predicting intention to quit, quit attempts and responses to the smoking ban, even when controlling for other important predictors such as nicotine dependence. Smokers with stronger non-smoker identities had stronger intentions to quit, were more likely to attempt to quit between measurements, and showed less negative and more positive responses to the smoking ban. The association between non-smoker self-identity and intention to quit was stronger among smokers with lower than higher SES. Antismoking measures might be more effective if they would focus also on the identity of smokers, and help smokers to increase identification with non-smoking and non-smokers.
Jiang, Nan; Lee, Youn O; Ling, Pamela M
Young adults frequently report social smoking. This study examined the relationship between different social smoking definitions and the co-use of cigarettes and alcohol, tobacco-related attitudes, and quitting efforts. Cross-sectional data were collected at bars using randomized time location sampling among young adults aged 21-26 in San Diego, California from 2010 to 2011 (73% response rate). Multivariable logistic regression examined if current smoking and quit attempts were associated with tobacco-related attitudes, and whether social smoking self-identification or behavior was associated with cigarette-and-alcohol co-use, tobacco-related attitudes, quit attempts, or quitline use. Among 537 current smokers, 80% self-identified and 49% behaved as social smokers. Social smoking self-identification was positively associated with cigarette-and-alcohol co-use, and quit attempts. Social smoking behavior was negatively associated with tobacco marketing receptivity, quit attempts, and quitline use. Tobacco-related attitudes were associated with smoking but did not generally differ by social smoking status. Identification and behavior as a social smoker have opposing associations with co-use of cigarettes and alcohol and quit attempts. Tobacco cessation programs for self-identified social smokers should address co-use. Interventions denormalizing the tobacco industry or emphasizing the health effects of temporary smoking and secondhand smoke may address smoking among young adult bar patrons regardless of social smoking status. Copyright © 2014 Elsevier Inc. All rights reserved.
Spokas, Megan; Wenzel, Amy; Brown, Gregory K; Beck, Aaron T
Previous research has identified only a few variables that have been associated with making an impulsive suicide attempt. The aim of the current study was to compare individuals who made an impulsive suicide attempt with those who made a premeditated attempt on both previously examined and novel characteristics. Participants were classified as making an impulsive or premeditated attempt based on the Suicide Intent Scale (Beck et al., 1974a) and were compared on a number of characteristics relevant to suicidality, psychiatric history, and demographics. Individuals who made an impulsive attempt expected that their attempts would be less lethal; yet the actual lethality of both groups' attempts was similar. Those who made an impulsive attempt were less depressed and hopeless than those who made a premeditated attempt. Participants who made an impulsive attempt were less likely to report a history of childhood sexual abuse and more likely to be diagnosed with an alcohol use disorder than those who made a premeditated attempt. Although the sample size was adequate for bivariate statistics, future studies using larger sample sizes will allow for multivariate analyses of characteristics that differentiate individuals who make impulsive and premeditated attempts. Clinicians should not minimize the significance of impulsive attempts, as they are associated with a similar level of lethality as premeditated attempts. Focusing mainly on depression and hopelessness as indicators of suicide risk has the potential to under-identify those who are at risk for making impulsive attempts. Copyright © 2011 Elsevier B.V. All rights reserved.
Lee, Peter N; Fry, John S; Thornton, Alison J
We attempted to quantify the decline in stroke risk following quitting using the negative exponential model, with methodology previously employed for IHD. We identified 22 blocks of RRs (from 13 studies) comparing current smokers, former smokers (by time quit) and never smokers. Corresponding pseudo-numbers of cases and controls/at risk formed the data for model-fitting. We tried to estimate the half-life (H, time since quit when the excess risk becomes half that for a continuing smoker) for each block. The method failed to converge or produced very variable estimates of H in nine blocks with a current smoker RR <1.40. Rejecting these, and combining blocks by amount smoked in one study where problems arose in model-fitting, the final analyses used 11 blocks. Goodness-of-fit was adequate for each block, the combined estimate of H being 4.78(95%CI 2.17-10.50) years. However, considerable heterogeneity existed, unexplained by any factor studied, with the random-effects estimate 3.08(1.32-7.16). Sensitivity analyses allowing for reverse causation or differing assumed times for the final quitting period gave similar results. The estimates of H are similar for stroke and IHD, and the individual estimates similarly heterogeneous. Fitting the model is harder for stroke, due to its weaker association with smoking. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.
Ramberg, Maria; Stanley, Barbara; Ystgaard, Mette; Mehlum, Lars
Posttraumatic stress disorder and major depressive disorder are well-established risk factors for suicidal behavior. This study compared depressed suicide attempters with and without comorbid posttraumatic stress disorder with respect to additional diagnoses, global functioning, depressive symptoms, substance abuse, history of traumatic exposure, and suicidal behavior. Adult patients consecutively admitted to a general hospital after a suicide attempt were interviewed and assessed for DSM-IV diagnosis and clinical correlates. Sixty-four patients (71%) were diagnosed with depression; of them, 21 patients (32%) had posttraumatic stress disorder. There were no group differences in social adjustment, depressive symptoms, or suicidal intent. However, the group with comorbid depression and posttraumatic stress disorder had more additional Axis I diagnoses, a higher degree of childhood trauma exposure, and more often reported previous suicide attempts, non-suicidal self-harm, and vengeful suicidal motives. These findings underline the clinical importance of diagnosis and treatment of posttraumatic stress disorder in suicide attempters.
Pechmann, Cornelia; Delucchi, Kevin; Lakon, Cynthia M; Prochaska, Judith J
We evaluated a novel Twitter-delivered intervention for smoking cessation, Tweet2Quit, which sends daily, automated communications to small, private, self-help groups to encourage high-quality, online, peer-to-peer discussions. A 2-group randomised controlled trial assessed the net benefit of adding a Tweet2Quit support group to a usual care control condition of nicotine patches and a cessation website. Participants were 160 smokers (4 cohorts of 40/cohort), aged 18-59 years, who intended to quit smoking, used Facebook daily, texted weekly, and had mobile phones with unlimited texting. All participants received 56 days of nicotine patches, emails with links to the smokefree.gov cessation website, and instructions to set a quit date within 7 days. Additionally, Tweet2Quit participants were enrolled in 20-person, 100-day Twitter groups, and received daily discussion topics via Twitter, and daily engagement feedback via text. The primary outcome was sustained abstinence at 7, 30 and 60 days post-quit date. Participants (mean age 35.7 years, 26.3% male, 31.2% college degree, 88.7% Caucasian) averaged 18.0 (SD=8.2) cigarettes per day and 16.8 (SD=9.8) years of smoking. Participants randomised to Tweet2Quit averaged 58.8 tweets/participant and the average tweeting duration was 47.4 days/participant. Tweet2Quit doubled sustained abstinence out to 60 days follow-up (40.0%, 26/65) versus control (20.0%, 14/70), OR=2.67, CI 1.19 to 5.99, p=0.017. Tweeting via phone predicted tweet volume, and tweet volume predicted sustained abstinence (p<0.001). The daily autocommunications caused tweeting spikes accounting for 24.0% of tweets. Tweet2Quit was engaging and doubled sustained abstinence. Its low cost and scalability makes it viable as a global cessation treatment. NCT01602536. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Dougherty, Donald M.; Mathias, Charles W.; Marsh, Dawn M.; Papageorgiou, T. Dorina; Swann, Alan C.; Moeller, F. Gerard
The purpose of this study was to examine the relationship between laboratory behavioral measured impulsivity (using the Immediate and Delayed Memory Tasks) and suicidal attempt histories. Three groups of adults were recruited, those with either: no previous suicide attempts (Control, n = 20), only a single suicide attempt (Single, n = 20), or…
Full Text Available Objectives: Among the Korean elderly (those 65 years of age and older, the suicide rate is 80.3/100 000 people, which is ten times higher than the Organization for Economic Cooperation and Development average. Because South Korea is rapidly becoming an aging population, this high elderly suicidal rate will only get worse. Although the size of the elderly suicide problem is quite large, previous research in South Korea has surveyed restricted areas and not the entire country. Even though the factors that affect elderly suicide are complicated, there has been little research into these influencing factors. Thus, this research uses the national survey data (Community Health Survey that was obtained in 2009. Additionally, we analyze factors affecting elderly suicidal ideation and attempts as well as the paths of these effects. Methods: Community Health Survey data obtained by the Korea Centers for Disease Control and Prevention in 2009 was used for this study. We additionally examined the factors that affect suicide with chi-squared tests, t-tests, Pearson’s correlation test, and path analysis. Results: Depressive symptoms and suicidal ideation are the only factors that directly affect suicidal attempts. Demographic, behavioral, and physical activity factors have indirect effects on suicidal attempts. Conclusions: Depression has the strongest influence on suicidal ideation and attempts. Demographic, behavioral, and physical activity factors affect suicidal attempts mostly through depressive symptoms. In addition, there is a path that suggests that demographic, behavioral, and physical activity factors affect suicidal attempts not through depression symptoms but only through suicidal ideation. This means that the elderly who do not have depression symptoms attempt suicide according to their own situations and characteristics.
Full Text Available Following the abdominal surgery, extensive adhesions often occur and they can cause difficulties during laparoscopic operations. However, previous laparotomy is not considered to be a contraindication for laparoscopy. The aim of this study is to present that an insertion of Veres needle in the region of umbilicus is a safe method for creating a pneumoperitoneum for laparoscopic operations after previous laparotomy. In the last three years, we have performed 144 laparoscopic operations in patients that previously underwent one or two laparotomies. Pathology of digestive system, genital organs, Cesarean Section or abdominal war injuries were the most common causes of previouslaparotomy. During those operations or during entering into abdominal cavity we have not experienced any complications, while in 7 patients we performed conversion to laparotomy following the diagnostic laparoscopy. In all patients an insertion of Veres needle and trocar insertion in the umbilical region was performed, namely a technique of closed laparoscopy. Not even in one patient adhesions in the region of umbilicus were found, and no abdominal organs were injured.
Nearly half of all graduate students majoring in various disciplines of science today are women, yet men still predominate the faculty makeup at most universities and research institutions. This issue was discussed at length last year in the journal Science and also in the Chemical Engineering News (the ACS weekly publication magazine). The question is: why do so many women decide to major in science but not to pursue a career in science? Over the years I have seen highly capable women quit science for two main reasons. First, intimidation that can be very difficult to deal with when someone is just starting a career in science. Thus, I encourage young women to make a sincere effort to surround themselves with colleagues who are both knowledgeable and considerate. Keep in my mind that you have a choice to choose your future collaborators, so make some smart choices early on and throughout your career. Second, is the need to balance the demands of work with those of family life. Personally, I don't believe a tenure system is fair to young women who wish to have children during this appointment. The level of stress can be very high, which prevents women from applying to a position where they are given only a few short years to prove themselves. Also, try not to make a radical decision (i.e. quit science) if you are too stressed. Talk to more senior women in the field to learn how to better deal with your stress. After all a career in science has many ups and downs, and to survive, one needs to balance the good and bad days. In this talk I will address the questions outlined in the announcement as they relate to me. Overall, my advice to young women who are just starting their scientific careers is to celebrate your accomplishments and learn from your mistakes.
Fathelrahman, Ahmed I; Li, Lin; Borland, Ron; Yong, Hua-Hie; Omar, Maizurah; Awang, Rahmat; Sirirassamee, Buppha; Fong, Geoffrey T; Hammond, David
We examined the impact of cigarette pack warning labels on interest in quitting and subsequent quit attempts among adult smokers in Malaysia and Thailand. Two overlapping cohorts of adults who reported smoking factory- made cigarettes from Malaysia and Thailand were interviewed face-to-face (3189 were surveyed at baseline and 1781 re-contacted at Wave 2; 2361 current smokers were surveyed at Wave 2 and 1586 re-contacted at Wave 3). In Thailand at baseline, large text only warnings were assessed, while at Wave 2 new large graphic warnings were assessed. In Malaysia, during both waves small text only warnings were in effect. Reactions were used to predict interest in quitting, and to predict making quit attempts over the following inter-wave interval. Multivariate predictors of "interest in quitting" were comparable across countries, but predictors of quit attempts varied. In both countries, cognitive reactions to warnings (adjusted ORs; 1.57 & 1.69 for Malaysia at wave 1 and wave 2 respectively and 1.29 & 1.19 for Thailand at wave 1 and wave 2 respectively), forgoing a cigarette (except Wave 2 in Malaysia) (adjusted ORs; 1.77 for Malaysia at wave 1 and 1.54 & 2.32 for Thailand at wave 1 and wave 2 respectively), and baseline knowledge (except wave 2 in both countries) (adjusted ORs; 1.71 & 1.51 for Malaysia and Thailand respectively) were positively associated with interest in quitting at that wave. In Thailand only, "cognitive reactions to warnings" (adjusted ORs; 1.12 & 1.23 at wave 1 and wave 2 respectively), "forgoing a cigarette" (adjusted OR = 1.55 at wave 2 only) and "an interest in quitting" (adjusted ORs; 1.61 & 2.85 at wave 1 and wave 2 respectively) were positively associated with quit attempts over the following inter-wave interval. Salience was negatively associated with subsequent quit attempts in both Malaysia and Thailand, but at Wave 2 only (adjusted ORs; 0.89 & 0.88 for Malaysia and Thailand respectively). Warnings appear to have common
Tatiana I Andreeva
Full Text Available Background: This study aimed to clarify whether smoke-free policies affect the initiation or the quitting of smoking among young adults. Methods: In this natural quasi-experiment study, three universities with different enforcement of smoke-free policies were considered in Kazan City, Russian Federation. Exposure data were collected in 2008-2009 through measurement of particulate matter concentrations in typical sets of premises in each university to distinguish smoke-free universities (SFU and those not smoke-free (NSFU. All present third year students were surveyed in class in April-June 2011. Number of valid questionnaires equaled 635. The questionnaire was adapted from the Health Professions Students Survey and contained questions on smoking initiation, current tobacco use, willingness to quit, quit attempts, perception of smoke-free policies enforcement, and the demographic data. Results: Among students of SFU, the percentage of current smokers was smaller than in NSFU: 42% vs. 64% in men and 32% vs. 43% in women. Prevalence of daily smoking was 11-12% in SFU, 26% in NSFU overall and 42% among male students. No advantage of SFU in limiting smoking initiation was found. Percentage of former smokers in SFU was 33% vs. 10% in NSFU. Among current smokers, 57% expressed willingness to quit in SFU and only 28% in NSFU. About 60% of current smokers in SFU attempted to quit within a year and only 36% did so in NSFU with 23% vs. 3% having done three or more attempts. Conclusion: Smoke-free universities help young adults to avoid establishing regular smoking by means of facilitating quitting smoking.
Nagelhout, Gera E; Heijndijk, Suzanne M; Cummings, K Michael; Willemsen, Marc C; van den Putte, Bas; Heckman, Bryan W; Hummel, Karin; de Vries, Hein; Hammond, David; Borland, Ron
Much attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviours of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success. We used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n=1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months. There was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR=0.99, p=0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta=0.05, p=0.019) and with a higher likelihood of attempting to quit smoking (OR=1.37, p=0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR=0.92, p=0.807). Noticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation. Copyright © 2015 Elsevier B.V. All rights reserved.
Heijndijk, Suzanne M.; Cummings, K. Michael; Willemsen, Marc C.; van den Putte, Bas; Heckman, Bryan W.; Hummel, Karin; de Vries, Hein; Hammond, David; Borland, Ron
Background Much attention has been directed towards the possible effects of e-cigarette advertisements on adolescent never smokers. However, e-cigarette advertising may also influence perceptions and behaviors of adult smokers. The aim of our study was to examine whether noticing e-cigarette advertisements is associated with current use of e-cigarettes, disapproval of smoking, quit smoking attempts, and quit smoking success. Methods We used longitudinal data from two survey waves of the ITC Netherlands Survey among smokers aged 16 years and older (n=1198). Respondents were asked whether they noticed e-cigarettes being advertised on television, on the radio, and in newspapers or magazines in the previous 6 months. Results There was a significant increase in noticing e-cigarette advertisements between 2013 (13.3%) and 2014 (36.0%), across all media. The largest increase was for television advertisements. There was also a substantial increase in current use of e-cigarettes (from 3.1% to 13.3%), but this was not related to noticing advertisements in traditional media (OR=0.99, p=0.937). Noticing advertisements was bivariately associated with more disapproval of smoking (Beta=0.05, p=0.019) and with a higher likelihood of attempting to quit smoking (OR=1.37, p=0.038), but these associations did not reach significance in multivariate analyses. There was no significant association between noticing advertisements and quit smoking success in either the bivariate or multivariate regression analysis (OR=0.92, p=0.807). Conclusion Noticing e-cigarette advertisements increased sharply in the Netherlands between 2013 and 2014 along with increased e-cigarette use, but the two appear unrelated. The advertisements did not seem to have adverse effects on disapproval of smoking and smoking cessation. PMID:26818084
Savvides, Elena Charis G; Christophi, Costas A; Paisi, Martha; Pampaka, Despina; Kinnunen, Taru; Connolly, Gregory N
To identify factors associated with adolescent smokers' desire to quit based on the 2006 Cyprus Global Youth Tobacco Survey. A cluster sample design was used to select a representative sample of students from all registered middle and high schools in Cyprus with >40 students in academic year 2005-2006. Multivariable logistic regression was used taking into account the weight associated with each of the respondents. Out of the total sample with available information (N=12,629), 1591 students were current smokers (weighted frequency=14%) and were included in the analysis, with 734 (46.1%) of them reporting that they want to quit smoking. In both males and females, strong predictors of intention to quit smoking include past quit attempts and physical activity. Intention to quit is also associated with the belief that smoking is harmful to them and inversely associated with having peers who smoke, in boys, and the belief that smoking is harmful to others and perceiving smokers as less attractive, and inversely associated with pocket money, in girls. The present study has identified factors that appear to influence youth's intention to quit tobacco, which is of major importance in developing successful tobacco cessation programs targeting adolescents. Copyright © 2013 Elsevier Inc. All rights reserved.
Stokłosa, Anna; Skoczylas, Agnieszka; Rudnicka, Anna; Bednarek, Michał; Krzyzanowski, Krystian; Górecka, Dorota
The success in smoking cessation depends not only on a method of treatment but also on patient motivation. The aim of this study was to estimate the motivation and the main reason to quit smoking among outpatients attending smoking cessation clinic. One hundred and eleven patients (50 men and 61 women), mean age 58, filled in a motivation test, nicotine dependence test and a questionnaire of the clinic. The main motivation to quit was for the health reasons (83%). Mean motivation test result was 6.93; mean nicotine addiction evaluated in dependence test was 5.49. Eighty seven percent of patients were ready to quit smoking during one month (36% in 24 hours; 23% in one week; 28% in four weeks). There was no significant difference between men and women. The main motivation to quit smoking were the health reasons as well among men as women. There was no correlation between the readiness to quit smoking determined as time to quit attempt and the motivation test.
Stenager, Elsebeth Nylev; Jensen, Børge; Stenager, Maria
The purposes of the study were (1) to estimate the risk of suicide attempts in multiple sclerosis (MS) patients in Denmark and compare the risk to the background population in the County of Funen, Denmark; (2) to estimate the risk of suicide attempts in MS patients receiving immunomodulating...... therapy compared with untreated patients. The Danish MS Registry, the Danish MS Treatment Registry and the Suicide Attempt Registry are linked and merged together using a person identification number given to all persons residing in Denmark. Among 404 MS patients, 15 patients had attempted suicide...
Bandiera, Frank C; Atem, Folefac; Ma, Ping; Businelle, Michael S; Kendzor, Darla E
Social support interventions have demonstrated limited effectiveness for preventing smoking relapse. The stress-buffering hypothesis may be a useful framework by which to understand social support in smoking cessation interventions. The current study evaluated the interrelations among social support, stress, and smoking cessation in both moderation and mediation models. Participants (N=139) were enrolled in a smoking cessation study at the safety-net hospital in Dallas, Texas. During the week prior to a scheduled quit attempt, general social support was measured using the Interpersonal Support Evaluation List (ISEL) questionnaire and smoking-specific social support was measured via repeated smartphone-based ecological momentary assessments (EMA). Post-quit stress was repeatedly assessed via smartphone. Logistic regression analyses evaluated potential interaction effects of pre-quit social support and post-quit stress on the likelihood of achieving biochemically-verified 7-day point prevalence abstinence at 4 weeks post-quit. Mediation models were evaluated to determine if post-quit stress mediated the association between pre-quit social support and smoking cessation. Participants were predominantly Black (63.3%) and female (57.6%); and 55% reported an annual household income of social support did not significantly interact with post-quit stress to influence smoking cessation. However, post-quit stress did mediate associations between social support variables and smoking cessation. Findings indicated that social support impacts smoking cessation through its influence on post-quit stress among socioeconomically disadvantaged adults participating in cessation treatment. Increasing social support for the specific purpose of reducing stress during a quit attempt may improve smoking cessation rates in disadvantaged populations. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.
Zvolensky, Michael J; Vujanovic, Anka A; Miller, Marcel O Bonn; Bernstein, Amit; Yartz, Andrew R; Gregor, Kristin L; McLeish, Alison C; Marshall, Erin C; Gibson, Laura E
The present investigation examined the relationships between anxiety sensitivity and motivation to quit smoking, barriers to smoking cessation, and reasons for quitting smoking among 329 adult daily smokers (160 females; M (age) = 26.08 years, SD = 10.92). As expected, after covarying for the theoretically relevant variables of negative affectivity, gender, Axis I psychopathology, nonclinical panic attack history, number of cigarettes smoked per day, and current levels of alcohol consumption, we found that anxiety sensitivity was significantly incrementally related to level of motivation to quit smoking as well as current barriers to quitting smoking. Partially consistent with the hypotheses, after accounting for the variance explained by other theoretically relevant variables, we found that anxiety sensitivity was significantly associated with self-control reasons for quitting smoking (intrinsic factors) as well as immediate reinforcement and social influence reasons for quitting (extrinsic factors). Results are discussed in relation to better understanding the role of anxiety sensitivity in psychological processes associated with smoking cessation.
Full Text Available BACKGROUND. Ukraine has adopted State targeted social program for reducing the harmful effects of tobacco on public health in Ukraine till 2012. One of the measures to be implemented is increasing excise tax on tobacco products; therefore, a highly important question is which groups of population are likely to benefit from tax increase through quitting or reducing smoking.METHODS. Data used for analysis were collected in a nationally representative survey of Ukrainian population conducted in 2010. An outcome measure was the anticipated keeping smoking versus quitting (reducing smoking due to tobacco tax increase. Independent variables included socio-demographic characteristics, experience of quitting smoking, exposure to different tobacco control measures, exposure to tobacco advertizing. Binary logistic regression was used to measure associations.RESULTS. Respondents were more likely to expect to keep smoking after the tobacco tax increase if they were dependent on tobacco (odds ratio 2.57, not interested in quitting, not in favor of tobacco tax increase, and exposed to tobacco advertising on TV and cigarette promotions. Respondents were more likely to expect to reduce or quit smoking if they had higher wealth status (OR=0.55, were aware of tobacco health hazard (OR=0.09, had earlier attempts of quitting smoking, were not exposed to secondhand smoke, observed tobacco-related information on television (OR=0.7 and in newspapers (OR=0.45, and observed advertizing of tobacco on radio (OR=0.33 and in public transport (OR=0.25.CONCLUSIONS. Several aspects are important while implementing taxation policy. It is more likely to result in quitting or reducing smoking among those who are less dependent, have tried quitting smoking earlier, and have higher wealth level. Concurrent smoke-free policies and awareness campaigns may potentiate the effect of taxation policies and are recommended to be developed further.
Dhumal, G G; Pednekar, M S; Gupta, P C; Sansone, G C; Quah, A C K; Bansal-Travers, M; Fong, G T
Global Adult Tobacco Survey India 2009-2010 revealed that more than one-third (35%) of adults in India use tobacco in some form: 21% use smokeless tobacco, 9% smoke, and 5% are mixed users (they smoke and use smokeless tobacco), and the quit rate is very low. In an effort to decrease prevalence of tobacco use, it is thus important to understand the factors that are related to intention to quit among Indian tobacco users. Research has shown consistently that intention to quit is a strong predictor of future quitting. The present study reports the factors encouraging quitting tobacco products in India. Cross-sectional data from Wave 1 of the International Tobacco Control Policy Evaluation India Survey conducted in four cities and surrounding rural areas (i.e. Mumbai [Maharashtra], Patna [Bihar], Indore [Madhya Pradesh], and Kolkata [West Bengal]) between August 2010 and December 2011 were analyzed. A total of 8051 tobacco users (15+ years) were randomly sampled from 8586 households: 1255 smokers, 5991 smokeless users, and 805 mixed (smoke and smokeless) users. Validated, standardized questions were asked about current tobacco use, intention to quit, and factors encouraging quitting. Overall, 19.6% of tobacco users intended to quit. Smokers had less intention to quit as compared to smokeless tobacco users whereas mixed users had more intention to quit (odds ratio [OR] =1.48, 95% confidence interval [CI] =1.12-1.97) compared to smokeless tobacco users. Highly educated people were more likely to report intention to quit (OR = 1.82, 95% CI = 1.09-3.02) compared to less educated. Advice by doctors to quit tobacco had a strong impact on intention to quit (OR = 1.68, CI = 1.29-2.15). Tobacco users who were exposed to antitobacco messages at work places (OR = 1.74, CI = 1.23-2.46), at restaurants (OR = 1.65, CI = 1.12-2.43), bars (OR = 1.81, CI = 1.07-3.06), on public transportation (OR = 2.14, CI = 1.49-3.08) and on tobacco packages (OR = 1.77, CI = 1.29-2.14) also
Quitting smoking is a major challenge for many people. Seeking help and using proven techniques can improve your chances of quitting for good. In this podcast, Steve Babb discusses ways to successfully quit smoking. Created: 1/12/2017 by MMWR. Date Released: 1/12/2017.
Turner, Lindsey R.; Mermelstein, Robin
Objectives : To examine reasons to quit among adolescents in a smoking cessation program, and whether reasons were associated with subsequent cessation. Methods : Participants were 351 adolescents. At baseline, adolescents reported motivation, reasons to quit, and stage of change for cessation. Quit status was assessed at end of treatment. Results…
João Mauricio Castaldelli-Maia
The Global Adult Tobacco Survey (GATS functions as a multi-partner initiative that represents global, regional, and national organizations. We acknowledge WHO, CDC, GATS Implementing Agency, Johns Hopkins Bloomberg School of Public Health, RTI International, and the National Governments of Bangladesh, Brazil, China, Egypt, India, Indonesia, Mexico, Philippines, Russia, Thailand, Turkey, Ukraine, and Vietnam, for carrying out such an important survey, and releasing data for public use. Dr. Castaldelli-Maia receives a Pfizer Independent Grant for Learning and Change (IGLC managed by Global Bridges (Healthcare Alliance for Tobacco Dependence Treatment hosted at the Mayo Clinic, to support free smoking cessation treatment training in addiction/mental health care units in Brazil (grant IGLC 13513957. The above had no connection to the present study.
Uppal, Navneet; Shahab, Lion; Britton, John; Ratschen, Elena
Although research suggests that the majority of smokers want to quit smoking, the uptake of Stop Smoking Services, designed to assist smokers with quitting, remains low. Little is known about continuing smokers who do not access these services, and opportunities to influence their motivation and encourage quit attempts through the uptake of services. Using PRIME theory, this study explored differences between continuing smokers who had varying levels of motivation to quit, in terms of their plans to quit, evaluative beliefs about smoking, cigarette dependence, and attitudes towards tobacco control policies and services. Twenty-two current smokers, recruited from the community, were classified by motivation level to quit using a self-report questionnaire (two groups: high/low). Four focus groups (n=13) and individual interviews (n=9) were conducted with both groups using an interview guide incorporating aspects of PRIME theory. Discussion areas included motives for smoking, attitudes towards smoking and quitting, perceptions of dependence, motives for quitting, barriers to quitting, and attitudes towards existing and impending tobacco control policies and services. Verbatim transcripts were analysed using thematic framework analysis. All participants expressed low motivation to quit during discussions, despite some initially self-classifying as having high explicit levels of motivation to quit. Both groups reported similar attitudes towards smoking and quitting, including a perceived psychological addiction to smoking, positive evaluations about smoking which inhibited plans to quit, and similar suggested methods to increase motivation (simply wanting to, save money, improve health). Most felt that they 'ought' to quit as opposed to 'wanted' to. Little influence was ascribed towards tobacco control policies such as plain packaging and hidden sales displays, and participants felt that price increases of tobacco products needed to be considerable in order to influence
Brunette, Mary F; Ferron, Joelle C; McHugo, Gregory J; Davis, Kristin E; Devitt, Timothy S; Wilkness, Sandra M; Drake, Robert E
Rates of cigarette smoking are high among people with severe mental illnesses compared with the general population (45%-90% versus 20%). The authors developed a Web-based computer decision support system that is tailored for use by people with cognitive deficits and is designed to stimulate motivation to quit smoking by using evidence-based treatment. This initial study used a quasi-experimental design to test the decision support system among a convenience sample of 41 smokers with severe mental illnesses. Researchers interviewed participants at baseline and two months later to assess for behaviors indicative of motivation to quit smoking. A negative binomial regression modeled the outcome and controlled for baseline group differences. Participants who used the decision support system were significantly more likely to show any behavioral motivation to quit smoking (such as meet with a clinician to discuss cessation, initiate cessation treatment, or otherwise attempt to quit) (67% versus 35%; χ(2)=4.11, df=41, p=.04). Further, using the decision support system increased by a factor of 2.97, or about 300%, the expected number of ways that a participant showed motivation. The encouraging results of this pilot study indicate that electronic decision supports may facilitate motivation to quit smoking and use of cessation treatment among people with severe mental illnesses.
O'Connor, Rory C; Smyth, Roger; Williams, J Mark G
Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking-suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression-as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking-suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Effectiveness of intensive smoking reduction counselling plus combination nicotine replacement therapy in promoting long-term abstinence in patients with chronic obstructive pulmonary disease not ready to quit smoking: Protocol of the REDUQ trial
Hagens, Petra; Pieterse, Marcel E.; van der Valk, Paul; van der Palen, Job
Introduction: Limited tobacco dependence treatment resources exist for smoking COPD patients not ready to quit. Smoking reduction may be a viable treatment approach if it prompts quit attempts and subsequent abstinence. This article describes the protocol of the REDUQ (REDUce and Quit) study, which
Balmford, James; Borland, Ron
To report on the prevalence of attitudes and beliefs about the importance of wanting to quit and need for use of cessation assistance, that may act as barriers to quitting smoking and adopting cessation assistance. National telephone survey of 802 randomly selected adults (685 smokers, 117 recent quitters). Seventy per cent of smokers believed that 'wanting to quit' was both a necessary and sufficient condition for being able to quit. While only one-third of smokers believed that they were too addicted to be able to quit, only a quarter believed they could quit any time they want to. Belief that use of cessation assistance is a sign of weakness was endorsed by 35% of participants, and related to stage of change. Beliefs about the importance of wanting to quit are commonly held. Many smokers appear to believe that a rational, unambivalent desire to quit is needed before it is worthwhile trying. Short-term impulses to act are not perceived as sufficient. The role of cessation assistance in helping smokers form a rational desire to quit appears to be poorly understood by the majority of smokers. There is a need to engender greater understanding of the potential value of cessation aids to smokers experiencing ambivalence about wanting to quit.
Catley, Delwyn; Goggin, Kathy; Harris, Kari Jo; Richter, Kimber P; Williams, Karen; Patten, Christi; Resnicow, Ken; Ellerbeck, Edward F; Bradley-Ewing, Andrea; Lee, Hyoung S; Moreno, Jose L; Grobe, James E
Despite limitations in evidence, the current Clinical Practice Guideline advocates Motivational Interviewing for smokers not ready to quit. This study evaluated the efficacy of Motivational Interviewing for inducing cessation-related behaviors among smokers with low motivation to quit. Randomized clinical trial. Two-hundred fifty-five daily smokers reporting low desire to quit smoking were recruited from an urban community during 2010-2011 and randomly assigned to Motivational Interviewing, health education, or brief advice using a 2:2:1 allocation. Data were analyzed from 2012 to 2014. Four sessions of Motivational Interviewing utilized a patient-centered communication style that explored patients' own reasons for change. Four sessions of health education provided education related to smoking cessation while excluding elements characteristic of Motivational Interviewing. A single session of brief advice consisted of brief, personalized advice to quit. Self-reported quit attempts; smoking abstinence (biochemically verified); use of cessation pharmacotherapies; motivation; and confidence to quit were assessed at baseline and 3- and 6-month follow-ups. Unexpectedly, no significant differences emerged between groups in the proportion who made a quit attempt by 6-month follow-up (Motivational Interviewing, 52.0%; health education, 60.8%; brief advice, 45.1%; p=0.157). Health education had significantly higher biochemically verified abstinence rates at 6 months (7.8%) than brief advice (0.0%) (8% risk difference, 95% CI=3%, 13%, p=0.003), with the Motivational Interviewing group falling in between (2.9% abstinent, 3% risk difference, 95% CI=0%, 6%, p=0.079). Both Motivational Interviewing and health education groups showed greater increases in cessation medication use, motivation, and confidence to quit relative to brief advice (all pmotivation relative to Motivational Interviewing (Cohen's d=0.36, 95% CI=0.12, 0.60). Although Motivational Interviewing was generally
Wilson, Stephen J.; Sayette, Michael A.; Fiez, Julie A.
The authors examined the effects of smoking expectancy on cue-reactivity among those motivated and those unmotivated to quit smoking using functional magnetic resonance imaging. Cue-elicited activation was observed in the rostral prefrontal cortex (PFC) in smokers who expected to smoke within seconds, but not in those who expected to have to wait hours before having the chance to smoke, regardless of quitting motivation. For quitting-unmotivated smokers expecting to smoke, rostral PFC activation was strongly positively correlated with the activation of several areas previously linked to cue-reactivity, including the medial orbitofrontal cortex (OFC) and rostral anterior cingulate cortex (ACC). In contrast, there was a non-significant negative relationship between activation of the rostral PFC and activation of the medial OFC/rostral ACC in quitting-motivated smokers expecting to smoke. Results extend previous work examining the effects of smoking expectancy and highlight the utility of examining interregional covariation during cue exposure. Findings also suggest that investigators may need to pay close attention to the motivational contexts associated with their experiments when studying cue-reactivity, as these contexts can modulate not only responses to drug cues, but perhaps also the functional implications of observed activity. PMID:21859165
Wyder, Marianne; De Leo, Diego
A considerable proportion of suicide attempts are made on impulse. However, knowledge of characteristics of impulsive attempters is still limited. The present study investigated some of these characteristics and aimed to identify the pattern (if any) of suicidal ideation before an impulsive attempt. Data from a randomized and stratified population of 5130 individuals from Brisbane, Australia, were analysed. Computer-assisted telephone interviews (CATI) were adopted to recruit subjects. Those reporting previous suicidal behaviour were sent a questionnaire by mail. One hundred and twelve subjects reported a suicide attempt. One quarter of these described a pattern consistent with an impulsive attempt. Most impulsive attempters experienced suicidal thoughts before their attempt. They were less likely to believe that their attempt would cause death, and less likely to experience depression. Impulsive attempters did not differ significantly from non-impulsive attempters in regards to age, gender, and motivations for the attempt. Surprisingly, no differences in mean scores of trait impulsivity between impulsive and non-impulsive attempters were found. In addition, the majority of suicide attempters (whether impulsive or not) experienced the suicidal process as fluctuating and not as developing along a continuum. The number of attempters who validly entered the study limited our ability to identify potential confounders. Due to the retrospective nature of the survey, the reliability of the information collected may have been affected by recall biases. In addition, as the surveys were administered by mail, it is possible that some questions may have been misinterpreted. The presence of suicidal feelings prior to an attempt constitutes an opportunity for intervention also in impulsive attempters. However, the identification of impulsiveness requires more research efforts.
Hancox, Robert J.; Shin, Hayden H.; Gray, Andrew R.; Poulton, Richie; Sears, Malcolm R.
Smoking cannabis is associated with symptoms of bronchitis. Little is known about the persistence of symptoms after stopping cannabis use. We assessed associations between changes in cannabis use and respiratory symptoms in a population-based cohort of 1037 young adults. Participants were asked about cannabis and tobacco use at ages 18, 21, 26, 32 and 38 years. Symptoms of morning cough, sputum production, wheeze, dyspnoea on exertion and asthma diagnoses were ascertained at the same ages. Frequent cannabis use was defined as ≥52 occasions over the previous year. Associations between frequent cannabis use and respiratory symptoms were analysed using generalised estimating equations with adjustments for tobacco smoking, asthma, sex and age. Frequent cannabis use was associated with morning cough (OR 1.97, pcannabis use was associated with reductions in the prevalence of cough, sputum and wheeze to levels similar to nonusers. Frequent cannabis use is associated with symptoms of bronchitis in young adults. Reducing cannabis use often leads to a resolution of these symptoms. PMID:25837035
Baillif-Couniou, Valérie; Bartoli, Christophe; Sastre, Caroline; Chèze, Marjorie; Deveaux, Marc; Léonetti, Georges; Pélissier-Alicot, Anne-Laure
Attempted murder by repeated poisoning is quite rare. The authors describe the case of a 62-year-old man who was admitted to an intensive care unit (ICU) for neurological disturbances complicated by inhalation pneumopathy. He presented a loss of consciousness while his wife was visiting him at the ICU (H0). Forty-eight hours later (H48), police officers apprehended the patient's wife pouring a liquid into his fruit salad at the hospital. Toxicological analyses of a blood sample and the infusion equipment (H0), as well as the fruit salad and its container (H48), confirmed the attempted poisoning with cyamemazine (H0) and hydrochloric acid (H48). In order to evaluate the anteriority of poisonings, hair analysis was requested and the medical records of the 6 previous months were also examined. Two 6-cm brown hair strands were sampled and the victim's medical record was seized in order to determine the treatments he had been given during the previous six months. Segmental hair testing on two 6-cm brown hair was conducted by GC-MS, LC-DAD and LC-MS/MS (0-2/2-4/4-6 cm; pg/mg). Haloperidol (9200/1391/227), amitriptyline (7450/1850/3260), venlafaxine (332/560/260), that had never been part of the victim's treatment were detected, as well as some benzodiazepines (alprazolam, bromazepam, nordazepam); cyamemazine was also detected in all the segments (9960/1610/2367) though only a single dose administration was reported in the medical records. The toxicological analyses performed at H0 and H48 confirmed the homicide attempts in the ICU. In addition, comparison of the results in hair analysis with the medical records confirmed repeated poisoning attempts over the previous six months, and thus explain the origin of the disorders presented by the victim. This case serves to remind us that repeated attempted murder can be difficult to diagnose and that hair analysis can be an effective way to detect such attempts. Copyright © 2018. Published by Elsevier Ltd.
Mikkelsen, Stine Schou; Dalum, Peter; Skov-Ettrup, Lise Skrubbeltrang
-2008. In all, 6445 persons reporting quitting successfully within the last 5 years were included in analyses. Users and non-users of cessation aid (medical or behavioural support) were compared with regards to age, education, years smoked, tobacco amount, tobacco type and smoking-related disease using logistic......, those who had smoked for 15 years or more also had lower odds of quitting unaided. Smoking 15 or more grams of tobacco daily was inversely associated with quitting unaided (eg, OR among men were 0.38, 95% CI 0.31 to 0.46). CONCLUSIONS: Quitting smoking without the use of formalised aid was the most...
Full Text Available Abstract Background Programs to encourage smokers to quit smoking tobacco have been implemented worldwide and are generally viewed as an effective public health intervention program. However, few studies have examined the social factors that influence a smoker’s intention to quit smoking. This study investigated the socio-contextual factors that are associated with the intention to quit smoking among male smokers in South Korea. Methods Data were obtained from a 2014 nationally representative panel that examined the influences of mass media on the health of the Korean population. Members of this panel were recruited using a mixed-method sampling and a combination of random digit dial and address-based sampling designs. Survey questions were based on those used in previous studies that assessed the effects of social context, including mass media and social capital, on health. Multivariate logistic regression analyses of the answers of 313 male smokers were undertaken. Results Male smokers who participated in community-based activities were 2.45 times more likely to intend to quit smoking compared to male smokers in general (95 % confidence interval [CI]: 1.25–6.82. In addition, male smokers who participated in informal social gathering networks were 2.38 times more likely to intend to quit smoking compared to male smokers in general (95 % CI: 1.11–5.10. Moreover, male smokers with high smartphone use were 1.93 times more likely than smokers with low smartphone use to intend to quit smoking within one year (95 % CI: 1.07–3.46. Conclusions A supportive environment that enables male smokers to access beneficial health information and that encourages them to quit smoking is necessary for a stop-smoking program to be effective. The result of this study contribute to establishing a new smoking control policy by identifying socio-contextual factors related to the intention to quit smoking.
Witte, Tracy K; Merrill, Katherine A; Stellrecht, Nadia E; Bernert, Rebecca A; Hollar, Daniel L; Schatschneider, Christopher; Joiner, Thomas E
The relationship between impulsivity and suicide has been conceptualized in the literature as a direct one. In contrast, Joiner's [Joiner, T.E., 2005. Why people die by suicide. Harvard University Press, Cambridge, MA.] theory posits that this relationship is indirect in that impulsive individuals are more likely to engage in suicidal behavior because impulsivity makes one more likely to be exposed to painful and provocative stimuli. Adolescents were selected from the Youth Risk Behavior Survey (YRBS) sample between the years of 1993-2003 who had planned for a suicide attempt but did not actually attempt (n=5685), who did not plan but did attempt ("impulsive attempters;" n=1172), and who both planned and attempted (n=4807). Items were selected from the YRBS to assess demographic variables, suicidal behaviors, and impulsive behaviors. Participants who had planned suicide without attempting were significantly less impulsive than those who had attempted without planning and than those who had both planned and attempted. Crucially, participants who had made a suicide attempt without prior planning were less impulsive than those who had planned and attempted. We were unable to conduct a multi-method assessment (i.e., measures were self-report); the measure of impulsivity consisted of items pulled from the YRBS rather than a previously validated impulsivity measure. The notion that the most impulsive individuals are more likely to plan for suicide attempts is an important one for many reasons both theoretical and clinical, including that it may refine risk assessment and attendant clinical decision-making.
Full Text Available Background and Objectives: Cigarette smoking as a major public health problem contributes extra health costs, and smoking cessation among youths is a priority for any prevention program. This study aimed to determine the prevalence of smoking and examined factors associated with having attempts to quit smoking and the motivations to quit among medical university students. Methods: A cross-sectional survey using a random sampling was carried out among 523 (293 male, and 246 female, aged 22.48±3.33years students in Tabriz University of Medical Sciences. Data were collected by using a self-administered questionnaire. The data were analyzed by t-test, chi-square test and Fisher exact tests.Results: The overal prevalence of smoking was 8.9%. (male 18% and 1.4% female. There were significant relationships between smoking status with male gender and alcohol consumption (p<0.001. The reasons for smoking initiation were: satisfying their curiosity, new experience (37.76%, pleasure and entertainment (17.48%, mental, emotional problems and sedation (16.08%, smoker friends (15.38%, inexperience and ignorance (4.89%. 54.16% of the current smokers had a history of smoking cessation.Conclusion: Regarding the higher prevalence of cigarette smoking in students, especialy in male and attempting to quit smoking in majority of them, preventive interventions in younger age and providing cigarette smoking cessation services for students seem necessary.
Research purpose: The purpose of this study was to investigate intention to quit amongst Generation Y academics in HEIs. Motivation for the study: Higher education institutions are more dependent on the abilities and commitment of their staff than most other organisations. More than 4000 academics will retire and need to be replaced by 2018, providing justification for the study of intention to quit of academics. Research design, approach and method: An ex post facto quantitative research design was followed. Academics at six HEIs in South Africa were sampled. Measurement instruments included abridged versions of the Utrecht Work Engagement Scale, Multifactor Leadership Questionnaire, Arnold and Feldman Intention to Quit Scale, Job Descriptive Scale and Chew’s reward scale. Main findings: Employee engagement, job satisfaction, remuneration, reward, recognition and transformational leadership were significantly related to intention to quit. In the partial model, three of these variables explained 45% of the variance in intention to quit. Partial least square path modelling revealed that employee engagement and job satisfaction have significant negative impacts on intention to quit. Practical/managerial implications: The findings serve as input for the development of efficacious strategies to retain Generation Y academics at HEIs in South Africa. Contribution/value-add: This study contributes to our knowledge of intention to quit amongst Generation Y academics. It provides evidence of the complexity and inter-relatedness of variables in the phenomenological network of intention to quit.
