Background: Cognitive deficit is prominent in schizophrenia patients. We investigated the decision-making ability among schizophrenia patients and healthy controls based on their performance in the Iowa Gambling Task (IGT), a laboratory task developed for measuring individuals’ decision-making ability. We hypothesized that deficits in IGT performance in schizophrenia patients could be specifically ameliorated by smoking tobacco. In order to test this hypothesis, we compared smoking and non-smoking schizophrenia patients with healthy subjects, on their IGT performance. Method: Ten smokers with schizophrenia, 9 non-smokers with schizophrenia, 16 non-psychiatric non-smokers and 7 non-psychiatric smokers were administered the computerized version of IGT. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess the degree of smoking dependence of subjects and to group the smokers and non-smokers. Results: Subjects with schizophrenia performed significantly worse than non-psychiatric controls on IGT. Moreover, smokers with schizophrenia performed significantly better than non-smokers in the task. Furthermore, when comparing IGT performance of all the 4 groups, non-psychiatric non-smokers performed significantly better than psychiatric smokers in the IGT. Conclusions: Similar to the results of previous research, schizophrenia patients performed worse than controls in the IGT, suggesting impairments in risk/ reward decision-making. Cigarette smoking may partially ameliorate schizophrenia patients’ performance deficits on neurological tasks, including the IGT. These findings on schizophrenia patients are clinically important since it is believed that the ability to make timely and correct decisions can result in good treatment compliance and coping strategies thus facilitates recovery. Last but not least, further research is needed to explain how smoking tobacco facilitates cognitive functioning in schizophrenia patients. / published_or_final_version / Psychological Medicine / Master / Master of Psychological Medicine

Thirty-two cigarette smokers received six sessions of rapid smoking after which they were randomly assigned to one of four maintenance conditions, The conditions were (a) contingency contracting, (b) social support, (c) a continuation of rapid smoking and (d) a minimal contact control group, A total of seven maintenance sessions were scheduled for each maintenance group, and they were spread over a three month period. At the end of the maintenance period the control group was smoking at baseline level again. No differences between the maintenance groups were detected, However, the contracting group and the social support group were smoking significantly less than the control group.

Three-hundred and thirty-three surveys were distributed to male and female nurses employed at the Veterans Administration Medical Center in Salem, Virginia. The survey was designed to determine if nurses who smoke perceive more stress from their jobs. Of the 124 nurses who responded to the survey, there were no significant differences in ratings of perceived stress between nurses who reported that they were current smokers and those who reported that they were non-smokers. Overall, the mean rating of perceived stress for both smokers and non-smokers were rated low to average on a six-point Likert-type Scale. Although the relationship between the smoking and perceived stress items on the survey did not reach statistical significance, over fifty percent of the respondents reported that they would be interested in participating in a stress management program; and a higher percentage of smokers reported an interest in stress management than non-smokers. No significant differences were found in the coping methods between smokers and non-smokers in reporting how they would cope with two specific stressful work situations. The results of this study indicate that, for this particular population, those who smoke do not perceive significantly higher levels of stress from their jobs than non-smokers. / Master of Science

