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BACKGROUND: Periodontitis is prevalent among adults 30 years and older and its prevalence increases with age. By 2040, there is an expected 50% increase in adults over the age of 65 years old in the US population. Therefore, it is essential to maintain good oral health and prevent tooth loss, pain, discomfort, and poor nutrition from improper chewing of food. Adults directly influence their periodontitis risk factors through at home oral care practices and smoking habits. Thus, the importance of home oral care practices and better choices in smoking habits may prevent the progression of periodontitis. The purpose of this study is to assess the association of at home oral care practices and smoking to periodontitis. The findings may be useful in future oral health education to emphasize the importance of oral hygiene care at home and smoking cessation. It may help dentists identify patients that will benefit from oral care instructions and smoking cessation and possibly aid in the development of prevention programs to combat the high prevalence of periodontitis in the foreseen growing population of the elders over the age of 65 in the U.S. OBJECTIVES: To assess the association of at home oral care practices to periodontitis and compare smokers and nonsmokers with respect to their oral care practices. We expect that people who regularly brush their teeth, floss, and use mouthwash twice or more per day, and who are nonsmokers will have less periodontitis. METHODS: Three categories of brushing: two to six times/week, once a day, or two or more/day in the past week were used. Additionally, three categories of flossing and rinsing: never, once to six times/week, or one or more times/day in the past week were also used. Odds ratio was calculated controlling for age, bone loss, gender, socioeconomic status, and smoking. Additionally, odds ratio was calculated for the oral care practices comparing smokers versus non-smokers. RESULTS: A total of 141 adults participated in the survey, 18% never flossed, 23% never rinsed, 6% brushed less than daily, and 35% had periodontitis. After controlling for variables, the lack of flossing was associated to periodontitis (odds ratio=1,88, 95% 1.00, p<0.0492) while rinsing and brushing were not associated with periodontitis. There were five times higher odds of periodontitis for a participant who never flossed compared to counterparts (95% CI 2.10-13.56). A dose response was not observed. After calculating for the odds ratio of the association of oral care practices to periodontitis among smokers versus non-smokers, the lack of flossing was positively associated with periodontitis such that smokers who never flossed had twice the higher odds of periodontitis compared to counterparts (odds ratio=4.20, CI 1.30-13.50, p<0.012). Participants who were smokers, with bone loss, and from low socioeconomic status had higher odds of having periodontitis. DISCUSSION: The lack of flossing was associated with higher prevalence of periodontitis. Smokers and especially daily smokers were more likely to engage in poor oral hygiene behaviors. Participants with bone loss, low socioeconomic status, and smokers were also associated with higher prevalence of periodontitis. Flossing at least once a week had a protective association to periodontitis. However, this was a cross-sectional study so a causal relation between the oral care practices and periodontitis cannot be established.

Smoking, physical activity, and insufficient fruit and vegetable consumption have been linked to increased instances of coronary heart disease, stroke, peripheral vascular disease, chronic obstructive lung disease, type 2 diabetes, osteoporosis, depression, hypertension, numerous cancers, and complications surrounding blood pressure and blood cholesterol. In the United States approximately 22% of college students have smoked at least one cigarette in the past 30 days; 70-85% are not meeting recommended levels of physical activity; and 75% are not consuming recommended levels of fruits and vegetables. The purpose of this study was to investigate differences in physical activity and fruit and vegetable consumption behaviors of self reported smokers and nonsmokers, and to determine the predictors of healthy behaviors at a mid-sized university in the southern region of the United States using the Theory of Planned Behavior and the Health Belief Model. Students in this study (N = 461) completed a written questionnaire during March-May 2012. Results indicated that 20% of the population smoked at least one cigarette in the past 30 days, with men being more likely to smoke than women. Physical activity was found to be significant to smoking status; however, fruit and vegetable consumption was not significant. Multiple regression determined the following constructs significantly predicted smoking status: attitudes and intentions from the Theory of Planned Behavior and perceived severity, perceived benefits, perceived barriers, and cues to action from the Health Belief Model. The results of this study may be utilized to address differences in college student engagement in adverse health behaviors, and in the enhancement of future smoking interventions on college campuses.