Ichinose, Genki; Sayama, Hiroki
The Ultimatum Game (UG) is an economic game where two players (proposer and responder) decide how to split a certain amount of money. While traditional economic theories based on rational decision making predict that the proposer should make a minimal offer and the responder should accept it, human subjects tend to behave more fairly in UG. Previous studies suggested that extra information such as reputation, empathy, or spatial structure is needed for fairness to evolve in UG. Here we show that fairness can evolve without additional information if players make decisions probabilistically and may continue interactions when the offer is rejected, which we call the Not Quite Ultimatum Game (NQUG). Evolutionary simulations of NQUG showed that the probabilistic decision making contributes to the increase of proposers' offer amounts to avoid rejection, while the repetition of the game works to responders' advantage because they can wait until a good offer comes. These simple extensions greatly promote evolution of fairness in both proposers' offers and responders' acceptance thresholds.
Rooke Sally E
Full Text Available Abstract Background In order to improve treatments for cannabis use disorder, a better understanding of factors associated with successful quitting is required. Method This study examined differences between successful (n = 87 and unsuccessful (n = 78 cannabis quitters. Participants completed a questionnaire addressing demographic, mental health, and cannabis-related variables, as well as quitting strategies during their most recent quit attempt. Results Eighteen strategies derived from cognitive behavioral therapy were entered into a principal components analysis. The analysis yielded four components, representing (1 Stimulus Removal, (2 Motivation Enhancement, (3 (lack of Distraction, and (4 (lack of Coping. Between groups comparisons showed that unsuccessful quitters scored significantly higher on Motivation Enhancement and (lack of Coping. This may indicate that unsuccessful quitters focus on the desire to quit, but do not sufficiently plan strategies for coping. Unsuccessful quitters also had significantly more symptoms of depression and stress; less education; lower exposure to formal treatment; higher day-to-day exposure to other cannabis users; and higher cannabis dependence scores. Conclusions The findings suggest that coping, environmental modification, and co-morbid mental health problems may be important factors to emphasize in treatments for cannabis use disorder.
Krigel, Susan W; Grobe, James E; Goggin, Kathy; Harris, Kari Jo; Moreno, Jose L; Catley, Delwyn
The decisional balance (DB) procedure examines the pros and cons of behavior change and was considered a component in early formulations of Motivational Interviewing (MI). However, there is controversy and conflicting findings regarding the use of a DB exercise within the treatment of addictions and a need to clarify the role of DB as a component of MI. College tobacco smokers (N=82) with no intentions on quitting were randomly assigned to receive a single counseling session of either Motivational Interviewing using only the decisional balance component (MIDB), or health education around smoking cessation (HE). Assessments were obtained at baseline, immediately post-treatment, 1week, and 4weeks. Compared to HE, the MIDB sessions scored significantly higher on the Motivational Interviewing Treatment Integrity (MITI) scale (all standardized differences d>1, pmotivation to quit, quit attempts, and self-reported abstinence, with no significant group differences. Changes in the Pros of smoking were correlated with MITI scores, but not with cessation outcomes. In contrast, increases in the Cons of smoking and therapeutic alliance were predictive of better cessation outcomes. The decisional balance exercise as formulated by earlier versions of MI may be counter-productive and cautions around its use are warranted. Instead, improved cessation outcomes appear associated with increasing perceived benefits of quitting and positive therapeutic alliance. Copyright © 2016 Elsevier Ltd. All rights reserved.
A definition of time intervals separating two states of systems of elementary particles and observers is attempted. The definition is founded on the notion of instant state of the system and uses no information connected with the use of a clock. Applying the definition to a classical clock and to a sample of unstable particles, results are obtained in agreement with experiment. However, if the system contains 'few' elementary particles, the properties of the time interval present some different features. (author)
Heydari, Abbas; Dashtgard, Ali; Moghadam, Zahra Emami
Addiction, especially addiction quitting, has been the main problem of health systems of many countries in recent years. High percentage of addiction recurrence (more than 80%) indicates that the nature and therapeutic method of addiction have not been recognized and it demands more efforts in this field. Thus, the present study was conducted with an aim to examine the effect of Bandura's social cognitive theory implementation on addiction quitting of clients referred to Imam Reza Hospital addiction quitting clinic. This two-group experimental study was conducted on 60 clients (30 clients in test group and 30 in control group) referred to Imam Reza Hospital addiction quitting clinic. The study tools were demographic and addiction-quitting self-efficacy questionnaires. After gathering demographic data and conducting pretest, the intervention was carried out based on Bandura's social cognitive theory for the test group and post-test was taken 1 month after the intervention. Data were analyzed by SPSS using related tests. According to the results, test group was more successful than the control group in addiction quitting. There was a significant difference between the two groups in terms of recurrence; it was less in the test group. A significant difference was also found between self-efficacy scores before and after the intervention in the test group. Using Bandura's social cognitive theory was effective on addiction quitting. So, it is recommended to apply it for clients referring to addiction quitting clinics.
Struik, Laura L; O'Loughlin, Erin K; Dugas, Erika N; Bottorff, Joan L; O'Loughlin, Jennifer L
It is well established that many adolescents who smoke want to quit, but little is known about why adolescents want to quit and if reasons to quit differ across gender. The objective of this study was to determine if reasons to quit smoking differ in boys and girls. Data on the Adolescent Reasons for Quitting (ARFQ) scale were collected in mailed self-report questionnaires in 2010-2011 from 113 female and 83 male smokers aged 14-19 years participating in AdoQuest, a longitudinal cohort study of the natural course of the co-occurrence of health-compromising behaviors in children. Overall, the findings indicate that reasons to quit in boys and girls appear to be generally similar, although this finding may relate to a lack of gender-oriented items in the ARFQ scale. There is a need for continued research to develop and test reasons to quit scales for adolescents that include gender-oriented items. © The Author(s) 2013.
Tucker, Joan S; Stucky, Brian D; Edelen, Maria Orlando; Shadel, William G; Klein, David J
The U.S. Public Health Service Clinical Practice Guideline on treating tobacco use and dependence recommends providing advice to quit to every tobacco user seen in a healthcare setting. However, the mechanism through which counseling encourages patients to quit has not been adequately studied. This study tests whether the association between receiving healthcare provider counseling and desire to quit is accounted for by negative health and psychosocial outcome expectancies of smoking. Data were collected online from 721 adult smokers who had seen a healthcare provider in the past 12 months. Associations between counseling to quit, negative outcome expectancies of smoking, and desire to quit were tested, as well as whether outcome expectancies and desire to quit differed by type of counseling (counseling only vs. counseling plus assistance) and level of smoking. Bivariate associations indicated a stronger desire to quit among patients receiving counseling, particularly when it included healthcare provider assistance to quit. SEM results indicated that the association between counseling and desire to quit was fully accounted for by patients' negative health and psychosocial outcome expectancies for smoking. These associations were found across levels of smoking in the case of health expectancies, but were limited to moderate and heavy smokers in the case of psychosocial expectancies. Results suggest that the time devoted to counseling patients about smoking should include providing some assistance to quit, such as recommending a product, prescription or program. Regardless of smoking level, this counseling should incorporate techniques to elicit patients' negative health and psychosocial expectancies of smoking. Copyright © 2018. Published by Elsevier Ltd.
Full Text Available The main purpose of this study is to explore the effects of the psychological capital on job satisfaction, job performance and intention to quit and to determine the mediator and moderator roles of job satisfaction and gender in these relations. Focusing just the relations between variables, the data were collected with using survey method from 237 employees working different positions in a large scale private company in Ankara. The instruments were psychological capital scale (Luthans et al, 2007, job satisfaction scale (Hackman & Oldham, 1975, intention to quit scale (Mobley et al, 1978 and job performance ratings. Results showed that psychological capital has positive relations with job satisfaction and job performance, and negative relations with intention to quit; also job satisfaction has a mediator role in the relations between psychological capital and intention to quit. Moreover it was determined that gender has a moderator role in the relations of psychological capital- job satisfaction, and psychological capital-intention to quit. All these results were discussed in the light of previous findings.
Yang, Tsui-Yun; Lin, Hung-Ru
To understand taxi drivers' successful experiences of quitting betel nut chewing. Previous studies verified that betel nut chewing significantly increases the risk of oral cancer. In Taiwan, taxi drivers work for approximately 10-13 hours per day, and 31·7-80% of them choose to chew betel nuts for their invigorating qualities, which enable them to work more hours and receive more income. A qualitative research design was used. This study used the grounded theory method with purposive sampling to perform in-depth interviews with male taxi drivers who had successfully quit betel nut chewing for more than six months. The interviewed participants were 25 taxi drivers aged 45-67 who had chewed betel nuts for an average of 30·9 years. A constant comparative analysis of the 25 interviews revealed six categories, namely the first experience of chewing betel nuts, a part of work and life, perceiving the impact of betel nuts, trying to change, acting to quit betel nut chewing and starting a new life. During the cessation process, taxi drivers tended to be affected by their addiction to chewing betel nuts and the temptation of friends' invitations to chew betel nuts. However, their recognition of the physical effects of betel nut chewing and their sense of responsibility and commitment to family were the critical factors affecting their determination to quit betel nut chewing. Their willpower to not to chew betel nuts and the source of their motivation to exercise self-control also contributed to their success. Healthcare personnel should understand the experiences and perceptions of betel nut chewers, strengthen their understanding of the effects of betel nut chewing on physical health during the cessation period and support their self-efficacy and quitting behaviours with the assistance of significant others. © 2016 John Wiley & Sons Ltd.
J. Seno Aditya Utama
Full Text Available The number of highly educated woman workers increased in recent year, but job quitting and woman career discontinuity was still high; it was related to working inequalities and work-family issues. The current study investigates the antecedent of woman job quitting decision, career aspiration, spouse and supervisor support. Individual in-depth interviews investigated the 12 highly educated ex-employee mothers. The findings were spouse support on woman job quitting, children care orientation, supervisor retention effort, current positive evaluation and unintended future career.
UK resuscitation guidelines suggest that parents and carers should be allowed to be present during a resuscitation attempt in hospital but no guidance is available regarding family presence when resuscitation takes place out of hospital. A new research study has suggested that relatives who were offered the opportunity to witness resuscitation were less likely to develop symptoms of post-traumatic stress disorder than those who were not given the chance. This article summarises the results of this study and provides an expert commentary on its conclusions.
Fleischer, Nancy L.; Thrasher, James F.; de Miera Juárez, Belén Sáenz; Reynales-Shigematsu, Luz Myriam; Santillán, Edna Arillo; Osman, Amira; Siahpush, Mohammad; Fong, Geoffrey T.
Background In high-income countries (HICs), higher neighborhood socioeconomic deprivation is associated with higher levels of smoking. Few studies in low- and middle-income countries (LMICs) have investigated the role of the neighborhood environment on smoking behavior. Objective To determine whether neighborhood socioeconomic deprivation is related to smoking intensity, quit attempts, quit success, and smoking relapse among a cohort of smokers in Mexico from 2010–2012. Methods Data were analyzed from adult smokers and recent ex-smokers who participated in Waves 4–6 of the International Tobacco Control (ITC) Mexico Survey. Data were linked to the Mexican government’s composite index of neighborhood socioeconomic deprivation, which is based on 2010 Mexican Census data. We used generalized estimating equations to determine associations between neighborhood deprivation and individual smoking behaviors. Findings Contrary to past findings in HICs, higher neighborhood socioeconomic deprivation was associated with lower smoking intensity. Quit attempts showed a U-shaped pattern whereby smokers living in high/very high deprivation neighborhoods and smokers living in very low deprivation neighborhoods were more likely to make a quit attempt than smokers living in other neighborhoods. We did not find significant differences in neighborhood deprivation on relapse or successful quitting, with the possible exception of people living in medium-deprivation neighborhoods having a higher likelihood of successful quitting than people living in very low deprivation neighborhoods (p=0.06). Conclusions Neighborhood socioeconomic environments in Mexico appear to operate in an opposing manner to those in HICs. Further research should investigate whether rapid implementation of strong tobacco control policies in LMICs, as occurred in Mexico during the follow-up period, avoids the concentration of tobacco-related disparities among socioeconomically disadvantaged groups. PMID:25170022
Siahpush, Mohammad; Yong, Hua-Hie; Borland, Ron; Reid, Jessica L; Hammond, David
To examine the association of financial stress with interest in quitting smoking, making a quit attempt and quit success. The analysis used data from 4984 smokers who participated in waves 4 and 5 (2005-07) of the International Tobacco Control (ITC) Four Country Survey, a prospective study of a cohort of smokers in the United States, Canada, the United Kingdom and Australia. The outcomes were interest in quitting at wave 4, making a quit attempt and quit success at wave 5. The main predictor was financial stress at wave 4: '. . . because of a shortage of money, were you unable to pay any important bills on time, such as electricity, telephone or rent bills?'. Additional socio-demographic and smoking-related covariates were also examined. Smokers with financial stress were more likely than others to have an interest in quitting at baseline [odds ratio (OR): 1.63; 95% confidence interval (CI): 1.22-2.19], but were less likely to have made a quit attempt at follow-up (OR: 0.74; 95% CI: 0.57-0.96). Among those who made a quit attempt, financial stress was associated with a lower probability of abstinence at follow-up (OR: 0.53; 95% CI: 0.33-0.87). Cessation treatment efforts should consider assessing routinely the financial stress of their clients and providing additional counseling and resources for smokers who experience financial stress. Social policies that provide a safety net for people who might otherwise face severe financial problems, such as not being able to pay for rent or food, may have a favorable impact on cessation rates.
to socialization or discrimination is the major cause of women’s over representation in crowded occupations. Some studies relate the amount of specific...c.l ^16 Arrowood Determinan ^t:^ of quit behavior aifiong managerial and professional women.
... information and resources, including Create My Quit Plan , smartphone apps , and text message programs Call the NCI ... 2017. Hatsukami DK, Stead LF, Gupta PC. Tobacco addiction. Lancet 2008; 371(9629):2027–2038. [PubMed Abstract] ...
Selvi, Yavuz; Aydin, Adem; Atli, Abdullah; Boysan, Murat; Selvi, Fatih; Besiroglu, Lutfullah
Morning- and evening-type individuals differ on a number of psychological and biological variables. There has been increasing interest in the relationship between chronotype and personality traits. The aim of this study was to investigate the relationship between impulsivity and chronotype in suicide attempters. Eighty-nine suicide attempters were included in the study, and systematic information on suicide attempts was recorded. The Morningness-Eveningness Questionnaire was applied to determine chronotype, and attempter impulsivity was measured by the total score of the Barratt Impulsiveness Scale. Significant differences between chronotype and impulsivity scores were found. Evening-type subjects reported significantly higher impulsivity scores than both neither- and morning-types. A significant association between chronotype and type of suicide attempt was detected. The largest proportion of violent suicide attempters were evening-type subjects. Violent suicide attempters also reported significantly higher impulsivity scores than nonviolent attempters. Previous studies have pointed out possible relations between eveningness and impulsivity. Current findings suggest that eveningness may be a risk factor for violent suicide attempts by increasing impulsivity.
Backinger, Cathy L; Pilsner, Alison M; Augustson, Erik M; Frydl, Andrea; Phillips, Todd; Rowden, Jessica
To conduct analyses to determine the extent to which YouTube videos posted specific to smoking cessation were actually about quitting smoking and if so, whether or not they portrayed evidence-based practices (EBPs). In August 2008, researchers identified YouTube videos by search strategies, 'relevance' and 'view count' using the following three search terms: 'stop smoking', 'quit smoking' and 'smoking cessation (n=296 for full sample and n=191 for unique videos). Overall, almost 60% of videos contained a message about quitting smoking. Differences were found across search terms for videos about quitting smoking, with 'stop smoking' yielding the highest percentage (80.8%) of videos about quitting smoking. Almost half of the videos (48.9%) contained EBPs for cessation strategies; however, a significant portion contained either non--EBPs (28.4%) or both EBPs and non-EBPs (22.7%). The number of views per an individual video across the six categories ranged from a low of 8 in the 'relevance' strategy and 'smoking cessation' search term to a high of 1,247,540 in the 'view count' strategy and 'stop smoking' search term. Of the top three most viewed videos by strategy and search term, 66.7% included a specific mention of quitting smoking and, of these, the majority included EBPs. Results highlight the need to develop and upload videos containing EBPs both to increase the overall proportion of EBP videos in all categories, particularly in 'quit smoking' and 'stop smoking.' Research is needed to study whether YouTube videos influence knowledge, attitudes and behaviours regarding quitting smoking.
Fathelrahman, Ahmed I; Li, Lin; Borland, Ron; Yong, Hua-Hie; Omar, Maizurah; Awang, Rahmat; Sirirassamee, Buppha; Fong, Geoffrey T; Hammond, David
Background We examined the impact of cigarette pack warning labels on interest in quitting and subsequent quit attempts among adult smokers in Malaysia and Thailand. Methods Two overlapping cohorts of adults who reported smoking factory- made cigarettes from Malaysia and Thailand were interviewed face-to-face (3189 were surveyed at baseline and 1781 re-contacted at Wave 2; 2361 current smokers were surveyed at Wave 2 and 1586 re-contacted at Wave 3). In Thailand at baseline, large text only w...
Meijer, Eline; Gebhardt, Winifred A.; Dijkstra, Arie; Willemsen, Marc C.; van Laar, Colette
Objective: We examined how ‘smoker’ and ‘non-smoker’ self- and group-identities and socio-economic status (SES) may predict smoking behaviour and responses to antismoking measures (i.e. the Dutch smoking ban in hospitality venues). We validated a measure of responses to the smoking ban. Design: Longitudinal online survey study with one-year follow-up (N = 623 at T1 in 2011; N = 188 at T2 in 2012) among daily smokers. Main outcome measures: Intention to quit, quit attempts and ‘rejecting...
Banwari, Girish H; Vankar, Ganpat K; Parikh, Minakshi N
Schizophrenia and major depressive disorder (MDD) are among the most common psychiatric diagnoses associated with suicide. There is a dearth of published research systematically comparing suicidal behavior in schizophrenia and MDD. The present study aimed to compare suicide attempts in schizophrenia and MDD. In this hospital-based, cross-sectional study, 50 outpatients each of schizophrenia and MDD were evaluated for their sociodemographic characteristics. In subjects with a history of suicide attempt(s), additional information related to the attempt(s) was obtained. Suicide Intent Scale (SIS) was used to assess the suicidal intent and Mini International Neuropsychiatric Interview (MINI) was used to measure the current suicidal risk. Thirty-four percent and 44% of patients with schizophrenia and MDD, respectively, attempted suicide. The attempters in schizophrenia compared to those in MDD were younger and more likely to be single (unmarried, separated or divorced). Suicidal intent was stronger in schizophrenia, while the attempters with MDD were more often preoccupied with a death wish and reported that stressful life events influenced the attempt. There were no differences in the attempt methods of the two groups. Current suicidal risk was higher in attempters compared to the non-attempters in schizophrenia as well as MDD. Suicide attempts in schizophrenia and MDD have similar features, with quite a few notable differences, which have been discussed at length in the present paper. Copyright © 2012 Wiley Publishing Asia Pty Ltd.
Suadicani, P; Bonde, J P; Olesen, K; Gyntelberg, F
Negative psychosocial work conditions may influence the motivation of employees to adhere to their job. To elucidate the perception of psychosocial work conditions among Danish hospital employees who would quit their job if economically possible and those who would not. A cross-sectional questionnaire study of hospital employees. The questionnaire gave information on elements of the psychosocial work environment (job demands, job influence, job support, management quality, exposure to bullying), general health status, sick-leave during the preceding year, life style (leisure time physical activity, alcohol intake and smoking habits), age, sex and profession. There were 1809 participants with a response rate of 65%. About a quarter (26%) reported that they would quit their job if economically possible; this rose to 40% among the 17% who considered their health mediocre or bad. In a final logistic regression model, six factors were identified as independently associated with the wish to quit or not: self-assessed health status, meaningfulness of the job, quality of collaboration among colleagues, age, trustworthiness of closest superior(s) and exposure to bullying. Based on these factors it was possible to identify groups with fewer than 15% wishing to quit, and similarly, groups where 50% or more would quit if this was economically possible. Psychosocial work conditions, in particular meaningfulness of the job, were independently associated with intention to quit the job if economically possible and relevant within different job categories.
Bekalu, Mesfin Awoke; Ramanadhan, Shoba; Bigman, Cabral A; Nagler, Rebekah H; Viswanath, Kasisomayajula
Research on graphic health warnings (GHWs) indicates that beyond changing cognitions about the health effects of smoking, GHWs evoke emotional reactions that can influence quit-related outcomes. Emotions can be classified based on valence (positive or negative) and arousal (calm or excited). However, although considerable research has examined the differential effectiveness of positive versus negative GHW-evoked emotions, research investigating the role of arousal activation in quit-related behaviors is scarce. This study examined associations between quit-related outcomes (intention and attempt to quit) and GHWs-evoked negative emotions classified as high and low in arousal activation as well as cognitive reactions among smokers of low socioeconomic position (SEP). It also examined whether perceived health risks of smoking moderate the relationship between emotional and cognitive reactions to GHWs and quit-related outcomes. Data were collected from low SEP smokers in three Massachusetts communities. Participants were screened and randomized to view one of the nine GHWs initially proposed for use by the U.S. Food and Drug Administration (FDA) and answered pre- and post-exposure questions. Results showed that GHW-evoked negative emotions high in arousal activation and cognitive reactions were both significantly associated with intention to quit during immediate post-test, controlling for age, warning label difference, and prior quit intention. However, these associations did not hold for quit attempts at follow-up. Perceived health risks of smoking moderated the association between cognitive reactions to GHWs and quit attempts at follow-up. The findings suggest that not all negative emotions evoked by GHWs are effective. Negative emotions high in arousal activation may be more effective in influencing quit-related behavioral intentions in low SEP groups. Additionally, unlike emotional reactions, cognitive reactions to GHWs may have effects that last relatively
Gøtzsche, Peter C; Gøtzsche, Pernille K
is excluded, the risk ratio becomes 0.61 (0.46-0.80) and the heterogeneity in the results disappears (I(2 )= 0%). Conclusions Cognitive behavioural therapy reduces not only repeated self-harm but also repeated suicide attempts. It should be the preferred treatment for all patients with depression.......Objective To study whether cognitive behavioural therapy decreases suicide attempts in people with previous suicide attempts. Design Systematic review and meta-analysis. Setting Randomised trials that compare cognitive behavioural therapy with treatment as usual. Participants Patients who had...... engaged in any type of suicide attempt in the six months prior to trial entry resulting in presentation to clinical services. Main outcome measure Suicide attempt. Results We included ten trials, eight from Cochrane reviews and two from our updated searches (1241 patients, 219 of whom had at least one new...
The existing literature on educational inequalities in adult smoking has focused extensively on differences in current smoking and quitting, rather than on differences in never smoking regularly (initiation) by education in the adult population. Knowing the relative contribution of initiation versus quitting is critical for understanding the mechanisms that produce educational gradients in smoking because initiation and quitting occur at different points in the life course. Using data from 31 waves of the U.S. National Health Interview Survey (N = 587,174), the analyses show the relative likelihood of being a never versus former smoker by education, sex, and age from 1966 to 2010 and for birth cohorts from 1920 to 1979. The analyses also describe differences in the cumulative probability of quitting over the life course, and the role of initiation versus quitting in producing educational gaps in smoking. The results show that educational gaps in never smoking explain the bulk of the educational inequality in adult smoking. Differences in former smoking play a small and decreasing role in producing these gaps. This is true across the life course, whether measured at age 25 or age 50, and for both men and women. While the prevalence and age patterns of former smoking by education converge across birth cohorts, differences in never smoking by education increase dramatically. At the population level, educational gaps in adult smoking are produced by the combination of inequalities in initiation and quitting, with differences in initiation playing a larger role in producing the observed gaps. The portion of the gap explained by differences in quitting is itself a function of educational differences in initiation. Thus, educational gradients in adult smoking are tethered to experiences in adolescence. These findings have important implications for both understanding and addressing disparities in this important health behavior. Copyright © 2013 Elsevier Ltd. All rights
Hall, Peter A; Fong, Geoffrey T; Yong, Hua-Hie; Sansone, Genevieve; Borland, Ron; Siahpush, Mohammad
Personality factors such as time perspective and sensation-seeking have been shown to predict smoking uptake. However, little is known about the influences of these variables on quitting behavior, and no prior studies have examined the association cross-nationally in a large probability sample. In the current study it was hypothesized that future time perspective would enhance - while sensation-seeking would inhibit - quitting activity among smokers. It was anticipated that the effects would be similar across English speaking countries. Using a prospective cohort design, this cross-national study of adult smokers (N=8845) examined the associations among time perspective, sensation-seeking and quitting activity using the first three waves of data gathered from the International Tobacco Control Four Country Survey (ITC-4), a random digit dialed telephone survey of adult smokers from the United Kingdom, United States, Canada and Australia. Findings revealed that future time perspective (but not sensation-seeking) was a significant predictor of quitting attempts over the 8-month follow-up after adjusting for socio-demographic variables, factors known to inhibit quitting (e.g., perceived addiction, enjoyment of smoking, and perceived value of smoking), and factors known to enhance quitting (e.g., quit intention strength, perceived benefit of quitting, concerns about health effects of smoking). The latter, particularly intention, were significant mediators of the effect of time perspective on quitting activity. The effects of time perspective on quitting activity were similar across all four English speaking countries sampled. If these associations are causal in nature, it may be the case that interventions and health communications that enhance future-orientation may foster more quit attempts among current smokers. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.
Full Text Available Krzysztof Buczkowski,1 Ludmila Marcinowicz,2 Slawomir Czachowski,1 Elwira Piszczek3 1Department of Family Medicine, Collegium Medicum, Nicolaus Copernicus University, Torun, 2Department of Family Medicine and Community Nursing, Medical University of Bialystok, Bialystok, 3Sociology Institute, Nicolaus Copernicus University, Torun, Poland Background: Smoking cessation plays a crucial role in reducing preventable morbidity and mortality and is a recognized public-health-policy issue in many countries. Two of the most important factors that affect the efficacy of quitting smoking are motivation and the ability to cope with situations causing relapse.Aim: The objective of the study reported here was to investigate former and current smokers’ motivations for smoking cessation, reasons for relapse, and modes of quitting.Methods: We arranged four focus groups with 24 participants (twelve current and twelve former smokers and eleven semi-structured interviews (five current and six former smokers with a view to understanding and categorizing their opinions on motivations and the course and process of smoking cessation. The data were next analyzed using descriptive qualitative methods.Results: Three main themes were identified: (1 motivations to quit smoking, (2 reasons why smokers sometimes relapse, and (3 modes of quitting smoking. Within the first theme, the following six subthemes surfaced: (1 a smoking ban at home and at work due to other people’s wishes and rules, (2 the high cost of cigarettes, (3 the unpleasant smell, (4 health concern, (5 pregnancy and breastfeeding, and (6 a variety of other factors. The second theme encompassed the following subthemes: (1 stress and the need to lessen it by smoking a cigarette, (2 the need to experience the pleasure connected with smoking, and (3 the smoking environment both at home and at work. Participants presented different smoking-cessation modes, but mainly they were unplanned attempts.Conclusion: Two
Hurley Susan F
Full Text Available Abstract Background In response to the lack of comprehensive information about the health and economic benefits of quitting smoking for Australians, we developed the Quit Benefits Model (QBM. Methods The QBM is a Markov model, programmed in TreeAge, that assesses the consequences of quitting in terms of cases avoided of the four most common smoking-associated diseases, deaths avoided, and quality-adjusted life-years (QALYs and health care costs saved (in Australian dollars, A$. Quitting outcomes can be assessed for males and females in 14 five year age-groups from 15–19 to 80–84 years. Exponential models, based on data from large case-control and cohort studies, were developed to estimate the decline over time after quitting in the risk of acute myocardial infarction (AMI, stroke, lung cancer, chronic obstructive pulmonary disease (COPD, and death. Australian data for the year 2001 were sourced for disease incidence and mortality and health care costs. Utility of life estimates were sourced from an international registry and a meta analysis. In this paper, outcomes are reported for simulated subjects followed up for ten years after quitting smoking. Life-years, QALYs and costs were estimated with 0%, 3% and 5% per annum discount rates. Summary results are presented for a group of 1,000 simulated quitters chosen at random from the Australian population of smokers aged between 15 and 74. Results For every 1,000 males chosen at random from the reference population who quit smoking, there is a an average saving in the first ten years following quitting of A$408,000 in health care costs associated with AMI, COPD, lung cancer and stroke, and a corresponding saving of A$328,000 for every 1,000 female quitters. The average saving per 1,000 random quitters is A$373,000. Overall 40 of these quitters will be spared a diagnosis of AMI, COPD, lung cancer and stroke in the first ten years following quitting, with an estimated saving of 47 life-years and
Li, Zhen; Zhang, Huang; Li, Shu-Hua; Byard, Roger W
Tattoo removal is increasingly required as the number of, particularly young, people acquiring tattoos is increasing. A 21-year-old man is reported who underwent attempted removal of large dragon tattoo utilizing a tattoo machine that injected a phenol-containing solution. At the end of the 3-h procedure, he collapsed and died. At autopsy, large areas of white skin discoloration with focal necrosis and sloughing were present overlying areas of previous tattooing. Histological examination showed collections of eosinophilic fluid with a minimal chronic inflammatory infiltrate in better preserved areas, with focal areas of dermal necrosis. Toxicology was positive for phenol in cardiac blood and liver tissue. There were no underlying organic disease or injuries present which could have caused or contributed to death. This idiosyncratic method of tattoo removal involving subcutaneous injection of phenol had resulted in death most likely from cardiotoxicity. © 2016 American Academy of Forensic Sciences.
Dejean, Alain; Corbara, Bruno; Azémar, Frédéric; Carpenter, James M.
Because group-hunting arboreal ants spread-eagle insect prey for a long time before retrieving them, these prey can be coveted by predatory flying insects. Yet, attempting to rob these prey is risky if the ant species is also an effective predator. Here, we show that trying to rob prey from Azteca andreae workers is a fatal error as 268 out of 276 potential cleptobionts (97.1 %) were captured in turn. The ant workers hunt in a group and use the "Velcro®" principle to cling firmly to the leaves of their host tree, permitting them to capture very large prey. Exceptions were one social wasp, plus some Trigona spp. workers and flies that landed directly on the prey and were able to take off immediately when attacked. We conclude that in this situation, previously captured prey attract potential cleptobionts that are captured in turn in most of the cases.
Nielsen, Helena Skyt; Rosholm, Michael
We analyse what determines the incidence of unemployment among Danish employees by estimation of a logit model for becoming unemployed. Our data is incomplete in the sense that we do not observe whether a transition was caused by the person quitting or being laid off, so we apply the EM-algorithm......We analyse what determines the incidence of unemployment among Danish employees by estimation of a logit model for becoming unemployed. Our data is incomplete in the sense that we do not observe whether a transition was caused by the person quitting or being laid off, so we apply the EM......-algorithm to this problem. The models are extended to account for the panel data structure of the data set by including random effects. We use exclusion restrictions to identify quits and lay offs. We find many quitters among young and old women but only few among men....
Leontaridi, Rannia M.; Ward, Melanie E.
The paper uses data from the International Social Surveys Program (ISSP) to investigate work-related stress among a group of 15 OECD countries. It examines the determinants of work-related stress and explores the importance of work-related stress as a predictor of individuals' quitting behaviour and the rate of absenteeism. We find that those individuals reporting to experience at least some stress in their current position are 10 - 14 % more likely to hold intentions to quit or be absent fro...
Allison Ford; Lesley Sinclair; Jennifer Mckell; Stephen Harrow; Jennifer Macphee; Andy Morrison; Linda Bauld
Background Many patients diagnosed with lung cancer continue to smoke even though this can make their treatment less effective and increase side effects. E-cigarettes form part of the UK's tobacco harm reduction policy landscape and are, by far, smokers' most popular quit attempt method. This pilot study explores feasibility and acceptability of e-cigarettes to aid smoking cessation among lung cancer patients undergoing chemotherapy. Methods 27 smokers with stage IV lung cancer we...
In the wake of the Chernobyl accident the public was greatly confused by the press because units quite unknown before used and large numbers suggested danger; the meaning of limits for radionuclide concentrations in foods was also misunderstood. The present paper attempts a clarification. (G.Q.).
Research on the dynamics of cigarette smoking and cessation though scarce in Nigeria are needed for successful tobacco control. The study evaluated cigarette smoking and quitting among young adults inEnugu, Nigeria. This was a cross sectional questionnaire-based survey undertaken in March 2007. There were 714 ...
Background: Smokeless and cigarette tobacco use is becoming increasingly popular among Nigerian adolescents. This study aimed to evaluate predictors of intention to quit tobacco use among adolescents that currently use tobacco products in Nigeria. Materials and Methods: A total of 536 male and female high school ...
This study examined the relationships between perceived job insecurity, job satisfaction and intention to quit among employees of selected banks in Nigeria. A total of two hundred and nine (n = 209) randomly selected employees of Guaranty Trust Bank, Oceanic International Bank, Zenith Bank, First Bank of Nigeria, Union ...
Lai, Ching-Shiun; Shieh, Tien-Yu; Yang, Yi-Hsin Connie; Chong, Mian-Yoon; Hung, Hsin-Chia; Tsai, Chi-Cheng
The purpose of this study was to provide useful data for a future abstinence project by identifying the factors related to quitting areca (betel) quid chewing. The study was cross-sectional. Data on demographic variables, psychological factors and substance-use behaviors were collected via questionnaires from 326 participants. Multiple logistic regression analysis indicated that the areca/betel quid chewers who were less educated (OR = 0.58, 95% CI = 0.34-0.98) were least likely to try to give up. Among the chewers who tried to quit, those employed as full-time drivers (OR = 2.24, 95% CI = 1.14-4.39), who had drinking habits (OR = 2.41, 95% CI = 1.24-4.66), and who preferred to chew only betel quid wrapped with leaf (OR = 4.44, 95% CI = 1.99-9.90) were more likely to fail. Chewers who successfully quit had a higher internal health locus of control compared with those who failed to quit (one-point increments, OR = 0.94, 95% CI = 0.90-0.98). The results suggest that health educators and researchers can better influence people's chewing behavior if the importance of chewers' education level, job type, substance use (i.e. drinking habits, type of betel quid), and level of health locus of control are all taken into consideration when devising interventions.
Wiersinga, Wilmar M.
Smoking is a risk factor for Graves disease. However, Carle et al. have demonstrated that individuals have a transient increased risk of developing overt autoimmune hypothyroidism in the first 2 years after quitting smoking. The mechanisms involved in these two opposing effects of smoking on the
Beck, Cheryl Tatano; Watson, Sue
Nine percent of new mothers in the United States who participated in the Listening to Mothers II Postpartum Survey screened positive for meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder after childbirth. Women who have had a traumatic birth experience report fewer subsequent children and a longer length of time before their second baby. Childbirth-related posttraumatic stress disorder impacts couples' physical relationship, communication, conflict, emotions, and bonding with their children. The purpose of this study was to describe the meaning of women's experiences of a subsequent childbirth after a previous traumatic birth. Phenomenology was the research design used. An international sample of 35 women participated in this Internet study. Women were asked, "Please describe in as much detail as you can remember your subsequent pregnancy, labor, and delivery following your previous traumatic birth." Colaizzi's phenomenological data analysis approach was used to analyze the stories of the 35 women. Data analysis yielded four themes: (a) riding the turbulent wave of panic during pregnancy; (b) strategizing: attempts to reclaim their body and complete the journey to motherhood; (c) bringing reverence to the birthing process and empowering women; and (d) still elusive: the longed-for healing birth experience. Subsequent childbirth after a previous birth trauma has the potential to either heal or retraumatize women. During pregnancy, women need permission and encouragement to grieve their prior traumatic births to help remove the burden of their invisible pain.
Full Text Available BACKGROUND. According to the Global Adult Tobacco Survey completed in 2010 in Ukraine, 28,8% (about 11,5 million of adults aged 15 years and older are current smokers. Among women, prevalence of current smoking is 11,2%, which is considerably less than among men (50%. The goal of the study was to reveal the determinants of quitting smoking among women.METHODS. The sample included 571 women, who were current or former daily smokers. Firstly, the bivariate analysis (cross-tabulation and chi-square test was conducted. Then, the significant determinants from bivariate analysis were included to binary logistic regression. The women’s smoking status (current daily smokers vs. former daily smokers was considered an outcome measure. Independent variables included education, age, occupation, income, religion, marital status, variation in prices for tobacco products, awareness of the negative consequences of smoking, permission to smoke at home, and whether the woman received an advice to quit smoking from a health worker.RESULTS. Bivariate analysis showed that there was statistically significant relationships with age, marital status, occupation, permission to smoke at home, having received information about the dangers of smoking from the radio, newspapers, and other sources. The multivariate analysis demonstrated that the unemployed women and women from households where smoking was banned were more likely to quit smoking. Unmarried women were less likely to quit smoking than married.CONCLUSIONS. Quitting smoking among women was associated with being married, unemployed, and living in a home where smoking is banned. Major limitations of the study are the small sample size and cross-sectional nature of the study; hence, the inerrant conclusions about cause-effect relationships are not possible. So, longitudinal study with larger sample could be a better future option.
Torres, L D; Barrera, A Z; Delucchi, K; Penilla, C; Pérez-Stable, E J; Muñoz, R F
Limited evidence has suggested that quitting smoking increases the incidence of major depressive episodes (MDEs), particularly for smokers with a history of depression. Further evidence for this increase would have important implications for guiding smoking cessation. Spanish- and English-speaking smokers without a current MDE (n=3056) from an international, online smoking cessation trial were assessed for abstinence 1 month after their initial quit date and followed for a total of 12 months. Incidence of screened MDE was examined as a function of abstinence and depression history. Continued smoking, not abstinence, predicted MDE screened at 1 month [smoking 11.5% v. abstinence 7.8%, odds ratio (OR) 1.36, 95% confidence interval (CI) 1.04-1.78, p=0.02] but not afterwards (smoking 11.1% v. abstinence 9.8%, OR 1.05, 95% CI 0.77-1.45, p=0.74). Depression history predicted MDE screened at 1 month (history 17.1% v. no history 8.6%, OR 1.71, 95% CI 1.29-2.27, pincreased MDE, even for smokers with a history of depression, although a history of depression was. Instead, not quitting was associated with increased MDE shortly following a quit attempt. Results from this online, large, international sample of smokers converge with similar findings from smaller, clinic-based samples, suggesting that in general, quitting smoking does not increase the incidence of MDEs.
Sarchiapone, Marco; Carli, Vladimir; Di Giannantonio, Massimo; Roy, Alec
We wished to examine determinants of suicidal behavior in prisoners. 903 male prisoners had a psychiatric interview which included various psychometric tests. Suicide attempters were compared with prisoners who had never attempted suicide. Significantly more of the attempters had a history of psychiatric disorder, substance abuse, a family history…
Attempting to retrieve information from memory enhances subsequent learning even if the retrieval attempt is unsuccessful. Recent evidence suggests that this benefit materializes only if subsequent study occurs immediately after the retrieval attempt. Previous studies have prompted retrieval using a cue (e.g., "whale-???") that has no…
Full Text Available With growing recognition of stagnant rates of attempted cigarette smoking cessation, the current study examined demographic and psychometric characteristics associated with successful and attempted smoking cessation in a nationally representative sample. This additional understanding may help target tobacco cessation treatments toward sub-groups of smokers in order to increase attempts to quit smoking.Data were used from the 2011 U.S. National Health and Wellness Survey (n = 50,000.Current smoking status and demographics, health characteristics, comorbidities, and health behaviors.In 2011, 18%, 29%, and 52% of U.S. adults were current, former, or never smokers, respectively. Over one quarter (27% of current smokers were attempting to quit. Current smokers (vs. others were significantly more likely to be poorer, non-Hispanic White, less educated, ages 45-64, and uninsured, and they had fewer health-conscious behaviors (e.g., influenza vaccination, exercise. Attempting quitters vs. current smokers were significantly less likely to be non-Hispanic White and more likely to be younger, educated, insured, non-obese, with family history of chronic obstructive pulmonary disease, and they had more health-conscious behaviors.Smokers, attempting quitters, and successful quitters differ on characteristics that may be useful for targeting and personalizing interventions aiming to increase cessation attempts, likelihood, and sustainability.
Sublette, M. Elizabeth; Carballo, Juan J.; Moreno, Carmen; Galfalvy, Hanga C.; Brent, David A.; Birmaher, Boris; Mann, J. John; Oquendo, Maria A.
1. Abstract Bipolar disorder (BD) is associated with high rates of suicide attempt and completion. Substance use disorders (SUD) have been identified as potent risk factors for suicidal behavior in BD. However, little is known concerning differences between BD subtypes with regard to SUD as a risk factor for suicidal behavior. We studied previous suicidal behavior in adults with a major depressive episode in context of BD type I (BD-I; N=96) or BD type II (BD-II; N=42), with and without history of SUD. Logistic regressions assessed the association between SUD and suicide attempt history by BD type, and exploratory analyses examined the effects of other clinical characteristics on these relationships. SUD were associated with suicide attempt in BD-I but not BD-II, an effect not attributable to sample size differences. The higher suicide attempt rate associated with alcoholism in BD-I was mostly explained by higher aggression scores, and earlier age of BD onset increased the likelihood that alcohol use disorder would be associated with suicide attempt(s). The higher suicide attempt rate associated with other drug use disorders in BD-I was collectively explained by higher impulsivity, hostility, and aggression scores. The presence of both alcohol and drug use disorders increased odds of a history of suicide attempt in a multiplicative fashion: 97% of BD-I who had both comorbid drug and alcohol use disorders had made a suicide attempt. A critical next question is how to target SUD and aggressive traits for prevention of suicidal behavior in BD-I. PMID:18590916
Richland, Lindsey E.; Kornell, Nate; Kao, Liche Sean
Testing previously studied information enhances long-term memory, particularly when the information is successfully retrieved from memory. The authors examined the effect of unsuccessful retrieval attempts on learning. Participants in 5 experiments read an essay about vision. In the test condition, they were asked about embedded concepts before…
Lu, Wenying; Chappell, Kate; Walters, Julia A E; Jacobson, Glenn A; Patel, Rahul; Schüz, Natalie; Ferguson, Stuart G
In recent years, there has been growing research interest in using nicotine replacement medications to aid smoking reduction prior to a quit attempt. Gaining a better understanding of how treatments influence smoking reduction may allow for better tailoring of treatments and, ultimately, better cessation outcomes. The objective of the current study was to test the effects of the pre-quit use of varenicline and nicotine patch on smoking rate and satisfaction with smoking. All participants were required to attend up to five study visit sections. Participants (n = 213) who were interested in quitting were randomised (open-label) to receive either pre-quit patch or varenicline (both treatments started 2 weeks prior to an assigned quit day, followed by 10 weeks post-quit) or standard patch (10 weeks starting from an assigned quit day). Participants used modified smartphones to monitor their smoking in real time for 4 weeks. Participants in the two pre-quit treatment groups reported significant reductions in both their satisfaction with smoking (p rate (p rate was associated with the satisfaction with smoking (p rate. Satisfaction was associated with changes in smoking rate, but the relationship was weak. As such, monitoring reductions in satisfaction do not appear to be a viable method of evaluating responsiveness to treatment.
Jari Ojala; Jaakko Pehkonen; Jari Eloranta
Ship jumping in foreign ports was widespread throughout the age of sail. Desertion by seamen was illegal, it occurred abroad, and men who deserted only seldom returned home. We analyse desertion quantitatively and link it to the broader question of quit behaviour and labour turnover. Though the better wages paid at the foreign ports were the main reason for desertion, the regression model of the determinants of desertion indicates that outside opportunities, such as migration, and monetary in...
Lewitzka, Ute; Denzin, Sebastian; Sauer, Cathrin; Bauer, Michael; Jabs, Burkhard
Suicidality is an individual behaviour caused by a complex framework of internal and external factors. The predictive values of personality traits for a suicide attempt have been demonstrated, especially in conjunction with Cloninger's TCI and impulsivity. Two issues remain unsolved, namely whether these traits alter over time after a suicide attempt, and how they may be influenced by depressive symptoms. We studied two patient cohorts: one sample of 81 patients after a suicide attempt no longer than 3 months previously (SA early) and another sample of 32 patients whose attempt had taken place more than 6 months previously (SA late). We carried out structured interviews with these subjects addressing diagnosis (MINI), suicidality (Scale for suicide ideation), depression (HAMD-17), temperament and character inventory (TCI), and impulsivity (BIS-10). Data analysis was done using SPSS 16.0. Our two groups did not differ significantly in sociodemographics or suicidality. However, patients in the SA early group were significantly more depressed (p impulsivity (p suicide attempt. Further investigations are necessary to verify our results, ideally in longitudinal studies with larger, carefully-described cohorts. It would be also clinically important to investigate the influence of therapeutic strategies on the variability of personality traits and their impact on suicidal behavior.