Wan, Lai Yin. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 100-126). / Abstract also in Chinese. / ABSTRACT --- p.i / 摘要(ABSTRACT IN CHINESE) --- p.ii / ACKNOWLEDGEMENTS --- p.iii / TABLE OF CONTENTS --- p.iv / LIST OF TABLES --- p.vi / LIST OF FIGURES --- p.vii / Chapter CHAPTER I: --- INTRODUCTION --- p.1 / APPLYING THE THEORY OF PLANNED BEHAVIOR TO ADOLESCENT SMOKING --- p.5 / ATTITUDES TOWARDS THE BELIEFS ABOUT SMOKING --- p.6 / SUBJECTIVE NORMS ABOUT SMOKING --- p.11 / PERCEIVED BEHAVIORAL CONTROL OVER SMOKING --- p.14 / BEHAVIORAL WILLINGNESS AS A COMPLEMENTARY ASSESSMENT TO BEHAVIORAL INTENTION --- p.15 / EXTENSION OF THE TPB´ؤIMPORTANCE OF PERSONALITY IN ADOLESCENT SMOKING --- p.16 / ROLE OF DIRECT FAMILY AND PEER SMOKING --- p.24 / GENDER AS MODERATOR IN ADOLESCENT SMOKING --- p.25 / OVERVIEW OF THE STUDY --- p.29 / Chapter CHAPTER II: --- METHOD --- p.35 / PARTICIPANTS --- p.35 / PROCEDURE --- p.37 / MEASURES --- p.38 / DATA ANALYSES --- p.45 / Chapter CHAPTER III: --- RESULTS --- p.48 / DESCRIPTIVE STATISTICS AND CORRELATIONS AMONG MAJOR VARIABLES --- p.48 / DIFFERENCES IN MAJOR VARIABLES ACROSS GENDER AND ACROSS CURRENT SMOKING STATUS --- p.53 / MEASUREMENT APPLICABILITY OF INSTRUMENTS --- p.56 / IDENTIFICATION OF THE BASIC TPB MODEL --- p.57 / INCORPORATION OF BEHAVIORAL WILLINGNESS AS AN OUTCOME VARIABLES INTO TPB MODEL --- p.60 / "EFFECTS OF PERSONALITY, FAMILY SMOKING AND PEER SMOKING" --- p.63 / MULTI-SAMPLE INVARIANCE ANALYSES --- p.68 / MULTI-SAMPLE INVARIANCE ANALYSES WITH MALE AND FEMALE SAMPLES --- p.69 / MULTI-SAMPLE INVARIANCE ANALYSES WITH EVER-SMOKER AND NEVER-SMOKER SAMPLES --- p.75 / Chapter CHAPTER IV: --- DISCUSSION --- p.82 / GENERALIZABILITY OF RESULTS WITH THE PRESENT SAMPLE --- p.82 / APPLICABILITY OF MEASURES USED IN CHINESE ADOLESCENT SMOKING RESEARCH --- p.83 / SMOKING WILLINGNESS AS A MORE SENSITIVE ASSESSMENT IN ADOLESCENT SMOKING --- p.84 / UTILITY OF TPB COMPONENTS IN PREDICTING SMOKING INTENTION AND WILLINGNESS --- p.85 / THE IMPORTANT ROLE OF PERSONALITY IN EXPLAINING SMOKING INTENTION AND WILLINGNESS --- p.87 / SIGNIFICANT INFLUENCES OF FAMILY AND PEER SMOKING ON ADOLESCENT SMOKING --- p.91 / DIFFERENCES IN PREDICTING ADOLESCENT SMOKING ACROSS GENDER --- p.92 / IMPLICATIONS OF THIS STUDY --- p.94 / LIMITATIONS OF THIS STUDY --- p.95 / DIRECTIONS FOR FUTURE RESEARCH --- p.97 / REFERENCES --- p.100

