Introduction: Cigarette preference increases as a function of nicotine content, but preference can be shifted by manipulating cigarette cost. The aim of the present study is to model whether the behavioral-economic metric of unit price (cigarette cost/nicotine content) accounts for cigarette preference shifts and whether preference changes to very low nicotine content cigarettes (VLNCs) are associated with corresponding changes in smoking rate. Methods: 169 daily smokers from populations vulnerable to smoking completed sessions in which choices between smoking normal nicotine content (NNC) (15.8mg/g) and VLNC (0.4mg/g) cigarettes were concurrently available. In Condition 1, choices for both products were available ad-lib at an equal cost of 10 responses/choice. In Condition 2, VLNCs were again available ad-lib at 10 responses/choice, but NNCs were available on a progressive-ratio (PR) schedule wherein response cost (and unit price) increased following each NNC choice (10,160,320…8400 responses/choice). Results were analyzed using ANOVAs and a binomial test (p<.05). Results: Participants preferred NNCs over VLNCs in Condition 1, but shifted preference to VLNCs in Condition 2 (p<.001) immediately before the point in the PR progression where unit price for NNCs exceeded unit price for VLNCs (p<.001). Additionally, this preference shift corresponded with reduced total cigarette consumption compared to Condition 1 levels (p<.001). Conclusions: These results suggest that unit price of nicotine underpins cigarette preference and may provide a metric by which regulators can predict product preference and potentially impact it through policy. These results also demonstrate that VLNCs sustain lower smoking rates than NNCs even under acute laboratory conditions.

Introduction: Financial incentives increase smoking abstinence among pregnant and postpartum women. They have also been reported to reduce psychological symptoms using the Beck Depression Inventory (BDI) and Brief Symptom Inventory (BSI) in women at risk for perinatal depression. This prospective study aims to replicate and extend these findings using the BDI and Edinburgh Postpartum Depression Scale (EPDS). Methods: Participants were 169 pregnant cigarette smokers who were assigned to one of two treatment conditions: Best Practices only (n=88), which entails brief counseling and a referral to a pregnancy-specific quit-line, or Best Practices + Incentives (n=81). Participants were categorized as at increased risk (Dep+; n= 91) or lower risk (Dep-; n= 76) for depression based on history of depressive symptoms and baseline symptom scores. Treatment effects on smoking status and BDI/EPDS scores were examined across nine perinatal assessments using repeated measures analyses of covariance. Results: Financial incentives increased rates of biochemically-verified abstinence through 12-weeks postpartum independent of depression risk (ps ≤ .01) but did not differentially decrease BDI or EPDS scores (ps > .05). Scores decreased with both interventions for the Dep+ women (p = .001). Conclusions: These results replicate earlier evidence that financial incentives increase perinatal smoking abstinence in Dep+ women but not their efficacy in differentially reducing depressive symptoms at levels greater than Best Practices. The failure to replicate effects on depressive symptoms may be due to use of different control conditions in the current and prior study or increased screening and intervention for perinatal mental health during routine obstetrical care.