Stefansson, Jon; Chatzittofis, Andreas; Nordström, Peter; Arver, Stefan; Åsberg, Marie; Jokinen, Jussi
Very few studies have assessed testosterone levels in the cerebrospinal fluid in suicide attempters. Aggressiveness and impulsivity are common behavioural traits in suicide attempters. Dual-hormone serotonergic theory on human impulsive aggression implies high testosterone/cortisol ratio acting on the amygdala and low serotonin in the prefrontal cortex. Our aim was to examine the CSF and plasma testosterone levels in suicide attempters and in healthy volunteers. We also assessed the relationship between the testosterone/cortisol ratio, aggressiveness and impulsivity in suicide attempters. 28 medication-free suicide attempters and 19 healthy volunteers participated in the study. CSF and plasma testosterone sulfate and cortisol levels were assessed with specific radio-immunoassays. The Karolinska Scales of Personality was used to assess impulsivity and aggressiveness. All patients were followed up for cause of death. The mean follow-up period was 21 years. Male suicide attempters had higher CSF and plasma testosterone levels than age- matched male healthy volunteers. There were no significant differences in CSF testosterone levels in female suicide attempters and healthy female volunteers. Testosterone levels did not differ significantly in suicide victims compared to survivors. In male suicide attempters, the CSF testosterone/cortisol ratio showed a significant positive correlation with both impulsivity and aggressiveness. Higher CSF testosterone levels may be associated with attempted suicide in young men through association with both aggressiveness and impulsivity, a key endophenotype in young male suicide attempters. Copyright © 2016 Elsevier Ltd. All rights reserved.
Kim, Jaeha; Lee, Kang-Sook; Kim, Dai Jin; Hong, Seung-Chul; Choi, Kyoung Ho; Oh, Youngmin; Wang, Sheng-Min; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk
The present study aimed to investigate predictors for planned suicide attempters. This study included 1,003 patients who attempted suicide and visited emergency department. They were divided into two groups, planned suicide attempters (SAs; n=133 [13.3%]) and impulsive SAs (n=870, [86.7%]), and the demographic variables, clinical characteristics, factors related to suicide, and psychiatric resources of the groups were compared. Major depressive disorder and substance use disorders were more common among planned SAs than among impulsive SAs. Additionally, the planned SAs were older, more likely to be divorced, separated or widowed, and more likely to have comorbid medical illnesses, severe depression, higher suicidality, and self-blaming tendencies than the impulsive SAs. Financial problems and physical illnesses were more common in planned SAs but interpersonal conflicts were more frequent in impulsive SAs. Planned SAs had fewer previous suicide attempts but these were more serious suicide attempts. The presence of the hope to die, a written will, and suicidal ideation of a repetitive, intense, and continuous nature were predictive of planned SAs. The present findings demonstrated that planned SAs had more severe psychopathology and medical illnesses than impulsive SAs. Therefore, screening for depression, substance use disorders, and suicidal plans among old and medically ill patients may be important for preventing suicide attempts.
Gautier, M; Normand, A-C; Ranque, S
The use of multi-locus DNA sequence analysis has led to the description of previously unknown 'cryptic' Aspergillus species, whereas classical morphology-based identification of Aspergillus remains limited to the section or species-complex level. The current literature highlights two main features concerning these 'cryptic' Aspergillus species. First, the prevalence of such species in clinical samples is relatively high compared with emergent filamentous fungal taxa such as Mucorales, Scedosporium or Fusarium. Second, it is clearly important to identify these species in the clinical laboratory because of the high frequency of antifungal drug-resistant isolates of such Aspergillus species. Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) has recently been shown to enable the identification of filamentous fungi with an accuracy similar to that of DNA sequence-based methods. As MALDI-TOF MS is well suited to the routine clinical laboratory workflow, it facilitates the identification of these 'cryptic' Aspergillus species at the routine mycology bench. The rapid establishment of enhanced filamentous fungi identification facilities will lead to a better understanding of the epidemiology and clinical importance of these emerging Aspergillus species. Based on routine MALDI-TOF MS-based identification results, we provide original insights into the key interpretation issues of a positive Aspergillus culture from a clinical sample. Which ubiquitous species that are frequently isolated from air samples are rarely involved in human invasive disease? Can both the species and the type of biological sample indicate Aspergillus carriage, colonization or infection in a patient? Highly accurate routine filamentous fungi identification is central to enhance the understanding of these previously unknown Aspergillus species, with a vital impact on further improved patient care. Copyright © 2016 European Society of Clinical Microbiology and
Cougle, Jesse R; Hawkins, Kirsten A; Macatee, Richard J; Zvolensky, Michael J; Sarawgi, Shivali
Hostility has emerged as an important predictor of smoking cessation difficulties, though the mechanisms underlying the hostility and smoking relationship are poorly understood. Further, research has yet to explore relations between hostile interpretation biases and different aspects of smoking behavior. In the present study, current daily smokers (N = 106) were administered measures of smoking characteristics, smoking motivation, reasons for quitting, hostility, and hostile interpretation bias. Neither trait hostility nor hostile interpretation bias were uniquely associated with motivation to quit, reasons for quitting, nicotine dependence, or problematic symptoms following past cessation attempts. However, hostility and hostile interpretation biases were uniquely associated with different reasons for smoking. Additionally, greater hostile interpretation bias (but not hostility) was uniquely associated with early relapse following past cessation attempts. The current findings add uniquely to the growing, but still relatively small, literature on hostility and smoking and implicate hostile interpretation bias as a potential treatment target in smoking cessation interventions.
Kushnir, Vladyslav; Godinho, Alexandra; Hodgins, David C; Hendershot, Christian S; Cunningham, John A
Considerable gender differences have been previously noted in the prevalence, etiology, and clinical features of problem gambling. While differences in affective states between men and women in particular, may explain differential experiences in the process of gambling, the role of affect in motivations for quitting gambling and recovery has not been thoroughly explored. The aim of this study was to examine gender differences within a sample of problem gamblers motivated to quit with or without formal treatment, and further, to explore the interactions between gender, shame and guilt-proneness, and autonomous versus controlled reasons for change. Motivation for change and self-conscious emotional traits were analyzed for 207 adult problem gamblers with an interest in quitting or reducing their gambling (96.6 % not receiving treatment). Overall, gender differences were not observed in clinical and demographic characteristics. However, women exhibited greater shame [F(1,204) = 12.11, p = 0.001] and guilt proneness [F(1,204) = 14.16, p motivation for change was associated with higher guilt-proneness, greater problem gambling severity, and the preparation stage of change; whereas controlled forms of motivation were significantly associated with higher shame-proneness and greater problem gambling severity. No gender effects were observed for either motivation for change. These findings suggest that the process of change can be different for shame-prone and guilt-prone problem gamblers, which may impact behavioral outcomes.
Rutten, Lila J Finney; Blake, Kelly D; Agunwamba, Amenah A; Grana, Rachel A; Wilson, Patrick M; Ebbert, Jon O; Okamoto, Janet; Leischow, Scott J
Research has documented growing availability and use of e-cigarettes in the United States over the last decade. We conducted a national panel survey of current adult cigarette smokers to assess attitudes, beliefs, and behaviors relating to e-cigarette use in the United States (N = 2,254). Among current cigarette smokers, 20.4% reported current use of e-cigarettes on some days and 3.7% reported daily use. Reported reasons for e-cigarette use included: quit smoking (58.4%), reduce smoking (57.9%), and reduce health risks (51.9%). No significant differences in sociodemographic characteristics between e-cigarette users and nonusers were observed. Prior quit attempts were reported more frequently among e-cigarette users (82.8%) than nonusers (74.0%). Intention to quit was reported more frequently among e-cigarette users (64.7%) than nonusers (46.8%). Smokers intending to quit were more likely to be e-cigarette users than those not intending to quit (odds ratio [OR] = 1.90, CI =1.36-2.65). Those who used e-cigarettes to try to quit smoking (OR = 2.25, CI = 1.25-4.05), reduce stress (OR = 3.66, CI = 1.11-12.09), or because they cost less (OR = 3.42, CI = 1.64-7.13) were more likely to report decreases in cigarette smoking than those who did not indicate these reasons. Smokers who reported using e-cigarettes to quit smoking (OR = 16.25, CI = 8.32-31.74) or reduce stress (OR = 4.30, CI = 1.32-14.09) were significantly more likely to report an intention to quit than those who did not indicate those reasons for using e-cigarettes. Nearly a quarter of smokers in our study reported e-cigarettes use, primarily motivated by intentions to quit or reduce smoking. These findings identify a clinical and public health opportunity to re-engage smokers in cessation efforts. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: email@example.com.
Blake, Kelly D.; Agunwamba, Amenah A.; Grana, Rachel A.; Wilson, Patrick M.; Ebbert, Jon O.; Okamoto, Janet; Leischow, Scott J.
Introduction: Research has documented growing availability and use of e-cigarettes in the United States over the last decade. Methods: We conducted a national panel survey of current adult cigarette smokers to assess attitudes, beliefs, and behaviors relating to e-cigarette use in the United States (N = 2,254). Results: Among current cigarette smokers, 20.4% reported current use of e-cigarettes on some days and 3.7% reported daily use. Reported reasons for e-cigarette use included: quit smoking (58.4%), reduce smoking (57.9%), and reduce health risks (51.9%). No significant differences in sociodemographic characteristics between e-cigarette users and nonusers were observed. Prior quit attempts were reported more frequently among e-cigarette users (82.8%) than nonusers (74.0%). Intention to quit was reported more frequently among e-cigarette users (64.7%) than nonusers (46.8%). Smokers intending to quit were more likely to be e-cigarette users than those not intending to quit (odds ratio [OR] = 1.90, CI =1.36–2.65). Those who used e-cigarettes to try to quit smoking (OR = 2.25, CI = 1.25–4.05), reduce stress (OR = 3.66, CI = 1.11–12.09), or because they cost less (OR = 3.42, CI = 1.64–7.13) were more likely to report decreases in cigarette smoking than those who did not indicate these reasons. Smokers who reported using e-cigarettes to quit smoking (OR = 16.25, CI = 8.32–31.74) or reduce stress (OR = 4.30, CI = 1.32–14.09) were significantly more likely to report an intention to quit than those who did not indicate those reasons for using e-cigarettes. Conclusions: Nearly a quarter of smokers in our study reported e-cigarettes use, primarily motivated by intentions to quit or reduce smoking. These findings identify a clinical and public health opportunity to re-engage smokers in cessation efforts. PMID:25589678
Doihara, Chiho; Kawanishi, Chiaki; Ohyama, Nene; Yamada, Tomoki; Nakagawa, Makiko; Iwamoto, Yohko; Odawara, Toshinari; Hirayasu, Yoshio
Suicide attempt is a risk factor for suicide. To investigate trait impulsivity among suicide attempters, 93 attempters admitted to an emergency department and 113 healthy controls were evaluated using the Japanese version of the Barratt Impulsiveness Scale (BIS-11J). Impulsivity was analyzed in relation to clinical data in the attempters. Total BIS-11J, attention impulsiveness, and motor impulsiveness scores were significantly higher in the attempters than in the controls. Both total BIS-11J and non-planning impulsiveness scores were significantly higher in attempters with schizophrenia and other psychotic disorders among the diagnostic groups. Control of impulsivity should be considered as one of the targets for suicide prevention. © 2012 The Authors. Psychiatry and Clinical Neurosciences © 2012 Japanese Society of Psychiatry and Neurology.
Shrier, Lydia A; Sarda, Vishnudas; Jonestrask, Cassandra; Harris, Sion Kim
Young adults using marijuana heavily often try multiple times to quit on their own. We sought to identify momentary experiences during marijuana use that could aid in predicting lapse when young adults subsequently attempt abstinence. Young adults (N=34) age 18-25 using marijuana ≥5days/week and planning to quit completed a survey of sociodemographic characteristics, substance use, marijuana expectancies, use motives, perceived social support, and confidence to abstain. They completed ecological momentary assessment (EMA) smartphone reports several times/day for two weeks prior to, then during two weeks of attempted abstinence. Use period EMA reports assessed affect, craving, accessibility, situational permissibility, use, and motivation to abstain. Baseline survey and EMA data were examined in relation to subsequent lapse during attempted abstinence. Nearly 3 in 4 participants (73.5%) reported lapsing during attempted abstinence from marijuana. On bivariate analyses, lower baseline dependence severity score, negative effect expectancies, perceived family support, and confidence to abstain were each associated with lapse. Of the use period EMA variables, greater percent of days with marijuana use, reports of easy accessibility, and reports of situational permissibility were each associated with lapse. Modeled together, negative effect expectancies, perceived family support, confidence to abstain, and situational permissibility during use were highly accurate in predicting lapse during attempted abstinence. Momentary factors may add to conventionally-surveyed characteristics to enhance prediction of lapse during attempted abstinence among young adults with heavy marijuana use. Momentary assessment prior to a quit attempt may thus enable more effective personalized approaches to preventing lapse. Copyright © 2018 Elsevier Ltd. All rights reserved.
Westmaas, J Lee; Ferrence, Roberta; Wild, T Cameron
According to Beck's cognitive theory of depression, autonomy (high achievement concerns) and sociotropy (high interpersonal concerns) are vulnerability factors for depression when achievement or interpersonal stressors, respectively, are experienced. This hypothesis was tested among men and women attempting to quit smoking, an achievement stressor that can provoke depressive symptoms. Smokers recruited from the community (N=210) provided information about their quit attempt through mailed questionnaires. For the 48-h period following the quit, relationships among autonomy, sociotropy, coping, depressive symptoms and lapsing were assessed. Structural equation models supported the trait-congruence hypothesis because greater autonomy, but not sociotropy, was associated with elevated depressive symptoms among both men and women smokers. However, results were stronger for men (beta=.47, p=.0001) than for women (beta=.20, p=.05). After accounting for autonomy's relationship with depressive symptoms, greater autonomy was inversely associated with lapsing among men (beta=-.35, p=.01), but not women. Results point to the potential usefulness of a theoretical approach to understanding relationships between depressive symptoms and smoking cessation, and indicate that autonomous personality may be an important factor in smoking cessation in men.
Sharon A. Munyaka
Full Text Available Orientation: The relationship between authentic leadership, psychological capital, psychological climate and team commitment in a manufacturing organisation could have a significant impact on employee intention to quit. Research purpose: To determine the relationship between five positive organisational behaviour variables (authentic leadership, psychological capital, psychological climate and team commitment and their ultimate influence on an individual’s intention to quit. Thus, it is preceded by the determination of the structural invariance of the measurement instruments when applied to a South African sample. Justification for the study: The study sought to fill the gap in the literature in relation to understanding the effect of the relationship between psychological capital, authentic leadership, psychological climate and team commitment on the behaviour of employees in a manufacturing organisation and how this influences their decision to quit. Such a study has not previously been conducted in the South African manufacturing sector. Research design, approach and method: Utilising a non-experimental correlational approach, a self-administered composite questionnaire consisting of five psychological scales was distributed to 204 employees in the junior to senior management level at a global tyre manufacturing organisation in South Africa. Multivariate data analysis included the structural equation modelling. Main findings: There is a significantly strong positive relationship between authentic leadership, psychological capital, psychological climate and team commitment. Authentic leadership has a significant influence on psychological capital and psychological climate. This results in a positive impact on organisational commitment, leading to employees’ intention to quit. Practical/managerial implications: Manufacturing organisations need to develop and implement collaborative leadership intervention strategies aimed at improving
Full Text Available Suicide attempt denotes activities directed towards one's own death which do not end in death. The ratio between attempted and realized suicides is expressed by the index called hazard ratio. Risk factors which contribute to suicidal behavior are: various emotional conditions, personality traits, stressful life events, substance misuse etc. The purpose of the study was to explore the frequencies and epidemiological and demographic characteristics of suicide attempts separately in men and women. The study sample involved 56 patients with the diagnosis suicide attempt (Tentamen suicidii treated on the Psychiatric department of the Clinical Center Priština, Gračanica. The data have been analyzed in respect to gender, age, profession/employment, mental disorder diagnosis, motivation (reason and the way of performing a suicide attempt. Results: suicide has been attempted by 42 women (75% and 14 men (25% of the sample. The prevalent age group of our sample (26.8% represents the patients below 20. The most prevalent are also unemployed patients, 33.3% of women and 50% of men. The most prevalent diagnosis is anxiety disorder (61.9% of women and 57.1% of men. The prevailing reason for attempting suicide in women was couple conflict (54.8% and existential problems in men (50%. Fifty one patients of the sample (91.1% have attempted suicide by intoxication with sedative drugs (anxiolytics. The majority of suicide attempts happened during afternoon and evening hours, i.e. in the period 12-24h. Conclusion: women have attempted suicide more frequently than men (ratio 3:1. Unemployment has been the prevailing professional characteristic in both genders. The most prevailing diagnosis is anxiety disorder. The chief motive in women is couple conflict and in men existential difficulties. In both genders the most frequent way of attempting suicide is poisoning, mostly in the period 12-24h.
Jagadeesan Madras Sundararajan
Full Text Available BACKGROUND Schizophrenia is a major mental illness whose sufferers have been found to have lesser longevity than general population. The most common cause for premature death in schizophrenia is suicide. There are very few Indian studies on suicide in persons suffering from schizophrenia. OBJECTIVES The objectives were to study the frequency of suicide attempt in schizophrenia to compare and study the clinical and sociodemographic profile of suicide attempters and non-attempters in schizophrenia and to analyse and study the various risk factors of suicide attempts in persons suffering from schizophrenia. METHODS A sample of 100 consecutive patients attending review OPD of a government tertiary care hospital in Chennai were selected. Those who had a diagnosis of schizophrenia were screened for past suicide attempts. They were divided into two groups as suicide attempters and non-attempters and analysed using the SAPS (Scale for Assessment of Positive Symptoms, SANS (Scale for Assessment of Negative Symptoms, Calgary depression scale, and Beck’s suicide intent scale. RESULTS People suffering from schizophrenia are at a high risk for making suicidal attempts (27% especially when the illness is acute and severe in early stages when accompanied by depressive symptoms. Demographic profile such as age, sex, education, occupation, socio-economic status, marital status, and family type were not significantly related to suicide attempts. Family history of suicide was a significant factor in patients with suicide attempts. Majority of the attempts were of medium-to-high intent, hanging being the commonest method, and were attributed to most commonly delusions and depressive symptoms.
Smith, Andrea L; Carter, Stacy M; Dunlop, Sally M; Freeman, Becky; Chapman, Simon
To better understand the process of quitting from the ex-smokers' perspective, and to explore the role spontaneity and planning play in quitting. Qualitative grounded theory study using in-depth interviews with 37 Australian adult ex-smokers (24-68 years; 15 males, 22 females) who quit smoking in the past 6-24 months (26 quit unassisted; 11 used assistance). Based on participants' accounts of quitting, we propose a typology of quitting experiences: measured, opportunistic, unexpected and naïve. Two key features integral to participants' accounts of their quitting experiences were used as the basis of the typology: (1) the apparent onset of quitting (gradual through to sudden); and (2) the degree to which the smoker appeared to have prepared for quitting (no evidence through to clear evidence of preparation). The resulting 2 × 2 matrix of quitting experiences took into consideration three additional characteristics: (1) the presence or absence of a clearly identifiable trigger; (2) the amount of effort (cognitive and practical) involved in quitting; and (3) the type of cognitive process that characterised the quitting experience (reflective; impulsive; reflective and impulsive). Quitting typically included elements of spontaneity (impulsive behaviour) and preparation (reflective behaviour), and, importantly, the investment of time and cognitive effort by participants prior to quitting. Remarkably few participants quit completely out-of-the-blue with little or no preparation. Findings are discussed in relation to stages-of-change theory, catastrophe theory, and dual process theories, focusing on how dual process theories may provide a way of conceptualising how quitting can include elements of both spontaneity and preparation.
Park, Subin; Lee, Yeeun; Youn, Tak; Kim, Byung Soo; Park, Jong Ik; Kim, Haesoo; Lee, Hyo Chu; Hong, Jin Pyo
Past attempted suicide is a strong predictor of future suicide risk, but the risk varies among suicide attempters. Hence, it is important to clarify distinguishing features of lifetime attempters with a high level of current suicide risk for efficient preventive management. We compared characteristics of suicide attempts and clinical characteristics among high-, moderate-, and low-risk attempters. Among the total of 6022 participants in the Korean Epidemiologic Catchment Area study, 193 reported a suicide attempt in their lifetime, 36 of which had high, 126 moderate, and 30 low levels of current suicide risk (1 incomplete response). High-risk suicide attempters had more past attempts compared with moderate- and low-risk suicide attempters. Suicide attempts were closely linked to a wide range of psychiatric comorbidities regardless of degree of current level of suicide risk, but the relative risk for having at least one mental disorder was the highest in high-risk attempters. Specifically, the relative risks for depressive disorder, anxiety disorders including obsessive-compulsive disorder and post-traumatic stress disorder, and substance use disorders were higher in high-risk attempters, and relative risk for somatoform disorder was higher in low-risk attempters than others. Our findings indicated that special attention is required for suicide attempters with a history of repeated attempts and current mental disorders, particularly anxiety disorders.
Herzog, Thaddeus; Pokhrel, Pallav; Kawamoto, Crissy T
Despite its potential for usefulness in informing the development of smoking cessation interventions, short-term fluctuations in motivation to quit is a relatively understudied topic. To assess the prevalence of smokers' day-to-day fluctuations in motivation to quit, and to assess associations of day-to-day fluctuations in motivation to quit with several established cessation-related variables. A cross-sectional survey was administered to smokers in Hawaii (N = 1,567). To assess short-term fluctuations in motivation to quit smoking, participants were asked to respond "True" or "False" to the statement: "My motivation to quit smoking changes from one day to the next." Other items measured desire to quit smoking, intention to quit, confidence in quitting, cigarette dependence, and other cessation-related variables. "My motivation to quit smoking changes from one day to the next" was endorsed as true by 64.7% of smokers, and false by 35.3%. Analyses revealed that smokers who indicated fluctuating motivation were significantly more interested in quitting as compared to smokers without fluctuations. Fluctuations in motivation to quit also were associated with greater confidence in quitting, lesser cigarette dependence, and more recent quitting activity (all p motivation to quit are common. Day-to-day fluctuations in motivation to quit are strongly associated with higher motivation to quit, greater confidence in future quitting, and other positive cessation-relevant trends.
Buchsbaum, M.S.; Haier, R.J.; Murphy, D.L.
The relationship between suicides and suicide attempts and two biological measures, platelet monoamine oxidase levels (MAO) and average evoked response (AER) augmenting was examined in 79 off-medication psychiatric patients and in 68 college student volunteers chosen from the upper and lower deciles of MAO activity levels. In the patient sample, male individuals with low MAO and AER augmenting, a pattern previously associated with bipolar affective disorders, showed a significantly increased incidence of suicide attempts in comparison with either non-augmenting low MAO or high MAO patients. Within the normal volunteer group, all male low MAO probands with a family history of suicide or suicide attempts were AER augmenters themselves. Four completed suicides were found among relatives of low MAO probands whereas no high MAO proband had a relative who committed suicide. These findings suggest that the combination of low platelet MAO activity and AER augmenting may be associated with a possible genetic vulnerability to psychiatric disorders. (author)
Stavrianakos, K; Kontaxakis, V; Moussas, G; Paplos, K; Papaslanis, T; Havaki-Kontaxaki, B; Papadimitriou, Gn
Suicidal behavior is considered as the result of complex cognitive and emotional processes and it is a timeless, global and multifactorial phenomenon. Periods of financial crises in the past, such as the Great Depression in the USA in 1929 and the economic crises of Asia, Russia and Argentina in the late 1990s, have been associated with impairment of mental health of the economically affected. Unemployment, job insecurity, debts, poverty and social exclusion seems to lead to higher incidence of anxiety and depressive symptoms and increased suicidality. Alcohol and substance use and the reduction of the state budget for health services reinforce the negative effects of the economic recession on mental health. The financial crisis which currently affects many European countries began in 2008 and its impact on the mental health of European citizens is in progress. Greece is probably the most affected country by the European financial crisis. The aim of this study is to investigate the potential impact of the crisis' consequences on the attempted suicide rates in the Athens population and the differentiation of suicide attempters on social, demographic and clinical-psychopathological parameters during the crisis. A retrospective study was conducted. The semi-structured records of 165 attempters who were hospitalized in the Internal Medicine Clinics of the "Sotiria" General Hospital in Athens, after attempted suicide in the years 2007 and 2011, before and during the financial crisis respectively, were studied. Among suicide attempters 95(57.6%) were suffering from mental disorders. Most often diagnoses were these of mood disorders (n=60, 63.2%). Demographic data, current psychiatric disorder, previous suicide attempt and severity of psychopathology at the time of suicide attempt were recorded for each patient. Furthermore, the severity of each suicide attempt was estimated. Suicide attempts were 70 in 2007, before the financial crisis (mean age 36.9 years, 71% women
Hedeland, Rikke; Jørgensen, Marianne H; Teilmann, Grete
Aims: To explore: (1) The relationship between children admitted to our paediatric department as a result of suicide attempts with acetaminophen and their parents and friends. (2) The extent to which the children had attempted to speak to their parents about their problems before their suicide...... Hospital, Denmark, 2006-2011. Study group: 107 children, 11 to 15 years old. Control group: 59 age- and gender-matched children. Results: 43.5% experienced a dissociated parental relationship characterized by the inability to speak to their parents about any problems, compared with 2% in the control group.......02). Prior to their suicide attempts, 41.5% of the children had attempted to speak to their parents about their problems but felt that they were not heard. There was a significant association among 'the feeling of not being heard' and the purpose of the suicide attempt (p = 0.002) and self-mutilation (p = 0...
Dombrovski, Alexandre Y; Clark, Luke; Siegle, Greg J; Butters, Meryl A; Ichikawa, Naho; Sahakian, Barbara J; Szanto, Katalin
Suicide rates are high in old age, and the contribution of cognitive risk factors remains poorly understood. Suicide may be viewed as an outcome of an altered decision process. The authors hypothesized that impairment in reward/punishment-based learning, a component of affective decision making, is associated with attempted suicide in late-life depression. They expected that suicide attempters would discount past reward/punishment history, focusing excessively on the most recent rewards and punishments. The authors further hypothesized that this impairment could be dissociated from executive abilities, such as forward planning. The authors assessed reward/punishment-based learning using the probabilistic reversal learning task in 65 individuals age 60 and older: suicide attempters, suicide ideators, nonsuicidal depressed elderly, and nondepressed comparison subjects. The authors used a reinforcement learning computational model to decompose reward/punishment processing over time. The Stockings of Cambridge test served as a control measure of executive function. Suicide attempters but not suicide ideators showed impaired probabilistic reversal learning compared to both nonsuicidal depressed elderly and nondepressed comparison subjects, after controlling for effects of education, global cognitive function, and substance use. Model-based analyses revealed that suicide attempters discounted previous history to a higher degree relative to comparison subjects, basing their choice largely on reward/punishment received on the last trial. Groups did not differ in their performance on the Stockings of Cambridge test. Older suicide attempters display impaired reward/punishment-based learning. The authors propose a hypothesis that older suicide attempters make overly present-focused decisions, ignoring past experiences. Modification of this "myopia for the past" may have therapeutic potential.
MMA Shalahuddin Qusar
Full Text Available Background: Suicide is a tragic and serious but preventable public health problem all over the world including Bangladesh. Committing suicide has become a burning issue and mortality rate increases especially in young females. Psychiatric evaluation is needed in suicide attempted patients for better management plan to reduce such unnatural mortality, as well as the impairment related to suicidal thought and psychiatric disorders. Objectives: To assess the psychiatric disorders and conditions that needed sufficient clinical attention among the suicide attempters who needed ICU intervention. Methods: This cross-sectional study was carried out in an Intensive Care Unit (ICU of a private hospital of Dhaka City from July 2008 to December 2008. Total forty four subjects of attempted suicide were included in the study and psychiatric diagnosis was made by using Diagnostic and Statistical Manual of Mental Disorders (DSM-IV by psychiatrists after initial physical problems subsided. Results: The most common psychiatric diagnosis was Major Depressive Disorder. Female suffered more and among them attention-seeking behaviors were frequent. Thirty-four patients (77.3% had previous history of psychiatric disorder. Chemicals (like; organophosphorous, kerosene, harpic and other medicine overdose ingestion was the most frequently used method by the suicide attempters. Conclusion: This study may be helpful for further research regarding suicide attempters and its' association with mental problems. In primary health care setting, the physicians may get a clue to design a system for preventing, early recognition and managing suicidal ideas, thoughts and attempts. Psychiatric consultation should be made mandatory for all patients admitted following attempted suicide. DOI: 10.3329/bsmmuj.v2i2.4761 BSMMU J 2009; 2(2: 73-77
Ramo, Danielle E; Thrul, Johannes; Chavez, Kathryn; Delucchi, Kevin L; Prochaska, Judith J
Young adult smokers are a challenging group to engage in smoking cessation interventions. With wide reach and engagement among users, Facebook offers opportunity to engage young people in socially supportive communities for quitting smoking and sustaining abstinence. We developed and tested initial efficacy, engagement, and acceptability of the Tobacco Status Project, a smoking cessation intervention for young adults delivered within Facebook. The intervention was based on the US Public Health Service Clinical Practice Guidelines and the Transtheoretical Model and enrolled participants into study-run 3-month secret Facebook groups matched on readiness to quit smoking. Cigarette smokers (N=79) aged 18-25, who used Facebook on most days, were recruited via Facebook. All participants received the intervention and were randomized to one of three monetary incentive groups tied to engagement (commenting in groups). Assessments were completed at baseline, 3-, 6-, and 12-months follow-up. Analyses examined retention, smoking outcomes over 12 months (7-day point prevalence abstinence, ≥50% reduction in cigarettes smoked, quit attempts and strategies used, readiness to quit), engagement, and satisfaction with the intervention. Retention was 82% (65/79) at 6 months and 72% (57/79) at 12 months. From baseline to 12-months follow-up, there was a significant increase in the proportion prepared to quit (10/79, 13%; 36/79, 46%, Pused a nicotine replacement therapy approved by the Food and Drug Administration, while 18% (14/79) used an electronic nicotine delivery system to quit (eg, electronic cigarette). A majority (48/79, 61%) commented on at least one Facebook post, with more commenting among those with biochemically verified abstinence at 3 months (P=.036) and those randomized to receive a personal monetary incentive (P=.015). Over a third of participants (28/79, 35%) reported reading most or all of the Facebook posts. Highest acceptability ratings of the intervention were
Nagendra Gouda M
Full Text Available Research Question: What are the factors responsible for suicidal attempts? Objectives: To study the socio-demographic factors, methods and reasons for suicidal attempts. Type of Study: Cross-sectional study. Setting: Bapuji and C.G. Hospitals attached to J.J.M. Medical College, Davanagere. Participants: A total of 540 suicidal attempters admitted to emergency wards. Methodology: A pretested proforma was administered to the subjects relating the factors responsible for the attempt. The data thus obtained was compiled and analyzed. Statistical Analysis: Proportions, Z -test and Chi-square test. Results: In this study, 61.3% were males and 38.7% were females. Peak occurrence of suicidal attempts was found in the second and third decades (15-29 years. Hindus constituted about 94.6% of the total suicidal attempters. Almost half (52.2% of the subjects had education below or up to matriculation and 83% of them were from the lower (classes IV and V socio-economic groups. Agriculturists, housewives and unskilled workers represented 75% of the total subjects. Fifty-five percent of the subjects were from nuclear families and most (62.4% of them were married; frequent mode of attempting suicides was by organo-phosphorus compounds (66.3% followed by overdosage of tablets (17.8%. Common cause was family problem (27.2% followed by illness (27%.
Stevenson, Richard; Tuddenham, Laurence
A man in his twenties who had no previous history of violence, snorted large quantities of two substances he identified as 3-methoxyphencyclidine (3-MeO-PCP), and methylenedioxypyrovalerone (MDPV); both are recognised as novel psychoactive substances, or commonly described in the media as "legal highs". He also inhaled butane gas. He experienced vivid hallucinations and developed bizarre ideas. During this state of mind he stabbed his father multiple times and was arrested and charged with attempted murder. He had a previous history of drug induced psychosis and although he had some slight residual symptoms before he consumed the substances, these were not considered relevant to his criminal liability at the time of the offence. The hallucinations caused by the use of these substances took six weeks to completely recede. He was convicted of attempted murder and sentenced to four years in prison. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.
Ginther, David Nathan; Dattani, Sheev; Miller, Sarah; Hayes, Paul
Attrition rates in general surgery training are higher than other surgical disciplines. We sought to determine the prevalence with which Canadian general surgery residents consider leaving their training and the contributing factors. An anonymous survey was administered to all general surgery residents in Canada. Responses from residents who considered leaving their training were assessed for importance of contributing factors. The study was conducted at the Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan, Canada, a tertiary academic center. The response rate was approximately 34.0%. A minority (32.0%) reported very seriously or somewhat seriously considering leaving their training, whereas 35.2% casually considered doing so. Poor work-life balance in residency (38.9%) was the single-most important factor, whereas concern about future unemployment (16.7%) and poor future quality of life (15.7%) were next. Enjoyment of work (41.7%) was the most frequent mitigating factor. Harassment and intimidation were reported factors in 16.7%. On analysis, only intention to practice in a nonacademic setting approached significant association with thoughts of leaving (odds ratio = 1.92, CI = 0.99-3.74, p = 0.052). There was no association with sex, program, postgraduate year, relationship status, or subspecialty interest. There was a nonsignificant trend toward more thoughts of leaving with older age. Canadian general surgery residents appear less likely to seriously consider quitting than their American counterparts. Poor work-life balance in residency, fear of future unemployment, and anticipated poor future quality of life are significant contributors to thoughts of quitting. Efforts to educate prospective residents about the reality of the surgical lifestyle, and to assist residents in securing employment, may improve completion rates. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.
Kim, Bora; Ahn, Joon-Ho; Cha, Boseok; Chung, Young-Chul; Ha, Tae Hyon; Hong Jeong, Seong; Jung, Hee Yeon; Ju, Gawon; Kim, Eun-Young; Kim, Jae Min; Kim, Moon-Doo; Kim, Min-Hyuk; Kim, Soo In; Lee, Kyoung-Uk; Lee, Sang-Hyuk; Lee, Seung Jae; Lee, Yu Jin; Moon, Eunsoo; Ahn, Yong-Min
Because the method used for a suicide attempt is an important determinant of outcome, these methods should be explored. The present study was a nationwide investigation of suicide attempts and the characteristics of suicidal behavior. To compare the suicide methods used in attempted suicides with those used in completed suicides and to examine the factors associated with each phenomenon. The present study reviewed the medical charts of subjects who had attempted suicide and subsequently visited the emergency rooms of 17 medical centers from May 1, 2013 to November 7, 2013. All subjects completed a full psychiatric interview conducted by trained psychiatric residents. Suicide-attempt methods were divided into the following six categories: drug poisoning, pesticide poisoning, gassing, cutting, hanging, and others. The associations among demographic variables, related psychiatric variables, and suicide-attempt methods were analyzed using a multinomial regression analysis. Of the 1359 suicide attempts or instrumental suicide-related behaviors with/without injuries and the 14,160 completed suicides, drug poisoning and cutting were the most common suicidal behaviors with/without injuries, but they were the least frequent method of completed suicides. In contrast, hanging and jumping from a height were less common among failed suicide attempts but resulted in a higher percentage of fatalities. Being male, age, and area of residence were associated with pesticide poisoning, whereas previous suicide attempts were associated with cutting, pesticide poisoning, and gassing. A previous suicide attempt is a risk factor for suicide; thus, assessing the characteristics of suicide attempts or instrumental suicide-related behaviors with/without injuries is necessary to prevent these attempts. The present findings showed that the methods of suicide used by individuals who only attempted suicide differed from those used by individuals who completed. Of the suicide methods, pesticide
Lippert, Adam M
To examine the sociodemographic traits of adolescent e-cigarette users and whether e-cigarettes are used as cessation aids among adolescent smokers. The study had a cross-sectional design. Study setting was the United States. A probability sample of 15,264 adolescents in grades 6 through 12 was used. The study measured self-reported lifetime e-cigarette use and recent conventional cigarette use, desire to quit, and number of recent quit attempts (among conventional cigarette smokers), and factors hypothesized to be related to e-cigarette use (e.g., race/ethnicity, age, friendships with smokers). Logistic regression was used to assess e-cigarette use among (1) all adolescents and (2) conventional cigarette smokers as a function of quit desire and attempts. Descriptive analyses show 3.2% of respondents had used e-cigarettes. E-cigarette use is significantly lower for females (adjusted odds ratio [OR], .70), non-Hispanic black youth (adjusted OR, .37), and Mexican-American youth (adjusted OR, .56), and higher for those who smoke conventional cigarettes (adjusted OR, 58.44) or have friends who smoke (adjusted OR, 2.38). Among conventional cigarette smokers, neither desire to quit nor recent quit attempts is significantly associated with e-cigarette use. E-cigarette use is more common among certain adolescent subgroups than others and does not appear to be part of a cessation regimen among conventional cigarette smokers wishing to quit. More regulatory and prevention efforts are needed, especially for certain adolescent subpopulations.
Buri, Caroline; von Bonin, Beatrice; Strik, Werner; Moggi, Franz
Suicide attempts are common in patients being treated for alcohol-use disorders (AUDs). However, clinical assessment of suicide risk is difficult. In this Swiss multisite study, we propose a decision tree to facilitate identification of profiles of AUD patients at high risk for suicidal behavior. In this retrospective study, we used a sample of 700 patients (243 female), attending 1 of 12 treatment programs for AUDs in the German-speaking part of Switzerland. Sixty-nine patients who reported a suicide attempt in the 3 months before the index treatment were compared using risk factors with 631 patients without a suicide attempt. Receiver operating characteristic (ROC) analyses were used to identify patients at risk of having had a suicide attempt in the previous 3 months. Consistent with previous empirical findings in AUD patients, a prior history of attempted suicide and severe symptoms of depression and aggression considerably increased the risk of a suicide attempt and, in combination, raised the likelihood of a prior suicide attempt to 52%. In addition, one third of AUD patients who had a history of suicide attempts and previous inpatient psychiatric treatment, or who were male and had previous inpatient psychiatric treatment, also reported a suicide attempt. The empirically supported decision tree helps to identify profiles of suicidal AUD patients in Switzerland and supplements clinicians' judgments in making triage decisions for suicide management.
Rezaei: Family process and content of suicide attempters and HIV positive patients. Annals of Medical ... the exclusion criteria (psychotic disorders, suicidal ideation, addiction, refusing ..... A review of mood disorders among juvenile offenders.
Lahoz, Titia; Hvid, Marianne; Wang, August G
BACKGROUND: The Amager Project was initiated as a quasi-experimental study in 2005, based on an active outreach suicide preventive intervention inspired by the Norwegian Baerum Model. A 1-year follow-up study was conducted as a randomized controlled trial showing that this kind of active outreach...... to suicide attempters had a significant preventive effect on the prevalence of suicide attempts and significantly reduced the number of patients repeating a suicide attempt. AIMS: In this 5-year RCT follow-up the aim was to investigate the sustainability of the suicide preventive effect shown in a 1-year...... follow-up study. METHOD: One hundred and thirty-three suicide attempters were included at this 5-year follow-up RCT study at Copenhagen University Hospital, Amager, and randomized to a rapid outreach suicide preventive intervention (OPAC) or TAU. RESULTS: Offering OPAC intervention to patients after...
Perez-Rodriguez, M. Mercedes; Baca-Garcia, Enrique; Oquendo, Maria A.; Blanco, Carlos
Suicide is one of the leading causes of death, and suicidal ideation and attempts are a major public health problem. However, little is known about the relationship between ethnicity and suicidal behaviors.
Kowitt, Sarah; Sheeran, Paschal; Jarman, Kristen; Ranney, Leah M; Schmidt, Allison M; Huang, Li-Ling; Goldstein, Adam O
Little is known on how to communicate messages on tobacco constituents to tobacco users. This study manipulated three elements of a message in the context of a theory-based communication campaign about tobacco constituents: (1) latency of response efficacy (how soon expected health benefits would accrue), (2) self-efficacy (confidence about quitting), and (3) interrogative cue ("Ready to be tobacco-free?"). Smokers (N = 1669, 55.4% women) were recruited via an online platform, and were randomized to a 3 (Latency of response efficacy) × 2 (Self-efficacy) × 2 (Interrogative cue) factorial design. The dependent variables were believability, credibility, perceived effectiveness of the communication message, and action expectancies (likelihood of seeking additional information and help with quitting). Latency of response efficacy influenced believability, perceived effectiveness, credibility, and action expectancies. In each case, scores were higher when specific health benefits were said to accrue within 1 month, as compared to general health benefits occurring in a few hours. The interrogative cue had a marginal positive effect on perceived effectiveness. The self-efficacy manipulation had no reliable effects, and there were no significant interactions among conditions. Smokers appear less persuaded by a communication message on constituents where general health benefits accrue immediately (within a few hours) than specific benefits over a longer timeframe (1 month). Additionally, smokers appeared to be more persuaded by messages with an interrogative cue. Such findings may help design more effective communication campaigns on tobacco constituents to smokers. This paper describes, for the first time, how components of tobacco constituent messages are perceived. We now know that smokers appear to be less persuaded by communication messages where general health benefits accrue immediately (within a few hours) than specific benefits over a longer timeframe (1 month
Bazrafshan, Mohammad-Rafi; Jahangir, Fereidun; Mansouri, Amir; Kashfi, Seyyed Hannan
Background: Having a set of effective coping skills can prevent suicidal behavior by increasing self-control and self-direction. This study examines coping styles used by suicidal patients. Objectives: The researchers in this study try to identify coping strategies used by suicide attempters admitted to Shiraz Shahid Faghihi Hospital emergency room. Materials and Methods: This is a analytical cross-sectional study. Participants consisted of 50 suicide-attempted people admitted to Shiraz Faghi...
Dhingra, Katie; Boduszek, Daniel; Hyland, Philip; Shagufta, Sonia
The aim was to investigate the role of age, drug abuse, period of confinement, loneliness, difficulty in controlling emotions, having no friends in prison, victimization in prison, guilt over crimes, insomnia, nightmares, anxiety, depression, and mood change in predicating suicide attempts in a sample of homicidal young prisoners. Poisson regression model indicated that five variables contributed significantly to the prediction of suicide attempts. Specifically, participants reporting drug ab...
Szanto, Katalin; Bruine de Bruin, Wändi; Parker, Andrew M; Hallquist, Michael N; Vanyukov, Polina M; Dombrovski, Alexandre Y
The propensity of people vulnerable to suicide to make poor life decisions is increasingly well documented. Do they display an extreme degree of decision biases? The present study used a behavioral-decision approach to examine the susceptibility of low-lethality and high-lethality suicide attempters to common decision biases that may ultimately obscure alternative solutions and deterrents to suicide in a crisis. We assessed older and middle-aged (42-97 years) individuals who made high-lethality (medically serious) (n = 31) and low-lethality suicide attempts (n = 29). Comparison groups included suicide ideators (n = 30), nonsuicidal depressed participants (n = 53), and psychiatrically healthy participants (n = 28). Attempters, ideators, and nonsuicidal depressed participants had nonpsychotic major depression (DSM-IV criteria). Decision biases included sunk cost (inability to abort an action for which costs are irrecoverable), framing (responding to superficial features of how a problem is presented), underconfidence/overconfidence (appropriateness of confidence in knowledge), and inconsistent risk perception. Data were collected between June 2010 and February 2014. Both high- and low-lethality attempters were more susceptible to framing effects as compared to the other groups included in this study (P ≤ .05, ηp2 = 0.06). In contrast, low-lethality attempters were more susceptible to sunk costs than both the comparison groups and high-lethality attempters (P ≤ .01, ηp2 = 0.09). These group differences remained after accounting for age, global cognitive performance, and impulsive traits. Premorbid IQ partially explained group differences in framing effects. Suicide attempters' failure to resist framing may reflect their inability to consider a decision from an objective standpoint in a crisis. Failure of low-lethality attempters to resist sunk cost may reflect their tendency to confuse past and future costs of their behavior, lowering their threshold for acting
Giegling, Ina; Olgiati, Paolo; Hartmann, Annette M; Calati, Raffaella; Möller, Hans-Jürgen; Rujescu, Dan; Serretti, Alessandro
Suicide is one of the leading causes of death worldwide, mortality from suicide being approximately 2%. Attempted suicide appears to be a major risk factor for suicide completion. Anger, aggression and impulsivity are personality traits associated with suicide attempt. In this study we analysed a part of a previously reported sample in order to test anger, impulsivity and temperament/character scales as predictors of aggression and self-aggression in suicide attempters and to compare anger- and aggression-related traits between impulsive and premeditated suicide attempts as well as between violent and non-violent suicide methods. One-hundred-eleven consecutively admitted inpatients with a lifetime history of attempted suicide were assessed for anger (State-Trait Anger Expression Inventory, STAXI), aggression (Questionnaire for Measuring Factors of Aggression, FAF) and temperament/character (Temperament and Character Inventory, TCI). Higher aggression scores, as measured by FAF, were predicted by being male, meeting criteria for borderline personality disorder and having higher angry temperament scores as assessed by STAXI; low cooperativeness was also associated with aggression but not after controlling for STAXI scales. TCI dimensions associated with self-aggression were high harm avoidance, high impulsivity and low self-directedness; state anger, inwardly directed anger and inhibition of aggression were also predictors of self-aggression. In conclusion, impulsivity and harm avoidance have emerged as temperament dimensions independently associated with self-aggressive tendencies in personality. Such interactions could explain the correlation between temperament and suicidality but further research is needed. Anger and self-directedness appear to have some effects on suicide attempt.