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SAMMANFATTNINGBakgrundParodontit är en kronisk sjukdom som beror på en endogen infektion i munhålan. Sjukdomen drabbar 8-20% av den vuxna befolkningen globalt och påverkas av såväl genetiska, systemiska och lokala faktorer, som av livsstilsfaktorer. En av de största livsstilsfaktorerna vid parodontal sjukdom är rökning. Rökning är både en stor riskfaktor för utveckling av parodontal sjukdom och en prediktor för en negativ behandlingsutkomst. I tidigare studier har rökare uppvisat en sämre följsamhet till parodontal stödbehandling än icke-rökare.Syfte, material och metodMed hjälp av tobaksanamneser, insamlade på avdelningen för parodontologi på tandvårdshögskolan vid Malmö högskola, var målet att via det elektroniska journalsystemet T4 utvärdera patienternas följsamhet till behandling. Vidare ville vi tydliggöra eventuella skillnader mellan rökare och icke-rökare, mellan olika åldersgrupper och mellan patienter med olika svårighetsgrader av parodontal skada. Tobaksanamneser från 213 patienter, insamlade under år 2013, inkluderades i studien. Samtliga journaler granskades och data relevant för studien extraherades enligt en utformad mall.Resultat och slutsatsEn signifikant skillnad gällande antalet återbud till planerad behandling kan ses mellan grupperna, där de rökande patienter har flest återbud. Antalet återbud påverkas också av bostadsort och parodontal diagnos. Även ålder och operatör kan påverka risken för återbud. Ytterligare skillnader mellan grupperna ses i relation till sysselsättning, där antalet sjukskrivna och arbetslösa patienter är överrepresenterade bland rökarna. Vidare studier bör utformas som prospektiva studier där patienter följs och behandlas enligt en kalibrerad mall. För att få mer pålitliga resultat behöver fler och bättre kontrollerade studier utföras i ämnet. / ABSTRACTIntroductionPeriodontal disease is a chronic disease that depends on an endogenous infection in the oral cavity. The disease affects 8-20% of the adult population worldwide and is influenced by both genetic, systemic, local and lifestyle factors. One of the major lifestyle factors in periodontal disease is smoking. Smoking is both a major risk factor for development of periodontal disease and a predictor of adverse treatment outcome. In previous studies, smokers showed a lower adherence to periodontal support therapy.Study design, methods and materialUsing tobacco anamnesis, collected in the Department of Periodontology at the School of Dentistry at Malmö University, the purpose was to to evaluate patient compliance to treatment taking into account various variables. Tobacco anamnesis from 213 subjects collected in 2013, were included in the study. All records were reviewed and data relevant to the study extracted according to a designed template.Results and conclusionSmokers, and non-smokers were compared and significant differences between the groups regarding number of cancellations of planned treatment could be seen. Smokers tended to have more cancellations. The number of cancellations were affected by place of residence and periodontal diagnosis. Also age and therapist could affect the risk. Differences between the groups was seen in relation to employment, where unemployed patients, as well as patients in early retirement/long term sickness were overrepresented among smokers. To get more reliable results more and better -controlled studies are needed.