The consumption of alcohol and smoking of cigarettes are both common practices in Australian society. With continued public health efforts exposure to both alcohol and nicotine during pregnancy has diminished, however little is known about exposure to these toxins in the postnatal period and the effect on the breastfed infant. To investigate the pattern of alcohol consumption and cigarette smoking in the postnatal period and the effect on breastfeeding outcomes, a longitudinal study was conducted in two public hospitals with maternity wards in Perth, Australia. Data for the Perth Infant Feeding Study (PIFSII) were collected from 587 mothers between mid-September 2002 and mid-July 2003. While in hospital participating mothers completed a self-administered baseline questionnaire. Follow-up telephone interviews were conducted at 4, 10, 16, 22, 32, 40 and 52 weeks. Data collected included sociodemographic, biomedical, hospital related and psychosocial factors. Further analysis of alcohol data was undertaken on the 1995 and 2001 National Health Survey (NHS) data sets to provide a national perspective. Alcohol and smoking related data were analysed and described using frequency distributions, means and medians. Univariate logistic regression was used to screen for potentially significant variables for subsequent incorporation in the multivariate analysis. Multivariate logistic regression analysis was employed to determine the effect of alcohol consumption and cigarette smoking on breastfeeding outcomes prenatally, antenatally and postnatally, after adjusting for factors identified in the literature as being associated with breastfeeding initiation and duration. The relationship between smoking status and breastfeeding duration was determined using survival analysis. / Analysis of the relationship between breastfeeding duration and the level of postpartum intake was investigated using a Cox hazards model with repeated measures for alcohol consumption. Results showed that: 1. PIFSII. During pregnancy approximately 32% of women stopped drinking alcohol. Thirty five percent of pregnant women continued to consume alcohol during their pregnancy with 82.2% of these women consuming two or fewer standard drinks per week. At 4, 6 and 12 months postpartum, 46.7%, 47.4% and 42.3% of breastfeeding women were consuming alcohol, respectively. 2. NHS. Sixteen point four percent and 1.3% of pregnant women from the 1995 and 2001 NHS, respectively were consuming more than that recommended in ‘Guideline 11’ from the National Health and Medical Research Council of Australia (ie >7 standard drinks/week). 3. NHS. Thirteen percent of lactating mothers from the 1995 NHS and 16.8% from the 2001 NHS were consuming seven or more standard drinks of alcohol in the reference week, thus exceeding the NHMRC recommended level. 4. PIFSII. After 6 months of follow up, women who consumed alcohol at levels of more than two standard drinks per day were almost twice as likely to discontinue breastfeeding earlier than women who drank below these levels (HR 1.9, 95% CI 1.1, 3.0). 5. PIFSII. With regard to smoking, 226 (39%) of mothers reported smoking pre- pregnancy. Mothers who smoked were more likely to have a partner who smoked, to have consumed alcohol prior to pregnancy and less likely to attend antenatal classes. / They were also less likely to know how they were going to feed their baby before conception and be more inclined to consider stopping breastfeeding before four months postpartum. 6. PIFSII. Women who smoked during pregnancy had a lower prevalence and shorter duration of breastfeeding than non-smoking mothers (28 weeks versus 11 weeks, 95% CI: 8.3-13.7). This effect remained even after adjustment for age, education, income, father’s smoking status, mother’s country of birth, intended duration of breastfeeding >6 months and birth weight (risk ratio HR 1.59, 95% CI 1.22 to 2.08). 7. PIFSII. Two hundred and twenty six (39%) mothers reported smoking prior to pregnancy and 77 (34%) of these stopped smoking during pregnancy. Quitting smoking during pregnancy was significantly associated with breastfeeding for longer than six months (OR = 3.70, 95% CI 1.55 to 8.83; p<0.05). The results of the present study suggest a negative association between drinking alcohol in the postpartum period and breastfeeding outcomes. Similarly, smoking cigarettes before, during and after pregnancy negatively affects breastfeeding. There is a need for guidelines outlining the safe intake of alcohol during lactation and for the cessation of cigarette smoking in the prenatal and antenatal period.