Full Text Available Cigarette smoking is widespread among HIV-infected patients, who confront increased risk of smoking-related co-morbidities. The effects of HIV infection and HIV-related variables on smoking and smoking cessation are incompletely understood. We investigated the correlates of smoking and quitting in an HIV-infected cohort using a validated natural language processor to determine smoking status.We developed and validated an algorithm using natural language processing (NLP to ascertain smoking status from electronic health record data. The algorithm was applied to records for a cohort of 3487 HIV-infected from a large health care system in Boston, USA, and 9446 uninfected control patients matched 3:1 on age, gender, race and clinical encounters. NLP was used to identify and classify smoking-related portions of free-text notes. These classifications were combined into patient-year smoking status and used to classify patients as ever versus never smokers and current smokers versus non-smokers. Generalized linear models were used to assess associations of HIV with 3 outcomes, ever smoking, current smoking, and current smoking in analyses limited to ever smokers (persistent smoking, while adjusting for demographics, cardiovascular risk factors, and psychiatric illness. Analyses were repeated within the HIV cohort, with the addition of CD4 cell count and HIV viral load to assess associations of these HIV-related factors with the smoking outcomes.Using the natural language processing algorithm to assign annual smoking status yielded sensitivity of 92.4, specificity of 86.2, and AUC of 0.89 (95% confidence interval [CI] 0.88-0.91. Ever and current smoking were more common in HIV-infected patients than controls (54% vs. 44% and 42% vs. 30%, respectively, both P<0.001. In multivariate models HIV was independently associated with ever smoking (adjusted rate ratio [ARR] 1.18, 95% CI 1.13-1.24, P <0.001, current smoking (ARR 1.33, 95% CI 1.25-1.40, P<0.001, and
Hausherr, Yann; Quinto, Carlos; Grize, Leticia; Schindler, Christian; Probst-Hensch, Nicole
To capitalise on the opportunities that the smoking ban legislation in Switzerland offers for the prevention of tobacco-related diseases, a smoking cessation programme in a workplace setting was developed and implemented in companies across the language and cultural regions of Switzerland. Our goal was to identify factors associated with relapse into smoking that may be overcome during training sessions or that should be considered for the optimisation of future interventions. Between 2006 and 2012, 1287 smokers aged 16 to 68 years voluntarily attended smoking cessation training at their workplace. The intervention was based on a cognitive behavioural group therapy combined with individual proactive telephone counselling. The evaluation consisted of three anonymised questionnaires (pre- and postintervention, and 12-month follow-up). In this prospective cohort study, we investigated the association of smoking quit rates with training and participant characteristics, including withdrawal symptoms, by use of multilevel logistic regression analysis with a random intercept for training courses. The self-reported abstinence rate was 72.4% at the end of the training, and 18.6% 1 year later. The risk of relapse during the training was positively associated with the number of years and daily cigarettes smoked, and negatively with increased appetite, sleeping troubles and satisfaction with learned techniques. Failed abstinence within the first year was associated with younger age, higher numbers of daily smoked cigarettes and unsuccessful recent quit attempts. Our evaluation suggests that younger and more addicted smokers attending smoking cessation trainings may need additional support to achieve long lasting abstinence rates. Offering smoking cessation training in a workplace setting can achieve reasonable long-term quit rates, but a subset of employees needs additional support at the group or personal level. Group behaviour therapy could be an effective method to achieve
Wiktorsson, Stefan; Runeson, Bo; Skoog, Ingmar; Ostling, Svante; Waern, Margda
To identify factors associated with attempted suicide in the elderly. Social, psychological, and psychiatric characteristics were compared in suicide attempters (70 years and older) and a representative population sample. Emergency departments at five hospitals in western Sweden and a representative sample of the elderly population. Persons with Mini Mental State Examination (MMSE) score age 80 years). Comparison subjects matched for gender and age group (N = 408) were randomly selected among participants in our general population studies. Symptoms were rated with identical instruments in cases and comparison subjects. The examination included the MMSE and tests of short- and long-term memory, abstract thinking, aphasia, apraxia, and agnosia. Depressive symptomatology was measured using the Montgomery-Asberg Depression Rating Scale, and major and minor depressions were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, using symptom algorithms. Factors associated with attempted suicide included being unmarried, living alone, low education level, history of psychiatric treatment, and previous suicide attempt. There was no association with dementia. Odds ratios were increased for both major (odds ratio [OR]: 47.4, 95% confidence interval [CI]: 19.1-117.7) and minor (OR: 2.6, 95% CI: 1.5-4.7) depressions. An association was observed between perceived loneliness and attempted suicide; this relationship was independent of depression (OR: 2.8, 95% CI: 1.3-6.1). Observed associations mirrored those previously shown for completed suicide. Results may help to inform clinical decisions regarding suicide risk evaluation in this vulnerable and growing age group.
Im, Mi Young; Kim, Yun Jeong
The purpose of this study was to examine the meaning and essence of suicide for elderly people who had previously attempted suicide as an older person. Giorgi's descriptive phenomenology was used for analysis. The researchers carried out in-depth interviews, recordings and memos individually with four elders. The elders were individuals who had attempted suicide sometime in the past 5 yr. They were interviewed from 5 to 10 times using open-ended questions and a semi-structural format. Demographic data were also collected. The meaning of suicide before a suicide attempt in older people had four core components: conflict with family, powerlessness and despair in their life with a drop in self-esteem, using internal and external resources to resolve their troubles and awareness of imminent crisis. These results of this study will increase understanding of suicide in older people by defining their subjective experience of suicide attempts and applying grounded data in the development of programs that provide concrete intervention strategies to prevent suicide in elderly people.
Gutierrez, Denise Machado Duran; Sousa, Amandia Braga Lima; Grubits, Sonia
We discuss the subjective experiences of elderly people who show suicidal ideation and/or attempts at suicide, based on their own reports. We understand the concept of 'subjective' as referring to intra-psychic experience resulting from social, economic, relationship or biographical conditions. Although the subject is sparsely covered in the literature, it is important, because it is in the field of subjectivity that ideations of, and attempts at, suicide develop and occur until they become a concrete act. Empirical data were collected through semi-structured interviews focusing on: social characterization, portrayal and mode of life, previous mental state, atmosphere of the attempt, effects on the health of the elderly person and family. Based on the analysis of the meanings that emerge, five empirical categories were generated: (1) subject's feeling of being in a non-place; (2) absence of acceptance of losses; (3) suffering due to ingratitude of family members; (4) feeling of uselessness of, and in, life; (5) re-signification of the situations that generate suicide-related conduct. The results point to a fundamental need to incorporate knowledge about the subjective processes into programs for prevention of suicide among the elderly who have ideation of, or attempts at, suicide.
Lim, Meerae; Lee, Soojung
Objective A considerable proportion of suicide attempts are the result of sudden desires. Understanding such impulsive suicide attempts is necessary for effective interventions. We evaluated the impulsivity of suicide attempters treated in emergency rooms. The aim of the study was to identify the characteristics of impulsive suicide attempts by comparing these individuals to those who attempted to commit suicide in a non-impulsive manner. Methods This study analyzed suicide attempters who visited the emergency departments of seven selected university hospitals. A total of 269 medical records in which impulsivity of suicide attempt were confirmed were subject to be analyzed. The impulsivity of the suicide attempt was examined using a summative score of items 6 and 15 on the Suicide Intent Scale. Results A total of 48.0% of the participants were impelled by sudden inclinations to attempt suicide. Impulsive attempters were younger, unmarried and less physical illness than non-impulsive attempters, whereas no significant differences were found on psychiatric history and previous suicide history. Impulsive suicide attempters had suicide ideations that were not as severe (χ2=55.33, pimpulsive suicide attempts were better than non-impulsive suicide attempts (t=-3.77, psuicide attempts were the result of sudden inclinations. Impulsive attempts were made in relatively earlier stages of suicide ideation; consequently, they have less intent than non-impulsive attempts. PMID:27482239
Stenager, E N; Stenager, Egon; Jensen, Knud
on analgesics for pain. Patients that suffered from a somatic disease differed from other suicide attempters in depression score, age, pain and the presence of psychosis. Fewer of the somatically ill suicide attempters had a psychosis. Patients complaining of pain were more often depressed and abused medicine....... Statistically, the risk of repetition of parasuicide for patients with a somatic disease but without depression was significantly less. The 7 patients committing suicide were older and a tendency was found towards painful somatic diseases and depression as risk factors for suicide.......In the period January 1, 1990 to March 31, 1991 a sample of suicide attempters admitted to the Department of Psychiatry, Odense University Hospital, underwent a structured interview. In the study 52% of the patients interviewed were found to suffer from a somatic disease, and 21% were daily...
Szanto, Katalin; Bruine de Bruin, Wändi; Parker, Andrew M; Hallquist, Michael N; Vanyukov, Polina M; Dombrovski, Alexandre Y
Objective The propensity of people vulnerable to suicide to make poor life decisions is increasingly well documented. Do they display an extreme degree of decision biases? The present study used a behavioral decision approach to examine the susceptibility of low-lethality and high-lethality suicide attempters to common decision biases, which may ultimately obscure alternative solutions and deterrents to suicide in a crisis. Method We assessed older and middle-aged individuals who made high-lethality (medically serious; N=31) and low-lethality suicide attempts (N=29). Comparison groups included suicide ideators (N=30), non-suicidal depressed (N=53), and psychiatrically healthy participants (N=28). Attempters, ideators, and non-suicidal depressed participants had unipolar non-psychotic major depression. Decision biases included sunk cost (inability to abort an action for which costs are irrecoverable), framing (responding to superficial features of how a problem is presented), under/overconfidence (appropriateness of confidence in knowledge), and inconsistent risk perception. Data were collected between June of 2010 and February of 2014. Results Both high- and low-lethality attempters were more susceptible to framing effects, as compared to the other groups included in this study (p≤ 0.05, ηp2 =.06). In contrast, low-lethality attempters were more susceptible to sunk costs than both the comparison groups and high-lethality attempters (p≤ 0.01, ηp2 =.09). These group differences remained after accounting for age, global cognitive performance, and impulsive traits. Premorbid IQ partially explained group differences in framing effects. Conclusion Suicide attempters’ failure to resist framing may reflect their inability to consider a decision from an objective standpoint in a crisis. Low-lethality attempters’ failure to resist sunk-cost may reflect their tendency to confuse past and future costs of their behavior, lowering their threshold for acting on suicidal
Pisinger, Charlotta; Aadahl, Mette; Toft, Ulla
To investigate motives, strategies and experiences to quit smoking and reasons to relapse as a function of socioeconomic status.......To investigate motives, strategies and experiences to quit smoking and reasons to relapse as a function of socioeconomic status....
Randah Ribhi Hamadeh
A high tobacco-quit rate among smokers seeking treatment at QTC is encouraging and indicates that the clinics contributed to tobacco cessation in Bahrain. Counselling sessions and more frequent visits to QTC helped participants to successfully quit tobacco.
Increasingly, women's experience of online life seems to run counter to the optimistic expectations of the cyberfeminists of the 90s and the utopian fervour of the present. Female journalists and internet users find themselves at the receiving end of a level of verbal abuse online previously unthinkable in the public sphere. Women are showing…
Nathan John Grills
Full Text Available Background. Nearly one-third of adults in India use tobacco, resulting in 1.2 million deaths. However, little is known about knowledge, attitudes, and practices (KAP related to smoking in the impoverished state of Uttarakhand. Methods. A cross-sectional epidemiological prevalence survey was undertaken. Multistage cluster sampling selected 20 villages and 50 households to survey from which 1853 people were interviewed. Tobacco prevalence and KAP were analyzed by income level, occupation, age, and sex. 95% confidence intervals were calculated using standard formulas and incorporating assumptions in relation to the clustering effect. Results. The overall prevalence of tobacco usage, defined using WHO criteria, was 38.9%. 93% of smokers and 86% of tobacco chewers were male. Prevalence of tobacco use, controlling for other factors, was associated with lower education, older age, and male sex. 97.6% of users and 98.1% of nonusers wanted less tobacco. Except for lung cancer (89% awareness, awareness of diseases caused by tobacco usage was low (cardiac: 67%; infertility: 32.5%; stroke: 40.5%. Conclusion. A dangerous combination of high tobacco usage prevalence, ignorance about its dangers, and few quit attempts being made suggests the need to develop effective and evidence based interventions to prevent a health and development disaster in Uttarakhand.
Curry, S J; Grothaus, L; McBride, C
An intrinsic-extrinsic model of motivation for smoking cessation is extended to a population-based sample of smokers (N = 1,137), using a previously validated Reasons for Quitting (RFQ) scale. Psychometric evaluation of the RFQ replicated the model that includes health concerns and self-control as intrinsic motivation dimensions and immediate reinforcement and social influence as extrinsic motivation dimensions. Compared to volunteers, the population-based sample of smokers reported equivalent health concerns, lower self-control, and higher social influence motivation for cessation. Within the population-based sample, women compared to men were less motivated to quit by health concerns and more motivated by immediate reinforcement; smokers above age 55 expressed lower health concerns and higher self-control motivation than smokers below age 55. Higher baseline levels of intrinsic relative to extrinsic motivation were associated with more advanced stages of readiness to quit smoking and successful smoking cessation at a 12-month follow-up. Among continuing smokers, improvement in stage of readiness to quit over time was associated with significant increases in health concerns and self-control motivation.
Villa-Manzano, Alberto Iram; Robles-Romero, Miguel Angel; Gutiérrez-Román, Elsa Armida; Martínez-Arriaga, María Guadalupe; Valadez-Toscano, Francisco Javier; Cabrera-Pivaral, Carlos E
A better understanding of risk factors for suicide in general population is crucial for the design of suicide prevention programs. Our objective was to identify personal and family risk factors in suicide attempters. Case-control design. We searched in patients with an acute intoxication, those subjects with and intoxication attributable to suicide attempt. These patients were matched with controls by gender and the date of intoxication. We use a structured questionnaire to identify personal characteristics, family features and network support. Odds ratio (OR) and 95 % confidence interval were obtained. 25 cases and 25 controls were evaluated. The risk factors associated with suicide attempt adjusted by age, were being a student and smoking habits. Family violence background showed OR = 3.8 (IC 95 % = 1.1-13), family disintegration a OR = 8.5 (IC 95 % = 2.1-35), critical events background OR = 8.8 (IC 95 % = 2.1-36), poor self-esteem OR = 8.2 (IC 95 % 2-35), depression OR = 22 (IC 95 % = 3-190), anxiety OR = 9 (IC 95 % = 2-47), family dysfunction OR = 25 (IC 95 % = 4-151). The principal risk factor for suicide attempt was family dysfunction and psychological traits.
First page Back Continue Last page Overview Graphics. A first attempt : k-center. Randomly select R= C x k points. expected C points from the “largest cluster”. Consider all C-points subsets of R. (at least one will be “purely” from largest cluster). Centroid of this will approximate cluster centre.
Weizman, Tal; Yagil, Yaron; Schreiber, Shaul
Based on Durkheim's "Control theory," we explored the association between frequency of terror attacks in Israel and the frequency of suicide attempts admitted to the Emergency Room of a major general hospital in Tel-Aviv (1999-2004). Analysis of the six-year study period as a whole revealed no significant correlation between the…
Pettersen, Kenneth; Rydningen, Nora Nord; Christensen, Tore Buer; Walby, Fredrik A.
According to the cry of pain model of suicidal behavior, an over-general autobiographical memory function is often found in suicide attempters. The model has received empirical support in several studies, mainly of depressed patients. The present study investigated whether deficits in autobiographical memory may be associated with an increased…
Palali, Ali; van Ours, Jan
If two partners smoke, their quit behavior may be related through correlation in unobserved individual characteristics and through common shocks. However, there may also be a causal effect whereby the quit behavior of one partner is affected by the quit decision of the other partner. If so, there is
Bostwick, J Michael; Pabbati, Chaitanya; Geske, Jennifer R; McKean, Alastair J
While suicide attempt history is considered to robustly predict completed suicide, previous studies have limited generalizability because of using convenience samples of specific methods/treatment settings, disregarding previous attempts, or overlooking first-attempt deaths. Eliminating these biases should more accurately estimate suicide prevalence in attempters. This observational retrospective-prospective cohort study using the Rochester Epidemiology Project identified 1,490 (males, N=555; females, N=935) Olmsted County residents making index suicide attempts (first lifetime attempts reaching medical attention) between January 1, 1986, and December 31, 2007. The National Death Index identified suicides between enrollment and December 31, 2010 (follow-up 3-25 years). Medical records were queried for sex, age, method, and follow-up care for index attempt survivors. Coroner records yielded data on index attempt deaths. During the study period, 81/1,490 enrollees (5.4%) died by suicide. Of the 81, 48 (59.3%) perished on index attempt; 27 of the surviving 33 index attempt survivors (81.8%) killed themselves within a year. Males were disproportionately represented: 62/81 (11.2% of men, 76.5% of suicides) compared with 19/81 (2.0% of women, 23.5% of suicides). Of dead index attempters, 72.9% used guns, yielding an odds ratio for gunshot death, compared with all other methods, of 140 (95% CI=60-325). When adjusted for covariates, survivors given follow-up psychiatric appointments had significantly lower likelihood of subsequent suicide (odds ratio=0.212, 95% CI=0.089-0.507). At 5.4%, completed suicide prevalence in this community cohort of suicide attempters was almost 59% higher than previously reported. An innovative aspect of this study explains the discrepancy: by including index attempt deaths-approximately 60% of total suicides-suicide prevalence more than doubled. We contend that counting both index and subsequent attempt deaths more accurately reflects
Vásquez-Rojas, Rafael; Quijano-Serrano, Margarita
Attempted suicide in children and adolescents is a disturbing and painful issue for patients, their families and physicians. Current medical literature provides little information about minors who attempt suicide, possibly because there is under-reporting of this condition as a diagnosis, or maybe because it is sometimes considered as a way for the child to draw attention. To present the experience of the Department of Psychiatry (Universidad Nacional de Colombia) at the Hospital Infantil de La Misericordia, from 2003 to 2013. An observational retrospective study was conducted by reviewing 213 cases of children and adolescents treated for attempted suicide at the Hospital Infantil de La Misericordia from January 1, 2003 to October 31, 2013, and who received hospital or outpatient care in Child Psychiatry. A review was performed of the diagnosis, the number of suicide attempts, the peak months of consultation for this reason, and the methods selected, as well as a detailed description of the group of patients under 12 years old, and those managed with outpatient follow-up. The average patient is a female teenager who becomes intoxicated with drugs. Most often, patients do not return to outpatient follow-up. Those with follow-up have multiple psychopathologies and a high level of suffering. The most common methods, other than poisoning by drugs, are hanging and jumping from heights. Patients under 12 years old generally have their first attempt by drug poisoning. There is a predominance of anxiety disorder and depression, with a strong association with cognitive dysfunction, as a vulnerability factor. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Davis, Kevin C; Patel, Deesha; Shafer, Paul; Duke, Jennifer; Glover-Kudon, Rebecca; Ridgeway, William; Cox, Shanna
Since 2012, the Centers for Disease Control and Prevention (CDC) has implemented Tips From Former Smokers ( Tips), the first federally funded tobacco education campaign in the United States. To date, there are no evaluations of its long-term impact. To assess the impact of varied doses of the Tips campaign from 2012 through 2015 on cessation-related behaviors and intentions among U.S. smokers. We used a national probability-based online survey of cigarette smokers ( n = 22,189) and recent quitters ( n = 776) to examine associations between doses of Tips advertising, measured by gross rating points (GRPs), and intentions to quit smoking in the next 30 days and quit attempts within the past 3 months. A curvilinear (i.e., square root) functional form of GRPs was used to capture patterns of diminishing effects at higher GRP levels. An increase of 1,000 quarterly Tips GRPs at the media market level was associated with increased odds of making a quit attempt in the past 3 months (adjusted odds ratio = 1.23, p campaign has had a substantial impact on cessation behaviors among U.S. adult smokers over time. These data support the continued use of graphic and/or emotional media campaigns that encourage smokers to quit to further reduce tobacco use in the United States.
Kshirod Kumar Mishra
Full Text Available Background: Suicides, attempted suicides and different form of suicidal behaviors are on the rise in most part of the world. It is generally assumed that official suicidal rate are underestimated from the true rate by 20-100 % due to prevailing socio-cultural issues, religious attitude, stigma attached, and legal process involved. Attempted suicides occur 8-20 times more frequently than complete suicide. Statistics on attempted suicide or deliberate self harm are not usually available officially. Materials and Methods: All the cases of attempted suicide who were admitted and referred for psychiatric evaluation and management to a rural medical college of central India during a period of one Year (April 13-March-14, following initial recovery they were evaluated on a semi-structured performa on socio demographic profile, mode of attempt and reason for attempt. Data collected was analyzed using suitable statistical methods. Results: Total 68 cases were evaluated during the study period. 43% of the cases were involved in farming. Among 85% of the study population pesticide consumption was the common mode of attempt, which is easily available among the agrarian community of rural India. Interpersonal conflict in the family due to indebtedness, financial loss due to crop failure was the commonest reason for attempt. Conclusion: Though there is reduced reporting in the incidents of suicide cases in media from this region, still quite a number of people attempt suicide due to financial constraint from crop failure, ongoing indebtedness, and poor socioeconomic condition culminating into poor mental health among the rural agrarian community of central Maharashtra.
Full Text Available Abstract Background The offer of free nicotine replacement therapy (NRT can be a cost-effective marketing strategy to induce smokers to call a telephone quitline for quitting assistance. However, the most cost-effective supply of free NRT to provide to smokers who call a quitline remains unknown. This study tests the hypothesis that smokers who call a telephone quitline and are given more free nicotine patches would report higher quit rates upon follow-up 12 months later. Methods A quasi-experimental design was used to assess nicotine patch usage patterns and quit rates among five groups of smokers who called the New York State Smokers' Quitline (NYSSQL between April 2003 and May 2006 and were mailed 2-, 4-, 6- or 8-week supplies of free nicotine patches. The study population included 2,442 adult (aged 18 years or older current daily smokers of 10 or more cigarettes per day, who were willing to make a quit attempt, and reported no contraindications for using the nicotine patch. Outcome variables assessed included the percentage of smokers who reported that they had not smoked for at least 7-days at the time of a 12 months telephone follow-up survey, sustained quitting, delayed quitting and nicotine patch use. Results Quit rates measured at 12 months were higher for smokers in the groups who received either 2, 6, or 8 weeks of free patches. The lowest quit rate was observed among the group of Medicaid/uninsured smokers who were eligible to receive up to six weeks of free patches. The quit rate for the 4-week supply group did not differ significantly from the 6-week or 8-week groups. These patterns remained similar in an intent-to-treat analysis of 12-month quit rates and in an analysis of sustained quitting. Conclusion No clear cut dose response relationship was observed between the number of free nicotine patches sent to smokers and smoking outcomes. Baseline diferences in the characteristics of the groups compared could account for the null
Schick, Robert S; Kelsey, Thomas W; Marston, John; Samson, Kay; Humphris, Gerald W
Approximately 11,000 people die in Scotland each year as a result of smoking-related causes. Quitting smoking is relatively easy; maintaining a quit attempt is a very difficult task with success rates for unaided quit attempts stubbornly remaining in the single digits. Pharmaceutical treatment can improve these rates by lowering the overall reward factor of nicotine. However, these and related nicotine replacement therapies do not operate on, or address, the spatial and contextual aspects of smoking behaviour. With the ubiquity of smartphones that can log spatial, quantitative and qualitative data related to smoking behaviour, there exists a person-centred clinical opportunity to support smokers attempting to quit by first understanding their smoking behaviour and subsequently sending them dynamic messages to encourage health behaviour change within a situational context. We have built a smartphone app-MapMySmoke-that works on Android and iOS platforms. The deployment of this app within a clinical National Health Service (NHS) setting has two distinct phases: (1) a 2-week logging phase where pre-quit patients log all of their smoking and craving events; and (2) a post-quit phase where users receive dynamic support messages and can continue to log craving events, and should they occur, relapse events. Following the initial logging phase, patients consult with their general practitioner (GP) or healthcare provider to review their smoking patterns and to outline a precise, individualised quit attempt plan. Our feasibility study consists of assessment of an initial app version during and after use by eight patients recruited from an NHS Fife GP practice. In addition to evaluation of the app as a potential smoking cessation aid, we have assessed the user experience, technological requirements and security of the data flow. In an initial feasibility study, we have deployed the app for a small number of patients within one GP practice in NHS Fife. We recruited eight
Demirağ, Elif Gizem; Demirag, Elif Gizem
How do a state's political regime type and power status influence leader's mediation attempts? This study develops an explanation as a response to this question derived from the democratic peace theory which underlines the role of democratic norms in motivating state leaders to play a third party role in peace processes. Based on this approach, the expectation is that democratic country representatives are more likely to mediate especially in the early stage of their careers. In addition, I a...
Reber, Paul J.
Kinder and Shanks report simulations aimed at describing a single-system model of the dissociation between declarative and non-declarative memory. This model attempts to capture both Artificial Grammar Learning (AGL) and recognition memory with a single underlying representation. However, the model fails to reflect an essential feature of recognition memory - that it occurs after a single exposure - and the simulations may instead describe a potentially interesting property of over-training non-declarative memory.
Tobacco use is the leading cause of preventable mortality in the world. Article 14 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) states that countries should promote cessation of tobacco use and adequate treatment for tobacco dependence. Health-care providers asking all patients about their tobacco use and advising tobacco users to quit are evidence-based strategies that increase tobacco abstinence. This report examines the proportion of tobacco smokers in 17 countries responding to the Global Adult Tobacco Survey (GATS) who saw a health-care provider in the past year and who reported that a health-care provider asked them about smoking and advised them to quit. Respondents were tobacco smokers aged ≥15 years surveyed during 2008-2011 in Bangladesh, Brazil, China, Egypt, India, Indonesia, Malaysia, Mexico, Philippines, Poland, Romania, Russia, Thailand, Turkey, Ukraine, Uruguay, and Vietnam. The proportion of smokers who had visited a health-care provider during the previous 12 months ranged from 21.6% in Egypt to 62.3% in Poland. Among these, the proportion reporting that a health-care provider asked if they smoked ranged from 34.9% in Vietnam to 82.1% in Romania. Among those screened for tobacco use, those who reported their health-care providers advised them to quit ranged from 17.3% in Mexico to 67.3% in Romania. In most countries, persons aged ≥45 years were more likely to report being screened and advised to quit than were persons aged ≤24 years. Health-care providers should identify smokers and provide advice and assistance in quitting at each visit as an adjunct to effective community interventions (e.g., increased price of tobacco products; smoke-free policies, mass media campaigns, and tobacco quitlines).
Borrelli, Belinda; Bartlett, Yvonne Kiera; Tooley, Erin; Armitage, Christopher J; Wearden, Alison
Both mHealth and eHealth interventions for smoking cessation are rapidly being developed and tested. There are no data on use of mHealth and eHealth technologies by smokers in general or by smokers who are not motivated to quit smoking. The aims of our study were to (1) assess technology use (eg, texting, social media, Internet) among smokers in the United States and United Kingdom, (2) examine whether technology use differs between smokers who are motivated to quit and smokers who are not motivated to quit, (3) examine previous use of technology to assist with smoking cessation, and (4) examine future intentions to use technology to assist with smoking cessation. Participants were 1000 adult smokers (54.90%, 549/1000 female; mean age 43.9, SD 15.5 years; US: n=500, UK: n=500) who were recruited via online representative sampling strategies. Data were collected online and included demographics, smoking history, and frequency and patterns of technology use. Among smokers in general, there was a high prevalence of mobile and smartphone ownership, sending and receiving texts, downloading and using apps, using Facebook, and visiting health-related websites. Smokers who were unmotivated to quit were significantly less likely to own a smartphone or handheld device that connects to the Internet than smokers motivated to quit. There was a significantly lower prevalence of sending text messages among US smokers unmotivated to quit (78.2%, 179/229) versus smokers motivated to quit (95.0%, 229/241), but no significant differences between the UK groups (motivated: 96.4%, 239/248; unmotivated: 94.9%, 223/235). Smokers unmotivated to quit in both countries were significantly less likely to use a handheld device to read email, play games, browse the Web, or visit health-related websites versus smokers motivated to quit. US smokers had a high prevalence of app downloads regardless of motivation to quit, but UK smokers who were motivated to quit had greater prevalence of app
Rimkeviciene, Jurgita; O'Gorman, John; De Leo, Diego
Extensive research on impulsive suicide attempts, but lack of agreement on the use of this term indicates the need for a systematic literature review of the area. The aim of this review was to examine definitions and likely correlates of impulsive attempts. A search of Medline, Psychinfo, Scopus, Proquest and Web of Knowledge databases was conducted. Additional articles were identified using the cross-referencing function of Google Scholar. 179 relevant papers were identified. Four different groups of research criteria used to assess suicide attempt impulsivity emerged: (a) time-related criteria, (b) absence of proximal planning/preparations, (c) presence of suicide plan in lifetime/previous year, and (d) other. Subsequent analysis used these criteria to compare results from different studies on 20 most researched hypotheses. Conclusions regarding the characteristics of impulsive attempts are more consistent than those on the risk factors specific to such attempts. No risk factors were identified that uniformly related to suicide attempt impulsivity across all criteria groups, but relationships emerged between separate criteria and specific characteristics of suicide attempters. Only published articles were included. Large inconsistencies in methods of the studies included in this review prevented comparison of effect sizes. The vast disparities in findings on risk factors for impulsive suicide attempts among different criteria groups suggest the need to address the methodological issues in defining suicide attempt impulsivity before further research into correlates of such attempts can effectively progress. Specific recommendations are offered for necessary research. Copyright © 2014 Elsevier B.V. All rights reserved.
Oztürk, Serdar; Bozkurt, Ali; Durmus, Muzaffer; Deveci, Mustafa; Sengezer, Mustafa
The studies of maxillofacial gunshot injuries mainly focused on evaluating the surgical interventions and physical outcomes of the procedures. In this study we aimed to analyze the pre- and post-injury psychiatric status of the patients with self-inflicted gunshot wounds to the face. This study is based on 12 subjects who attempted suicide resulting in extensive maxillofacial injuries using guns placed beneath their chins. The psychiatric evaluation was conducted by interview and using SCID-I, SCID-II, MMPI, Rosenberg Self-Esteem Scale and Suicide Probability Scale. Two subjects were healthy, 1 had bereavement, 6 had current and 5 had previous MDD (major depressive disorder), 2 had dysthymic disorder, 3 had alcohol abuse, 2 had drug abuse and 4 had antisocial personality disorder. The suicidal group was more socially introverted according to MMPI. According to Rosenberg self-esteem subscale, self esteem, the constancy of self respect and depressive mood subtests were statistically significant in the suicide group compared to the healthy controls (P suicide. The changes in the physical facial appearance after the suicide attempt caused impairment of self-esteem and the constancy of self-respect. Similar to other studies, none of our patients reattempted suicide and all tried to return to their pre-injury lifestyle and appeared to accommodate to the stigma of their physical deformities. Early diagnosis and treatment should be considered as a factor to reduce the risk for suicide attempt.
Hamit Sirri Keten
Material and Methods: A total of 70 attempted suicide cases admitted to Emergency Department of Kahramanmaras Sutcu imam University Medical Faculty Hospital between 01.03.2012 and 01.03.2013 examined retrospectively. Results: Among the 70 patients included in the study, 26 (37.1% were male and 44 (62.9% were female with a mean age of 26.3+/-11.2 years. Of all, 10 (14.3% cases were reported to have one or more previous suicide attempts. Investigation of methods of suicide revealed that 64 (91.4% used medication or toxic substance ingestion, 5 (7.1% stabbing, and 1 (1.4% preferred hanging as suicide method. All of those of preferred stabbing as a means of suicide were males. Conclusion: In order to tackle suicidal attempts author suggests that collective preventive policies should be developed by local governments, non-governmental organizations and health care providers. [J Contemp Med 2015; 5(2.000: 102-105
Rimkeviciene, Jurgita; O'Gorman, John; De Leo, Diego
Inconsistencies in the definition of impulsive suicide attempts hamper research integration. To expand the currently limited data on how this construct is used in clinical practice, researchers interviewed eight suicide attempters to create timelines of their suicide process, then had seven experienced clinicians review these timelines. Thematic analysis of the patient and clinician data revealed three themes: "thinking out," build-up, and unclear intentionality. The results imply that assessing build-up of agitation and exhaustion symptoms can contribute to understanding acuteness of suicide risk. In addition, uncertainty about one's intentions during the attempt should not be equated to low intent to die.
Kotz, Daniel; Böckmann, Melanie; Kastaun, Sabrina
Current data on tobacco use are a necessary prerequisite for the study of the implementation of tobacco control measures in the general population. The German Study on Tobacco Use (Deutsche Befragung zum Rauchverhalten, DEBRA) provides previously lacking data on key indicators of smoking behavior and on the consumption of new products such as e-cigarettes. The continual acquisition and accumulation of data permits the analysis of trends and precise statistical evaluation. Data were obtained by repeated face-to-face interviews, at 2-month intervals, of representative samples of approximately 2000 persons across Germany aged 14 years and above. For this article, data from 12 273 persons that were acquired in 6 waves of the survey (June/July 2016 to April/May 2017) were aggregated and weighted. The one-year prevalence of current tobacco consumption was 28.3% (95% confidence interval: [27.5; 29.1]) in the overall survey population and 11.9% [8.9; 14.9] among persons under age 18. Higher tobacco consumption was correlated with lower educational attainment and lower income. 28.1% of the smokers had tried to quit smoking in the past year; the most commonly used method of quitting was e-cigarettes (9.1%). Brief physician advice or pharmacotherapy for smoking cessation were tried by 6.1% and 7.0%, respectively. 1.9% of the overall survey population but only 0.3% of persons who had never smoked were current consumers of e-cigarettes. Tobacco consumption is very high in Germany compared to other countries in Western and Northern Europe, and its distribution across the population is markedly uneven, with a heavy influence of socioeconomic status.
Full Text Available Abstract Background Suicide is the leading cause of death among Japanese adolescents, and they may commit suicide differently from adults. However, there are few studies in medical-based data concerning adolescent patients seriously attempting suicide. We aimed to explore the characteristics of serious suicide attempts in Japanese adolescents, comparing them with those in adults. Methods We investigated adolescents who seriously attempted suicide and were treated at the Critical Care Medical Center (CCMC of Nippon Medical School Hospital between 2000 and 2010, and we compared them with adult suicide attempters treated during 2009. We retrospectively studied medical records and collected clinical data and socio-demographic factors, including age, sex, psychiatric symptoms or diagnosis, methods of suicide attempt, motives for suicide attempt, previous deliberate self-harm, previous psychiatric history, parent loss experience, and previous psychiatric history in the family. Results Adolescent attempters were 15 males and 44 females, 13 to 18 years old (mean 16.39. Adult attempters were 37 males and 65 females, 19 to 79 years old (mean 39.45. In comparison to adult attempters, adolescent attempters were more frequently diagnosed with Borderline Personality Disorder (BPD, had more school problems and parent loss experience, but they had less financial problems. Gender differences between adolescents and adults were examined, and male adolescent attempters were found to be more frequently diagnosed with schizophrenia and had less financial problems than their adult counterparts, while female adolescent attempters were more frequently diagnosed with BPD, had more school problems and parent loss, but they had less previous psychiatric history than their adult counterparts. Conclusions Our findings indicated that adolescent attempters were more frequently diagnosed with BPD and had more school problems and parent loss experience but had less financial
Fedyszyn, Izabela E.; Erlangsen, Annette; Hjorthoj, Carsten
Objective: Emergency departments are important, albeit underutilized, sites for suicide prevention. Preventive strategies and interventions could benefit from a greater understanding of factors influencing the course of suicide risk after emergency department contact due to attempted suicide...... = 1.74; 95% CI, 1.22-2.49). The cumulative rates of repeated attempts and suicide deaths in the total sample were particularly high within the first week of the index attempt, reaching 3.6% and 0.1%, respectively. Conclusions: Preventive efforts need to target the period close to discharge from....... The aim of our study was 2-fold: to identify predictors of repeated suicide attempts and suicide and to investigate the timing of these events. Methods: Data from Danish nationwide, longitudinal registers were used in this prospective, population-based study of all individuals first presenting...
Saddichha, Sahoo; Prasad, M N V; Saxena, Mukul Kumar
Suicide continues to be one of the biggest killers in the world, with suicide rates varying between 8.1 and 58.3/100,000 population for different parts of India. Andhra Pradesh, the fourth largest state in India, is responsible for more than 11% of these. Unfortunately, most suicides are under-reported and there is scant data on attempted suicides. This study aimed to comprehensively study the characteristics of attempted suicides in Andhra Pradesh and using the primary data, make secondary projections for the forthcoming years. Using Patient Care Record (PCR) forms of all emergencies serviced by 108, the first comprehensive emergency service in India, an analysis of all cases was done to detect possible suicides during the period January-December 2007. A follow up 48 hours later was then done to confirm status and diagnosis. A total of 1007 cases were recorded as confirmed suicides. Hanging and insecticide poisoning (72%) were the most common methods used. Males preferred hanging and insecticide poisoning while females preferred self-immolation and hanging as common methods. Self-immolation and insecticide poisoning had the highest mortality (41.6%). Estimates of attempted suicides for the year 2008 revealed a mean of 3.2-3.8 per 1000 population for males, 3.3-3.7 per 1000 population for females and 6.4-7.6 per 1000 population combined. A serious epidemic of suicides seems to be in store in the coming years unless preventive steps in the form of policy changes are undertaken. Restricting access to poisonous substances or prescription drugs and taking into consideration the prevailing social, economic and cultural factors could help in reducing numbers. Starting tele-help services or offering brief interventions during hospital stays are other programs which may be considered.
Many scientists agree that various difficulties arise when one tries to build up a worldview incorporating some form of realism which can accommodate our knowledge about natural phenomena. We investigate whether quantum mechanics (Q.M.), in the standard interpretation or in some of its more widely known and accepted variants, can be taken as a basis for such a program. Having pointed out that, in our opinion, this is not the case, we present an attempt to overcome the difficulties by accepting stochastic and nonlinear modifications of the evolution equation of the theory. (author). 30 refs
Christoffersen, Mogens; Poulsen, Henrik Day; Nielsen, Anne
was also found among adolescents who had psychiatric disorder or a physical handicap, those who had been sentenced, were addicted to drugs, or had unstable education and unemployment records. A common feature of these significant risk factors seemed to be stigmatisation or social exclusion......This paper has been submitted to a journal for consideration, so please do not quote without permission. Adolescents' first-time suicide attempt tends to be characterized by parental psychiatric disorder or suicidal behaviour, family violence, especially child abuse and neglect. An increased risk...
Christiansen, Erik; Jensen, Børge Frank
This study was undertaken in order to estimate the incidence of repetition of suicide attempt, suicide and all deaths, and to analyse the influence of psychiatric illness and socio-demographic factors on these.......This study was undertaken in order to estimate the incidence of repetition of suicide attempt, suicide and all deaths, and to analyse the influence of psychiatric illness and socio-demographic factors on these....
Full Text Available Since the emergence of complementary currencies in the 1980s there have been numerous attempts to classify them, despite that the terms local currency, community currency and many others describing place-based monetary tools are not considered similarly by scholars. The local currencies take many forms, and local governments play different roles in their emergence and development. In Hungary there has been an increasing attention and discussion around the idea of implementing these alternative monetary tools. There is a growing number of working complementary currencies in Hungary, but academic research focuses mostly on whether these can contribute to the local development and what kind of effects they have. The aim of this paper is to present a possible categorization of Hungarian complementary currencies based on the role local governments played in their implementation. I evaluate whether these community currencies are effective at first, and attempt to categorize them based on their purpose, association form and their relationships with local governments, with the purpose of increasing awareness for these initiatives in the process of policy-making.
E. R. Black
Full Text Available Objective. Trichloroacetic acid (TCAA, or trichloroethanoic acid, is a chemical analogue of acetic acid where three methyl group hydrogen atoms are replaced by chlorine. TCAAs are also abbreviated and referred to as TCAs, causing confusion with the psychiatric antidepressant drug class, especially among patients. TCAAs exist in dermatological treatments such as chemical peels or wart chemoablation medication. TCAA ingestion or overdose can cause gastric irritation symptoms including vomiting, diarrhea, or lassitude. This symptomatology is less severe than TCA overdose, where symptoms may include elevated body temperature, blurred vision, dilated pupils, sleepiness, confusion, seizures, rapid heart rate, and cardiac arrest. Owing to the vast difference in symptoms, the need for clinical intervention differs greatly. While overdose of either in a self-harm attempt can warrant psychiatric hospital admission, the risk of death in TCAA ingestion is far less. Case Report. A patient ingested TCAA in the form of a commercially available dermatological chemical peel as a self-harm attempt, thinking that it was a more injurious TCA. Conclusion. Awareness among physicians, particularly psychiatrists, regarding this relatively obscure chemical compound (TCAA and its use by suicidal patients mistakenly believing it to be a substance that can be significantly more lethal (TCA, is imperative.
Full Text Available In recent years changes have been noted in the motivations for acute suicidal poisonings among young people from various environments, which are due to psychosocial changes both in the urban and rural environments. Suicidal attempts are accompanied – especially in the rural environment – by low social status, difficulties with adapting to a free market economy, emotional tension within the family, at school, in the environment of young people, addiction to alcohol, drug overuse, including psychotropes. Based on clinical material concerning rural inhabitants hospitalized due to suicidal poisonings, the authors performed the analysis of attitudes, motivations and causes of acute poisonings among the young rural population. Among rural adolescents who continued school or university education the dominant causes of undertaking a suicidal attempt were: adolescent period problems, conflicts within the family, conflicts with mates, and disappointment in love. Among young adults the motivations were as follows: difficulties with finding employment in the place of residence, conflicts within the family, overuse of stimulants, and sometimes states of depression during the period of aggravation of a disease.
Lee, Peter N; Fry, John S; Forey, Barbara A
We quantified the decline in COPD risk following quitting using the negative exponential model, as previously carried out for other smoking-related diseases. We identified 14 blocks of RRs (from 11 studies) comparing current smokers, former smokers (by time quit) and never smokers, some studies providing sex-specific blocks. Corresponding pseudo-numbers of cases and controls/at risk formed the data for model-fitting. We estimated the half-life (H, time since quit when the excess risk becomes half that for a continuing smoker) for each block, except for one where no decline with quitting was evident, and H was not estimable. For the remaining 13 blocks, goodness-of-fit to the model was generally adequate, the combined estimate of H being 13.32 (95% CI 11.86-14.96) years. There was no heterogeneity in H, overall or by various studied sources. Sensitivity analyses allowing for reverse causation or different assumed times for the final quitting period little affected the results. The model summarizes quitting data well. The estimate of 13.32years is substantially larger than recent estimates of 4.40years for ischaemic heart disease and 4.78years for stroke, and also larger than the 9.93years for lung cancer. Heterogeneity was unimportant for COPD, unlike for the other three diseases. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.
Ballard, Elizabeth D; Ionescu, Dawn F; Vande Voort, Jennifer L; Slonena, Elizabeth E; Franco-Chaves, Jose A; Zarate, Carlos A; Grillon, Christian
Suicide is a common reason for psychiatric emergency and morbidity, with few effective treatments. Anxiety symptoms have emerged as potential modifiable risk factors in the time before a suicide attempt, but few studies have been conducted using laboratory measures of fear and anxiety. We operationally defined fear and anxiety as increased startle reactivity during anticipation of predictable (fear-potentiated startle) and unpredictable (anxiety-potentiated startle) shock. We hypothesized that a lifetime history of suicide attempt (as compared to history of no suicide attempt) would be associated with increased fear-potentiated startle. A post-hoc analysis of fear- and anxiety-potentiated startle was conducted in 28 medication-free patients with Major Depressive Disorder (MDD) divided according to suicide attempt history. The magnitude of fear-potentiated startle was increased in depressed patients with lifetime suicide attempts compared to those without a lifetime history of suicide attempt (F(1,26)=5.629, p=.025). There was no difference in anxiety-potentiated startle by suicide attempt history. This is a post-hoc analysis of previously analyzed patient data from a study of depressed inpatients. Further replication of the finding with a larger patient sample is indicated. Increased fear-potentiated startle in suicide attempters suggests the role of amygdala in depressed patients with a suicide attempt history. Findings highlight the importance of anxiety symptoms in the treatment of patients at increased suicide risk. Published by Elsevier B.V.