The study’s objective was to assess whether resting-state regional functional connectivity and current source density (CSD) measured during smoking abstinence predict smoking progression across 18 months, depressive traits, and nicotine-enhanced reward sensitivity (NERS) in young light-nicotine (NIC) smokers using low-resolution brain electromagnetic tomography analysis (LORETA). A secondary goal was to assess whether depressive traits moderate the ability of connectivity and regional CSD to predict NERS. Brain regions of interest (ROIs) hypothesized to predict smoking progression, NERS, and depressive traits include structures with high-density nicotinic acetylcholine receptors (nAChRs) and reward-related areas. A total of N=108, 14-hour NIC-deprived young (age 18-24) light (5-35 NIC uses/week) smokers underwent electroencephalogram (EEG) recording while at rest (i.e., viewed a white crosshair on a black background) for 8 minutes then completed the PRT, an assessment of reward sensitivity, after smoking a placebo (0.05 mg NIC) and NIC (0.8 mg NIC) cigarette using a within-subjects design allowing for the assessment of NIC-induced changes in reward sensitivity. All EEG power and LORETA activity bands underwent regression analysis to discover if EEG-assessed brain activity can predict smoking progression, depressive traits, NERS, and their potential interaction. Localized brain regions include 1) reward-related structures, 2) depressive trait-related structures, and 3) large-scale neural (e.g., salience network (SN), default mode network (DMN), executive control network (ECN)) and substance use disorder networks (e.g., orbital frontal cortex (OFC), insula, dorsal lateral prefrontal cortex (dlPFC) anterior cingulate cortex (ACC)). Weaker resting-state connectivity (rsC) between the insula and ACC (i.e., SN) predicted greater smoking progression at 18 months (theta1 and theta2) and greater depressive traits (delta and theta1), while greater rsC within the SN predicted greater NERS (alpha2 and beta 2/3[23.19 – 25.14 Hz]). Greater NERS was also predicted by greater alpha2 connectivity between the 1) ACC and posterior cingulate cortex (PCC) and 2) ACC and left dlPFC. Greater depressive traits were also predicted by 1) weaker delta and theta2 connectivity between the bilateral insula, 2) weaker delta, theta1, and theta2 between the insula and dlPFC, 3) weaker delta and theta1 between the insula and subgenual cortex, 4) greater theta2 in the right vs. left default mode, and 5) greater delta (2.44 – 3.41 Hz) in the left vs. right default mode network. Both greater depressive traits and greater NERS were predicted by weaker 1) theta2/alpha1 (6.59 – 9.52 Hz) between the insula and dlPFC and 2) alpha1 (7.5 – 9.5 Hz) between the left orbital frontal cortex and right dlPFC. These findings provide the first evidence that differences in EEG-assessed brain connectivity in young light smokers are associated with nicotine-enhanced reward sensitivity, depressive traits, and smoking progression. Notably, weaker low-frequency rsC within the salience network predicted depressive traits and smoking progression, while greater high-frequency rsC predicted greater nicotine-enhanced reward sensitivity. These findings suggest that salience network rsC and drug-enhanced reward sensitivity may be useful tools and potential endophenotypes for reward sensitivity and drug-dependence research.

Yes / Smokers attend preferentially to cigarettes and other smoking-related cues in the environment, in what is known as an attentional bias. There is evidence that attentional bias may contribute to craving and failure to stop smoking. Attentional retraining procedures have been used in laboratory studies to train smokers to reduce attentional bias, although these procedures have not been applied in smoking cessation programmes. This trial will examine the efficacy of multiple sessions of attentional retraining on attentional bias, craving, and abstinence in smokers attempting cessation. This is a double-blind randomised controlled trial. Adult smokers attending a 7-session weekly stop smoking clinic will be randomised to either a modified visual probe task with attentional retraining or placebo training. Training will start 1 week prior to quit day and be given weekly for 5 sessions. Both groups will receive 21 mg transdermal nicotine patches for 8–12 weeks and withdrawal-orientated behavioural support for 7 sessions. Primary outcome measures are the change in attentional bias reaction time and urge to smoke on the Mood and Physical Symptoms Scale at 4 weeks post-quit. Secondary outcome measures include differences in withdrawal, time to first lapse and prolonged abstinence at 4 weeks post-quit, which will be biochemically validated at each clinic visit. Follow-up will take place at 8 weeks, 3 months and 6 months post-quit. This is the first randomised controlled trial of attentional retraining in smokers attempting cessation. This trial could provide proof of principle for a treatment aimed at a fundamental cause of addiction. / National Institute for Health Research (NIHR) Doctoral Research Fellowship (DRF) awarded to RB (DRF-2009-02-15)