Syfte: Syftet med studien var att belysa sambandet mellan cigarrettrökning och paro-dontit.Metod: Studien bygger på en allmän litteraturstudie som sammanställer aktuell forsk-ning inom det valda ämnesområdet. Detta studerades genom att granska olika studiers koppling mellan parodontit och cigarrettrökning. Studien baseras på 15 kvantitativa artiklar som söktes via PubMed och Sience Direct.Resultat: Resultatet visade att det fanns ett samband mellan parodontit och cigarrett-rökning. Rökning var den främsta beteendemässiga riskfaktorn för uppkomst av paro-dontit. Rökare uppvisar ett mer ohälsosamt beteende och negativ attityd till allmän hälsa. Kroppens infektionsförsvar försämrades hos rökare. Slutsats: Studien har funnit att det finns ett samband mellan cigarrettrökning och pa-rodontit. Variabler som ålder och kön har ingen påverkan på associationen mellan ci-garettrökning och parodontit. Däremot är det antalet rökta cigarretter per år och anta-let år av konsumtion som har en påverkan för uppkomst av parodontit. / Aim: The purpose of this study was to investigate the relationship between cigarette smoking and parodontitis. Method: The study is based on a general literature study that compiles current research in the chosen subject. The study is based on 15 quantitative articles which were searched through PubMed and Sience Direct. Results: The results showed that there was a relation between periodontal disease and cigarette smoking. Smoking was the primary behavioral risk factor for the occurrence of parodontitis and smokers showed a more unhealthy behavior and negative attitude to the general health. Studies also showed that the body's defense against bacteria decreased in smokers who had a high amount of plaque and thus contributed to the immune system overreacts to the bacteria. This in turn caused widespread damage in the tissue and resulted in loss of tissue.Conclusion: The study showed that there is a relation between cigarette smoking and periodontitis. Variables such as age and sex have no influence on the association between cigarette smoking and periodontitis. In contrast, the number of smoked cigarettes per year and the number of years of consumption that have an impact on the occurrence of periodontal disease.

The purpose of this study was to investigate the relationship between cigarette smoking and socio-demographic variables based on the empirical literature and the primitive theories in the field. Two regression approaches, logistic regression and linear multiple regression, were conducted on the two most recent Arizona Adult Tobacco Surveys to test the hypothesized models. The results showed that cigarette smokers in Arizona are mainly residents who have not completed a four-year college degree, who are unemployed, White, non-Hispanic, or young to middle-aged adults. Among the socio-demographic predictors of interest, education is the most important variable in identifying cigarette smokers, even though the predictive power of these socio-demographic variables is small. Practical and methodological implications of these findings are discussed.

Background and Aims: There is little information about the epidemiology and risk factors of periodontal diseases in Latin America in general, and Brazil in particular. The principal aims of this study were to: 1) describe the prevalence and severity of periodontal attachment loss and gingival recession, and to assess the contribution of demographic, behavioral, and environmental exposures to the occurrence of periodontal disease outcomes in a sample representative of the urban population in the state of Rio Grande do Sul in south Brazil; and 2) report the epidemiology and risk indicators of aggressive periodontitis in this population. Methods: A representative sample consisting of 1,586 subjects 14-103 years of age (mean 38 y) and comprising 45.3% males and 54.7% females was selected using a multi-stage, probability, cluster sampling strategy. The subjects were interviewed using a structured questionnaire and underwent a full-mouth, six sites per tooth clinical examination in a mobile examination center. Results: Moderate and severe clinical attachment loss and gingival recession were widespread among adults in this population. The prevalence and extent of attachment loss ³5 and ³7 mm were 79% and 52% subjects, and 36% and 16% teeth; and for gingival recession ³3 mm and ³5 mm were 52% and 22% subjects, and 17% and 6% teeth, respectively. Aggressive periodontitis was diagnosed in 5.5% of subjects, which is significantly higher than the reported prevalence in most other populations. Among the main risk indicators for chronic as well as aggressive destructive periodontal diseases were: older age, low socioeconomic status, dental calculus, and smoking. Cigarette smoking accounted for an important part of periodontal disease burden, particularly in adults, and should be considered an important target in any prevention strategy aimed at reducing the burden of periodontal diseases. Partial recording methods consistently underestimated the prevalence of attachment loss in the population, and the extent of underestimation was dependent on the type of system used and the threshold of attachment loss. Conclusions: Destructive periodontal diseases are prevalent in this Brazilian population. Suitable disease prevention and health promotion programs should be established to improve the periodontal health in this population.