Wu, Lei; He, Yao; Jiang, Bin; Zuo, Fang; Liu, Qinghui; Zhang, Li; Zhou, Changxi; Liu, Miao; Chen, Hongyan
To investigate the predictors for 'quitting' among male smokers in a smoking cessation clinic. The target population consisted of smokers who volunteered to seek treatment for cessation at our clinic in Beijing. Smokers received face-to-face counseling and psychological intervention at the first visit by trained physicians and standardized telephone discussion, was carried out with counselors at 1 week, 1/3/6 months a follow-up study. The main outcomes would involve 'successful quitting' at the 7-day point, continuous quit rates at 3 and 6 months as well as the predictors of 'quitting'. From October 2008 to December 2012, we collected 355 eligible male smokers among whom 255 had completed the 6-month follow-up program. Results from the analysis (n = 255) showed that the quitting rates at the 7-day point and 3 months were 34.9% and 25.5%, while the rates were 25.1% and 18.3% among the 355 smokers who had the intention for treatment. Data from the stepwise logistic regression model analysis showed that lower exhaled CO level at the first visit, higher perceived confidence in quitting, lower expenditure on cigarettes and had diagnosed tobacco-related chronic diseases by physicians, were important predictors for quitting smoking. The main reasons of failure to quit were addiction of tobacco cigarette, craving for cigarettes to relieve pressure from work, peer influence from other smokers, lack of mental preparation and perseverance to quit, etc. Smokers who smoked less cigarettes, had higher perceived confidence in quitting and had physician-diagnosed tobacco-related chronic diseases seemed easier to quit. Regular follow-up intervention services for smokers should be established to enhance the motivation for quitting so as to create a favorable environment for the smokers.
Cheng, Andrew T A; Hawton, Keith; Chen, Tony H H; Yen, Amy M F; Chen, Chung-Ying; Chen, Lin-Chen; Teng, Po-Ren
To investigate the impact of media reporting of a celebrity suicide on subsequent suicide attempts. A Poisson time series autoregression analysis was conducted to examine whether there was a significant increase in suicide attempts during the 3-week period after the start of extensive media reporting of a celebrity suicide. The reporting began on May 2, 2005, and lasted about 17 days. To investigate the influence of media reporting on suicide attempts, a structured interview was conducted with 124 suicide attempters identified from 2 counties in Mid Taiwan who had exposure to the media reporting. After controlling for seasonal variation, calendar year, temperature, and humidity, there was a marked increase in the number of suicide attempts during the 3-week period after media reporting began (adjusted relative risk = 1.55, 95% CI = 1.26 to 1.91). Among 124 suicide attempters exposed to the media reports, 23.4% reported an influence from them. There was no relationship between the attempters' ages and the age of the celebrity or the method, but male attempters had a significantly higher risk for such influence. A considerably higher risk for such influence was found among subjects with a history of suicide attempt(s) in the previous year (odds ratio = 52.3, 95% CI = 5.96 to 459.1). The extensive media reporting of the suicide of a celebrity was followed by an increase in suicide attempts. The effect was particularly marked in individuals with a recent history of a suicide attempt. The results provide further support for the need for more restrained reporting of suicides as part of suicide prevention strategies and for special vigilance for contagious effects of such reporting on people who have carried out recent suicidal acts.
Kim L. Bercovitz
Full Text Available Construction-related occupations have very high smoking prevalence rates and are an identified priority population for efforts to promote cessation. This study sought to identify the smoking cessation supports and services which best suited this workforce group, and to identify gaps in reach of preventive health services. We performed qualitative text analysis on pre-existing conversations about smoking cessation among workers in this sector. The material appeared on a discussion forum about residential construction from 1998 and 2011. Roughly 250 unique user names appeared in these discussions. The qualitative analysis addressed knowledge, motivation, environmental influences, and positive and negative experiences with supports for cessation. Self-identified smokers tended to want to quit and described little social value in smoking. Actual quit attempts were attributed to aging and tangible changes in health and fitness. Peer-to-peer social support for cessation was evident. Advice given was to avoid cigarettes and smokers, to focus on personal skills, personal commitment, and the benefits of cessation (beyond the harms from smoking. Many discussants had received medical support for cessation, but behavioural counselling services appeared underutilized. Our findings support efforts toward more complete bans on workplace smoking and increased promotion of available behavioural support services among dispersed blue-collar workers.
Full Text Available Narratives, i.e., stories told by suicidal people, describing personal experiences and meanings given to these experiences, play an important role in understanding suicidal behaviour. The aim of the current study was to analyse suicidal processes that have resulted in attempted suicide and to improve the understanding of protective and risk factors of suicidal behaviour. Special emphasis was paid to religious/spiritual aspects. The material was collected in Estonia by conducting narrative interviews with adults (18 years or older who had attempted suicide during their lifetimes (N = 8. Thematic analysis was used for analysing the data. The main themes identified from the narratives were: childhood and family relationships, romantic relationships, alcohol/drug abuse, losses, sleep, previous suicide attempts, and religious/spiritual beliefs. The findings of the study show that there are many pathways to attempted suicide and that the process leading to attempted suicide is complex. Protective and risk factors are both multi-faceted.
Thilakarathna, Surangi H.; Rupasinghe, H. P. Vasantha
Flavonoids are a group of phytochemicals that have shown numerous health effects and have therefore been studied extensively. Of the six common food flavonoid classes, flavonols are distributed ubiquitously among different plant foods whereas appreciable amounts of isoflavones are found in leguminous plant-based foods. Flavonoids have shown promising health promoting effects in human cell culture, experimental animal and human clinical studies. They have shown antioxidant, hypocholesterolemic, anti-inflammatory effects as well as ability to modulate cell signaling and gene expression related disease development. Low bioavailability of flavonoids has been a concern as it can limit or even hinder their health effects. Therefore, attempts to improve their bioavailability in order to improve the efficacy of flavonoids are being studied. Further investigations on bioavailability are warranted as it is a determining factor for flavonoid biological activity. PMID:23989753
Sebnem Eren Cevik
Full Text Available Potassium permanganate is a highly corrosive, water-soluble oxidizing antiseptic. A 68- year-old female patient was admitted to our Emergency Department after ingestion of 3 tablets of 250 mg potassium permanganate as a suicide attempt. The physical exam revealed brown stained lesions in the oropharynx. Emergency endoscopy was performed by the gastroenterologist after the third hour of ingestion. Emergency endoscopy revealed multiple superficial (Grade I-II lesions on the esophagus and cardia, which were considered secondary to the caustic substance. The mainstay in the treatment of potassium permanganate is supportive and the immediate priority is to secure the airway. Emergency endoscopy is an important tool used to evaluate the location and severity of injury to the esophagus, stomach and duodenum after caustic ingestion. Patients with signs and symptoms of intentional ingestion should undergo endoscopy within 12 to 24 h to define the extent of the disease.
Tuba Cimilli Ozturk
Full Text Available Potassium permanganate is a highly corrosive, water-soluble oxidizing antiseptic. A 68- year-old female patient was admitted to our Emergency Department after ingestion of 3 tablets of 250 mg potassium permanganate as a suicide attempt. The physical exam revealed brown stained lesions in the oropharynx. Emergency endoscopy was performed by the gastroenterologist after the third hour of ingestion. Emergency endoscopy revealed multiple superficial (Grade I-II lesions on the esophagus and cardia, which were considered secondary to the caustic substance. The mainstay in the treatment of potassium permanganate is supportive and the immediate priority is to secure the airway. Emergency endoscopy is an important tool used to evaluate the location and severity of injury to the esophagus, stomach and duodenum after caustic ingestion. Patients with signs and symptoms of intentional ingestion should undergo endoscopy within 12 to 24 h to define the extent of the disease.
Bricker, Jonathan B; Mull, Kristin E; McClure, Jennifer B; Watson, Noreen L; Heffner, Jaimee L
Millions of people world-wide use websites to help them quit smoking, but effectiveness trials have an average 34% follow-up data retention rate and an average 9% quit rate. We compared the quit rates of a website using a new behavioral approach called Acceptance and Commitment Therapy (ACT; WebQuit.org) with the current standard of the National Cancer Institute's (NCI) Smokefree.gov website. A two-arm stratified double-blind individually randomized trial (n = 1319 for WebQuit; n = 1318 for Smokefree.gov) with 12-month follow-up. United States. Adults (n = 2637) who currently smoked at least five cigarettes per day were recruited from March 2014 to August 2015. At baseline, participants were mean [standard deviation (SD)] age 46.2 years (13.4), 79% women and 73% white. WebQuit.org website (experimental) provided ACT for smoking cessation; Smokefree.gov website (comparison) followed US Clinical Practice Guidelines for smoking cessation. The primary outcome was self-reported 30-day point prevalence abstinence at 12 months. The 12-month follow-up data retention rate was 88% (2309 of 2637). The 30-day point prevalence abstinence rates at the 12-month follow-up were 24% (278 of 1141) for WebQuit.org and 26% (305 of 1168) for Smokefree.gov [odds ratio (OR) = 0.91; 95% confidence interval (CI) = 0.76, 1.10; P = 0.334] in the a priori complete case analysis. Abstinence rates were 21% (278 of 1319) for WebQuit.org and 23% (305 of 1318) for Smokefree.gov (OR = 0.89 (0.74, 1.07; P = 0.200) when missing cases were imputed as smokers. The Bayes factor comparing the primary abstinence outcome was 0.17, indicating 'substantial' evidence of no difference between groups. WebQuit.org and Smokefree.gov had similar 30-day point prevalence abstinence rates at 12 months that were descriptively higher than those of prior published website-delivered interventions and telephone counselor-delivered interventions. © 2017 Society for the Study of Addiction.
Emery, Sherry; Kim, Yoonsang; Choi, Young Ku; Szczypka, Glen; Wakefield, Melanie; Chaloupka, Frank J
We investigated whether state-sponsored antitobacco advertisements are associated with reduced adult smoking, and interactions between smoking-related advertising types. We measured mean exposure to smoking-related advertisements with television ratings for the top-75 US media markets from 1999 to 2007. We combined these data with individual-level Current Population Surveys Tobacco Use Supplement data and state tobacco control policy data. Higher exposure to state-sponsored, Legacy, and pharmaceutical advertisements was associated with less smoking; higher exposure to tobacco industry advertisements was associated with more smoking. Higher exposure to state- and Legacy-sponsored advertisements was positively associated with intentions to quit and having made a past-year quit attempt; higher exposure to ads for pharmaceutical cessation aids was negatively associated with having made a quit attempt. There was a significant negative interaction between state- and Legacy-sponsored advertisements. Exposure to state-sponsored advertisements was far below Centers for Disease Control and Prevention-recommended best practices. The significant negative relationships between antismoking advertising and adult smoking provide strong evidence that tobacco-control media campaigns help reduce adult smoking. The significant negative interaction between state- and Legacy-sponsored advertising suggests that the campaigns reinforce one another.
Wojnar, Marcin; Ilgen, Mark A; Jakubczyk, Andrzej; Wnorowska, Anna; Klimkiewicz, Anna; Brower, Kirk J
The present study was designed to examine the influence of suicidality on relapse in alcohol-dependent patients. Specifically, a lifetime suicide attempt at baseline was used to predict relapse in the year after treatment. Also, the unique contribution of impulsive suicide attempts was examined. A total of 154 patients with alcohol dependence, consecutively admitted to four addiction treatment facilities in Warsaw, Poland participated in the study. Of the 154 eligible patients, 118 (76.6%) completed a standardized follow-up assessment at 12 months. Previous suicide attempts were common in adults treated for alcohol dependence with 43% patients in the present sample reporting an attempt at some point during their lifetime. Additionally, more than 62% of those with a lifetime suicide attempt reported making an impulsive attempt. Lifetime suicide attempts were not associated with post-treatment relapse (chi-square=2.37, d.f.=1, p=0.124). However, impulsive suicide attempts strongly predicted relapse (OR=2.81, 95% CI=1.13-6.95, p=0.026) and time to relapse (OR=2.10, 95% CI=1.18-3.74, p=0.012) even after adjusting for other measures of baseline psychopathology, depression, impulsivity, hopelessness and alcohol use severity. This study is the first to document the relationship between pre-treatment impulsive suicide attempts and higher likelihood of post-treatment relapse in alcohol-dependent patents. Clinicians should routinely conduct an assessment for previous suicide attempts in patients with alcohol use disorders, and when impulsive suicidality is reported, they should recognize the increased risk for relapse and formulate their patients' treatment plans accordingly with the goals of reducing both alcoholic relapse and suicide rates.
Pavey, Toby G; Gartner, Coral E; Coombes, Jeff S; Brown, Wendy J
Smoking and physical inactivity are major risk factors for heart disease. Linking strategies that promote improvements in fitness and assist quitting smoking has potential to address both these risk factors simultaneously. The objective of this study is to compare the effects of two exercise interventions (high intensity interval training (HIIT) and lifestyle physical activity) on smoking cessation in female smokers. This study will use a randomised controlled trial design. Women aged 18-55 years who smoke ≥ 5 cigarettes/day, and want to quit smoking. all participants will receive usual care for quitting smoking. Group 1--will complete two gym-based supervised HIIT sessions/week and one home-based HIIT session/week. At each training session participants will be asked to complete four 4-min (4 × 4 min) intervals at approximately 90% of maximum heart rate interspersed with 3- min recovery periods. Group 2--participants will receive a resource pack and pedometer, and will be asked to use the 10,000 steps log book to record steps and other physical activities. The aim will be to increase daily steps to 10,000 steps/day. Analysis will be intention to treat and measures will include smoking cessation, withdrawal and cravings, fitness, physical activity, and well-being. The study builds on previous research suggesting that exercise intensity may influence the efficacy of exercise as a smoking cessation intervention. The hypothesis is that HIIT will improve fitness and assist women to quit smoking. ACTRN12614001255673 (Registration date 02/12/2014).
Synnott, John; Ioannou, Maria; Coyne, Angela; Hemingway, Siobhan
Fifty suicide notes of those who died by suicide and 50 suicide notes of those who survived their suicide attempt were analyzed using Smallest Space Analysis. The core of all suicide notes was discovered to be constructed with the use of four variables: saying goodbye to their audience, feelings of loneliness, method used to attempt suicide, and negative self-image. Furthermore, three different suicide note themes of those who died and three suicide note themes from those who survived were also identified. The analysis revealed that suicide note writers who died by their attempt were more likely to combine a dislike of themselves and a concern for loved ones. The implications of the work in terms of suicide prevention are discussed. © 2017 The American Association of Suicidology.
Conclusion: Our study confirms some previous Western reports that adolescents with depressive disorders commonly manifest suicide attempts. There are, however, some cultural differences in risk factors. School-related problems play an important role in Taiwan among the adolescent suicides, and prior suicide attempts predict future suicidal behavior. Enhancing school-based screening for adolescents with suicide risk and transferring them to psychiatric professionals for intervention is important. We should focus suicide prevention resources mainly on the adolescent population with psychiatric illness, prior suicide attempts, and with high risk factors.
Verhagen, J.; Wagenmakers, E.-J.
Replication attempts are essential to the empirical sciences. Successful replication attempts increase researchers’ confidence in the presence of an effect, whereas failed replication attempts induce skepticism and doubt. However, it is often unclear to what extent a replication attempt results in
Bleakley, Amy; Jordan, Amy; Ellithorpe, Morgan E; Lazovich, DeAnn; Grossman, Sara; Glanz, Karen
Indoor tanning is a risk factor for melanoma among young white women. Health communications can be an effective way of reaching this population and promoting behavior change. The purpose of this study was (i) to investigate the associations between intention to quit indoor tanning and attitudes, normative pressure, and efficacy about quitting, and (ii) to identify beliefs about quitting indoor tanning that can be used to design effective health communication messages to reduce skin cancer risk. A national online survey was conducted with 279 non-Hispanic white women ages 18-25 in the USA who are indoor tanners. The survey, based on the reasoned action approach, assessed intention, attitudes, norms, and efficacy and their corresponding underlying beliefs related to quitting indoor tanning, along with other known covariates. Data were collected in November/December 2015. Intention to quit indoor tanning was significantly associated with attitudes, specifically with the beliefs that it would "reduce damage to skin" (increased intention) and "make me less happy" (decreased intention). While self-efficacy was not related to intention to quit indoor tanning, injunctive normative beliefs were with key referent groups including mothers, friends, and romantic partners. Messages aimed at discouraging indoor tanning among young, non-Hispanic, white women should highlight the salient belief that quitting indoor tanning will reduce skin damage, counter the belief that it will make them less happy, and highlight key people who would approve of them quitting indoor tanning.
J. Delfgaauw (Josse)
textabstractThis paper employs survey data on the reasons to quit of Dutch job changers who entered or left a public sector job in 2001. We show that workers' reasons to quit their public sector job influence their decision to stay in or leave their industry of employment. A bad experience with, for
Little, Melissa A; Pokhrel, Pallav; Murphy, Kelle L; Kawamoto, Crissy T; Suguitan, Gil S; Herzog, Thaddeus A
Despite the global significance of betel quid chewing and the associated health risks, there have been no studies assessing chewers' intention to quit. Given the difficulties associated with quitting betel quid and the serious health consequences of chewing, it is important for researchers to develop interventions aimed at helping chewers quit. Betel quid chewers experience similar patterns of dependence and withdrawal symptoms as tobacco smokers, and the use of both substances causes serious adverse health effects. Therefore, it is possible that intention to quit betel quid and tobacco would also be similar. If similarities were found, researchers could look to existing tobacco cessation interventions to inform the development of betel quid cessation interventions. In the current study we sought to understand chewers' intention to quit and how it compares to smokers' intention to quit cigarettes. A total of 351 adult betel quid chewers from Guam were compared against 1,555 adult tobacco users from Hawaii. These comparisons were made possible because of the deliberate use of identical questionnaire items (mutatis mutandis) for betel quid chewing and cigarette smoking. Smokers reported higher levels of wanting to quit, intending to quit, and wishing they have never started in the first place compared to chewers (p'sbetel quid cessation interventions.
Macpherson, D S; Snow, R; Lofgren, R P
To determine the frequency of tests done in the year before elective surgery that might substitute for preoperative screening tests and to determine the frequency of test results that change from a normal value to a value likely to alter perioperative management. Retrospective cohort analysis of computerized laboratory data (complete blood count, sodium, potassium, and creatinine levels, prothrombin time, and partial thromboplastin time). Urban tertiary care Veterans Affairs Hospital. Consecutive sample of 1109 patients who had elective surgery in 1988. At admission, 7549 preoperative tests were done, 47% of which duplicated tests performed in the previous year. Of 3096 previous results that were normal as defined by hospital reference range and done closest to the time of but before admission (median interval, 2 months), 13 (0.4%; 95% CI, 0.2% to 0.7%), repeat values were outside a range considered acceptable for surgery. Most of the abnormalities were predictable from the patient's history, and most were not noted in the medical record. Of 461 previous tests that were abnormal, 78 (17%; CI, 13% to 20%) repeat values at admission were outside a range considered acceptable for surgery (P less than 0.001, frequency of clinically important abnormalities of patients with normal previous results with those with abnormal previous results). Physicians evaluating patients preoperatively could safely substitute the previous test results analyzed in this study for preoperative screening tests if the previous tests are normal and no obvious indication for retesting is present.
Savoy, Elaine; Reitzel, Lorraine R; Scheuermann, Taneisha S; Agarwal, Mohit; Mathur, Charu; Choi, Won S; Ahluwalia, Jasjit S
Although the relationship between risk perceptions and quit intentions has been established, few studies explore the potential impact of smoking level on these associations, and none have done so among diversely-aged samples of multiple ethnicities. Participants, ranging in age from 25 to 81, were 1133 nondaily smokers (smoked ≥1 cigarette on 4 to 24days in the past 30days), 556 light daily smokers (≤10 cigarettes per day), and 585 moderate to heavy daily smokers (>10 cigarettes per day). Each smoking level comprised approximately equal numbers of African Americans, Latinos, and Whites. A logistic regression analysis, adjusted for sociodemographics, self-rated health, time to the first cigarette of the day and smoking level, was used to examine the association between risk perception (perceived risk of acquiring lung cancer, lung disease, and heart disease) and intention to quit (≤6months versus >6months/never). A second adjusted model tested moderation by smoking level with an interaction term. Greater risk perception was associated with a higher odds of planning to quit within 6months (AOR=1.34, CI.95=1.24, 1.45). Smoking level did not moderate this association (p=.85). Results suggest that educating all smokers, irrespective of their smoking level, about increased risk of developing smoking-related diseases might be a helpful strategy to enhance their intention to make a smoking quit attempt. Copyright © 2014 Elsevier Ltd. All rights reserved.
Jokinen, Jussi; Nordström, Peter
Hyperactivity of the Hypothalamic-Pituitary-Adrenal (HPA) axis is a consistent finding in Major Depressive Disorder (MDD) and most prospective studies of HPA-axis function have found that non-suppressors in the dexamethasone suppression test (DST) are more likely to commit suicide during follow-up. The results of studies on HPA-axis function and attempted suicide are less consistent. Suicide attempts are more common among young people than the elderly, whereas suicide is more common among the elderly. The impact of age related changes in HPA-axis system activity in relation to suicidal behaviour across the lifecycle may be of importance. The aim of the present study was to investigate the DST results in 36 young adult (30 years or younger) inpatients with mood disorder, with (n=18) and without suicide attempt at the index episode. The DST non-suppressor rate was 25% among young mood disorder inpatients. DST non-suppression was associated with suicide attempt and post-dexamethasone serum cortisol at 11:00 p.m. was significantly higher in suicide attempters compared to non-attempters. The DST non-suppressor rate was 39% in young adult suicide attempters compared with 11% in non-attempters. The results add to previous evidence in support of the role of HPA axis hyperactivity and suicidal behaviour. The present findings motivate to include HPA axis measures in the assessment of depression in young adults.
Wakefield, J C; Schmitz, M F
To establish which symptoms of major depressive episode (MDE) predict postremission suicide attempts in complicated single-episode cases. Using the nationally representative two-wave National Epidemiologic Survey on Alcohol and Related Conditions data set, we identified wave 1 lifetime single-episode MDE cases in which the episode remitted by the beginning of the wave 2 three-year follow-up period (N = 2791). The analytic sample was further limited to 'complicated' cases (N = 1872) known to have elevated suicide attempt rates, defined as having two or more of the following: suicidal ideation, marked role impairment, feeling worthless, psychomotor retardation, and prolonged (>6 months) duration. Logistic regression analyses showed that, after controlling for wave 1 suicide attempt which significantly predicted postremission suicide attempt (OR = 10.0), the additional complicated symptom 'feelings of worthlessness' during the wave 1 index episode significantly and very substantially predicted postremission suicide attempt (OR = 6.96). Neither wave 1 psychomotor retardation nor wave 1 suicidal ideation nor any of the other wave 1 depressive symptoms were significant predictors of wave 2 suicide attempt. Among depressive symptoms during an MDE, feelings of worthlessness is the only significant indicator of elevated risk of suicide attempt after the episode has remitted, beyond previous suicide attempts. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Klemperer, Elias M; Hughes, John R; Solomon, Laura J; Callas, Peter W; Fingar, James R
To test whether, in comparison to usual care, brief motivational or reduction interventions increase quit attempts (QA) or abstinence among smokers who are not ready to quit. A parallel-group randomized controlled trial of brief motivational (n = 185), reduction (n = 186) or usual care (n = 189) telephone interventions delivered over the course of 4 weeks. Outcomes were assessed at 6- and 12-month follow-ups. No medication was provided. United States. A total of 560 adult smokers of ≥ 10 cigarettes per day who were not ready to quit in the next 30 days. The primary outcomes were whether participants made a QA that lasted ≥ 24 hours and whether they made a QA of any length between baseline and 6 months. Secondary outcomes included 7-day point-prevalence abstinence at 6 and 12 months. The 12-month follow-up was added after the study began. A priori-defined comparisons were between motivational versus usual care and reduction versus usual care conditions. The probability of making a QA that lasted ≥ 24 hours was not significantly different between the motivational (38%) or the reduction (31%) conditions and the usual care (34%) condition [motivational versus usual care odds ratio (OR) = 1.19, 95% confidence interval (CI) = 0.78-1.82; reduction versus usual care OR = 0.89, 95% CI = 0.57-1.36]. Bayes factors ranged from 0.13 to 0.18. Findings regarding a QA of any length were similar. At 6 months, the motivational condition had marginally more abstinence than usual care (11 versus 5%, OR = 2.17, 95% CI = 0.99-4.77), but the reduction condition was not significantly different from usual care (8 versus 5%, OR = 1.57, 95% CI = 0.69-3.59). At 12 months, the motivational condition had significantly more abstinence than usual care (10 versus 4%, OR = 2.80, 95% CI = 1.14-6.88) and the reduction condition had marginally more abstinence than usual care (9 versus 4%, OR = 2.45, 95% CI = 0.98-6.09). Among adult smokers who are not ready
Granados, C. E.; Martin, F.
A valve which permits the maintenance of an installation vacuum when electric current fails is described. It also lets the air in the previous vacuum bomb to prevent the oil ascending in the vacuum tubes. (Author)
Asarnow, Joan Rosenbaum; Baraff, Larry J.; Berk, Michele; Grob, Charles; Devich-Navarro, Mona; Suddath, Robert; Piacentini, John; Tang, Lingqi
The study examines ideators, single attempters, and repeats attempters of suicide to clarify optimal strategies for emergency department management and risk assessment to help them in reducing youth suicide and suicide attempts. Depression was found to be a strong predictor of suicide/suicide attempts along with substance use, externalizing…
Full Text Available Introduction. Filicide is the killing of a son or daughter by a parent. The paper examines interaction between stress and maternal psychopathology that led to the killing. Case Outline. After prolonged conflict with her ex-husband and father of her only child, the respondent committed filicide. Two years before committing filicide, after she had divorced the father of the child, the respondent attempted suicide and had to be hospitalized. On that occasion, she was diagnosed with depressive disorder, which was not treated after hospitalization. Having killed her daughter by cutting her throat, she tried to commit suicide in the same manner, by slitting her throat. During further observation, the respondent was found to suffer from acute psychotic disorder, depressive disorder and histrionic personality disorder. These disorders in interaction with stress do not provide us with an explanation for an unusual and psychopathological motivation analysis of killing the child. Conclusion. Filicide is a violent act, most frequently multifactorial in its nature. Histrionic personality disorder in mother cannot explain the filicide act. Only interactive and dynamic evaluation of this psychiatric disorder in its longitudinal, development aspects and its potentiality to enable the expression of some other psychiatric disorders, especially dissociative states, as well as the importance of prolonged and acute stress and its subjective importance for the individual can shed some more light on the mental state of the mother at the time of filicide.
Kirmes, Tomasz; Wilk, Mateusz; Chowaniec, Czesław
This article is an attempt to complete and holistically discuss problem of euthanasia, especially its ethical and legal aspects, comparing to Polish law. The subject of euthanasia arouse interest of the society because it touches one of the most important aspects of life, which is the death. Even bigger emotions are aroused amongst physicians. They are forced to put on the line the life as biggest value on the one side and autonomy of human being on the other. It also touches the empathy for suffering. The euthanasia was divided into three forms: active euthanasia, passive euthanasia and assisted suicide. Any form of euthanasia is illegal in Poland according to both the Penal Code and Code of Medical Ethics. Range of possible penal consequences perpetrator is very wide from waiver of punishment to life imprisonment and it comes from different penal qualification of the euthanasia. Qualification of the euthanasia is based on terms of intent of perpetrator's act, request of patient, strong empathy for suffering if the patient and decision based on up-to-date medical knowledge. It is valuable to mention "do-not-resuscitate" DNR procedure, which in case of medical futility is legally accepted in Poland, but in other form may be qualified as passive euthanasia.
Full Text Available Inhalant abuse is a problem that is getting more common all around the world. The increase in prevalence of inhalant abuse escalates morbidity and mortality rates. About 22% of people using inhalant have died at their first attempt. Particularly propane, butane, or propane-butane mixture has highest mortality rates. Sudden sniffing death syndrome, cardiomyopathy, central nervous system toxicity, hematological abnormalities, kidney toxicity, and hepatocellular toxicities are the major complications of inhalant abuse. Herein we present a patient with inhalant use disorder. At the age of 19, after a stressful life event he had unsuccessfully tried to suicide by inhaling LPG (liquefied petroleum gas, a mixture of butane and propane gases. After he realized that he had hallucinations and felt better during the inhalation, he started to abuse it. He was addicted to LPG for 10 years at the time of admission. Besides being dangerous for the society security, this intense level of LPG inhalation (12 liters a day not giving any physical harm makes this case interesting.
Kosmala, Alicja; Foltyn, Natalia; Klejment, Piotr; Dębski, Wojciech
Hydraulic fracturing is a technique widely used in oil, gas and unconventional reservoirs exploitation in order to enable the oil/gas to flow more easily and enhance the production. It relays on pumping into a rock a special fluid under a high pressure which creates a set of microcracks which enhance porosity of the reservoir rock. In this research, attempt of simulation of such hydrofracturing process using the Discrete Element Method approach is presented. The basic assumption of this approach is that the rock can be represented as an assembly of discrete particles cemented into a rigid sample (Potyondy 2004). An existence of voids among particles simulates then a pore system which can be filled out by fracturing fluid, numerically represented by much smaller particles. Following this microscopic point of view and its numerical representation by DEM method we present primary results of numerical analysis of hydrofracturing phenomena, using the ESyS-Particle Software. In particular, we consider what is happening in distinct vicinity of the border between rock sample and fracking particles, how cracks are creating and evolving by breaking bonds between particles, how acoustic/seismic energy is releasing and so on. D.O. Potyondy, P.A. Cundall. A bonded-particle model for rock. International Journal of Rock Mechanics and Mining Sciences, 41 (2004), pp. 1329-1364.
Blank, Mei-Ling; Hoek, Janet; George, Mark; Gendall, Philip; Conner, Tamlin S; Thrul, Johannes; Ling, Pamela M; Langlotz, Tobias
Electronic nicotine delivery systems (ENDS) are used to aid smoking cessation attempts; however, many smokers continue to smoke while using an ENDS (dual use). Although uncertainty remains regarding whether specific ENDS patterns hinder or support successful smoking cessation, recent advances in "smart" technology allow passive and active recording of behaviors in real time, enabling more detailed insights into how smoking and vaping patterns may coevolve. We describe patterns of ENDS initiation, and subsequent use, including any changes in cigarette consumption, among daily smokers using a "smart" ENDS (S-ENDS) to quit smoking. An 8-week long mixed-methods feasibility study used Bluetooth-enabled S-ENDS that passively recorded real-time device use by participants (n = 11). Daily surveys administered via smartphones collected data on self-reported cigarette consumption. All 11 participants were dual users, at least initially, during their quit attempt. We observed three provisional vaping and smoking patterns: immediate and intensive ENDS initiation coupled with immediate, dramatic, and sustained smoking reduction, leading to smoking abstinence; gradual ENDS uptake with gradual smoking reductions, leading to daily dual use throughout the study period; and ENDS experimentation with return to exclusive smoking. For six participants, the patterns observed in week 1 were similar to the vaping and smoking patterns observed throughout the rest of the study period. Technological advances now allow fine-grained description of ENDS use and smoking patterns. Larger and longer studies describing smoking-to-vaping patterns, and estimating associations with smoking outcomes, could inform ENDS-specific cessation advice promoting full transition from smoking to exclusive ENDS use. The use of an S-ENDS that recorded real-time device use among daily smokers engaged in a quit attempt provides insight into patterns and trajectories of dual use (continuing to smoke while using ENDS
Bolton, James M; Pagura, Jina; Enns, Murray W; Grant, Bridget; Sareen, Jitender
No longitudinal study has examined risk factors for future suicide attempts in major depressive disorder in a nationally representative sample. The objective of this study was to investigate baseline sociodemographic characteristics, comorbid mental disorders, specific depressive symptoms, and previous suicidal behavior as potential risk factors for suicide attempts at 3 years follow-up. Data came from the national epidemiologic survey on alcohol and related conditions (NESARC), a large nationally representative longitudinal survey of mental illness in adults [Wave 1 (2001-2002); Wave 2 (2004-2005) n=34,653]. Logistic regression examined associations between risk factors present at Wave 1 and suicide attempts at Wave 2 (n=169) among individuals with major depressive disorder at baseline assessment (n=6004). Risk factors for incident suicide attempts at Wave 2 (n=63) were identified among those with major depressive disorder at Wave 1 and no lifetime history of suicide attempts (n=5170). Results revealed specific comorbid anxiety, personality, and substance use disorders to be associated with incident suicide attempts at Wave 2. Comorbid borderline personality disorder was strongly associated with suicide attempts in all models. Several comorbid disorders were strongly associated with suicide attempts at Wave 2 even after adjusting for previous suicidal behavior, notably posttraumatic stress disorder (adjusted odds ratio (AOR)=2.20; 95% confidence interval (95% CI) 1.27-3.83) and dependent personality disorder (AOR=4.43; 95% CI 1.93-10.18). These findings suggest that mental illness comorbidity confers an increased risk of future suicide attempts in major depressive disorder that is not solely accounted for by past suicidal behavior.
Montserrat Yepes; Maria R. Vinas; Inmaculada Armadans; Miguel A. Soria
A sample of 46 men was evaluated with the DAPP (Questionnaire of Domestic Aggressor Psychological Profile). All were inmates convicted for various degrees of violence against their wives in different prisons. The sample was divided into three groups: homicides without previous violence against their wives (H) (n=11), homicides with previous violence (VH) (n=9) and domestic batterers without previous homicide attempts against their partners (B) (n=26). The aim of the study was to analyze the p...
Chaudhury, Sadia R; Singh, Tanya; Burke, Ainsley; Stanley, Barbara; Mann, J John; Grunebaum, Michael; Sublette, M Elizabeth; Oquendo, Maria A
Suicide attempters differ in the degree of planning for their suicide attempts. The purpose of this study was to identify differences between individuals who make planned (≥3 hours of planning) and unplanned (suicide attempts. Depressed suicide attempters (n = 110) were compared based on degree of planning of their most recent suicide attempt on demographic and clinical variables. Participants who made planned suicide attempts were more likely to have family history of completed suicide, more severe and frequent suicidal ideation, greater trait impulsivity, and greater suicidal intent and more severe medical consequences for both their most recent and most serious suicide attempts. These results suggest clear clinical differences based on the degree of suicide attempt planning. Severe suicidal ideation, high suicide intent, family history of suicide completion, and high levels of motor impulsivity contribute to a phenotype that is at greater risk of planned, highly lethal suicide attempts.
Park, Min-Hyeon; Kim, Tae-Suk; Yim, Hyeon-Woo; Jeong, Seung Hee; Lee, Chul; Lee, Chang-Uk; Kim, Jae-Min; Jung, Sung-Won; Lee, Min-Soo; Jun, Tae-Youn
South Korea is a country with one of the highest suicide rates in the world, and the suicide rate is still on the rise. The purpose of this study was to determine the sociodemographic and clinical characteristics of suicide attempts and risk factors related to suicide attempts among depressed patients in South Korea. Among the 1183 participants, 21.4% had a history of a suicide attempt. When the severity of depression was controlled, the risk factors for patients who attempted suicide included younger age, experienced significant life events before 12 years of age, psychotic symptoms, and previous depressive episodes. The characteristics of attempted suicide in depressed patients in South Korea can be summarized as a high suicide attempt rate with no difference in the number of suicide attempts and lethality between males and females. This unique tendency is probably related to the sociodemographic and cultural characteristics of South Korea.
Fagan, Pebbles; Little, Melissa A.; Kawamoto, Crissy T.; Herzog, Thaddeus A.
Objectives. We characterized smokers who are likely to use electronic or “e-”cigarettes to quit smoking. Methods. We obtained cross-sectional data in 2010–2012 from 1567 adult daily smokers in Hawaii using a paper-and-pencil survey. Analyses were conducted using logistic regression. Results. Of the participants, 13% reported having ever used e-cigarettes to quit smoking. Smokers who had used them reported higher motivation to quit, higher quitting self-efficacy, and longer recent quit duration than did other smokers. Age (odds ratio [OR] = 0.98; 95% confidence interval [CI] = 0.97, 0.99) and Native Hawaiian ethnicity (OR = 0.68; 95% CI = 0.45, 0.99) were inversely associated with increased likelihood of ever using e-cigarettes for cessation. Other significant correlates were higher motivation to quit (OR = 1.14; 95% CI = 1.08, 1.21), quitting self-efficacy (OR = 1.18; 95% CI = 1.06, 1.36), and ever using US Food and Drug Administration (FDA)–approved cessation aids such as nicotine gum (OR = 3.72; 95% CI = 2.67, 5.19). Conclusions. Smokers who try e-cigarettes to quit smoking appear to be serious about wanting to quit. Despite lack of evidence regarding efficacy, smokers treat e-cigarettes as valid alternatives to FDA-approved cessation aids. Research is needed to test the safety and efficacy of e-cigarettes as cessation aids. PMID:23865700
Younes, N; Melchior, M; Turbelin, C; Blanchon, T; Hanslik, T; Chee, C Chan
General Practitioners (GPs) play a central role in suicide prevention. This study aims to compare the characteristics of individuals who attempt suicide to those who complete suicide in a same primary care setting. We compared the characteristics and GP's management of all patients with attempted (N=498, SA) or completed suicide (N=141, SC) reported to the GPs'French Sentinelles surveillance system (2009-2013). Compared to patients who attempted suicide, those who completed suicide were more likely to be male, older and to have used a more lethal method; for men they were less likely to have a history of previous suicide attempt and prior contacts with their GP. In terms of GPs' management, we found no differences between the SA and SC groups in the identification of psychological difficulties and in the care, but GPs were more likely to provide psychological support to the SA group. During the last consultation, the SC group expressed suicidal ideas more frequently than the SA group (26.7% vs. 14.8%, pcommit suicide differ from those who attempt suicide in terms of demographic characteristics and by sex, of history of suicide attempt, previous contact and expressed suicidal ideas. We show that GPs do not act more intensively with patients who will commit suicide, as if they do not foresee them. Current prevention programs particularly in primary care should be tailored. Copyright © 2014 Elsevier B.V. All rights reserved.
Kwon, Ahye; Song, Jungeun; Yook, Ki-Hwan; Jon, Duk-In; Jung, Myung Hun; Hong, Narei; Hong, Hyun Ju
We examined predictors of suicide attempts in clinically depressed adolescents in Korea and gender differences in suicidal behavior. In total, 106 adolescents diagnosed with depressive disorder were recruited in South Korea. We assessed various variables that might affect suicide attempts, and used a structured interview for the diagnosis of depression and comorbidities and to evaluate suicidality. Demographic and clinical characteristics of the subjects were compared between suicide attempt and non-suicide attempt groups and we examined significant predictors of suicide attempts. Gender differences in suicidal ideation and suicidal behavior were also analyzed. Among 106 depressed participants, 50 (47.2%) adolescents were classified in the suicide attempt group. Generally, the suicide attempt and non-suicide attempt group shared similar clinical characteristics. The suicide attempt group had more females, more major depressive disorder diagnoses, more depressive episodes, and higher suicidal ideation than the non-suicide attempt group. Suicidal ideation was the only significant predictor of suicidal attempt, regardless of gender. Higher suicidal ideation frequency scores and more non-suicidal self-injurious behaviors were shown in the female suicide attempt group than the male suicide attempt group. It is recommended that suicidal ideation be assessed regularly and managed rigorously to decrease suicide risks in depressive adolescents. PMID:27776392
... participants' previous participation in government programs and ensure that the past record is acceptable prior... information is designed to be 100 percent automated and digital submission of all data and certifications is... government programs and ensure that the past record is acceptable prior to granting approval to participate...
Nysangaliev, A.N.; Kuspangaliev, T.K.
Tengiz petroleum deposit previous study is described. Some consideration about structure of productive formation, specific characteristic properties of petroleum-bearing collectors are presented. Recommendation on their detail study and using of experience on exploration and development of petroleum deposit which have analogy on most important geological and industrial parameters are given. (author)
Nijkamp, J. W.; Korteweg, F. J.; Holm, J. P.; Timmer, A.; Erwich, J. J. H. M.; van Pampus, M. G.
Objective: A history of foetal death is a risk factor for complications and foetal death in subsequent pregnancies as most previous risk factors remain present and an underlying cause of death may recur. The purpose of this study was to evaluate subsequent pregnancy outcome after foetal death and to
Zhang, Zhi-qun; Guo, Lan-ting
To study the prevalence and associated factors of suicide attempt in middle school students. Five middle schools in Chengdu were randomly sampled in the study. A total of 1393 students between the ages of 11 and 18 finished a self-administered questionnaire, Beck Depression Inventory (BDI), Adolescent Self-Rating Life Events Check List (ASLEC) and Egma Minnen av Bardodosnauppforstran (EMBU). Everyone who had suicide attempts was interviewed. Data were analysed by SPSS 8.0 (statistical package for the social science) program on computer. Thirty-six (2.6%) of the 1 393 students has the history of attempted suicide and the ratio of boys and girls was 1:2. Among the suicide attempters, 33.3% had recurrent events. The most common reason of suicide attempts in middle school stage was family conflicts (34.4%) with most common event as taking overdose tranquilizers or poisoning (50.0%). Risk factors of suicide attempt seemed to include hallucination, cigarette smoking, being bullied by peers, wanting to change sex, parents' remarriage, being female, father's refusal, being neglected in childhood and experiencing more events in the previous year. Protecting factor was found to have been family warmness. Suicide attempts were not uncommonly seen in middle school students. Clinicians and teaching staff should identify the risk factors and carry out intervention as early as possible.
Odlaug, Brian Lawrence; Grant, Jon E; Kim, Suck Won
Suicide attempts in kleptomania have received little investigation. This study examined rates, correlates, and predictors of suicide attempts in kleptomania. A total of 107 adolescent and adult subjects (n = 32 [29.9%] males) with DSM-IV kleptomania were assessed with standard measures of symptom...... severity, psychiatric comorbidity, and functional impairment. Subjects had high rates of suicide attempts (24.3%). The suicide attempt in 92.3% of those who attempted suicide was attributed specifically to kleptomania. Suicide attempts were associated with current and life-time bipolar disorder (p = .047......) and lifetime personality disorder (p = .049). Individuals with kleptomania have high rates of suicide attempts. Bipolar disorder is associated with suicide attempts in individuals with kleptomania and underscores the importance of carefully assessing and monitoring suicidality in patients with kleptomania....
Odlaug, Brian L; Grant, Jon E; Kim, Suck Won
Suicide attempts in kleptomania have received little investigation. This study examined rates, correlates, and predictors of suicide attempts in kleptomania. A total of 107 adolescent and adult subjects (n = 32 [29.9%] males) with DSM-IV kleptomania were assessed with standard measures of symptom severity, psychiatric comorbidity, and functional impairment. Subjects had high rates of suicide attempts (24.3%). The suicide attempt in 92.3% of those who attempted suicide was attributed specifically to kleptomania. Suicide attempts were associated with current and life-time bipolar disorder (p = .047) and lifetime personality disorder (p = .049). Individuals with kleptomania have high rates of suicide attempts. Bipolar disorder is associated with suicide attempts in individuals with kleptomania and underscores the importance of carefully assessing and monitoring suicidality in patients with kleptomania.
Lizardi, Dana; Thompson, Ronald G; Keyes, Katherine; Hasin, Deborah
Research suggests parental divorce during childhood increases risk of suicide attempt for male but not female offspring. The negative impact on offspring associated with parental divorce may be better explained by parental psychopathology, such as depression. We examined whether adult offspring of parental divorce experience elevated risk of suicide attempt, controlling for parental history of depression, and whether the risk varies by the gender of the offspring. Using the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the sample consists of respondents who experienced parental divorce (N = 4895). Multivariable regressions controlled for age, race/ethnicity, income, marital status, and parental history of depression. Females living with their fathers were significantly more likely to report lifetime suicide attempts than females living with their mothers, even after controlling for parental depression. Findings suggest that childhood/adolescent parental divorce may have a stronger impact on suicide attempt risk in female offspring than previously recognized.
Hajek, Peter; Tønnesen, Philip; Arteaga, Carmen
AIM: While older behavioural and pharmacological approaches to preventing relapse to smoking show little efficacy, a recent randomized trial of an extended course of varenicline reported positive results. In this secondary analysis, trial data were examined to see whether smokers who manage......, 44% of the 12-week abstainers were abstinent from the target quit date (TQD), while the rest stopped smoking later. We examined the relationship between quit pattern and the varenicline versus placebo difference in continuous abstinence rates at week 52 and contributions of baseline patient...... characteristics. RESULTS: With increasing delay in initial quitting, 12-month success rates declined. Participants who had their last cigarette at week 11 of open-label treatment had quit rates at 52 weeks of 5.7% compared with 54.9% in those who last smoked in week 1 [odds ratio (OR) 20.3 (6.3, 65.9); P
... to be effective in helping smokers quit. The mind and body practices discussed here are generally considered safe for healthy people when they’re performed appropriately. If you ...