published_or_final_version / abstract / toc / Community Medicine / Doctoral / Doctor of Philosophy

Made available in DSpace on 2016-08-30T10:37:54Z (GMT). No. of bitstreams: 1 tese_2464_.pdf: 771639 bytes, checksum: f32eb6cc8b3677e2e4834d559fc48d7c (MD5) Previous issue date: 2005-08-05 / Este estudo visa a compreender como os indivíduos vivenciam e elaboram o processo de cessação de fumar em seus contextos sociais, a partir da experiência de ex-fumantes. Os tabagistas passam por estágios motivacionais, até conseguirem deixar de fumar, o que, para alguns, pode levar pouco tempo; para outros, a cessação poderá se dar em alguns anos. A mudança de estágio é influenciada por vários fatores. Dentre eles, o estágio de cessação de fumar decorre da ação de forças presentes nas sociedades que buscam controlar o tabagismo, como também por fatores culturais que promovem indiretamente a abstenção do fumar. Esse fato ocorre por ser tabagismo uma prática que não se coaduna com as atuais concepções de saúde, beleza e bem-estar. A pesquisa desenvolve um estudo qualitativo com indivíduos que deixaram de fumar há pelo menos um ano e estavam em acompanhamento no Centro de Referência Estadual de Prevenção e Tratamento do Tabagismo (CREPTT). Foram entrevistados 17 sujeitos (11 mulheres e 6 homens), com idades que variam entre 36 a 71 anos. Os dados empíricos obtidos a partir dos discursos dos informantes foram analisados segundo a Análise Temática de Conteúdo e interpretados com aporte da Teoria das Representações Sociais. As conclusões mais importantes são as seguintes: a cessação de fumar evidenciou-se como um processo decorrente da tomada de consciência do tabagismo como um problema para o próprio indivíduo e para as pessoas próximas a ele. Fatores relacionados com o corpo e a convivência social contribuíram para que buscassem a recuperação do tabagismo. Os elos de experiência, interpretados como apoios para a abstinência, foram as redes interpessoais constituídas por familiares, profissionais e colegas do grupo de tratamento, contatos com ex-fumantes, sua determinação e fé. A abstenção do tabagismo foi associada a mudanças. Essas mudanças foram percebidas como condições para uma vida melhor. A abstenção do tabagismo é vista pelos ex-fumantes sujeitos deste estudo como uma condição, dentre outras, para se sentirem mais saudáveis, com melhor aparência física e aceitos socialmente. / This study aims to understand how individuals live and elaborate the stopping smoking process in their social contexts, beginning with former-smokers' experiences. The smokers go through motivational stages, until they manage to stop smoking, which for some can be a short time while for others, takes years. The stage change is influenced by several factors. It can be seen, among these, that the stopping smoking stage occurs due to present forces in the societies which aim to control tabaccoism, as well as, from cultural factors that promote smoking abstention indirectly. This last one being attributed, to the fact that tabaccoism as a practice does suit the current conceptions of health, beauty and well being. A qualitative study with carried out on individuals that had stopped smoking for at least one year and were being attended by the Prevention State Reference and Tabaccoism Treatment Center (CREPTT). 17 subjects (11 women and 6 men) with ages ranging from 36 to 71 years were interviewed. The empiric data obtained from interviews from former smokers were analyzed according to Content Thematic Analysis and interpreted according to the Social Representations Theory. The most important considerations are as follows: stopping smoking was shown to be an awareness process of perceiving tabaccoism as a problem of the individual and the people close to him or her. Factors related to the body and social coexistence contributed to the search for recovery from tabaccoism. The experience links, interpreted as abstinence supports, were the interpersonal network of relatives, professionals and treatment group colleagues, contact with former-smokers, determination and faith. Tabaccoism abstention was associated to changes. These changes, were perceived as conditions for a better life. Tabaccoism abstention by the former-smokers of this study is seen, to be the condition, among others, of feeling healthier, with a better physical appearance and social acceptance.