Nos últimos anos, um grande número de estudos tem investigado o consumo de cigarros com base em uma teoria que permeia uma relação entre custos e benefícios, envolvendo trocas entre consequências em curto e longo prazo, que tem sido proposta para explicar porque escolhas insalubres – incluindo exemplos nos âmbitos de poupança, procrastinação, vício e auto-confiança – ocorrem, apesar de refletirem prejuízos. Esta abordagem, aqui definida como preferência de tempo, é um fenômeno conhecido quando os benefícios estão no presente e os custos são projetados para o futuro, permeando a teoria de tomada de decisões ao longo do tempo (escolha intertemporal) – que reflete uma escolha entre uma recompensa menor imediata e uma recompensa maior atrasada. A fim de analisar a relação de escolha entre ganhos e perdas imediatos e atrasados, em diferentes contextos, e os diversos fatores que influenciam essa escolha, um questionário foi desenvolvido a partir de artigos anteriores (Kirby, 2009; Myerson et al., 2016) e aplicado a uma amostra da população de fumantes. O objetivo das análises do presente estudo baseia-se em avaliar a influência de variáveis como domínio, gênero, idade e impulsividade em cada uma das condições do questionário, chegando a conclusões a respeito da influência das mesmas, dependendo de variáveis como contexto, tipo e efeito. Os resultados do estudo comprovam que a preferência de tempo é uma medida válida para predizer o processo de tomada de decisão de consumidores de cigarros, o que significa que fumantes são mais propensos a escolher resultados imediatos em vez de resultados atrasados. Isto indica que, de modo geral, fumantes preferem recompensas imediatas do que benefícios futuros. No entanto, os resultados do estudo apontam que, sob determinadas condições, esse efeito de preferência de tempo se reduz, aumentando a propensão de escolha por resultados atrasados em vez de resultados imediatos. Estas circunstâncias foram encontradas em diferenças relacionadas ao contexto (fumo x genérico), diferenças relacionadas ao efeito de sinal (ganho x perda), diferenças em relação aos domínios (financeiro, saúde, estético e social), diferenças a cerca do modo de comprometimento de participação (pessoal x outros) e diferenças relacionadas às características demográficas dos respondentes (faixa etária e gênero). / In the last past years, a large number of studies have investigated cigarette smoking based on a theory that permeates a relationship between costs and benefits, involving trade-offs between short and long-term consequences, which has been proposed to explain why unhealthy choices, including exemples in the areas of savings, procrastination, addiction and self-confidence - occur, even though they reflect losses. This approach, here defined as time preference, is a known phenomenon when benefits are at the present and costs are projected into the future, permeating a decision-making theory over time (intertemporal choice) - which reflect a choice between a immediate but small reward and a larger but late reward. In order to analyze these choices between immediate and delayed gains and losses in different contexts, and the various factors that influence this choice, a questionnaire was developed based on previous articles (Kirby, 2009, Myerson et al., 2016) and applied into a sample of the population of smokers. The objective of the present study is to evaluate the influence of variables such as domain, gender, age and impulsivity in each of the conditions of the questionnaire, leading to conclusions about their influence, depending on variables such as context, type and effect. The results of the study prove that time preference is a valid measure to predict the decision-making process of smokers, which means that smokers are more likely to choose immediate outcomes rather than late outcomes. This indicates that, overall, smokers prefer immediate rewards than future benefits. However, the study results point out that, under certain conditions, this time preference effect is reduced, increasing the tendency to choose for delayed results rather than immediate results. These circumstances were found in differences related to the context (smoking x generic), differences related to the sign effect (gain x loss), differences in relation to the domains (financial, health, aesthetic and social), differences about the mode of commitment of participation (personal x other) and differences related to the demographic characteristics of the respondents (age rage and gender).