Prochaska, Judith J; Pechmann, Cornelia; Kim, Romina; Leonhardt, James M
Widely popular, Twitter, a free social networking and micro-blogging service, offers potential for health promotion. This study examined the activity of Twitter quit smoking social network accounts. A cross-sectional analysis identified 153 activated Twitter quit smoking accounts dating back to 2007 and examined recent account activity for the month of August 2010. The accounts had a median of 155 followers and 82 total tweets per account; 49% of accounts had >100 tweets. Posted content was largely inconsistent with clinical guidelines; 48% linked to commercial sites for quitting smoking and 43% had tweets on e-cigarettes. In August 2010, 81 of the accounts (53%) were still active. Though popular for building quit smoking social networks, many of the Twitter accounts were no longer active, and tweet content was largely inconsistent with clinical guidelines. Future research is needed to examine the effectiveness of Twitter for supporting smoking cessation.
Athamneh, Liqa; Essien, E James; Sansgiry, Sujit S; Abughosh, Susan
In this study, we examined the effect of theory of planned behavior (TPB) constructs on the intention to quit water pipe smoking by using an observational, survey-based, cross-sectional study design with a convenient sample of Arab American adults in Houston, Texas. Multivariate logistic regression models were used to determine predictors of intention to quit water pipe smoking in the next year. A total of 340 participants completed the survey. Behavioral evaluation, normative beliefs, and motivation to comply were significant predictors of an intention to quit water pipe smoking adjusting for age, gender, income, marital status, and education. Interventions and strategies that include these constructs will assist water pipe smokers in quitting.
McInerney, Dennis M.; Korpershoek, Hanke; Wang, Hui; Morin, Alexandre J.S.
Little is known about the determinants of teachers' psychological wellbeing, job satisfaction, occupational self-concept and quitting intentions. In this paper, teachers' occupational attributes (i.e. professional and personal characteristics) were investigated as determinants. Henceforth, the
... may be used to smoking when drinking beer, wine, liquor, or mixed drinks, and you may associate ... Related Resources Harms of Cigarette Smoking and Health Benefits of Quitting Where To Get Help When You ...
Özer, Özlem; Şantaş, Fatih; Şantaş, Gülcan; Şahin, Deniz Say
This study examines the association of nurses' perception of their work environment and communication satisfaction with their intention to quit. The implementation part of the study was conducted with nurses working in a public hospital in the city of Burdur, Turkey. Data were collected in January 2017 from 175 participants and then assessed. The analysis showed that perceptions of the work environment and communication satisfaction taken together explain the total variance of the intention to quit. While participants' perceptions of the work environment become increasingly positive, their communication satisfaction increases and their intention to quit decreases. The findings of this study suggest that making improvements to the nursing work environment and nurses' communication satisfaction will decrease their intention to quit. © 2017 John Wiley & Sons Australia, Ltd.
Richter, Kimber P; Shergina, Elena; Grodie, Amanda; Massey, Justin K; Ellerbeck, Edward F; Applegate, Amanda; Faseru, Babalola
Although many states have expanded Medicaid coverage of cessation medications, utilization remains low. Anecdotal reports suggest that beneficiaries are at times denied coverage of cessation medications at the pharmacy counter. We conducted an observational community-wide case study of Medicaid beneficiary attempts to fill over-the-counter nicotine replacement therapy at pharmacies. We recruited tobacco-using beneficiaries from a Federally Qualified Health Center, whose providers wrote paper prescriptions for nicotine patches. Study staff escorted beneficiaries to all eligible pharmacies (n = 18) in a Midwestern community to observe fill attempts. Study staff recorded encounters via smartphone into a secure database on a university server. Seven of 18 pharmacies (39%) did not fill the prescription on the day of the attempt. Of these, 6 offered to order the patch for pick-up at a later date. All (4/4) chain pharmacies filled the prescription; 2/3 mass merchant pharmacies failed to fill. Combining successful same-day fills with offers to order for pick-up, 17/18 (94%) would ultimately have been able to obtain patches. This pilot study found that many beneficiaries left pharmacies without a prescription in hand. Successful same-day fills varied markedly by store type. For people with low incomes, transportation presents a major barrier for delayed pick-up. In addition, delays can fuel ambivalence toward quitting. Future research based on this pilot study might address whether patients who fail to secure a same-day prescription ever fill the prescription and, if not, the degree to which this barrier contributes to success or failure in quitting. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Peña, Juan B.; Kuhlberg, Jill A.; Zayas, Luis H.; Baumann, Ana A.; Gulbas, Lauren; Hausmann-Stabile, Carolina; Nolle, Allyson P.
This study examined the relationship between familism and family environment type as well as the relationship between family environment type and suicide attempts among Latina youth. Latina teen attempters (n=109) and non-attempters (n=107) were recruited from the NYC area. Latent class analysis revealed three family environment types: tight-knit; intermediate-knit; and loose-knit. Tight-knit families (high cohesion and low conflict) were significantly less likely to have teens that attempted...
Pokhrel, Pallav; Herzog, Thaddeus A.
Despite the lack of clarity regarding their safety and efficacy as smoking cessation aids, electronic or e-cigarettes are commonly used to quit smoking. Currently little is understood about why smokers may use e-cigarettes for help with smoking cessation compared to other, proven cessation aids. This study aimed to determine the reasons for wanting to quit cigarettes that are associated with the use of e-cigarettes for cessation help versus the use of conventional Nicotine Replacement Therapy...
Piñeiro, Bárbara; López-Durán, Ana; Del Río, Elena Fernández; Martínez, Úrsula; Brandon, Thomas H; Becoña, Elisardo
Although quitting motivation predicts smoking cessation, there have been inconsistent findings regarding motivation predicting long-term maintenance of abstinence. Moreover, most such research has been conducted in North America and the United Kingdom. The aim of this study was to examine motivation to quit as a predictor of smoking cessation and of abstinence maintenance in a Spanish sample. The sample comprised 286 Spanish smokers undergoing psychological treatment for smoking cessation. Motivation to quit was assessed pre-treatment and post-treatment with the Readiness to Quit Ladder. Abstinence post-treatment and at 6month follow-up was biochemically verified. Participants with higher levels of pre-treatment and post-treatment motivation were more likely to be abstinent at the end of the treatment (OR=1.36) and at 6month follow-up (OR=4.88). Among abstainers at the end of the treatment (61.9%), higher levels of motivation to quit post-treatment predicted maintaining abstinence at 6months (OR=2.83). Furthermore, participants who failed to quit smoking reported higher levels of motivation to quit post-treatment than they had pretreatment (pMotivation to quit smoking predicted short and long-term cessation, and also predicted long-term maintenance of abstinence. These results have implications for understanding motivational processes of smoking cessation in general, while extending research to Spanish smokers. They may also help in the design of cessation and relapse-prevention interventions. Specifically, the results suggest that motivational enhancement is important throughout the cessation and maintenance periods. Copyright © 2015 Elsevier Ltd. All rights reserved.
Martin, Rosemarie A.; Cassidy, Rachel; Murphy, Cara M.; Rohsenow, Damaris J.
For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n = 18...
Fordwood, Samantha R.; Asarnow, Joan R.; Huizar, Diana P.; Reise, Steven P.
Although depression is strongly associated with suicide attempts and suicide deaths, most depressed youth do not make an attempt, indicating the need to identify additional risk factors. We examined suicide attempts among 451 depressed primary care patients, 13 to 21 years of age. In bivariate analyses, youth classified as suicide attempters…
Suicide Attempt in a Recently Diagnosed HIV Positive Subject: Is Pre and Post Counseling Still Being Adequately Practiced? ... A case of attempted suicide in a recently diagnosed HIV positive subject without adequate counseling is reported. Subject ... Key Words: Suicide Attempt, HIV/AIDS, Pre and Post test Counseling.
Ali, Ayesha; Kaplan, Cameron M; Derefinko, Karen J; Klesges, Robert C
To provide a systematic review and cost-effectiveness analysis on smoking interventions targeting smokers not ready to quit, a population that makes up approximately 32% of current smokers. Twenty-two studies on pharmacological, behavioral, and combination smoking-cessation interventions targeting smokers not ready to quit (defined as those who reported they were not ready to quit at the time of the study) published between 2000 and 2017 were analyzed. The effectiveness (measured by the number needed to treat) and cost effectiveness (measured by costs per quit) of interventions were calculated. All data collection and analyses were performed in 2017. Smoking interventions targeting smokers not ready to quit can be as effective as similar interventions for smokers ready to quit; however, costs of intervening on this group may be higher for some intervention types. The most cost-effective interventions identified for this group were those using varenicline and those using behavioral interventions. Updating clinical recommendations to provide cessation interventions for this group is recommended. Further research on development of cost-effective treatments and effective strategies for recruitment and outreach for this group are needed. Additional studies may allow for more nuanced comparisons of treatment types among this group. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
Denholm, Rachel; Schüz, Joachim; Straif, Kurt; Stücker, Isabelle; Jöckel, Karl-Heinz; Brenner, Darren R.; De Matteis, Sara; Boffetta, Paolo; Guida, Florence; Brüske, Irene; Wichmann, Heinz-Erich; Landi, Maria Teresa; Caporaso, Neil; Siemiatycki, Jack; Ahrens, Wolfgang; Pohlabeln, Hermann; Zaridze, David; Field, John K.; McLaughlin, John; Demers, Paul; Szeszenia-Dabrowska, Neonila; Lissowska, Jolanta; Rudnai, Peter; Fabianova, Eleonora; Dumitru, Rodica Stanescu; Bencko, Vladimir; Foretova, Lenka; Janout, Vladimir; Kendzia, Benjamin; Peters, Susan; Behrens, Thomas; Vermeulen, Roel; Brüning, Thomas; Kromhout, Hans
Rationale: Previous respiratory diseases have been associated with increased risk of lung cancer. Respiratory conditions often co-occur and few studies have investigated multiple conditions simultaneously. Objectives: Investigate lung cancer risk associated with chronic bronchitis, emphysema, tuberculosis, pneumonia, and asthma. Methods: The SYNERGY project pooled information on previous respiratory diseases from 12,739 case subjects and 14,945 control subjects from 7 case–control studies conducted in Europe and Canada. Multivariate logistic regression models were used to investigate the relationship between individual diseases adjusting for co-occurring conditions, and patterns of respiratory disease diagnoses and lung cancer. Analyses were stratified by sex, and adjusted for age, center, ever-employed in a high-risk occupation, education, smoking status, cigarette pack-years, and time since quitting smoking. Measurements and Main Results: Chronic bronchitis and emphysema were positively associated with lung cancer, after accounting for other respiratory diseases and smoking (e.g., in men: odds ratio [OR], 1.33; 95% confidence interval [CI], 1.20–1.48 and OR, 1.50; 95% CI, 1.21–1.87, respectively). A positive relationship was observed between lung cancer and pneumonia diagnosed 2 years or less before lung cancer (OR, 3.31; 95% CI, 2.33–4.70 for men), but not longer. Co-occurrence of chronic bronchitis and emphysema and/or pneumonia had a stronger positive association with lung cancer than chronic bronchitis “only.” Asthma had an inverse association with lung cancer, the association being stronger with an asthma diagnosis 5 years or more before lung cancer compared with shorter. Conclusions: Findings from this large international case–control consortium indicate that after accounting for co-occurring respiratory diseases, chronic bronchitis and emphysema continue to have a positive association with lung cancer. PMID:25054566
Massen, Jorg J M; Szipl, Georgine; Spreafico, Michela; Bugnyar, Thomas
The competition for power in a complex social world is hypothesized to be a driving force in the evolution of intelligence. More specifically, power may be obtained not only by brute force but also by social strategies resembling human politics. Most empirical evidence comes from primate studies that report unprovoked aggression by dominants to maintain power by spreading fear and third-party interventions in conflicts. Coalitionary support has also been described in other animals and is often linked to social bonding. As coalitions can lead to a gain in power and fitness benefits, individuals may try to prevent coalitionary support or indirectly prevent others from forming social bonds that might lead to coalitions. Although there is some empirical evidence that coalitionary support can be manipulated, little is known about the indirect strategy. We show here that wild ravens (Corvus corax) regularly intervene in affiliative interactions of others even though such interventions are potentially risky and without immediate benefits. Moreover, the identities of both interveners and intervened pairs are not randomly distributed. Ravens with existing ties initiate most interventions, and ravens that are creating new ties are most likely to be the targets of interventions. These patterns are consistent with the idea that interventions function to prevent others from forming alliances and consequently becoming future competitors. We thus show previously undescribed social maneuvers in the struggle for power. These maneuvers are likely to be of importance in other social species as well. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.
Vanyukov, P M; Szanto, K; Hallquist, M N; Siegle, G J; Reynolds, C F; Forman, S D; Aizenstein, H J; Dombrovski, A Y
Alongside impulsive suicide attempts, clinicians encounter highly premeditated suicidal acts, particularly in older adults. We have previously found that in contrast to the more impulsive suicide attempters' inability to delay gratification, serious and highly planned suicide attempts were associated with greater willingness to wait for larger rewards. This study examined neural underpinnings of intertemporal preference in suicide attempters. We expected that impulsivity and suicide attempts, particularly poorly planned ones, would predict altered paralimbic subjective value representations. We also examined lateral prefrontal and paralimbic correlates of premeditation in suicidal behavior. A total of 48 participants aged 46-90 years underwent extensive clinical and cognitive characterization and completed the delay discounting task in the scanner: 26 individuals with major depression (13 with and 13 without history of suicide attempts) and 22 healthy controls. More impulsive individuals displayed greater activation in the precuneus/posterior cingulate cortex (PCC) to value difference favoring the delayed option. Suicide attempts, particularly better-planned ones, were associated with deactivation of the lateral prefrontal cortex (lPFC) in response to value difference favoring the immediate option. Findings were robust to medication exposure, depression severity and possible brain damage from suicide attempts, among other confounders. Finally, in suicide attempters longer reward delays were associated with diminished parahippocampal responses. Impulsivity was associated with an altered paralimbic (precuneus/PCC) encoding of value difference during intertemporal choice. By contrast, better-planned suicidal acts were associated with altered lPFC representations of value difference. The study provides preliminary evidence of impaired decision processes in both impulsive and premeditated suicidal behavior.
Hettige, Nuwan C; Nguyen, Thai Binh; Yuan, Chen; Rajakulendran, Thanara; Baddour, Jermeen; Bhagwat, Nikhil; Bani-Fatemi, Ali; Voineskos, Aristotle N; Mallar Chakravarty, M; De Luca, Vincenzo
Suicide is a major concern for those afflicted by schizophrenia. Identifying patients at the highest risk for future suicide attempts remains a complex problem for psychiatric interventions. Machine learning models allow for the integration of many risk factors in order to build an algorithm that predicts which patients are likely to attempt suicide. Currently it is unclear how to integrate previously identified risk factors into a clinically relevant predictive tool to estimate the probability of a patient with schizophrenia for attempting suicide. We conducted a cross-sectional assessment on a sample of 345 participants diagnosed with schizophrenia spectrum disorders. Suicide attempters and non-attempters were clearly identified using the Columbia Suicide Severity Rating Scale (C-SSRS) and the Beck Suicide Ideation Scale (BSS). We developed four classification algorithms using a regularized regression, random forest, elastic net and support vector machine models with sociocultural and clinical variables as features to train the models. All classification models performed similarly in identifying suicide attempters and non-attempters. Our regularized logistic regression model demonstrated an accuracy of 67% and an area under the curve (AUC) of 0.71, while the random forest model demonstrated 66% accuracy and an AUC of 0.67. Support vector classifier (SVC) model demonstrated an accuracy of 67% and an AUC of 0.70, and the elastic net model demonstrated and accuracy of 65% and an AUC of 0.71. Machine learning algorithms offer a relatively successful method for incorporating many clinical features to predict individuals at risk for future suicide attempts. Increased performance of these models using clinically relevant variables offers the potential to facilitate early treatment and intervention to prevent future suicide attempts. Copyright © 2017 Elsevier Inc. All rights reserved.
Kaminsky, Sarah; Chrisler, Joan C.
Depression and low self-esteem are commonly considered to be at the root of suicidal ideation. Previous research has examined the correlations between a lack of purpose in life and depression, low self-esteem, substance abuse and suicidal thoughts. This study investigated personality differences among student groups who have attempted suicide.…
Spreen, Otfried; Haaf, Robert G.
Test scores of two groups of learning disabled children (N=63 and N=96) were submitted to cluster analysis in an attempt to replicate previously described subtypes. All three subtypes (visuo-perceptual, linguistic, and articulo-graphomotor types) were identified along with minimally and severely impaired subtypes. Similar clusters in the same…
Dawson Anna P
Full Text Available Abstract Introduction Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. Methods We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff and 3 focus groups (n = 17 participants with key informants. Content analysis was performed on transcribed text and interview notes. Results Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy
Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark
Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal
Williams, Jessica H; DeLaughter, Kathryn; Volkman, Julie E; Sadasivam, Rajani S; Ray, Midge N; Gilbert, Gregg H; Houston, Thomas K
To describe the content of messages sent by smokers through asynchronous counseling within a Web-based smoking cessation intervention. Qualitative. National community-based setting of patients who had been engaged by the medical or dental practices at which they attended or via Google advertisements. Adults older than 19 years who were current smokers and interested in quitting. Participants throughout the United States referred to a Web-based cessation intervention by their medical or dental provider or by clicking on a Google advertisement. We conducted a qualitative review of 742 asynchronous counseling messages sent by 270 Web site users. Messages were reviewed, analyzed, and organized into qualitative themes by the investigative team. The asynchronous counseling feature of the intervention was used most frequently by smokers who were white (87%), female (67%), aged 45 to 54 (32%), and who had at least some college-level education (70%). Qualitative analysis yielded 7 basic themes-Talk about the Process of Quitting, Barriers to Quitting, Reasons to Quit, Quit History, Support and Strategies for Quitting, Quitting with Medication, and Quit Progress. The most common theme was Support and Strategies for Quitting with 255 references among all messages. We found rich communication across the spectrum of the quit process, from persons preparing to quit to those who had successfully quit. Asynchronous smoking cessation counseling provides a promising means of social support for smokers during the quit process.
Mannocci, Alice; Antici, Daniele; Boccia, Antonio; La Torre, Giuseppe
) reduced the number cigarettes per day, and 5% (12 smokers) attempted to quit. Forty-five percent of smokers did not know the real impact of light cigarettes on their health, and 49% decided to smoke light cigarettes after having read the warnings. Women were more susceptible to immediate consequences of smoking (appearance of wrinkles; p<0.001), and were more prone to switch to light cigarettes (p=0.002). Smoking dependence, computed with Fagerstrom's test, showed significant differences by age groups (higher in smokers aged 30-45 years; p=0.001), and in smokers who were not interested to deepen knowledge of smoking effects (p=0.009). Individuals more motivated to quit were younger smokers (p=0.012). Smokers aged ≥ 45 years (OR=2.54; 95%CI 1.05-6.17), more motivated to quit (OR=2.92; 95%CI 1.17-7.30), those who reported they do not like the smoking smell on their own clothes (OR=3.6; 95%CI 1.4-9.0), those who reported warning messages are important (OR=4.93; 95%CI 1.55-15.71), those who changed their own smoking behavior due the warnings (OR=3.31; 95%CI 1.10-9.99) were more likely to reduce daily number of cigarettes due the health warnings. Forty-seven percent thought that health warnings with text and images could have a higher impact in comparison to text-only warnings. Moreover, women were more motivated to change cigarette brand if a brand should introduce pictorial warnings (OR=2.54; 95%CI 1.41-4.56). our study showed some positive effects of the introduction of health warnings on cigarette packages. In fact, almost all were informed on tobacco effects, 14% of them reduced the amount of daily smoking, and 5% attempted to quit. Many smokers still believe that switching to lighter cigarettes (e.g. those with less nicotine and tar contents) reduces smoking-related diseases. More than 50% of smokers recognized the importance of health warnings in communicating health risks of smoking, while women were more impressed than men by shocking pictorial warnings.
Borgan, Saif M; Marhoon, Zaid A; Whitford, David L
There is a rising prevalence of waterpipe smoking worldwide, but still a paucity of information on perceptions toward quitting waterpipe use. We set out to establish the beliefs and perceptions of café waterpipe smokers toward quitting waterpipe smoking in the Kingdom of Bahrain. A cross-sectional study. A random sample of 20 of 91 cafés serving waterpipe tobacco in Bahrain was taken. A questionnaire was administered in each café to 20 participants aged 18 and above. Three hundred eighty participants completed questionnaires from waterpipe smokers. Eighty-four percent of participants were Bahraini and 71% had a university degree. Mean age was 28.9 years. Average age of waterpipe smoking initiation was 20.3 years. The majority of waterpipe users chose flavored tobacco. Sixty-one percent smoked waterpipe tobacco daily with a mean smoking time of 2.6hr/day. Seventy-two percent considered waterpipe tobacco as harmful as or more harmful than cigarettes, but 67% considered cigarettes as more addictive. Eighty-two percent stated that they could quit waterpipe at any time, but only 40% were interested in quitting. Interest in quitting smoking was related to 4 variables: a physician mentioning the need to quit smoking, being non-Bahraini, having a family with a hostile attitude toward waterpipe smoking, and not considering oneself "hooked" on waterpipe tobacco. Waterpipe smokers in Bahrain cafés are frequent and high users. Health professionals must consider waterpipe smoking in all consultations and health promotion messages. A partnership between health professionals and disapproving members of families may be an effective strategy in encouraging waterpipe smokers to quit.
May, Alexis M; Klonsky, E David
Suicide attempts are often regarded as impulsive acts. However, there is little consensus regarding the definition or clinical characteristics of an "impulsive" attempt. To clarify this issue, we examined 3 indicators of the impulsivity of an attempt: (a) preparation, (b) time contemplating the attempt, and (c) self-report that impulsivity motivated the attempt. We examined relationships among the indicators and their relationship to trait impulsivity and characteristics of the suicide attempt. Adult participants (N = 205) with a history of suicide attempts were administered validated interviews and questionnaires. In general, the 3 attempt impulsivity indicators correlated only moderately with each other and not at all with trait impulsivity or with important characteristics of the attempt (e.g., lethality, preattempt communication, motivations). However, there were 2 exceptions. First, intent to die was inversely related to the 3 attempt impulsivity indicators (rs ranged from -.17 to .45) such that more impulsive attempts were associated with lower intent. Second, self-report that the attempt was motivated by impulsivity was related to 3 facets of trait impulsivity (rs ranged from .16 to .41). These findings suggest that individuals endorsing trait impulsivity are likely to describe their attempts as motivated by impulsivity, regardless of the presence of preparation or prolonged contemplation. Overall, study results suggest that the common conception of a unidimensional impulsive attempt may be inaccurate and that the emphasis on general impulsivity in prevention guidelines should be tempered. Implications for suicide risk assessment and prevention are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Gysin-Maillart, Anja; Schwab, Simon; Soravia, Leila; Megert, Millie; Michel, Konrad
Editors' Summary Background Suicide is a serious public health problem. Over 800,000 people worldwide die by suicide every year. In the US, one suicide death occurs approximately every 12 minutes. While the causes of suicide are complex, the goals of suicide prevention are simple?reduce factors that increase risk, and increase factors that promote resilience or coping. Factors that increase suicide risk include family history of suicide, family history of child abuse, previous suicide attempt...
Dunne, Jacklyn; Kimergård, Andreas; Brown, Jamie; Beard, Emma; Buykx, Penny; Michie, Susan; Drummond, Colin
To compare the proportion of people in England with probable alcohol dependence [Alcohol Use Disorders Identification Test (AUDIT) score ≥ 20] with those with other drinking patterns (categorized by AUDIT scores) in terms of motivation to reduce drinking and use of alcohol support resources. A combination of random probability and simple quota sampling to conduct monthly cross-sectional household computer-assisted interviews between March 2014 and August 2017. The general population in all nine regions of England. Participants in the Alcohol Toolkit Study (ATS), a monthly household survey of alcohol consumption among people aged 16 years and over in England (n = 69 826). The mean age was 47 years [standard deviation (SD) = 18.78; 95% confidence interval (CI) = 46.8-47] and 51% (n = 35 560) were female. χ 2 tests were used to investigate associations with demographic variables, motivation to quit drinking, attempts to quit drinking, general practitioner (GP) engagement and types of support accessed in the last 12 months across AUDIT risk zones. A total of 0.6% were classified as people with probable alcohol dependence (95% CI = 0.5-0.7). Motivation to quit (χ 2 = 1692.27, P AUDIT risk zone. People with probable dependence were more likely than other ATS participants to have a past-year attempt to cut down or quit (51.8%) and have received a specialist referral from their GP about drinking (13.7%), and less likely to report no motivation to reduce their drinking (26.2%). Those with probable dependence had higher use of self-help books and mobile applications (apps) than other ATS participants; however, 27.7% did not access any resources during their most recent attempt to cut down. Adults in England with probable alcohol dependence, measured through the Alcohol Use Disorders Identification Test, demonstrate higher motivation to quit drinking and greater use of both specialist treatment and self-driven support compared with those in other
.001. ASSIP participants spent 72% fewer days in the hospital during follow-up (ASSIP: 29 d; control group: 105 d; W = 94.5, p = 0.038. Higher scores of patient-rated therapeutic alliance in the ASSIP group were associated with a lower rate of repeat suicide attempts. Prior suicide attempts, depression, and a diagnosis of personality disorder at baseline did not significantly affect outcome. Participants with a diagnosis of borderline personality disorder (n = 20 had more previous suicide attempts and a higher number of reattempts. Key study limitations were missing data and dropout rates. Although both were generally low, they increased during follow-up. At 24 months, the group difference in dropout rate was significant: ASSIP, 7% (n = 4; control, 22% (n = 13. A further limitation is that we do not have detailed information of the co-active follow-up treatment apart from participant self-reports every 6 months on the setting and the duration of the co-active treatment.ASSIP, a manual-based brief therapy for patients who have recently attempted suicide, administered in addition to the usual clinical treatment, was efficacious in reducing suicidal behavior in a real-world clinical setting. ASSIP fulfills the need for an easy-to-administer low-cost intervention. Large pragmatic trials will be needed to conclusively establish the efficacy of ASSIP and replicate our findings in other clinical settings.ClinicalTrials.gov NCT02505373.
Bentley, R Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios
For the 20(th) century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade.
Bentley, R. Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios
For the 20th century since the Depression, we find a strong correlation between a ‘literary misery index’ derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade. PMID:24416159
Gao, Keming; Tolliver, Bryan K; Kemp, David E; Ganocy, Stephen J; Bilali, Sarah; Brady, Kathleen L; Findling, Robert L; Calabrese, Joseph R
A rapid-cycling course in bipolar disorder has previously been identified as a risk factor for attempted suicide. This study investigated factors associated with suicide attempts in patients with rapid-cycling bipolar I or II disorder. Cross-sectional data at the initial assessment of patients who were enrolled into 4 clinical trials were used to study the factors associated with suicide attempt. An extensive clinical interview and the Mini-International Neuropsychiatric Interview were used to ascertain DSM-IV diagnoses of rapid-cycling bipolar disorder, substance use disorders, anxiety disorders, psychosis, and other clinical variables. Chi-square, t test, and logistic regression or Poisson regression were used to analyze the data where appropriate, with odds ratios (ORs) for relative risk estimate. The data were collected from September 1995 to June 2005. In a univariate analysis, 41% of 561 patients had at least 1 lifetime suicide attempt. Earlier age of depression onset, bipolar I subtype, female sex, unmarried status, and a history of drug use disorder, panic disorder, sexual abuse, and psychosis were associated with significantly higher rates of attempted suicide (all p drug abuse (OR = 1.62, p = .0317) were independent predictors for increased risk of attempted suicide. However, white race was associated with a lower risk for suicide attempt (OR = 0.47, p = .0160). Psychosis during depression (p = .0003), bipolar I subtype (p = .0302), and physical abuse (p = .0195) were associated with increased numbers of suicide attempts by 248%, 166%, and 162%, respectively; white race was associated with a 60% decrease in the number of suicide attempts (p = .0320). In this highly comorbid group of patients with rapid-cycling bipolar disorder, 41% had at least 1 suicide attempt. Among the demographics, female sex was positively associated, but white race was negatively associated, with the risk for suicide attempt. Independent clinical variables for increased risk and
Behn, V; Sotomayor, H; Cruz, M; Naveas, R
In Chile, 10% of deaths in adults are directly attributed to smoking. To identify intrinsic and extrinsic motivations to quit smoking among a group of subjects that quitted without external help. The motivations to quit smoking were measured using the 20 items Reasons for Quitting Scale (RFQ), in 145 ex smokers (80 students and 65 workers at The University of Conception). The scale identifies intrinsic motivations in the categories health and self control and extrinsic motivations in the categories immediate reinforcement and social pressure. Factorial analysis with orthogonal rotation of the 20 items of the scale, suggested an optimal solution with five factors, that had a maximal impact of 0.43 and explained the motivations in up to a 66% of workers and 65% of students. The factors with the greater impact were the items of immediate reinforcement, social pressure and self control. The category health had only a 6% influence in the modification of smoking habits. The most important motivations to quit smoking in this sample were an immediate reinforcement, social pressure and self control. The analysis of motivations will help to orient smoking cessation programs.
Hamid Tavakoli Ghouchani
Full Text Available Background and Objectives: The world population has reached over seven billion people. Of these, 230 million individuals abuse substances. Therefore, substance abuse prevention and treatment programs have received increasing attention during the past two decades. Understanding people’s motivations for quitting drug abuse is essential to the success of treatment. This study hence sought to identify major motivations for quitting and to compare them with the constructs of health education models. Materials and Methods: In the present study, qualitative content analysis was used to determine the main motivations for quitting substance abuse. Overall, 22 patients, physicians, and psychotherapists were selected from several addiction treatment clinics in Bojnord (Iran during 2014. Purposeful sampling method was applied and continued until data saturation was achieved. Data were collected through semi-structured, face-to-face interviews and field notes. All interviews were recorded and transcribed. Results: Content analysis revealed 33 sub-categories and nine categories including economic problems, drug-related concerns, individual problems, family and social problems, family expectations, attention to social status, beliefs about drug addiction, and valuing the quitting behavior. Accordingly, four themes, i.e. perceived threat, perceived barriers, attitude toward the behavior, and subjective norms, were extracted. Conclusion: Reasons for quitting substance abuse match the constructs of different behavioral models (e.g. the health belief model and the theory of planned behavior.
Williams, Rebecca J; Herzog, Thaddeus A; Simmons, Vani N
The Health Action Process Approach (HAPA) posits a distinction between pre-intentional motivation processes and a post-intentional volition process that leads to the actual behavior change. For smoking cessation, the HAPA predicts that increased risk perceptions would foster a decision to quit smoking. From a cross-sectional perspective, the HAPA predicts that those who do not intend to quit (non-intenders) should have lower risk perceptions than those who do intend to quit (intenders). Adult smokers participated in a cross-sectional survey. Multiple measures of motivation to quit smoking and risk perceptions for smoking were assessed. ANOVA and contrast analysis were employed for data analysis. The results were generally supportive of the HAPA. Non-intenders had systematically lower risk perceptions compared to intenders. Most of these findings were statistically significant. The results demonstrated that risk perceptions distinguish non-intenders from intenders. These results suggest that smokers low in motivation to quit could benefit from information and reminders about the serious health problems caused by smoking. Copyright © 2011 Elsevier Ltd. All rights reserved.
Lopez-Castroman, Jorge; Perez-Rodriguez, Maria de las Mercedes; Jaussent, Isabelle; Alegria, Analucia A; Artes-Rodriguez, Antonio; Freed, Peter; Guillaume, Sébastien; Jollant, Fabrice; Leiva-Murillo, Jose Miguel; Malafosse, Alain; Oquendo, Maria A; de Prado-Cumplido, Mario; Saiz-Ruiz, Jeronimo; Baca-Garcia, Enrique; Courtet, Philippe
In spite of the high prevalence of suicide behaviours and the magnitude of the resultant burden, little is known about why individuals reattempt. We aim to investigate the relationships between clinical risk factors and the repetition of suicidal attempts. 1349 suicide attempters were consecutively recruited in the Emergency Room (ER) of two academic hospitals in France and Spain. Patients were extensively assessed and demographic and clinical data obtained. Data mining was used to determine the minimal number of variables that blinded the rest in relation to the number of suicide attempts. Using this set, a probabilistic graph ranking relationships with the target variable was constructed. The most common diagnoses among suicide attempters were affective disorders, followed by anxiety disorders. Risk of frequent suicide attempt was highest among middle-aged subjects, and diminished progressively with advancing age of onset at first attempt. Anxiety disorders significantly increased the risk of presenting frequent suicide attempts. Pathway analysis also indicated that frequent suicide attempts were linked to greater odds for alcohol and substance abuse disorders and more intensive treatment. Novel statistical methods found several clinical features that were associated with a history of frequent suicide attempts. The identified pathways may promote new hypothesis-driven studies of suicide attempts and preventive strategies. Copyright © 2010 Elsevier Ltd. All rights reserved.
McGrady, Angele; Lynch, Denis; Rapport, Daniel
Suicidal attempts occur more frequently in patients with bipolar disorder compared to other mood disorders. The goal of this study is to identify psychosocial factors and comorbidity associated with this serious and life-threatening behavior. Subjects were 121 patients evaluated and treated at a university outpatient psychiatric clinic. The patients' charts were examined to determine history of suicide attempts, demographic and psychosocial variables, and comorbid symptoms. Forty-one percent of the subjects had attempted suicide. Patients who were younger at onset of illness (p = 0.02) and those who had been abused (p = 0.003) were more likely to attempt suicide. Suicide attempts were also more common in subjects with a history of alcohol abuse (p = 0.003) and those with psychotic symptoms (p = 0.02). Based on the results of this study, it is recommended that increased emphasis be placed on the psychosocial history and comorbid symptoms in patients with bipolar disorder. While asking about previous suicide attempts is the most accurate way to predict suicidal behavior, age of onset, past abuse, and overuse of alcohol may also be helpful. Since suicidal behavior in patients with bipolar disorder is relatively common, intensified efforts to predict this behavior may be life-saving. © 2017 S. Karger AG, Basel.
Daray, Federico M; Rojas, Sasha M; Bridges, Ana J; Badour, Christal L; Grendas, Leandro; Rodante, Demián; Puppo, Soledad; Rebok, Federico
Child sexual abuse (CSA) is a causal agent in many negative adulthood outcomes, including the risk for life-threatening behaviors such as suicide ideation and suicide attempts. Traumatic events such as CSA may pose risk in the healthy development of cognitive and emotional functioning during childhood. In fact, high impulsivity, a risk factor for suicidal behavior, is characteristic of CSA victims. The current study aims to understand the relations among CSA, impulsivity, and frequency of lifetime suicide attempts among a female patient sample admitted for suicidal behavior. Participants included 177 female patients between the ages of 18 and 63 years admitted at two hospitals in Buenos Aires, Argentina. Number of previous suicide attempts and CSA were assessed via structured interviews, while impulsivity was assessed with the Barratt Impulsiveness Scale (BIS-11). A model of structural equations was employed to evaluate the role of impulsivity in the relation between CSA and suicide attempts. CSA (β=.18, pimpulsivity (β=.24, psuicide attempts. However, impulsivity was not significantly associated with CSA (β=.09, p>.05). CSA and impulsivity are independently associated with lifetime suicide attempts among female patients with recent suicidal behavior. Copyright © 2016 Elsevier Ltd. All rights reserved.
Despite of a relatively low budget, Stoptober reached its targeted population. Stoptober is effective in changing people´s attitude towards quitting positively and supporting smokers to quit for 28 days.
Full Text Available Shaul Lev,1 David Snyder,2 Carmil Azran,3 Victor Zolotarsky,1 Arik Dahan4 1Intensive Care Unit, Rabin Medical Center, Petah-Tikva, 2Sackler School of Medicine NY/American Program, Tel-Aviv University, Tel Aviv, 3Clinical Pharmacy, Herzliya Medical Center, Herzliya, 4Department of Clinical Pharmacology, School of Pharmacy, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Abstract: Colchicine overdose is uncommon but potentially life threatening. Due to its serious adverse systemic effects, overdose must be recognized and treated. We report a case of an 18-year-old female who ingested 18 mg (~0.4 mg/kg of colchicine in a suicide attempt. The patient’s clinical manifestations included abdominal cramps, vomiting, pancytopenia, hypocholesterolemia, and rhabdomyolysis. Two unique manifestations of toxicity in this patient were profound and persistent, severe hypertriglyceridemia and electrolyte imbalance, mainly hypophosphatemia, with no other evident cause except the colchicine intoxication. Following intensive supportive treatment, including ventilator support, N-acetylcysteine, granulocyte colony stimulating factor, electrolyte repletion, and zinc supplementation, the patient made a complete recovery. Colchicine intoxication is a severe, life-threatening situation that should be followed closely in intensive care units. Severe changes in body functions can rapidly develop, as previously described in the literature. To our knowledge, this extremely elevated triglyceride level has never been reported without the administration of propofol, and requires further evaluation. Keywords: colchicine, intoxication, hypophosphatemia, hypertriglyceridemia
Brandt, Caroline Lyng; Dalum, Peter; Skov-Ettrup, Lise
Background: A growing body of literature demonstrates internet-based smoking cessation interventions as a promising aid in helping people quit smoking. However, the underlying mechanisms of how these interventions influence the cessation process are still relatively unknown. Several studies have...... indicated blogging as a potential source in providing social support to users of internet-based smoking cessation interventions and thereby enhance their change of succeeding in quitting. Objective: The study aimed to investigate themes discussed on a blog in an internet-based smoking cessation intervention....... Conclusions: The blog offers a unique platform for informal conversations about quitting smoking and is important in providing social support to people in a smoking cessation process....
Pingree, Suzanne; Boberg, Eric; Patten, Christi; Offord, Kenneth; Gaie, Martha; Schensky, Ann; Gustafson, David H; Dornelas, Ellen; Ahluwalia, Jasjit
This study compared the survey responses of 280 current and former adolescent smokers for what they perceived would be helpful (or what had helped) in quitting smoking. The survey was developed from focus groups and was structured using Prochaska and DiClementes Stages of Change health behavior framework. Results showed that former smokers and current smokers in the preparation stage of change shared beliefs about the importance of interpersonal support, those who were contemplating a quit decision worried about obstacles and internal issues, and current smokers not thinking about quitting focused on external rewards. The findings that significant differences exist based on the adolescent smokers Stage of Change imply that this framework can be appropriately applied to this context.
Salih Cihat Paltun
Full Text Available Abstract Background: Only 29% of cannabis dependent individuals seek treatment, yet significant decreases in cannabis use are seen in 31-36% of individuals that seek treatment. Follow-up studies have found that over 60% in substance use disorders end in relapse, leading to potentially chronic and relapsing cases. New and effective therapies should be researched in order to increase the success of relapse prevention treatments. Objective: In this study we aimed to evaluate the relationship between trait mindfulness level, substance dependence severity and quitting cannabis use. Methods: A hundred and sixty four patients, diagnosed with cannabis dependence, were involved in the study; socidemographic datas were recorded and Addiction Profile Index (API, Mindfuness Attention and Awareness Scale (MAAS were carried out. Results: We found that the trait mindfulness level is significantly related with quitting cannabis use. Discussion: Trait mindfulness may be an important determining factor of the ability to quit substance use and achieve remission.
Paget, L-M; Chan Chee, C; Sauvage, C; Saboni, L; Beltzer, N; Velter, A
Since the 1990s, several studies have found higher rates of suicide attempts in homosexuals and bisexuals than in heterosexuals. The current challenge is to identify risk factors for targeting prevention. The aim of this paper was to determine, for the first time in France, the prevalence of suicide attempts over a 12-month period and associated factors in a population of men and women who self-identified as homosexuals or bisexuals. A convenience sample cross-sectional survey was conducted in 2011 using an anonymous self-administered questionnaire made available in the gay press, and Internet sites targeting the gay or lesbian community. Among the persons completing the questionnaire, 10,100 men and 2963 women residing in France answered the questions on suicide attempts. The factors associated with suicide attempts during the previous 12 months were identified by logistic regression. Lifetime prevalence for suicide attempts was 16% in men and 18% in women; 12-month prevalence was 1.6% in men and 1.9% in women. Factors independently associated with suicide attempts in the past 12 months in men and women were lack of occupational activity, victim of sexual abuse, termination of a long-term relationship, excessive alcohol consumption in the past 12 months, depression, and in addition, in men, living in a small locality, victim of verbal or physical aggression and use of anxiolytics. According to our results, the fight against homophobia is an important element for the prevention of suicide attempts among homosexual and bisexual men. Indeed, in addition to traditional risk factors for suicide attempt, a significant association was also found with homophobic aggression in the past year. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Full Text Available Lifetime suicide attempts in patients with comorbidity between psychotic disorders and Substance Use Disorder (SUD, known as dual diagnosis, was associated with a worse clinical and cognitive state, poor prognosis and premature death. However, to date no previous study has examined the cognitive performance of these patients considering as independent the presence or absence of lifetime suicide attempts.We explore executive functioning differences between suicide attempters and non-attempters in dual schizophrenia (DS patients and the possible related factors for both executive performance and current suicide risk. Fifty DS male patients in remission of SUD and clinically stables, 24 with and 26 without lifetime suicide attempts, were evaluated. We considered Z scores for all neuropsychological tests and a composite summary score for both premorbid IQ and executive functioning.DS patients showed low performance in set-shifting, planning and problem solving tasks. Those with suicide attempts presented lower composite summary scores, together with worse problem solving skills and decision-making, compared with non-attempters. However, after controlling for alcohol dependence, only differences in decision-making remained. Executive functioning was related to the premorbid intelligence quotient, and several clinical variables (duration, severity, months of abstinence and relapses of SUD, global functioning and negative symptoms. A relationship between current suicide risk, and first-degree relatives with SUD, insight and positive symptoms was also found.Our results suggest that problem solving and, especially, decision-making tasks might be sensitive to cognitive impairment of DS patients related to presence of lifetime suicide attempts. The assessment of these executive functions and cognitive remediation therapy when necessary could be beneficial for the effectiveness of treatment in patients with DS. However, further research is needed to expand
Okan Ibiloglu A
Full Text Available Aslihan Okan Ibiloglu, Abdullah Atli, Suleyman Demir, Mehmet Gunes, Mehmet Cemal Kaya, Mahmut Bulut, Aytekin Sir Department of Psychiatry, Faculty of Medicine, Dicle University, Diyarbakir, Turkey Background: Suicide is an important health problem in Turkey as it is in all regions of the world. Suicidal behavior has multiple causes, which are broadly divided into those related to proximal stressors and those due to predisposition. Suicide statistics may be associated with mental health disorders, which are among the foremost predictors of suicide attempts. More than 90% of patients who commit suicide have a diagnosable psychiatric disorder, usually a major depressive disorder. Other major risk factors for suicide attempts are history of suicide attempts in the family, stressful life events, sleep disturbances, poor income, unemployment, severity of symptoms of depression, and anxiety. Sleep is a complex phenomenon. Sleep disturbances can therefore be contributed to the emergence of suicidal behavior allowing for the possibility of predicting future suicides. Methods: We evaluated 106 patients who were admitted after suicide attempts to the Department of Psychiatry at Dicle University Faculty of Medicine. The recruited subjects were assessed by Structured Clinical Interview for DSM-IV Axis I disorders, and the intensity of symptoms was evaluated using the Beck Anxiety Inventory, Hamilton Depression Rating Scale, and Pittsburgh Sleep Quality Index. The mean values of the subjects attempting multiple and single suicides were compared using appropriate inferential statistical tests. Results: Most suicide attempts are believed to be preventable. Our results revealed that a great variety of risk factors are associated with an increased risk for multiple suicide attempts. Most of these attempts appeared to be spontaneous and impulsive rather than planned. In particular, this study highlights the importance of previous suicide attempts, history of
Christiansen, Erik; Agerbo, Esben; Bilenberg, Niels
BACKGROUND: SSRIs are widely used in the treatment of mental illness for both children and adults. Studies have found a slightly increased risk of suicidal thoughts and suicide attempts in young people using SSRIs but SSRIs' impact on risk for suicides in youth is not well-established. AIM......: Is there indication that SSRIs might raise risk for suicide attempts in young people? METHODS: We used an observational register-based historical cohort design, a large cohort of all Danish individuals born in 1983-1989 (n = 392,458) and a propensity score approach to analyse the impact from SSRIs on risk for suicide...... attempts. Every suicide attempt and redeemed prescription of SSRIs was analysed by Cox regression. RESULTS: We found a significant overlap between redeeming a prescription on SSRIs and subsequent suicide attempt. The risk for suicide attempt was highest in the first 3 months after redeeming the first...