Attention-deficit hyperactivity disorder (ADHD), once considered a childhood-limited neuropsychiatric condition, is now recognized as often persisting into adolescence and beyond. Recent studies of ADHD and its symptom domains--hyperactivity and inattention--indicate that symptoms can wax and wane over time and follow discrete trajectories characterized by different symptom levels and shapes. However, little is known about symptom trajectories in high-risk groups, such as boys from low socioeconomic backgrounds. Childhood ADHD is associated with cigarette smoking in adolescence, but whether the risk is specific to hyperactivity or inattention or their respective symptom trajectories is not clear. The aims of my dissertation research were to identify trajectories of hyperactivity and inattention symptom scores in a sample of boys from low socioeconomic backgrounds and to assess the associations of those trajectories with cigarette smoking outcomes in late adolescence and young adulthood. In pursuit of those aims, I first conducted a narrative literature review to assess current evidence regarding the persistence of childhood ADHD, hyperactivity and inattention into adolescence, and the associations of persistent ADHD and its symptom domains with the risks of cigarette smoking and nicotine abuse and dependence in adolescence and early adulthood. Data on boys of low socioeconomic status, where available, were summarized. Evidence suggests that nearly 50% of individuals with childhood ADHD or its symptom domains continue to have symptoms in adulthood. Hyperactivity symptom trajectories are likely to decline over time, whereas inattention symptom trajectories are more stable. The sparse literature on the association between ADHD, hyperactivity, and inattention symptom persistence and high symptom score trajectories and smoking outcomes suggests that high inattention symptom score trajectories are associated with earlier onset and higher risk of nicotine abuse or dependence in early adulthood than lower trajectories. Evidence on hyperactivity symptom score trajectories and similar smoking outcomes is inconclusive. Literature on symptom trajectories in low socioeconomic boys is sorely lacking; no study has evaluated the association of symptom score trajectories with smoking outcomes. Second, in a sample of 1,037 boys from low socioeconomic neighborhoods, I derived trajectories of hyperactivity and inattention symptom scores between childhood and mid-adolescence (ages 6-15 years), using teachers’ and mothers’ ratings, separately. I also evaluated risk factors for high symptom score trajectories. Three trajectories were identified for both hyperactivity and inattention symptom scores. Hyperactivity symptom scores generally declined over time (high declining, moderate declining, and low declining), whereas inattention symptom scores remained stable (high stable, moderate stable, and low stable). Most boys had low symptom scores over time (i.e., low declining for hyperactivity or low stable for inattention), but approximately one-fifth to one-third followed high symptom score trajectories (high declining for hyperactivity or high stable for inattention). Mothers were more likely than teachers to rate boys as having higher symptom scores. Boys’ behavioral symptom scores (hyperactivity, inattention, opposition, and anxiety) at age 6 years and lack of family intactness were risk factors for high hyperactivity and inattention symptom score trajectories. Third, in the same sample of boys from low socioeconomic neighborhoods, I assessed the associations of the hyperactivity and inattention symptom score trajectories with frequency of cigarette smoking at ages 16-17 years (late adolescence) and daily and heavy (≥1 pack/day) smoking at ages 23 and 28 years (young adulthood). I further conducted mediational analyses to assess the potential impact of cigarette smoking frequency and use of alcohol, marijuana, and other drugs in late adolescence on smoking outcomes in young adulthood. High vs. low symptom score trajectories of hyperactivity (i.e., high declining vs. low declining) and inattention (i.e., high stable vs. low stable) were associated with nearly doubled odds of high cigarette smoking frequency (≥40 times in the past year) in late adolescence (hyperactivity: OR=1.97 [95% CI=1.30-2.98]; inattention: OR=1.87 [1.27-2.76]). High (vs. low) symptom score trajectory of inattention, but not hyperactivity, was further associated with elevated risk for daily cigarette smoking (OR=2.67 [1.53-4.64]) and heavy cigarette smoking (OR=1.95 [1.10-3.45]) in young adulthood. Part of the associations (about 11-23%) was mediated by high cigarette smoking frequency in late adolescence. The mediation roles of other substances were not statistically significant. Although the socioeconomically disadvantaged boys whose data I analyzed were similar in number of symptom score trajectories and trends (declining for hyperactivity and stable for inattention) to boys in general populations, they were at elevated risk for high scores for both of the symptom domains over time. Childhood behavioral problems as well as lack of family intactness were associated with high symptom score trajectories of both hyperactivity and inattention. High trajectories of both hyperactivity and inattention scores were associated with high risk of cigarette smoking frequency in late adolescence, but inattention appeared to have a longer-term impact on smoking behaviors. Altogether, my research findings suggest that children with high symptom levels of hyperactivity and/or inattention at an early age, especially those with symptoms that persist over time, might benefit from early interventions to manage and reduce their symptoms and their risk of becoming cigarette smokers.

An experiment was done to investigate whether or not there is a need to treat smokers and non-smokers as separate target audiences when creating tobacco counter-advertisements. The Extended Parallel Process Model (Witte, 1992) and Reactance Theory (Brehm, 1966) were used to guide the development of predictions. The study revealed that social marketers need to have different advertising tactics for smokers and non-smokers, since smokers have reported more maladaptive coping responses and fewer adaptive coping responses than non-smokers. Moreover, based on the fact that a smoker’s brand forms an essential part of their self-identity (Goldberg et al., 1995) the experiment was also designed to see if smokers would have differing levels of reactance and other maladaptive coping responses if they saw a counter-advertisement attacking their brand, one attacking a competing brand, and a non-branded one. The study did not reveal any significant differences in reactions among the three conditions. / x, 125 leaves : ill. ; 29 cm