Background and Aims: There is little information about the epidemiology and risk factors of periodontal diseases in Latin America in general, and Brazil in particular. The principal aims of this study were to: 1) describe the prevalence and severity of periodontal attachment loss and gingival recession, and to assess the contribution of demographic, behavioral, and environmental exposures to the occurrence of periodontal disease outcomes in a sample representative of the urban population in the state of Rio Grande do Sul in south Brazil; and 2) report the epidemiology and risk indicators of aggressive periodontitis in this population. Methods: A representative sample consisting of 1,586 subjects 14-103 years of age (mean 38 y) and comprising 45.3% males and 54.7% females was selected using a multi-stage, probability, cluster sampling strategy. The subjects were interviewed using a structured questionnaire and underwent a full-mouth, six sites per tooth clinical examination in a mobile examination center. Results: Moderate and severe clinical attachment loss and gingival recession were widespread among adults in this population. The prevalence and extent of attachment loss ³5 and ³7 mm were 79% and 52% subjects, and 36% and 16% teeth; and for gingival recession ³3 mm and ³5 mm were 52% and 22% subjects, and 17% and 6% teeth, respectively. Aggressive periodontitis was diagnosed in 5.5% of subjects, which is significantly higher than the reported prevalence in most other populations. Among the main risk indicators for chronic as well as aggressive destructive periodontal diseases were: older age, low socioeconomic status, dental calculus, and smoking. Cigarette smoking accounted for an important part of periodontal disease burden, particularly in adults, and should be considered an important target in any prevention strategy aimed at reducing the burden of periodontal diseases. Partial recording methods consistently underestimated the prevalence of attachment loss in the population, and the extent of underestimation was dependent on the type of system used and the threshold of attachment loss. Conclusions: Destructive periodontal diseases are prevalent in this Brazilian population. Suitable disease prevention and health promotion programs should be established to improve the periodontal health in this population.

Orientador: Patrícia Monteiro Seraphim / Banca: Ismael Forte Freitas Júnior / Banca: Cecília Edna Mareze da Costa / Resumo: A gravidez é um período de ajustes metabólicos e, quando associado ao tabagismo provoca alterações que trazem malefícios tanto à saúde materna quanto à saúde fetal. Assim, o estudo investigou o efeito da exposição à fumaça de cigarro sobre a expressão do transportador de glicose GLUT4 e parâmetros séricos e morfométricos de ratas prenhes e sua prole. Foram utilizadas ratas Wistar divididas em: CG- controle sacrificadas após a gestação, com prole adotada pelo grupo CL; CL - controle sacrificadas após o término da lactação; FG - expostas à fumaça de cigarro até o período gestacional e sacrificadas posteriormente, com prole adotada pelo grupo FL; FG - expostas à fumaça de cigarro até o fim da amamentação e posteriormente sacrificadas. As proles foram divididas por sexo e de acordo com a exposição ou não da rata à fumaça. Foram coletados sangue e tecidos para análise de glicemia e do conteúdo gênico e protéico de GLUT4. Nas ratas expostas à fumaça de cigarro, houve redução de peso corpóreo e de tecido adiposo, aumento da glicemia e modulação do transportador GLUT4 no músculo esquelético. Nas proles, houve... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Pregnancy is a period of metabolic adjustments, and when associated with cigarette smoke causes changes both to maternal health as the fetal. The study has investigated the effect of cigarette smoke exposure on the expression of glucose transporter GLUT4 and morphometric parameters and serum of pregnant smoker rats and their offspring. Wistar rats were divided in: CG- nonsmokers sacrificed after pregnancy with offspring adopted by CL; CL - nonsmoker group sacrificed after the end of lactation; FG - smoker group sacrificed after pregnancy with offspring adopted by FL; FL - smoker sacrificed after the end of lactation. The offspring was divided by sex and according to the protocol of their mothers. Blood and tissue were collected for analysis of glucose and the content of GLUT4 gene and protein. In smoker mothers, body weight and adipose tissue were reduced, glucose level was increased, and GLUT4 expression was higher in skeletal muscle. In offspring... (Complete abstract click electronic access below) / Mestre