The aim of this paper is to review the literature on suicide attempts in Malaysia. PsycINFO, PubMed, and Medline databases from 1845 to 2012 and detailed manual search of local official reports from the Ministry of Health and the Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training were included in the current review. A total of 38 studies on suicide attempts in Malaysia were found and reviewed. Twenty-seven (76%) of the studies on suicide attempts were descriptive studies looking at sociodemographic data, psychiatric illnesses, and methods and reasons for suicide attempts. No study has been conducted on treatment and interventions for suicide attempts and the impact of culture was rarely considered. The review showed that in order for researchers, clinicians, and public health policy makers to obtain a better understanding of suicide attempts in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used. PMID:24672358
Sinniah, Aishvarya; Maniam, T; Oei, Tian Po; Subramaniam, Ponnusamy
The aim of this paper is to review the literature on suicide attempts in Malaysia. PsycINFO, PubMed, and Medline databases from 1845 to 2012 and detailed manual search of local official reports from the Ministry of Health and the Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training were included in the current review. A total of 38 studies on suicide attempts in Malaysia were found and reviewed. Twenty-seven (76%) of the studies on suicide attempts were descriptive studies looking at sociodemographic data, psychiatric illnesses, and methods and reasons for suicide attempts. No study has been conducted on treatment and interventions for suicide attempts and the impact of culture was rarely considered. The review showed that in order for researchers, clinicians, and public health policy makers to obtain a better understanding of suicide attempts in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.
Petersen, Liselotte; Sørensen, Thorkild I A; Andersen, Per Kragh
OBJECTIVES: Genetic factors have been found to influence the risk of suicide. It is less clear if this also applies to attempted suicide. We have investigated genetic and familial environmental factors by studying the occurrence of suicide attempts in biological and adoptive siblings of adoptees...... who attempted suicide compared to siblings of adoptees with no suicide attempts. METHOD: We used a random sample of 1933 adoptees from the Danish Adoption Register, a register of non-familial adoptions of Danish children, i.e. the adoptive parents are biologically unrelated to the adoptee. Analyses...... admission of siblings the increased rate was statistically significant (IRR=3.88; 95% CI-1.42-10.6). LIMITATIONS: Information on attempted suicide and psychiatric history was limited to that which involved hospitalisation. CONCLUSIONS: Genetic factors influence risk of suicide attempts....
Full Text Available The aim of this paper is to review the literature on suicide attempts in Malaysia. PsycINFO, PubMed, and Medline databases from 1845 to 2012 and detailed manual search of local official reports from the Ministry of Health and the Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training were included in the current review. A total of 38 studies on suicide attempts in Malaysia were found and reviewed. Twenty-seven (76% of the studies on suicide attempts were descriptive studies looking at sociodemographic data, psychiatric illnesses, and methods and reasons for suicide attempts. No study has been conducted on treatment and interventions for suicide attempts and the impact of culture was rarely considered. The review showed that in order for researchers, clinicians, and public health policy makers to obtain a better understanding of suicide attempts in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.
Lee, Peter N; Fry, John S; Hamling, Jan S
No previous review has formally modelled the decline in IHD risk following quitting smoking. From PubMed searches and other sources we identified 15 prospective and eight case-control studies that compared IHD risk in current smokers, never smokers, and quitters by time period of quit, some studies providing separate blocks of results by sex, age or amount smoked. For each of 41 independent blocks, we estimated, using the negative exponential model, the time, H, when the excess risk reduced to half that caused by smoking. Goodness-of-fit to the model was adequate for 35 blocks, others showing a non-monotonic pattern of decline following quitting, with a variable pattern of misfit. After omitting one block with a current smoker RR 1.0, the combined H estimate was 4.40 (95% CI 3.26-5.95) years. There was considerable heterogeneity, H being 10years for 12. H increased (p<0.001) with mean age at study start, but not clearly with other factors. Sensitivity analyses allowing for reverse causation, or varying assumed midpoint times for the final open-ended quitting period little affected goodness-of-fit of the combined estimate. The US Surgeon-General's view that excess risk approximately halves after a year's abstinence seems over-optimistic. Copyright © 2012 Elsevier Inc. All rights reserved.
Naqui, SZH; Lovell, SJ; Lovell, ME
INTRODUCTION We noted a report that more significant symptoms may be expressed after second whiplash injuries by a suggested cumulative effect, including degeneration. We wondered if patients were underestimating the severity of their earlier injury. PATIENTS AND METHODS We studied recent medicolegal reports, to assess subjects with a second whiplash injury. They had been asked whether their earlier injury was worse, the same or lesser in severity. RESULTS From the study cohort, 101 patients (87%) felt that they had fully recovered from their first injury and 15 (13%) had not. Seventy-six subjects considered their first injury of lesser severity, 24 worse and 16 the same. Of the 24 that felt the violence of their first accident was worse, only 8 had worse symptoms, and 16 felt their symptoms were mainly the same or less than their symptoms from their second injury. Statistical analysis of the data revealed that the proportion of those claiming a difference who said the previous injury was lesser was 76% (95% CI 66–84%). The observed proportion with a lesser injury was considerably higher than the 50% anticipated. CONCLUSIONS We feel that subjects may underestimate the severity of an earlier injury and associated symptoms. Reasons for this may include secondary gain rather than any proposed cumulative effect. PMID:18201501
Napierała, Marta; Kulza, Maksymilian; Wachowiak, Anna; Jabłecka, Katarzyna; Florek, Ewa
Currently very popular in the market of tobacco products have gained electronic cigarettes (ang. E-cigarettes). These products are considered to be potentially less harmful in compared to traditional tobacco products. However, current reports indicate that the statements of the producers regarding to the composition of the e- liquids not always are sufficient, and consumers often do not have reliable information on the quality of the product used by them. This paper contain a review of previous reports on the composition of e-cigarettes and their impact on health. Most of the observed health effects was related to symptoms of the respiratory tract, mouth, throat, neurological complications and sensory organs. Particularly hazardous effects of the e-cigarettes were: pneumonia, congestive heart failure, confusion, convulsions, hypotension, aspiration pneumonia, face second-degree burns, blindness, chest pain and rapid heartbeat. In the literature there is no information relating to passive exposure by the aerosols released during e-cigarette smoking. Furthermore, the information regarding to the use of these products in the long term are not also available.
McClure, Jennifer B; Greene, Sarah M; Wiese, Cheryl; Johnson, Karin E; Alexander, Gwen; Strecher, Victor
The Internet is a promising venue for delivering smoking cessation treatment, either as a stand-alone program or as an adjunct to pharmacotherapy. However, there is little data to indicate what percent of smokers are interested in receiving online smoking cessation services or how best to recruit smokers to Internet-based programs. Using a defined recruitment sample, this study aimed to identify the percentage of smokers who expressed interest in or enrolled in Project Quit, a tailored, online, cognitive-behavioral support program offered with adjunctive nicotine replacement therapy patches. In addition, we examined the effectiveness of several individual-level versus population-level recruitment strategies. Members from two large health care organizations in the United States were invited to participate in Project Quit. Recruitment efforts included proactive invitation letters mailed to 34533 likely smokers and reactive population-level study advertisements targeted to all health plan members (> 560000 adults, including an estimated 98000 smokers across both health care organizations). An estimated 1.6% and 2.5% of adult smokers from each health care organization enrolled in Project Quit. Among likely smokers who received proactive study invitations, 7% visited the Project Quit website (n = 2260) and 4% (n = 1273) were eligible and enrolled. Response rates were similar across sites, despite using different sources to assemble the invitation mailing list. Proactive individual-level recruitment was more effective than other forms of recruitment, accounting for 69% of website visitors and 68% of enrollees. Smokers were interested in receiving online smoking cessation support, even though they had access to other forms of treatment through their health insurance. Uptake rates for this program were comparable to those seen when smokers are advised to quit and are referred to other forms of smoking cessation treatment. In this sample, proactive mailings were the best
Rosenthal, Lisa; Carroll-Scott, Amy; Earnshaw, Valerie A; Sackey, Naa; O'Malley, Stephanie S; Santilli, Alycia; Ickovics, Jeannette R
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. 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. 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. 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. Copyright © 2012 Elsevier Ltd. All rights reserved.
Full Text Available Background: Health systems play key roles in identifying tobacco users and providing evidence-based care to help them quit. This treatment includes different methods such as simple medical consultation, medication, and telephone counseling. To assess different quit smoking methods selected by patients in tobacco cessation centers in Iran in order to identify those that are most appropriate for the country health system. Methods: In this cross-sectional and descriptive study, a random sample of all quit centers at the country level was used to obtain a representative sample. Patients completed the self-administered questionnaire which contained 10 questions regarding the quality, cost, effect, side effects and the results of quitting methods using a 5-point Likert-type scale. Percentages, frequencies, mean, T-test, and variance analyses were computed for all study variables. Results: A total of 1063 smokers returned completed survey questionnaires. The most frequently used methods were Nicotine Replacement Therapy (NRT and combination therapy (NRT and Counseling with 228 and 163 individuals reporting these respectively. The least used methods were hypnotism (n = 8 and the quit and win (n = 17. The methods which gained the maximum scores were respectively the combined method, personal and Champix with means of 21.4, 20.4 and 18.4. The minimum scores were for e-cigarettes, hypnotism and education with means of 12.8, 11 and 10.8, respectively. There were significant differences in mean scores based on different cities and different methods. Conclusions: According to smokers′ selection the combined therapy, personal methods and Champix are the most effective methods for quit smoking and these methods could be much more considered in the country health system.
farideh faraji; Neda Kakayi; Mohammad Kazem Atef Vahid; Ahmad Sohraby; Samira Purghorbani
Objective: The present study was conducted to identify risk and prediction factors of suicide attempts among drug abusers. Method: This causal-comparative study was conducted on 91 drug abusers that included 42 male and female suicide attempters and 49 male and female counterparts. Millon multi-axial personality inventory-II (MCMI-II), Dass-42 (depression, anxiety, stress), and coping styles inventory were used for data collection purposes. Results: The highest rate of suicide attempt was fou...
Ever since the colonial era, attempts have been made throughout the various regions of Africa at building supranational units chiefly for administrative and legal convenience. Examples of such attempts include the Federation of Rhodesia and Nyasaland, the East African High Commission and the federations in former French West and Equatorial Africa, all of which were attempts at forging a supranational nation state. These experiments laid the foundation for further supranational initiatives in ...
Weinberger, Andrea H; Seng, Elizabeth K; Esan, Hannah; Shuter, Jonathan
Persons living with HIV/AIDS (PLWH) smoke at high prevalences and experience significant smoking-related consequences. In community samples, perceived risks and benefits of quitting smoking are related to quit motivation and outcomes and are more strongly endorsed by women. This study examined perceived risks and benefits of quitting smoking and the relationship between risks and benefits and quit motivation and confidence in male and female PLWH. One hundred seven PLWH who reported current cigarette smoking completed measures of demographics, smoking, perceived risks and benefits of quitting smoking, motivation to quit smoking, and confidence in ability to quit smoking. The highest endorsed risks of quitting smoking were cravings and weight gain and higher endorsement of craving risks was associated with lower confidence in the ability to quit smoking. Women endorsed overall risks and risks related to negative affect more highly than men. Women and men did not differ in their endorsement of the other risks, the benefits of quitting, or the relationship between risks and benefits and quit motivation or confidence. It may be useful for health care professionals to incorporate information about perceived risks and benefits of quitting smoking into treatment when working with PLWH who want to stop smoking.
This paper re-examines the first documented attempts to establish the quantitative law of motion for a body oscillating about a fixed axis (a compound pendulum). This is quite a complex problem as weight and motion are not concentrated in a point, but are spread over a volume. Original documents by René Descartes and Gilles Personne de Roberval, who made the first contributions to solving the problem, are discussed. The two scientists had important insights into the problem which, although they were incomplete, nevertheless somehow complemented each other - at least when seen from the viewpoint of modern mechanics. Descartes was right in considering only the absolute value of the inertia forces, Roberval was right in assuming that the force of gravity should also be taken into account.
Full Text Available Background: The objective was to study the sociodemographic data, psychiatric disorder, precipitating events, and mode of attempt in suicide attempted patients referred to consultation liaison psychiatric services. Settings and Design: A prospective study of 6-month duration was done in a tertiary care center in India. Materials and Methods: During the 6-month period all referrals were screened for the presence of suicide attempters in consultation liaison services. Those who fulfilled the criteria for suicide attempters were evaluated by using semistructured pro forma containing sociodemographic data, precipitating events, mode of attempt, and psychiatric diagnosis by using ICD-10. Results: The male-to-female ratio was similar. Adult age, urban background, employed, matriculation educated were more represented in this study. More than 80% of all attempters had psychiatric disorder. Majority had a precipitating event prior to suicide attempt. The most common method of attempt was by use of corrosive. Conclusions: Majority of suicide attempter patients had mental illness. Early identification and treatment of these disorders would have prevented morbidity and mortality associated with this. There is a need of proper education of relatives about keeping corrosive and other poisonous material away from patients as it was being commonest mode of attempt.
Nguyen, Nhung Thi Phuong; Tran, Bach Xuan; Hwang, Lu Y; Markham, Christine M; Swartz, Michael D; Vidrine, Jennifer I; Phan, Huong Thu Thi; Latkin, Carl A; Vidrine, Damon J
Smoking cessation is emerging as an important component in current HIV care to reduce smoking-related adverse health outcomes. This study aimed to examine motivation to quit and its associated factors in a sample of 409 HIV-positive smokers in Vietnam. A cross-sectional survey was conducted from January to September 2013 in Hanoi (the capital) and Nam Dinh (a rural city). Motivation to quit was measured by a 4-point single item, and was dichotomized as having any motivation versus no motivation. Smoking history, nicotine dependence (Fagerstrom Test of Nicotine Dependence), and other covariates were self-reported by participants. Multivariate logistic regression was performed to identify correlates of motivation to quit. The sample was mostly male (97%). Mean age was 36 years (SD = 5.8). Approximately 37% and 69% of the sample were hazardous drinkers and ever drug users, respectively. The mean duration of HIV infection and ART treatment were 6 years (SD = 3.6) and 5 years (SD = 2.2), respectively. Overall, 59% of the sample was motivated to quit. Factors significantly associated with motivation to quit were income, pain, currently taking Methadone, and the interaction between binge drinking and lifetime drug use. Individuals with the highest income level (OR = 2.2, 95% CI = 1.3-3.6), moderate income level (OR = 1.8, 95% CI = 1.1-3.1), and currently feeling pain (OR = 1.6, 95% CI = 1.0-2.5) were more likely to be motivated to quit. Conversely, taking Methadone was associated with a lower likelihood of motivation to quit (OR = 0.4, 95% CI = 0.2-0.9). Also, those who reported binge drinking only (OR = 0.5, 95% CI = 0.3-0.9), lifetime drug use only (OR = 0.3, 95% CI = 0.1, 0.7), or both substance uses (OR = 0.4, 95% CI = 0.2, 0.8) were less motivated to quit smoking. Smoking cessation treatment should be integrated into HIV care in Vietnam, and should be tailored to meet specific needs for
Jordan, Jenna N; Everett, Kevin D; Ge, Bin; McElroy, Jane A
The purpose of this study is to more completely quantify smoking and intention to quit from a sample of sexual and gender minority (SGM) Black individuals (N = 639) through analysis of data collected at Pride festivals and online. Frequencies described demographic characteristics; chi-square analyses were used to compare tobacco-related variables. Black SGM smokers were more likely to be trying to quit smoking than White SGM smokers. However, Black SGM individuals were less likely than White SGM individuals to become former smokers. The results of this study indicate that smoking behaviors may be heavily influenced by race after accounting for SGM status.
Determining counselling communication strategies associated with successful quits in the National Health Service community pharmacy Stop Smoking programme in East London: a focused ethnography using recorded consultations.
Rivas, Carol; Sohanpal, Ratna; MacNeill, Virginia; Steed, Liz; Edwards, Elizabeth; Antao, Laurence; Griffiths, Chris; Eldridge, Sandra; Taylor, Stephanie; Walton, Robert
To determine communication strategies associated with smoking cessation in the National Health Service community pharmacy Stop Smoking programme. 11 community pharmacies in three inner east London boroughs. 9 stop smoking advisers and 16 pairs of smokers who either quit or did not quit at 4 weeks, matched on gender, ethnicity, age and smoking intensity. 1-3 audio-recorded consultations between an adviser and each pair member over 5-6 weeks were analysed using a mixed-method approach. First a content analysis was based on deductive coding drawn from a theme-oriented discourse analysis approach and the Roter Interaction Analysis System. Core themes were identified through this quantification to explore in detail the qualitative differences and similarities between quitters and non-quitters. Quantitative analysis revealed advisers used a core set of counselling strategies that privileged the 'voice of medicine' and often omitted explicit motivational interviewing. Smokers tended to quit when these core strategies were augmented by supportive talk, clear permission for smokers to seek additional support from the adviser between consultations, encouragement for smokers to use willpower. The thematic analysis highlighted the choices made by advisers as to which strategies to adopt and the impacts on smokers. The first theme 'Negotiating the smoker-adviser relationship' referred to adviser judgements about the likelihood the smoker would quit. The second theme, 'Roles of the adviser and smoker in the quit attempt', focused on advisers' counselling strategies, while the third theme, 'Smoker and adviser misalignment on reasons for smoking, relapsing and quitting', concerned inconsistencies in the implementation of National Centre for Smoking Cessation and Training recommendations. Advisers in community pharmacies should use the advantages of their familiarity with smokers to ensure appropriate delivery of patient-centred counselling strategies and reflect on the impact on
Kim, Yoo-Ra; Choi, Kyoung Ho; Oh, Youngmin; Lee, Hae-Kook; Kweon, Yong-Sil; Lee, Chung Tai; Lee, Kyoung-Uk
Suicide is a major public health concern. The elderly have the highest rate of suicide and they make more lethal suicide attempts and have fewer psychiatric interventions than young people. Furthermore, they have old-age specific psychosocial difficulties. The present study investigated psychosocial risk factors and characteristics of an index suicide attempt of the elderly suicide attempters. Subjects included 388 patients who were admitted to the emergency room following self-poisoning. Two age groups were defined: younger patients (aged less than 65 years) and older patients (aged over 65 years). Data including demographic factors, suicidal risk factors and information about the current suicide attempt were obtained from a retrospective chart review. The number of suicide attempters over the age of 65 years old was 57, and their mean age was 73.5 ± 7.5 years. The elderly patients had more underlying medical illnesses than the under-65 group (p suicide attempters had higher risk-rating scores (p suicide attempters had different psychosocial stressors such as physical illness and more lethal suicide attempts. Our study suggests the need for development of specific preventive strategies and management guidelines for the elderly suicide attempters.
Nolen, Scott; McReynolds, Larkin S; DeComo, Robert E; John, Reni; Keating, Joseph M; Wasserman, Gail A
To describe suicide risk in youth seen at a Juvenile Assessment Center (JAC), we examined relationships among self-reported lifetime attempts and demographic, justice, and psychiatric data via logistic regression. Similar to other settings, youth reporting lifetime attempts were more likely to be older, female, not living with both parents and currently arrested for a violent or felony crime. Mood, substance use, and behavior disorder each increased prediction substantially. Anxiety Disorder was associated with elevated attempt rates for boys only. JACs need to develop protocols for identifying suicide risk; further, since suicide history predicts future attempts, Anxiety Disordered boys may be at particular risk.
Brent, David A.; Melhem, Nadine M.; Oquendo, Maria; Burke, Ainsley; Birmaher, Boris; Stanley, Barbara; Biernesser, Candice; Keilp, John; Kolko, David; Ellis, Steve; Porta, Giovanna; Zelazny, Jamie; Iyengar, Satish; Mann, J. John
IMPORTANCE Suicide attempts are strong predictors of suicide, a leading cause of adolescent mortality. Suicide attempts are highly familial, although the mechanisms of familial transmission are not understood. Better delineation of these mechanisms could help frame potential targets for prevention. OBJECTIVE To examine the mechanisms and pathways by which suicidal behavior is transmitted from parent to child. DESIGN, SETTING, AND PARTICIPANTS In this prospective study conducted from July 15, 1997, through June 21, 2012, a total of 701 offspring aged 10 to 50 years (mean age, 17.7 years) of 334 clinically referred probands with mood disorders, 191 (57.2%) of whom had also made a suicide attempt, were followed up for a mean of 5.6 years. MAIN OUTCOMES AND MEASURES The primary outcome was a suicide attempt. Variables were examined at baseline, intermediate time points, and the time point proximal to the attempt. Participants were assessed by structured psychiatric assessments and self-report and by interview measures of domains hypothesized to be related to familial transmission (eg, mood disorder and impulsive aggression). RESULTS Among the 701 offspring, 44 (6.3%) had made a suicide attempt before participating in the study, and 29 (4.1%) made an attempt during study follow-up. Multivariate logistic regression revealed that proband suicide attempt was a predictor of offspring suicide attempt (odds ratio [OR], 4.79; 95% CI, 1.75–13.07), even controlling for other salient offspring variables: baseline history of mood disorder (OR, 4.20; 95% CI, 1.37–12.86), baseline history of suicide attempt (OR, 5.69; 95% CI, 1.94–16.74), and mood disorder at the time point before the attempt (OR, 11.32; 95% CI, 2.29–56.00). Path analyses were consistent with these findings, revealing a direct effect of proband attempt on offspring suicide attempt, a strong effect of offspring mood disorder at each time point, and impulsive aggression as a precursor of mood disorder
Korhonen, T; Uutela, A; Korhonen, H J; Puska, P
This article summarizes an impact evaluation of the North Karelia Project (Finnish CINDI program) on smoking cessation attempts. During the period 1989-1996, data were collected by annual surveys, with response rates varying from 66% to 76%. This study included 1,694 adult current smokers or persons who had quit smoking during the past year, out of a total of 6,011 respondents. Smoking cessation attempts during the past 12 months were examined as a dependent variable. Reported exposures to mass media and interpersonal health communication were examined as possible determinants of smoking cessation. Weekly exposure to mass media health messages was significantly associated with cessation attempts among men only. In contrast, interpersonal health communication, or social influence, was a significant determinant of cessation attempts among both sexes. Exposure to both mass media and interpersonal health communication had an even stronger impact on cessation attempts. Thus, interpersonal communication appears to be an important catalyst of community programs, and its inclusion should be emphasized to obtain a higher impact with community programs.
Kim, Hyeyoung; Kim, Bora; Kim, Se Hyun; Park, C Hyung Keun; Kim, Eun Young; Ahn, Yong Min
It is essential to understand the latent structure of the population of suicide attempters for effective suicide prevention. The aim of this study was to identify subgroups among Korean suicide attempters in terms of the details of the suicide attempt. A total of 888 people who attempted suicide and were subsequently treated in the emergency rooms of 17 medical centers between May and November of 2013 were included in the analysis. The variables assessed included demographic characteristics, clinical information, and details of the suicide attempt assessed by the Suicide Intent Scale (SIS) and Columbia-Suicide Severity Rating Scale (C-SSRS). Cluster analysis was performed using the Ward method. Of the participants, 85.4% (n = 758) fell into a cluster characterized by less planning, low lethality methods, and ambivalence towards death ("impulsive"). The other cluster (n = 130) involved a more severe and well-planned attempt, used highly lethal methods, and took more precautions to avoid being interrupted ("planned"). The first cluster was dominated by women, while the second cluster was associated more with men, older age, and physical illness. We only included participants who visited the emergency department after their suicide attempt and had no missing values for SIS or C-SSRS. Cluster analysis extracted two distinct subgroups of Korean suicide attempters showing different patterns of suicidal behaviors. Understanding that a significant portion of suicide attempts occur impulsively calls for new prevention strategies tailored to differing subgroup profiles. Copyright © 2018 Elsevier B.V. All rights reserved.
Schutte, Nicola S.; Marks, Anthony D. G.
The purpose of this research was to examine how affective associations with smoking and outcome expectancies regarding smoking are related to smoking status and intention to quit among smokers. Researchers and practitioners can draw on findings regarding affective associations and outcome expectancies to provide a further basis for smoking…
Thomson, George; Wilson, Nick; Weerasekera, Deepa; Edwards, Richard
To further explore smoker views on reasons to quit. As part of the multi-country ITC Project, a national sample of 1,376 New Zealand adult (18+ years) smokers was surveyed in 2007/08. This sample included boosted sampling of Māori, Pacific and Asian New Zealanders. 'Setting an example to children' was given as 'very much' a reason to quit by 51%, compared to 45% giving personal health concerns. However, the 'very much' and 'somewhat' responses (combined) were greater for personal health (81%) than 'setting an example to children' (74%). Price was the third ranked reason (67%). In a multivariate analysis, women were significantly more likely to state that 'setting an example to children' was 'very much' or 'somewhat' a reason to quit; as were Māori, or Pacific compared to European; and those suffering financial stress. The relatively high importance of 'example to children' as a reason to quit is an unusual finding, and may have arisen as a result of social marketing campaigns encouraging cessation to protect families in New Zealand. The policy implications could include a need for a greater emphasis on social reasons (e.g. 'example to children'), in pack warnings, and in social marketing for smoking cessation. © 2011 The Authors. ANZJPH © 2010 Public Health Association of Australia.
Full Text Available This study examined the degree to which the pregnant or postpartum women, in the process of quitting smoking, felt that writing in a blog about their smoking cessation journeys helped them in their efforts to become or remain smoke free. Five women who blogged for Prevention of Gestational and Neonatal Exposure to Tobacco Smoke (a website designed to help pregnant and postpartum women quit smoking were interviewed about their experiences as bloggers. Participants were asked to complete an online survey, which had closed-ended questions regarding their sociodemographic and smoking characteristics. Once they completed the survey, semistructured qualitative interviews were conducted over the phone. Findings suggest that blogging might combine several evidence-based behavioral strategies for tobacco cessation, such as journaling and getting support from others who use tobacco. Being part of a blogging community of women who have experienced or are experiencing similar challenges can be therapeutic and help women gain confidence in their ability to quit smoking. In conclusion, blogging may help pregnant and postpartum women quit smoking by increasing their social support and promoting self-reflection.
Yzer, M.; van den Putte, B.
Consistent with behavioral theory such as the theory of planned behavior, numerous studies on determinants of smoking cessation confirmed that attitude, subjective norm, and perceived control each can correlate with intention to quit smoking. However, such main effect findings indicate additive
Full Text Available The purpose of this research was to demonstrate the importance of employee engagement and its relationship to employee intent to quit witch moderated by job insecurity on employees frontline state bank in Bandung City Indonesia. The method used is explanatory survey method that this study took a sample of the population with a questionnaire and interview techniques as the primary means of data collection. The subjects of the study were also as the unit of analysis in this study is the frontline employees teller and customer service that serve the general customers where the position is vulnerable to employee turnover whereas they are the spearhead or the forefront frontline that connects to the customers bank the customer . A randomly selected sample of 4 bank was used in this study. A total of 270 respondents participated. Data were analyzed using Smart PLS 2.0. The linear regression analysis indicated there was a significant strong and negative linear relationship between employee engagement level and employee intent to quit rate. The results of this research promote employee engagement is a significant negative effect amounted 4142 of the intention to quit while the variable job insecurity is not proven significantly. The conclusion from this study is that the employe engagement give significant influence on the intention to quit and variable job insecurity is not a variable moderation.
Carson, Russell L.; Baumgartner, Jennifer J.; Ota, Carrie L.; Kuhn, Ann Pulling; Durr, Anthony
Guided by affective events theory, the purpose of this study was to examine the temporal aspects of childcare teacher burnout, particularly as to how feelings of exhaustion throughout the day relate to perceptions of end-of-day job satisfaction and quitting intentions. A secondary purpose of the study was to explore the frequency and type of…
Hukkelberg, Silje Sommer; Hagtvet, Knut A; Kovac, Velibor Bobo
This study applies three latent interaction models in the theory of planned behaviour (TPB; Ajzen, 1988, Attitudes, personality, and behavior. Homewood, IL: Dorsey Press; Ajzen, 1991, Organ. Behav. Hum. Decis. Process., 50, 179) to quitting smoking: (1) attitude × perceived behavioural control on intention; (2) subjective norms (SN) × attitude on intention; and (3) perceived behavioural control × intention on quitting behaviour. The data derive from a longitudinal Internet survey of 939 smokers aged 15-74 over a period of 4 months. Latent interaction effects were estimated using the double-mean-centred unconstrained approach (Lin et al., 2010, Struct. Equ. Modeling, 17, 374) in LISREL. Attitude × SN and attitude × perceived behavioural control both showed a significant interaction effect on intention. No significant interaction effect was found for perceived behavioural control × intention on quitting. The latent interaction approach is a useful method for investigating specific conditions between TPB components in the context of quitting behaviour. Theoretical and practical implications of the results are discussed. © 2013 The British Psychological Society.
Okada, Kensuke; Vandekerckhove, Joachim; Lee, Michael D
People often interact with environments that can provide only a finite number of items as resources. Eventually a book contains no more chapters, there are no more albums available from a band, and every Pokémon has been caught. When interacting with these sorts of environments, people either actively choose to quit collecting new items, or they are forced to quit when the items are exhausted. Modeling the distribution of how many items people collect before they quit involves untangling these two possibilities, We propose that censored geometric models are a useful basic technique for modeling the quitting distribution, and, show how, by implementing these models in a hierarchical and latent-mixture framework through Bayesian methods, they can be extended to capture the additional features of specific situations. We demonstrate this approach by developing and testing a series of models in two case studies involving real-world data. One case study deals with people choosing jokes from a recommender system, and the other deals with people completing items in a personality survey.
Basar, Ufuk; Sigri, Ünsal
This research aims to discover the effects of teachers' organizational justice perceptions on intention to quit as well as the mediation role of teachers' organizational identification in this process. Interactions between research variables were measured using structural equation models. The sample used comprised teachers working at primary and…
Frenkel, S.; Sanders, Karin; Bednall, T.
In this paper we use a relational approach to investigate how employee perceptions of their relationships with three types of managers—senior, line, and human resource managers—are related to employees’ job satisfaction and intention to quit. Based on an employee survey (n = 1,533), and manager
Abdul Kadar Muhammad Masum
Full Text Available The aim of this study was to identify the facets influencing job satisfaction and intention to quit of nurses employed in Turkey. Using a non-probability sampling technique, 417 nurses from six large private hospitals were surveyed from March 2014 to June 2014. The nurses’ demographic data, their job-related satisfaction and turnover intentions were recorded through a self-administered questionnaire. In this study, descriptive and bivariate analyses were used to explore data, and multivariate analysis was performed using logistic regression. Nurses’ job satisfaction was found at a moderate level with 61% of the nurses intended to quit. Nevertheless, nurses reported a high satisfaction level with work environment, supervisor support, and co-workers among the selected nine facets of job satisfaction. They also reported a low satisfaction level with contingent reward, fringe benefits, and pay. The impact of demographic characteristics on job satisfaction and intention to quit was also examined. The study revealed a negative relationship between job satisfaction and intention to quit the existing employment. Moreover, satisfaction with supervisor support was the only facet that significantly explained turnover intent when controlling for gender, age, marital status, education, and experience. The implications for nurse management were also described for increasing nurses’ job satisfaction and retention. This study is beneficial for hospital management to ensure proper nursing care that would lead to a better quality healthcare service.
Masum, Abdul Kadar Muhammad; Azad, Md Abul Kalam; Hoque, Kazi Enamul; Beh, Loo-See; Wanke, Peter; Arslan, Özgün
The aim of this study was to identify the facets influencing job satisfaction and intention to quit of nurses employed in Turkey. Using a non-probability sampling technique, 417 nurses from six large private hospitals were surveyed from March 2014 to June 2014. The nurses' demographic data, their job-related satisfaction and turnover intentions were recorded through a self-administered questionnaire. In this study, descriptive and bivariate analyses were used to explore data, and multivariate analysis was performed using logistic regression. Nurses' job satisfaction was found at a moderate level with 61% of the nurses intended to quit. Nevertheless, nurses reported a high satisfaction level with work environment, supervisor support, and co-workers among the selected nine facets of job satisfaction. They also reported a low satisfaction level with contingent reward, fringe benefits, and pay. The impact of demographic characteristics on job satisfaction and intention to quit was also examined. The study revealed a negative relationship between job satisfaction and intention to quit the existing employment. Moreover, satisfaction with supervisor support was the only facet that significantly explained turnover intent when controlling for gender, age, marital status, education, and experience. The implications for nurse management were also described for increasing nurses' job satisfaction and retention. This study is beneficial for hospital management to ensure proper nursing care that would lead to a better quality healthcare service.
Asher, Marilyn K; Martin, Rosemarie A; Rohsenow, Damaris J; MacKinnon, Selene Varney; Traficante, Regina; Monti, Peter M
Little is known about the perceived barriers to quitting smoking among alcohol abusers. In addition to the usual barriers perceived by smokers, alcohol dependent smokers may have a few barriers unique to their addictive lifestyle. The Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) was administered to 96 alcohol dependent smokers in residential substance abuse treatment. The BQS-SAT is designed to assess perceived barriers to quitting smoking among alcohol abusers using eleven true-false items. One open-ended item was included to gather information about potential additional barriers. The majority of respondents reported withdrawal-related barriers such as expecting to feel irritable, anxious, restless, and about half expected intolerable urges to smoke if they were to quit smoking, as most smokers do. However, concerns about effects on sobriety and needing cigarettes to cope with feeling down were also endorsed by almost half of the patients. Total number of perceived barriers was significantly related to smoking history, expected effects from smoking, and smoking temptation but was not associated with severity of alcohol use or dependence on admission. Providing corrective feedback about these barriers could be useful when addressing smoking with patients who have alcohol abuse or dependence.
Bowen, Sarah; Kurz, Andrew S
Few smoking cessation programs are designed for college students, a unique population that may categorically differ from adolescents and adults, and thus may have different motivations to quit than the general adult population. Understanding college student motives may lead to better cessation interventions tailored to this population. Motivation to quit may differ, however, between racial groups. The current study is a secondary analysis examining primary motives in college student smokers, and differences between Asian American and Caucasian students in smoking frequency, nicotine dependence, and motives to quit. Participants (N = 97) listed personal motives to quit cigarette smoking, which were then coded into categories: health, personal relationships (e.g., friends, family, romantic partners), self-view (e.g., "addicted" or "not in control"), image in society, impact on others or the environment (e.g., second-hand smoke, pollution), and drain on personal resources (e.g., money, time). Mean number of motives were highest in the category of health, followed by personal relationships, drain on resources, self-view, image, and impact. Asian American students listed significantly fewer motives in the categories of health, self-view and image, and significantly more in the category of personal relationships than Caucasian students. Nicotine dependence was significantly higher for Asian American students. However, frequency of smoking did not differ between groups. Results may inform customization of smoking cessation programs for college students and address relevant culturally specific factors of different racial groups.
Azad, Md. Abul Kalam; Hoque, Kazi Enamul; Beh, Loo-See; Wanke, Peter; Arslan, Özgün
The aim of this study was to identify the facets influencing job satisfaction and intention to quit of nurses employed in Turkey. Using a non-probability sampling technique, 417 nurses from six large private hospitals were surveyed from March 2014 to June 2014. The nurses’ demographic data, their job-related satisfaction and turnover intentions were recorded through a self-administered questionnaire. In this study, descriptive and bivariate analyses were used to explore data, and multivariate analysis was performed using logistic regression. Nurses’ job satisfaction was found at a moderate level with 61% of the nurses intended to quit. Nevertheless, nurses reported a high satisfaction level with work environment, supervisor support, and co-workers among the selected nine facets of job satisfaction. They also reported a low satisfaction level with contingent reward, fringe benefits, and pay. The impact of demographic characteristics on job satisfaction and intention to quit was also examined. The study revealed a negative relationship between job satisfaction and intention to quit the existing employment. Moreover, satisfaction with supervisor support was the only facet that significantly explained turnover intent when controlling for gender, age, marital status, education, and experience. The implications for nurse management were also described for increasing nurses’ job satisfaction and retention. This study is beneficial for hospital management to ensure proper nursing care that would lead to a better quality healthcare service. PMID:27168960
Full Text Available Online-games are products of hedonic information technology. Players’ addiction will lead to seriously negative consequences. That how to prevent online-game addiction exclusively becomes a problem concerned by whole society. The purpose of this study is to explore the influence factors and its mechanism that can weaken or even eliminate online-game addiction. On the basis of the theory of planned behaviour, anticipated guilt and past behaviour are introduced into the model to explain players’ quit intention of online-game. Data collected from 393 online-game players around China mainland indicate that negative attitude, negative-subjective norm and perceived behavioural control significantly affect the quit intention of online-game players, while the anticipated guilt plays a mediator role. Past behaviour can moderate the relations between the anticipated guilt and the quit intention of online-game players. The more the past game behaviour the player owns, the stronger the positive effects of anticipated guilt on game quit intention he/she will harbor. Conclusions are helpful to the intervention of player’s game behaviour and strengthen the self-control ability of players.
Ohara, Kenryo; Saeki, Keigo; Konoike, Yoshizumi; Okamoto, Nozomi; Tomioka, Kimiko; Nishioka, Hisayuki; Kurumatani, Norio
More women in Japan continue to quit a job when they find out they are pregnant than in other industrialized countries. The purpose of this study was to clarify factors affecting the quitting rate among female workers who become aware they are pregnant. All pregnant women visiting or admitted to seven obstetrics medical institutions in Nara Prefecture between November and December 2004 for examination or delivery were surveyed. Of these women, 603 who were working when they discovered their pregnancy were subjects of the analysis. Quitting a job was treated as an event occurrence, and those working at the time of the survey were considered censored cases. The Kaplan-Meier method was used to determine the trend of the quitting rate associated with gestational weeks. The Cox proportional hazard model was used to examine the relationship between quitting a job and workplace factors such as number of staff at the workplace, types of employment, and availability of a legal maternity protection system, and individual factors such as age and thoughts (both subject's and husband's) on continuing work. The quitting rate up to delivery was 63.1%, but this increased to 69.8% when limited to pregnancy with a first child. Significantly independent factors behind continuation of work after discovering pregnancy were the following: receiving time off for medical examinations (HR=0.59, 95% CI (0.41-0.83)), availability of a child care leave system (0.37 (0.22-0.63)), arranged support system after returning from maternity and child care leave (0.60 (0.42-0.87)), workplace ambience is supportive of working after marriage and childbirth (0.59 (0.43-0.81)), and the subject (0.63 (0.43-0.93)) or husband (0.50 (0.30-0.86)) considers it good to continue working during pregnancy. In contrast, a non-regular employee (1.93 (1.46-2.56)) and being young (1.74 (1.10-2.75)) were factors behind quitting a job. Key conditions that encourage work continuation after becoming aware of pregnancy
Mayes, Susan Dickerson; Gorman, Angela A.; Hillwig-Garcia, Jolene; Syed, Ehsan
Frequency of suicide ideation and attempts in 791 children with autism (1-16 years), 35 nonautistic depressed children, and 186 typical children and risk factors in autism were determined. Percent of children with autism for whom suicide ideation or attempts was rated as sometimes to very often a problem by mothers (14%) was 28 times greater than…
Blanken, I.; van de Ven, N.; Zeelenberg, M.; Meijers, Marijn H. C.
The present work includes three attempts to replicate the moral licensing effect by Sachdeva, Iliev, and Medin (2009). The original authors found that writing about positive traits led to lower donations to charity and decreased cooperative behavior. The first two replication attempts (student
Henkel, Linda A.
The impact of repeated and prolonged attempts at remembering on false memory rates was assessed in three experiments. Participants saw and imagined pictures and then made repeated recall attempts before taking a source memory test. Although the number of items recalled increased with repeated tests, the net gains were associated with more source…
Chinnian, R. Rawlin; Johnson, Shelonitda
Suicide and deviance are related because loss in social interaction is a consequence of deviance and an antecedent to suicide. This study examined the cognitive and affective experiences of suicidal individuals for evidence of neurosis. Sixty young attempted suicides with a history of a serious suicidal attempts attending the suicide prevention…
Background: Research on the prevalence of suicidal ideation, attempt, and cormorbid psychiatric disorders in post-conflict areas is still limited. Aim: We explored the prevalence of suicidal ideation, attempt, associated psychiatric disorders and HIV/AIDS in post-conflict Northern Uganda, an area that experienced civil strife ...
Brodsky, Beth S.; Groves, Shelly A.; Oquendo, Maria A.; Mann, J. John; Stanley, Barbara
Borderline personality disorder (BPD) is often characterized by multiple low lethality suicide attempts triggered by seemingly minor incidents, and less commonly by high lethality attempts that are attributed to impulsiveness or comorbid major depression. The relationships among life events, impulsiveness, and type of suicidal behavior has hardly…
ARL-TN-0824 MAY 2017 US Army Research Laboratory Attempted α- to β-Phase Conversion of Croconic Acid via Ball Milling by...Laboratory Attempted α- to β-Phase Conversion of Croconic Acid via Ball Milling by Steven W Dean, Rose A Pesce-Rodriguez, and Jennifer A Ciezak...
Reijnierse, Esmee M.; de Jong, Nynke; Trappenburg, Marijke C.; Blauw, Gerard Jan; Butler-Browne, Gillian; Gapeyeva, Helena; Hogrel, Jean Yves; Mcphee, Jamie S.; Narici, Marco V.; Sipilä, Sarianna; Stenroth, Lauri; van Lummel, Rob C.; Pijnappels, Mirjam; Meskers, Carel G M; Maier, Andrea B.
Background: Handgrip strength (HGS) is used to identify individuals with low muscle strength (dynapenia). The influence of the number of attempts on maximal HGS is not yet known and may differ depending on age and health status. This study aimed to assess how many attempts of HGS are required to
Berkol, Tonguç D; İslam, Serkan; Kırlı, Ebru; Pınarbaşı, Rasim; Özyıldırım, İlker
To identify clinical predictors of suicide attempts in patients with bipolar disorder. This study included bipolar patients who were treated in the Psychiatry Department, Haseki Training and Research Hospital, Istanbul, Turkey, between 2013 and 2014; an informed consent was obtained from the participants. Two hundred and eighteen bipolar patients were assessed by using the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) Axis-I (SCID-I) in order to detect all possible psychiatric comorbid diagnoses. Clinical predictors of suicide attempts were examined in attempters and non-attempters. The study design was retrospective. The lifetime suicide attempt rate for the entire sample was 19.2%. Suicide attempters with bipolar disorder had more lifetime comorbidity of eating disorder. Female gender and family history of mood disorder were significant predictors for suicide attempts. There was no difference between groups in terms of bipolar disorder subtype, onset age of bipolar disorder, total number of episodes, first and predominant episode type, suicide history in first degree relatives, severity of episodes, and hospitalization and being psychotic. Our study revealed that female gender, family history of mood disorder, and eating disorder are more frequent in bipolar patients with at least one suicide attempt.
Verwey, B.; Eling, P.A.T.M.; Wientjes, H.J.F.M.; Zitman, F.G.
Backgroud: a prospective study was done to investigate the presence of anterograde amnesia in suicide attempters who took benzodiazepines (BZ) and to study the correlation with sedation. Method: in 43 patients, who attempted suicide by taking benzodiazepines, memory perfomrance was tested on a
Pena, Juan B.; Kuhlberg, Jill A.; Zayas, Luis H.; Baumann, Ana A.; Gulbas, Lauren; Hausmann-Stabile, Carolina; Nolle, Allyson P.
In this study, we examined the relationship between familism and family environment type as well as the relationship between family environment type and suicide attempts among Latina youth. Latina teen attempters (n = 109) and nonattempters (n = 107) were recruited from the New York City area. Latent class analysis revealed three family…
Lyon, Maureen E.; Benoit, Marilyn; O'Donnell, Regina M.; Getson, Pamela R.; Silber, Tomas; Walsh, Thomas
Evaluates risk factors in African American adolescent suicide attempters (n=51) and nonsuicidal (n=124) adolescents. Results show that threat of separation from a parental figure, insomnia, neglect, substance abuse, suicidal ideation, and failing grades were the strongest predictors of suicide attempt. Unexpected findings include high levels of…
Full Text Available Suicide attempts in North India are generally underreported but have been considered to be rising. The number of admissions due to attempted suicide at Duncan Hospital, North Bihar, rose from 82 in 2007 to 419 in 2011.A structured interview and the WHO (World Health Organization Major (ICD-10 Depression Inventory were completed by 157 suicide-attempt survivors. Immediate relatives were also interviewed. Only 23% of patients came from India; 77% of patients came from Nepal. The highest incidence was in the age group 16-20 years. Females have higher rates in the 21-30 year age group (p=0.012, but after 30 years of age, the number of males becomes higher than the females (p=0.048; 81.5% of the respondents were below the age of 30 years.Pesticide poisoning was the major mode of attempted suicide (94.3%. Using the WHO Major (ICD-10 Depression Inventory, 28 of the participants suffered from depression (17.7%. Ninety people (56.9% admitted to previous thoughts of suicide, and nine (5.7% people had attempted suicide previously.Hindus made up 84.0% of the respondents. Almost 50% of respondents only carried out their religious rituals on an occasional basis or not at all. 70.2% had not completed education beyond primary school, and 49.7% earned less than Rs10,000 per month (US$200. Eighty percent of the participants stated conflicts with family members led to the attempted suicide. Relatives did not expect the attempted suicide in 97.4% of cases. Knowledge of the suicide of a neighbour, friends, or relative influenced 77.0% of the participants to attempt suicide.Efforts to prevent suicide attempts and deaths need to be multifaceted. Banning the most poisonous pesticides and improving poison storage in the community must be encouraged. Prevention, early intervention and treatment all are required in a suicide prevention plan. The lack of psychiatrists necessitates that other professionals and trained non-professionals be utilised in the mental health team
Bille-Brahe, U; Hansen, W; Kolmos, L
During a 6 months' period, 99 persons, randomly chosen among patients admitted for attempted suicide to the Department of Psychiatry, Odense University Hospital, were interviewed. This paper, which is the first in a series, deals with the theoretical and methodological background of the survey...... and the validity of the sample and also with some basic social characteristics of the suicide attempters. The majority of the suicide attempters were found to be single and many of them were living alone or alone with children. The sample could also be characterized by a low level of vocational education...... and by lack of association with the labour market. The suicide attempters could not, however, be unequivocally described as being in bad financial circumstances, neither were they solely from the lower social classes; the social status profile of the suicide attempters was closer to the status profile...