Nos últimos anos, um grande número de estudos tem investigado o consumo de cigarros com base em uma teoria que permeia uma relação entre custos e benefícios, envolvendo trocas entre consequências em curto e longo prazo, que tem sido proposta para explicar porque escolhas insalubres – incluindo exemplos nos âmbitos de poupança, procrastinação, vício e auto-confiança – ocorrem, apesar de refletirem prejuízos. Esta abordagem, aqui definida como preferência de tempo, é um fenômeno conhecido quando os benefícios estão no presente e os custos são projetados para o futuro, permeando a teoria de tomada de decisões ao longo do tempo (escolha intertemporal) – que reflete uma escolha entre uma recompensa menor imediata e uma recompensa maior atrasada. A fim de analisar a relação de escolha entre ganhos e perdas imediatos e atrasados, em diferentes contextos, e os diversos fatores que influenciam essa escolha, um questionário foi desenvolvido a partir de artigos anteriores (Kirby, 2009; Myerson et al., 2016) e aplicado a uma amostra da população de fumantes. O objetivo das análises do presente estudo baseia-se em avaliar a influência de variáveis como domínio, gênero, idade e impulsividade em cada uma das condições do questionário, chegando a conclusões a respeito da influência das mesmas, dependendo de variáveis como contexto, tipo e efeito. Os resultados do estudo comprovam que a preferência de tempo é uma medida válida para predizer o processo de tomada de decisão de consumidores de cigarros, o que significa que fumantes são mais propensos a escolher resultados imediatos em vez de resultados atrasados. Isto indica que, de modo geral, fumantes preferem recompensas imediatas do que benefícios futuros. No entanto, os resultados do estudo apontam que, sob determinadas condições, esse efeito de preferência de tempo se reduz, aumentando a propensão de escolha por resultados atrasados em vez de resultados imediatos. Estas circunstâncias foram encontradas em diferenças relacionadas ao contexto (fumo x genérico), diferenças relacionadas ao efeito de sinal (ganho x perda), diferenças em relação aos domínios (financeiro, saúde, estético e social), diferenças a cerca do modo de comprometimento de participação (pessoal x outros) e diferenças relacionadas às características demográficas dos respondentes (faixa etária e gênero). / In the last past years, a large number of studies have investigated cigarette smoking based on a theory that permeates a relationship between costs and benefits, involving trade-offs between short and long-term consequences, which has been proposed to explain why unhealthy choices, including exemples in the areas of savings, procrastination, addiction and self-confidence - occur, even though they reflect losses. This approach, here defined as time preference, is a known phenomenon when benefits are at the present and costs are projected into the future, permeating a decision-making theory over time (intertemporal choice) - which reflect a choice between a immediate but small reward and a larger but late reward. In order to analyze these choices between immediate and delayed gains and losses in different contexts, and the various factors that influence this choice, a questionnaire was developed based on previous articles (Kirby, 2009, Myerson et al., 2016) and applied into a sample of the population of smokers. The objective of the present study is to evaluate the influence of variables such as domain, gender, age and impulsivity in each of the conditions of the questionnaire, leading to conclusions about their influence, depending on variables such as context, type and effect. The results of the study prove that time preference is a valid measure to predict the decision-making process of smokers, which means that smokers are more likely to choose immediate outcomes rather than late outcomes. This indicates that, overall, smokers prefer immediate rewards than future benefits. However, the study results point out that, under certain conditions, this time preference effect is reduced, increasing the tendency to choose for delayed results rather than immediate results. These circumstances were found in differences related to the context (smoking x generic), differences related to the sign effect (gain x loss), differences in relation to the domains (financial, health, aesthetic and social), differences about the mode of commitment of participation (personal x other) and differences related to the demographic characteristics of the respondents (age rage and gender).