Maraš, J S; Kolundžija, K; Dukić, O; Marković, J; Okanović, P; Stokin, B; Mitrović, D; Ivanović-Kovačević, S
In most countries, suicide is second or third leading cause of death in youth. Suicidal tendencies among youth have been the subject of extensive research. Reports of increased rate of suicide attempts in the past few decades indicate that this phenomenon has not been fully understood. The aim of this study was to better understand the phenomenon of adolescent suicide behavior by defining some specific psychological characteristics of adolescents who were hospitalized at the psychiatric ward because of the suicide attempt. 62 participants were assigned to two groups: clinical (adolescents who were hospitalized after a suicide attempt) and non-clinical (adolescents without psychiatric symptoms). They filled in a series of instruments: a questionnaire examining adolescents' demographic characteristics, Rosenberg's Self-Esteem Scale, Youth Self Report. Compared to the non-clinical populaton adolescents attempting suicide had significantly more frequent suicidal thoughts (χ2 = 18.627, df = 1, p self-esteem (t = 4.23, p suicide attempt.
Skovlund, Charlotte Wessel; Mørch, Lina Steinrud; Kessing, Lars Vedel
OBJECTIVE: The purpose of this study was to assess the relative risk of suicide attempt and suicide in users of hormonal contraception. METHOD: The authors assessed associations between hormonal contraceptive use and suicide attempt and suicide in a nationwide prospective cohort study of all women...... in Denmark who had no psychiatric diagnoses, antidepressant use, or hormonal contraceptive use before age 15 and who turned 15 during the study period, which extended from 1996 through 2013. Nationwide registers provided individually updated information about use of hormonal contraception, suicide attempt......, suicide, and potential confounding variables. Psychiatric diagnoses or antidepressant use during the study period were considered potential mediators between hormonal contraceptive use and risk of suicide attempt. Adjusted hazard ratios for suicide attempt and suicide were estimated for users of hormonal...
Ottilingam Somasundaram Ravindran
Full Text Available BACKGROUND Schizophrenia has been called a ‘Life-shortening disease’, because many sufferers die early than general population and suicide accounts for a significant proportion of those dying prematurely. Suicide attempts in schizophrenia has been an intriguing area of research work for mental health professionals. Indian research on suicide attempts in schizophrenia have been few. OBJECTIVES The objectives were to study the suicidal behaviour in schizophrenia, to compare and study the positive and negative symptoms, depressive symptoms, hopelessness and suicide intent in schizophrenic population with suicide attempt compared to nonattempters, along with socio-demographic parameters. METHODS A sample of 60 consecutive patients attending OPD of a Private tertiary care Hospital in Chennai were selected. Those who had a diagnosis of schizophrenia were screened for the presence of past suicide attempts. They were divided into two groups as suicide attempters and non-attempters, and analysed using the Positive and Negative Syndrome Scale (PANSS, Calgary Depression Scale for Schizophrenia (CDSS, Beck’s hopelessness scale (BHS, and Suicide intent scale (SIS. RESULTS Among the disorders schizophrenia is rated the second most common reason for suicide attempts (53.3%, especially when associated with positive symptoms, depressive features and significant hopelessness. Demographic parameters like age, sex, educational status, occupation, economic status, and marital status were not found to be significant factors linked to the suicide attempts, however family history of suicide had a significant association in schizophrenic suicide attempts. Suicidal intent severity was medium to high among most of the attempters; poisoning was the commonest method; and were found to be due to positive symptoms and depressive symptoms in the schizophrenic illness course.
Full Text Available Massimiliano Beghi,1,2 Jerrold F Rosenbaum,3 Cesare Cerri,1,4 Cesare M Cornaggia1,51Psychiatry Clinic, University of Milano Bicocca, Milan, Italy; 2Department of Psychiatry, Salvini Hospital, Rho, Italy; 3Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; 4Department of Rehabilitation Medicine, Zucchi Clinical Institute, Carate Brianza, Italy; 5Forensic Psychiatric Hospital, Castiglione delle Stiviere, Mantua, ItalyObjectives: This review aimed to identify the evidence for predictors of repetition of suicide attempts, and more specifically for subsequent completed suicide.Methods: We conducted a literature search of PubMed and Embase between January 1, 1991 and December 31, 2009, and we excluded studies investigating only special populations (eg, male and female only, children and adolescents, elderly, a specific psychiatric disorder and studies with sample size fewer than 50 patients.Results: The strongest predictor of a repeated attempt is a previous attempt, followed by being a victim of sexual abuse, poor global functioning, having a psychiatric disorder, being on psychiatric treatment, depression, anxiety, and alcohol abuse or dependence. For other variables examined (Caucasian ethnicity, having a criminal record, having any mood disorders, bad family environment, and impulsivity there are indications for a putative correlation as well. For completed suicide, the strongest predictors are older age, suicide ideation, and history of suicide attempt. Living alone, male sex, and alcohol abuse are weakly predictive with a positive correlation (but sustained by very scarce data for poor impulsivity and a somatic diagnosis.Conclusion: It is difficult to find predictors for repetition of nonfatal suicide attempts, and even more difficult to identify predictors of completed suicide. Suicide ideation and alcohol or substance abuse/dependence, which are, along with depression, the most consistent predictors for initial nonfatal
Perlis, Roy H; Ruderfer, Douglas; Hamilton, Steven P; Ernst, Carl
Suicide is one of the top ten leading causes of death in North America and represents a major public health burden, particularly for people with Major Depressive disorder (MD). Many studies have suggested that suicidal behavior runs in families, however, identification of genomic loci that drive this efffect remain to be identified. Using subjects collected as part of STAR D, we genotyped 189 subjects with MD with history of a suicide attempt and 1073 subjects with Major Depressive disorder that had never attempted suicide. Copy Number Variants (CNVs) were called in Birdsuite and analyzed in PLINK. We found a set of CNVs present in the suicide attempter group that were not present in in the non-attempter group including in SNTG2 and MACROD2 - two brain expressed genes previously linked to psychopathology; however, these results failed to reach genome-wide signifigance. These data suggest potential CNVs to be investigated further in relation to suicide attempts in MD using large sample sizes.
Full Text Available Background Many patients diagnosed with lung cancer continue to smoke even though this can make their treatment less effective and increase side effects. E-cigarettes form part of the UK's tobacco harm reduction policy landscape and are, by far, smokers' most popular quit attempt method. This pilot study explores feasibility and acceptability of e-cigarettes to aid smoking cessation among lung cancer patients undergoing chemotherapy. Methods 27 smokers with stage IV lung cancer were recruited from one NHS site in Scotland between May-16 and June-17. They were provided with a 2 nd generation e-cigarette kit at a baseline home visit conducted by a researcher and a volunteer who was an experienced e-cigarette user. Participants were followed-up weekly for four weeks and at 16 weeks. Participants´ response to, and use of, e-cigarettes was explored along with cessation outcomes (self-reported and CO verified. In-depth qualitative interviews were conducted with health professionals (n=8 engaged with lung cancer patients to obtain their views on the study. Results Overall, participants were motivated to stop smoking and took easily to using e-cigarettes. Minor issues arose around choice of flavour, and some side effects were noted, although participants reported difficulty in distinguishing these from treatment side effects. Seven participants were lost to follow-up. Preliminary findings show that at 4-week follow-up: average CO reading had reduced from 14 (range 3-37 to 8 (range 1-29, and 70% of participants reported daily e-cigarette use, however, use was dependent on individuals' day-to-day health. Health professionals interviewed were generally supportive of e-cigarettes as a tool for quitting, and suggested future efforts should concentrate on patients with curable cancer. Conclusions E-cigarettes have a potential role to play for lung cancer patients. Future smoking cessation research should take account of the impact of cancer treatment on
Short-term changes in quitting-related cognitions and behaviours after the implementation of plain packaging with larger health warnings: findings from a national cohort study with Australian adult smokers.
Durkin, Sarah; Brennan, Emily; Coomber, Kerri; Zacher, Meghan; Scollo, Michelle; Wakefield, Melanie
Plain packaging (PP) with larger graphic health warnings (GHWs) was implemented in Australia in late 2012. This study examined effects of these packaging changes on short-term changes in quitting-related cognitions and behaviours. We used a series of cohorts of Australian adult cigarette smokers originally sourced from a nationally representative cross-sectional tracking survey, followed up approximately 1 month after their baseline interview (n(weighted)=5441). Logistic regression analyses compared changes in seven quitting-related outcomes over this 1-month follow-up period for the cohorts surveyed before PP, over the period of transition to PP, and during the first year of PP, adjusting for baseline levels of the outcome and covariates. Compared to the referent group of smokers who completed their follow-up survey pre-PP, those who were followed-up in the early transition period showed significantly greater increases in rates of stopping themselves from smoking (OR=1.51, 95% CI (1.08 to 2.10)) and higher quit attempt rates (OR=1.43, 95% CI (1.00 to 2.03)), those followed-up in the late transition period showed greater increases in intentions to quit (OR=1.42, 95% CI (1.06 to 1.92)) and pack concealment (OR=1.55, 95% CI (1.05 to 2.31)), and those followed-up in the first year of PP showed higher levels of pack concealment (OR=1.65, 95% CI (1.01 to 2.72)), more premature stubbing out of cigarettes (OR=1.55, 95% CI (1.01 to 2.36)), and higher quit attempt rates (OR=1.52, 95% CI (1.01 to 2.30)). These findings provide some of the strongest evidence to date that implementation of PP with larger GHWs was associated with increased rates of quitting cognitions, microindicators of concern and quit attempts among adult cigarette smokers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Bouhlel, S; M'solly, M; Benhawala, S; Jones, Y; El-Hechmi, Z
The mortality rate in schizophrenia is 4.5 times higher than in the general population. Suicide is one of the main causes of premature death in this affection. Life time prevalence of this behavior ranges from 10 to 15%, which represents a risk 20 to 50 times higher than in the general population. In addition, 40 to 93% of patients who committed suicide had attempted suicide previously. Thus, assessment of correlated variables with suicide attempts is a fundamental issue for developing preventive and therapeutic strategies in suicidal behavior. To the best of our knowledge, no systematic study has yet investigated suicide attempts in an Arabic Muslim population with schizophrenia, although many authors have demonstrated cultural differences in socio-demographic and clinical variables related to suicide attempts within many geographic areas around the world. The objectives of this study were to assess the frequency and characteristics of lifetime suicide attempts in Tunisian schizophrenic outpatients and to determine the correlated socio-demographic, clinical and therapeutic variables. A total of 134 patients with a DSM-IV diagnosis of schizophrenia who attended the outpatient department of the university psychiatric hospital of Tunis were included. The main demographic and lifetime clinical variables considered were: gender, marital status, family history of psychiatric disorders and suicide attempts, age at time of recruitment, age at onset of illness, duration of untreated psychosis defined as the interval between the onset of the illness and the first antipsychotic treatment, the type and dose of current treatment, dose of antipsychotic drugs converted to chlorpromazine equivalents, extrapyramidal side effects assessed with the Simpson Angus rating scale, number of hospitalizations, comorbid substance abuse, cigarette smoking, severity of psychopathology measured with the Positive And Negative Syndrome Scale (PANSS), and history of at least one suicide attempt
Lipsicas, Cendrine Bursztein; Mäkinen, Ilkka Henrik; Wasserman, Danuta; Apter, Alan; Kerkhof, Ad; Michel, Konrad; Renberg, Ellinor Salander; van Heeringen, Kees; Värnik, Airi; Schmidtke, Armin
Objectives To compare frequencies of suicide attempt repetition in immigrants and local European populations, and the timing of repetition in these groups. Method: Data from 7 European countries, comprising 10 574 local and 3032 immigrant subjects, were taken from the World Health Organization European Multicentre Study on Suicidal Behaviour and the ensuing Monitoring Suicidal Behaviour in Europe (commonly referred to as MONSUE) project. The relation between immigrant status and repetition of suicide attempt within 12-months following first registered attempt was analyzed with binary logistic regression, controlling for sex, age, and method of attempt. Timing of repetition was controlled for sex, age, and the recommended type of aftercare. Results: Lower odds of repeating a suicide attempt were found in Eastern European (OR 0.50; 95% CI 0.41 to 0.61, P Europe stands in contrast to their markedly higher tendency to attempt suicide in general, possibly pointing to situational stress factors related to their suicidal crisis that are less persistent over time. Our findings also raise the possibility that suicide attempters and repeaters constitute only partially overlapping populations. PMID:25565687
Stulz, Niklaus; Hepp, Urs; Gosoniu, Dominic G; Grize, Leticia; Muheim, Flavio; Weiss, Mitchell G; Riecher-Rössler, Anita
Attempted suicide is a major public health problem. The aim of this study was to identify patient-identified problems and triggers typically leading to attempted suicide. A representative sample of 66 adult patients was recruited from all clinical sites and psychiatrists who treat patients after attempted suicide in the Canton of Basel-City (Switzerland). Patients were diagnosed using the Structured Clinical Interview for DSM-IV (SCID) and interviewed with a local adaptation of the Explanatory Model Interview Catalogue (EMIC) to study underlying problems and triggers of attempted suicide. Of the patients, 92.4% had at least one DSM-IV disorder, with depressive disorders being the most prevalent disorder. Although half (50.0%) of the patients identified a health problem, 71.2% identified an interpersonal conflict as underlying problem leading to the suicide attempt. Furthermore, an interpersonal conflict was identified as the trigger of the suicide attempt by more than half of the patients (54.5%). The study included German-speaking patients only. According to patients, interpersonal problems often amplify underlying psychiatric problems, leading to suicide attempts. Social and interpersonal stressors should be acknowledged with integrated clinical and social interventions to prevent suicidal behavior in patients and populations.
Wong, Li Ping; Mohamad Shakir, Sharina Mahavera; Alias, Haridah; Aghamohammadi, Nasrin; Hoe, Victor Cw
The rapidly increasing uptake of e-cigarettes in Malaysia as of late demands a study to identify factors leading to its increased popularity and user intentions to quit smoking e-cigarettes. A convenience sample of e-cigarette smokers visiting e-cigarette retail shops in Selangor and Kuala Lumpur was recruited. The majority of e-cigarette smokers were youth in colleges or universities (39 %), and young professionals and managers (36 %). The main reasons for using e-cigarettes were to help the user quit tobacco cigarettes (88 %), the perception that e-cigarettes are not as intrusive as tobacco cigarettes (85 %) and can be used in public areas (70 %), the perception that e-cigarettes are healthier than tobacco cigarettes (85 %), and its relatively lower cost compared to tobacco cigarettes (65 %). A total of 65.3 % of respondents expressed intentions to quit e-cigarettes. In a multivariate analysis, the respondents who earned monthly income of RM1000 or less were significantly more likely to intend to quit smoking e-cigarettes [OR 1.551; 95 % CI 1.022-2.355; p = 0.015] compared to the respondents who earned a monthly income of more than RM2000. The respondents who disagreed with the statement 'Smoking e-cigs is relatively cheaper compared to tobacco cigarettes' were significantly more likely to intend to quit smoking e-cigarettes [OR 1.548; 95 % CI 1.045-2.293; p = 0.027] compared to respondents who did not agree. e-cigarette preventive interventions should target areas related to the identified main reasons for using e-cigarettes, namely as an aid for quitting tobacco cigarettes, the perception that e-cigarettes are not as intrusive as tobacco cigarettes and can be used in public areas, the idea that e-cigarettes are healthier than tobacco cigarettes, and its relatively lower cost compared to tobacco cigarettes.
O'Connor, Stephen S; Comtois, Katherine Anne; Atkins, David C; Kerbrat, Amanda H
While previous studies have examined motivational aspects of self-directed violence, few studies have included specific motivations in predictive models for future suicide attempts. The current study utilized a sample of 160 individuals treated in an acute emergency setting following a suicide attempt who completed an interview battery that included an assessment of functional aspects of the index suicide attempt. A follow-up interview was conducted at 6 months to ascertain subsequent suicide attempts. The functional domains of suicide attempts were labeled as reduction-of-distress, communication, perceived better alternative to living, and self-loathing. Above and beyond other known risk factors, including history and highest lethality of previous self-injury, suicide attempts that served a communication function (OR = 0.18, p = .02, CI = 0.04, 0.73) and higher ratings of clinical dysfunction (OR = 3.41, p = .05, CI = 1.02, 11.36) were associated with a significant reduction in likelihood to engage in a suicide attempt during the 6-month follow-up window. Including the perceived effectiveness of the index suicide attempt in getting one's needs met strengthened the overall model predicting a suicide attempt in the follow-up window and was an independent risk factor above and beyond other variables in the model OR = 1.75, p = .04, CI = 1.02, 3.01). Assessment of functional aspects of suicide attempt is feasible and may improve formulation of risk in a population where typical risk factors for suicide are ubiquitous. Copyright © 2016. Published by Elsevier Ltd.
Results: In Mr Green's case, the nurse chose to share the information of Mr Green's suicide attempt with other health care professionals. The nursing team followed the self-harm and suicide protocol of the hospital strictly, they maintained the effective communication with Mr Green, identified the factors which cause patient's suicide attempt, provided the appropriate nursing intervention to deal will these risk factors and collaborated with other health care professionals to prefect the further care. The patient transferred to a palliative care service with no sign of suicide attempt and other self-harm behaviors and passed away peacefully 76 days after discharged with his relatives and pastors accompany.
Mumoli, Laura; Ciriaco, Miriam; Gambardella, Antonio; Bombardiere, Giuseppe Nicodemo; Valentino, Paola; Palleria, Caterina; Labate, Angelo; Russo, Emilio
β-Interferon therapy is known to be a potential trigger of suicidal behavior, but this effect has not been previously reported for other multiple sclerosis (MS) treatments, such as, natalizumab. Here we report the case history of a 32-year-old woman affected by relapsing-remitting MS, who attempted suicide during natalizumab treatment. This case suggests that a suicidal ideation might be a rare side effect of natalizumab. Nevertheless, this case represents the first evidence of the new advers...
Martin, Rosemarie A; Cassidy, Rachel N; Murphy, Cara M; Rohsenow, Damaris J
For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n=184 and 340). Both components (general barriers, weight concerns) were replicated with excellent internal consistency reliability. Construct validity was supported by significant correlations with pretreatment nicotine dependence, smoking variables, smoking self-efficacy, and expected effects of smoking. General barriers significantly predicted 1-month smoking abstinence, frequency and heaviness, and 3-month smoking frequency; weight concerns predicted 1-month smoking frequency. Implications involve addressing barriers with corrective information in smoking treatment for smokers with SUD. Copyright © 2016 Elsevier Inc. All rights reserved.
Martin, Rosemarie A.; Cassidy, Rachel; Murphy, Cara M.; Rohsenow, Damaris J.
For smokers with substance use disorders (SUD), perceived barriers to quitting smoking include concerns unique to effects on sobriety as well as usual concerns. We expanded our Barriers to Quitting Smoking in Substance Abuse Treatment (BQS-SAT) scale, added importance ratings, validated it, and then used the importance scores to predict smoking treatment response in smokers with substance use disorders (SUD) undergoing smoking treatment in residential treatment programs in two studies (n = 184 and 340). Both components (General Barriers, Weight Concerns) were replicated with excellent internal consistency reliability. Construct validity was supported by significant correlations with pretreatment nicotine dependence, smoking variables, smoking self-efficacy, and expected effects of smoking. General Barriers significantly predicted 1-month smoking abstinence, frequency and heaviness, and 3-month smoking frequency; Weight Concerns predicted 1-month smoking frequency. Implications involve addressing barriers with corrective information in smoking treatment for smokers with SUD. PMID:26979552
Hayes, Kim A.; Dickinson, Denise M.
Abstract Introduction: Data from a randomized controlled trial designed primarily to test the effect of an antismoking socialization parenting program on child initiation of smoking were used to test the subsidiary hypothesis that providing antismoking socialization to children would lower the odds of relapse within a sub-sample of parents who had recently quit smoking. Methods: Over 13 months, 11 state Quitlines provided contact information for callers who were parents of 8- to 10-year-old children. Of 1604 parents enrolled in the trial, 689 (344 treatment; 345 control) had quit smoking cigarettes for at least 24 hours after calling a Quitline. Their data were used to test for group differences in 30-day abstinence measured using telephone interviews conducted 7 and 12 months post-baseline. Analyses of parents with complete follow-up data and intent-to-treat analyses incorporating parents lost to follow-up are presented. Results: Among 465 parents with complete follow-up data, treatment group parents had twice the odds of being abstinent 12 months post-baseline (adjusted OR = 2.01; P = .001) relative to controls. Intent-to-treat analysis with all 689 parents, in which those lost to follow-up were coded as having relapsed, showed a smaller though significant treatment effect on 30-day abstinence at 12 months (adjusted OR = 1.58; P = .017). Conclusions: This study is the first to observe that engaging parents who have quit smoking in antismoking socialization of children can lower their odds of relapse. Additional research is needed to replicate this finding and to identify the psychological mechanisms underlying the observed effect. Implications: There is a clear the need for research to develop new relapse prevention strategies. This study is the first to observe that engaging parents who have quit smoking in antismoking socialization of children can lower their odds of relapse. PMID:26416824
Baggett, Travis P; Lebrun-Harris, Lydie A; Rigotti, Nancy A
We determined whether or not homelessness is associated with cigarette smoking independent of other socio-economic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. We analyzed data from 2678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using US federally funded community health centers. We used multivariable logistic regression to examine the association between homelessness and (i) current cigarette smoking among all adults, and (ii) past-year desire to quit among current smokers, adjusting for demographic, socio-economic and behavioral health characteristics. Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57 versus 27%, P homelessness was associated independently with current smoking [adjusted odds ratio (AOR) 2.09; 95% confidence interval (CI) = 1.49-2.93], even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness and alcohol and drug abuse. Housing status was not associated significantly with past-year desire to stop smoking in unadjusted (P = 0.26) or adjusted (P = 0.60) analyses; 84% of currently homeless, 89% of formerly homeless and 82% of never homeless smokers reported wanting to quit. Among patients of US health centers, a history of homelessness doubles the odds of being a current smoker independent of other socio-economic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. © 2013 Society for the Study of Addiction.
Richey, Phyllis A.; Klesges, Robert C.; Talcott, Gerald W.; DeBon, Margaret; Womack, Catherine; Thomas, Fridtjof; Hryshko-Mullen, Ann
Thirty percent of all military personnel smoke cigarettes. Because of the negative health consequences and their impact on physical fitness, overall health, and military readiness, the Department of Defense has identified the reduction of tobacco use as a priority of US military forces. This study aims to evaluate the one-year efficacy of a proactive versus reactive smoking quit line in the US military with adjunctive nicotine replacement therapy (NRT) in both groups. This paper reports on the baseline variables of the first 1000 participants randomized, the design, and proposed analysis of the randomized two-arm clinical trial “Efficacy of a Tobacco Quit Line in the Military”. Participants are adult smokers who are Armed Forces Active Duty personnel, retirees, Reservist, National Guard and family member healthcare beneficiaries. All participants are randomized to either the Counselor Initiated (proactive) group, receiving 6 counseling sessions in addition to an 8-week supply of NRT, or the Self-Paced (reactive) group, in which they may call the quit line themselves to receive the same counseling sessions, in addition to a 2-week supply of NRT. The primary outcome measure of the study is self-reported smoking abstinence at 1-year follow-up. Results from this study will be the first to provide evidence for the efficacy of an intensive Counselor Initiated quit line with provided NRT in military personnel and could lead to dissemination throughout the US Air Force, the armed forces population as a whole and ultimately to civilian personnel that do not have ready access to preventive health services. PMID:22561390
Sharma, Ratika; Lucas, Maya; Ford, Pauline; Meurk, Carla; Gartner, Coral E
YouTube is the most popular video sharing website, and is increasingly used to broadcast health information including smoking cessation advice. This study examines the quality and quantity of YouTube quit smoking videos targeted at people living with mental illness (MI). We systematically searched YouTube using selected relevant search terms. The first 50 videos obtained for each search term were screened for relevance and further videos screened through snowball sampling. Forty unique, English language videos focussing on people with MI were included in the assessment and evaluated for general video characteristics, themes, format, targeted smoking cessation and harm reduction information. Most videos either discussed the problem of high smoking rates among people with MI (n=12) or smoking cessation programmes and policies at an institutional level (n=13). Only nine videos were aimed at providing quit smoking advice to this population. One video recommended higher doses of nicotine replacement therapy (NRT) for people with MI while six videos referred to possible changes in medication dosage on quitting smoking. Four videos suggested cutting down smoking for harm reduction. Very few YouTube videos specifically focus on the problem of high smoking rates among people with MI and even fewer provide targeted smoking cessation and harm reduction advice for this priority population. There is a need to develop comprehensive, evidence based, quit smoking video resources for smokers with a MI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Full Text Available This empirical paper provides evidence that commitment based human resource practices (CBHRP influence employees' turnover intentions by embedding newcomers more extensively into organisations. The study was conducted with 501 managers in 19 financial service organisations in India. Results reveal that CBHRP enable organisations to actively embed employees. The results also indicate that on-the-job embeddedness (on-the-JE is negatively related to turnover intentions and mediates relationships between CBHRP and employees' intention to quit.
Baggett, Travis P.; Lebrun-Harris, Lydie A.; Rigotti, Nancy A.
Aims We determined whether homelessness is associated with cigarette smoking independent of other socioeconomic measures and behavioral health factors, and whether homeless smokers differ from non-homeless smokers in their desire to quit. Design, Setting, and Participants We analyzed data from 2,678 adult respondents to the 2009 Health Center Patient Survey, a nationally representative cross-sectional survey of homeless and non-homeless individuals using U.S. federally-funded community health centers. Measurements We used multivariable logistic regression to examine the association between homelessness and (1) current cigarette smoking among all adults, and (2) past-year desire to quit among current smokers, adjusting for demographic, socioeconomic, and behavioral health characteristics. Findings Adults with any history of homelessness were more likely than never homeless respondents to be current smokers (57% vs. 27%, phomelessness was independently associated with current smoking (AOR 2.09; 95% CI 1.49-2.93), even after adjusting for age, sex, race, veteran status, insurance, education, employment, income, mental illness, and alcohol and drug abuse. Housing status was not significantly associated with past-year desire to stop smoking in unadjusted (p=0.26) or adjusted (p=0.60) analyses; 84% of currently homeless, 89% of formerly homeless, and 82% of never homeless smokers reported wanting to quit. Conclusions Among patients of U.S. health centers, a history of homelessness doubles the odds of being a current smoker independent of other socioeconomic factors and behavioral health conditions. However, homeless smokers do not differ from non-homeless smokers in their desire to quit and should be offered effective interventions. PMID:23834157
Personality traits, brie' recurrent depression and attempted suicide. ... South African Medical Journal ... After 5 years, 205 respondents were traced to complete a follow-up questionnaire and, where possible, a personality assessment was ...
The profile analysis of attempted-suicide patients referred to Pelonomi ... The main precipitating factors included problematic relationships (55.4%), ... physical – 18.2%), low self-esteem/ worthlessness/hopelessness/humiliation (16.7%), and
Finding a political framework for self-government in Northern Ireland that will be supported by both nationalists and unionists is referred to as a modern day attempt to do the impossible-to 'square the circle...
Keyes, M. A.; Malone, S. M.; Sharma, A.
OBJECTIVE: We asked whether adoption status represented a risk of suicide attempt for adopted and nonadopted offspring living in the United States. We also examined whether factors known to be associated with suicidal behavior would mediate the relationship between adoption status and suicide att...... of the risk of suicide attempt in adopted offspring may inform the larger investigation of suicidality in all adolescents and young adults.......OBJECTIVE: We asked whether adoption status represented a risk of suicide attempt for adopted and nonadopted offspring living in the United States. We also examined whether factors known to be associated with suicidal behavior would mediate the relationship between adoption status and suicide...... attempt. METHODS: Participants were drawn from the Sibling Interaction and Behavior Study, which included 692 adopted and 540 nonadopted offspring and was conducted at the University of Minnesota from 1998 to 2008. Adoptees were systematically ascertained from records of 3 large Minnesota adoption...
Chin, Eun Young; Kim, Hyun Kyung
This study was performed to identify the meaning of life experience following suicide attempt among middle-aged men. A qualitative research design was adopted using van Manen's hermeneutic phenomenological approach. The participants were six middle-aged men who had attempted suicide at least one time. Data were collected in 2013 through in-depth interviews. Individual interviews were recorded; and literary, art works and phenomenological literature were searched to identify the meaning of the experience. The five essential themes of the life experience of middle-aged men who attempted suicide were 'Bitter reality confronted again', 'Anger buried deep inside', 'Broken family, inescapable fetters', 'Blocked relationships, closed world' and 'A step towards a new life'. The meaning of lived experience found in this study provides deep insight into the experience following suicide attempt in middle-aged men and crucial information to give directions to appropriate support and nursing interventions.
Kubiak, Jan J.; Khankhane, Premraj J.; Kleingeld, Pieter J.; Lima, Ana T.
Water polluted with arsenic presents a challenge for remediation. A combination of phyto- and electro-remediation was attempted in this study. Four tanks were setup in order to assess the arsenic removal ability of the two methods separately
Fai, Sui Chee; Yen, Gan Kim; Malik, Nurdiyana
Smoking cessation clinics have been established in Malaysia since 2004, but wide variations in success rates have been observed. This study aimed to evaluate the proposed pharmacist-led Integrated Quit Smoking Service (IQSS) in Sabah, Malaysia, and identify factors associated with successful smoking cessation. Data from 176 participants were collected from one of the quit-smoking centres in Sabah, Malaysia. Pharmacists, doctors and nurses were involved throughout the study. Any health care provider can refer patients for smoking cessation, and free pharmacotherapy and counselling was provided during the cessation period for up to 3 months. Information on demographic characteristics, smoking behaviours, follow-up and pharmacotherapy were collected. The main outcome measure was the abstinence from smoking, which was verified through carbon monoxide in expired air during the 6-month follow-up. A 42.6% success rate was achieved in IQSS. Smoking behaviour such as lower cigarette intake and lower Fagerström score were identified as factors associated with success. On top of that, a longer duration of follow-up and more frequent visits were significantly associated with success in quitting smoking. Collaboration among health care practitioners should be the main focus, and we need a combination of proven effective modalities in order to create an ideal smoking cessation module.
Gilpin, Elizabeth A; Emery, Sherry; White, Martha M; Pierce, John P
The objective of this analysis was to examine further whether tobacco industry marketing using the labels light and ultra-light is perceived by smokers as a health claim. Smokers might view low tar/nicotine brands of cigarettes as a means to reduce the harm to their health from smoking and postpone quitting. Data were from smokers responding to a large, population-based survey of Californians' smoking behavior, conducted in 1996 (8,582 current smokers). Sixty percent of smokers thought the labels light and ultra-light referred to low tar/nicotine cigarettes, or otherwise implied a health claim. This percentage was higher for smokers of low tar/nicotine brands. Among smokers of regular brands, the more highly addicted, those who were trying unsuccessfully to quit, those who had cut consumption or thought about it, and those with health concerns were more likely to have considered switching. While some of these characteristics also were associated with smokers of low tar/nicotine brands, the associations were not as numerous or as strong. We conclude that some smokers appear to view low tar/nicotine brands as one short-term strategy to reduce the harm to their health from smoking without quitting. By implying reduced tar or nicotine exposure, tobacco industry marketing using the labels light and ultra-light is misleading smokers. The use of such labels should be regulated.
Knani, Mouna; Fournier, Pierre-Sébastien; Biron, Caroline
Despite a rich literature on association between psychosocial factors, the demand-control-support (DCS) model and burnout, there are few integrated frameworks encompassing the DCS model, burnout and intention to quit, particularly in a technological context. This manuscript examines the relationships between psychosocial risks, the demand-control-support (DCS) model, burnout syndrome and intention to quit following the introduction of new software at work. Data was collected from agents and advisors working at a Canadian university and using newstudy management software. An online questionnaire was sent via the university's internal mail. Finally, 112 people completed the online survey for a response rate of 60.9% . The results of structural equation modeling show that psychological demands, decision latitude and social support are associated with burnout. It is also clear that burnout, in particular depersonalization and emotional exhaustion, is positively associated with intention to quit. The few studies that raise the negative consequences of technology on quality of life in the workplace, and particularly on health, have not succeeded in establishing a direct link between a deterioration of health and the use of technology. This is due to the fact that there are few epidemiological studies on the direct consequences of the use of ITC on health.
Gorty, Prasad V. S. N. R.; Allam, Apparao
During the field work to control oral cancer, difficulty in communication was encountered with illiterates. A study to define the role of illiteracy, ignorance and willingness to quit smoking among the villagers was undertaken in a rural area surrounding Doddipatla Village, A.P., India. Out of a total population of 3,550, 272 (7.7%) persons, mostly in the age range of 21–50 years, attended a cancer detection camp. There were 173 (63.6%) females and 99 (36.4%) males, among whom 66 (M53 + F13) were smokers; 36.4% of males and 63% of females were illiterate. Among the illiterates, it was observed that smoking rate was high (56%) and 47.7% were ignorant of health effects of smoking. The attitude of illiterate smokers was encouraging, as 83.6% were willing to quit smoking. Further research is necessary to design health education material for 413.5 million illiterates living in India (1991 Indian Census). A community health worker, trained in the use of mass media coupled with a person‐to‐person approach, may help the smoker to quit smoking. PMID:1506267
Ravi S Kumar
Full Text Available Background: Globally, farming as an industry is considered a high-risk occupation for suicides. Certain states in India like Karnataka have a suicide rate higher than the national average, and this is generally attributed to the farmers' suicide. Aims: The aim is to study the characteristics of suicidal attempts among the farmer community in South India, with special emphasis on gender differences, modes used, and the immediate precipitant causes. Materials and Methods: Retrospective, case register-based, explorative-descriptive study of 426 consecutive medicolegal case files of patients whose stated occupation was farming and who were admitted as cases of deliberate self-harm or suicide attempt to a rural tertiary care hospital in rural South India. Results: Out of the 426 farmers who attempted suicide, majority were male (355, 83.3%, in the age group of 21–40 years (318, 75%, married (358, 84%, and belonging to lower socioeconomic status (268, 62.9%. About 54% of them had attempted suicide by consuming pesticides (230. Surprisingly, 183 (43% and 86 (20.2% reported the immediate precipitant as being relationship issues and marital conflict, respectively, and only 100 (23.5% attributed it to financial reasons. Females were significantly associated with a past history of suicidal attempt while males tended to abuse alcohol before an attempt more frequently. Conclusions: Pesticide poisoning was the most common mode for attempting suicide among the farmers. Contrary to public perception and other studies, relationship, and marital issues, not financial reasons were found to be the most common immediate precipitant for the attempters in our study.
Stenbacka, Marlene; Jokinen, Jussi
There is a paucity of studies on the role of early risk factors for the choice of methods for violent suicide attempts. Adolescent risk factors for the choice of violent or non-violent methods for suicide attempts and the risk of subsequent suicide were studied using a longitudinal design. A national Swedish cohort of 48 834 18-20-year-old young men conscripted for military service from 1969 to 1970 was followed through official registers during a 37-year period. Two questionnaires concerning their psychosocial background were answered by each conscript. Cox proportional hazard regression analyses were used to estimate the risk for different methods of attempted suicide and later suicide. A total of 1195 (2.4 %) men had made a suicide attempt and of these, 133 (11.1 %) committed suicide later. The number of suicide victims among the non-attempters was 482 (1 %). Half of the suicides occurred during the same year as the attempt. Suicide victims had earlier onset of suicidal behaviour and had more often used hanging as a method of attempted suicide than those who did not later commit suicide. The early risk factors for both violent and non-violent methods of suicide attempt were quite similar. Violent suicide attempts, especially by hanging, are associated with a clearly elevated suicide risk in men and require special clinical and public health attention. The early risk factors related to the choice of either a violent or a non-violent suicide attempt method are interlinked and circumstantial factors temporally close to the suicide attempt, such as access to a specific method, may partly explain the choice of method.
Lunde, Ingeborg; Myhre Reigstad, Marte; Frisch Moe, Kristin; Grimholt, Tine K.
Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care. PMID:29738447
Full Text Available Objective: The present study was conducted to identify risk and prediction factors of suicide attempts among drug abusers. Method: This causal-comparative study was conducted on 91 drug abusers that included 42 male and female suicide attempters and 49 male and female counterparts. Millon multi-axial personality inventory-II (MCMI-II, Dass-42 (depression, anxiety, stress, and coping styles inventory were used for data collection purposes. Results: The highest rate of suicide attempt was found in young male drug abusers with these characteristics: single, junior school graduate, unemployed, suicide history, sex and physical abuse history during childhood, legal problems, suicide and self-injury witness, and violence and suicide in family members. Compared to non-attempters, suicide attempters obtained higher scores in depressive, obsessive, masochistic, and borderline personality disorders clinical somatoform symptoms, alcohol abuse in addition to drug use, major depressive disorder, and stress. Suicide attempters also used lower levels of task-focused and avoidance-focused strategies and higher levels of emotion-focused strategies to cope with stressors. Conclusion: The findings of this study can contribute to suicide identification and prevention among drug abusers.
Full Text Available Background: Exposure to parental suicide attempt is associated with higher risks of adverse outcomes like lower educational performance, drug abuse and delinquent behavior. When a patient is hospitalized after a suicide attempt, this presents a unique opportunity to identify whether the patient has children, and thereby provide adequate follow-up for both the parent/patient and their children. The objective of this paper was to review the existing literature on follow-up measures for children subjected to parental suicide attempt. Methods: In line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA statement, we conducted a systematic literature search. Results: The search resulted in a total of 1275 article titles, of which all abstracts were screened. Out of these, 72 full text papers were read, and a final four articles were included. Three of the included papers described parts of the same study from an emergency department in The Hague, where a protocol was implemented for monitoring and referring children of parents attempting suicide. The fourth article described the association between maternal attempted suicide and risk of abuse or neglect of their children. Conclusions: The lack of research in this particular area is striking. The circumstances surrounding a parent’s suicide attempt call for appropriate familial care.
Pifarré, Marc; Carrera, Adrián; Vilaplana, Jordi; Cuadrado, Josep; Solsona, Sara; Abella, Francesc; Solsona, Francesc; Alves, Rui
Tobacco smoking is a major risk factor for a wide range of respiratory and circulatory diseases in active and passive smokers. Well-designed campaigns are raising awareness to the problem and an increasing number of smokers seeks medical assistance to quit their habit. In this context, there is the need to develop mHealth Apps that assist and manage large smoke quitting programs in efficient and economic ways. Our main objective is to develop an efficient and free mHealth app that facilitates the management of, and assistance to, people who want to quit smoking. As secondary objectives, our research also aims at estimating the economic effect of deploying that App in the public health system. Using JAVA and XML we develop and deploy a new free mHealth App for Android, called TControl (Tobacco-quitting Control). We deploy the App at the Tobacco Unit of the Santa Maria Hospital in Lleida and determine its stability by following the crashes of the App. We also use a survey to test usability of the app and differences in aptitude for using the App in a sample of 31 patients. Finally, we use mathematical models to estimate the economic effect of deploying TControl in the Catalan public health system. TControl keeps track of the smoke-quitting users, tracking their status, interpreting it, and offering advice and psychological support messages. The App also provides a bidirectional communication channel between patients and clinicians via mobile text messages. Additionally, registered patients have the option to interchange experiences with each other by chat. The App was found to be stable and to have high performances during startup and message sending. Our results suggest that age and gender have no statistically significant effect on patient aptitude for using TControl. Finally, we estimate that TControl could reduce costs for the Catalan public health system (CPHS) by up to € 400M in 10 years. TControl is a stable and well behaved App, typically operating near
Bannister, Susan L; Dolson, Mark S; Lingard, Lorelei; Keegan, David A
As part of their training, physicians are required to learn how to perform technical skills on patients. The previous literature reveals that this learning is complex and that many opportunities to perform these skills are not converted into attempts to do so by learners. This study sought to explore and understand this phenomenon better. A multi-phased qualitative study including ethnographic observations, interviews and focus groups was conducted to explore the factors that influence technical skill learning. In a tertiary paediatric emergency department, staff physician preceptors, residents, nurses and respiratory therapists were observed in the delivery and teaching of technical skills over a 3-month period. A constant comparison methodology was used to analyse the data and to develop a constructivist grounded theory. We conducted 419 hours of observation, 18 interviews and four focus groups. We observed 287 instances of technical skills, of which 27.5% were attempted by residents. Thematic analysis identified 14 factors, grouped into three categories, which influenced whether residents attempted technical skills on real patients. Learner factors included resident initiative, perceived need for skill acquisition and competing priorities. Teacher factors consisted of competing priorities, interest in teaching, perceived need for residents to acquire skills, attributions about learners, assessments of competency, and trust. Environmental factors were competition from other learners, judgement that the patient was appropriate, buy-in from team members, consent from patient or caregivers, and physical environment constraints. Our findings suggest that neither the presence of a learner in a clinical environment nor the trust of the supervisor is sufficient to ensure the learner will attempt a technical skill. We characterise this phenomenon as representing a pool of opportunities to conduct technical skills on live patients that shrinks to a much smaller pool of
Ortíz-Gómez, L D; López-Canul, B; Arankowsky-Sandoval, G
Comorbidity of major depression with substance abuse increases the risk of committing suicide. The objective of this work was to determine the psychological and socio-demographic factors associated with depression and suicide attempts in patients rehabilitating for drug consumption. 57 Patients attending a center for drug abuse treatment answered the following instruments: the Mini-international neuropsychiatric interview, a questionnaire of general information and background data on consumption of substances, depression and suicide attempts, and the Spanish adaptation of the Holmes and Rahe scale for the assessment of life events. Chi-square and logistic regression tests were used to establish associations between variables. 68.4% of the Patients had current major depression, of these, 75.4% experienced it before the onset of substance abuse. Patients attempting suicide before drug use corresponded to 26%, whilst 28.1% attempted suicide within the last year. Current depression-related variables were receiving a diagnosis of depression prior to the consumption of drugs and the first used drugs, which were alcohol or marijuana. The adverse life event "Familial drug abuse history", was also significantly related to depression (p=0.02). Variables associated with current suicide attempts were: receiving a diagnosis of depression prior to the consumption of drugs (p=0.02), and suicide attempts previous to drug use (psuicide prior to the use of drugs also experienced these conditions during the rehabilitation process. Substance use in the family was a risk factor for both, underscoring the need of actions aimed at preventing addictions in the household environment. Copyright © 2014. Published by Elsevier B.V.
Baek, Ji Hyun; Kang, Eun-Suk; Fava, Maurizio; Mischoulon, David; Nierenberg, Andrew A; Yu, Bum-Hee; Lee, Dongsoo; Jeon, Hong Jin
Major depressive disorder (MDD) is associated with suicide. Although several studies have reported its association with low serum lipid, few studies have investigated relationships between current suicidality and lipid profiles, comparing with other blood measures in MDD patients. The study population consisted of 555 subjects with MDD who were ≥ 18 years old, evaluated by the Mini International Neuropsychiatric Interview (MINI) with the suicidality module. At the evaluation visit, we measured serum lipid profiles including total cholesterol, triglycerides (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and very low-density lipoprotein (VLDL), and blood measures such as fasting glucose, total protein, albumin, blood urea nitrogen, creatinine, thyroid hormones, red and white blood cells, platelet count, hemoglobin, and hematocrit. Recent attempters who had attempted suicide within the past month showed significantly lower TG and higher HDL levels than lifetime and never attempters, using Tukey's post-hoc analysis. Recent attempters exhibited lower TG and higher HDL than those with recent suicide ideation and wish to self-harm and those without previous attempt. Linear regression analysis revealed that TG was negatively associated with current suicidality scores (β = -0.187, p = 0.039), whereas VLDL was positively associated with the recent suicide status (β = 0.198, p = 0.032) after controlling for age and sex. There were no significant differences between the groups in terms of other serum lipid profiles and blood measures. Low serum TG, high HDL and VLDL levels are associated with recent suicide attempt or recent suicide status in patients with MDD. Copyright © 2014 Elsevier Inc. All rights reserved.
Brennan, Emily; Durkin, Sarah J; Wakefield, Melanie A; Kashima, Yoshihisa
Decisions about which antismoking advertisements should be aired are often guided by audience ratings of perceived effectiveness (PE). Given that the usefulness of PE measures depends on their ability to predict the likelihood that a message will have a pos