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Background: Currently, there are no population-level smoking cessation interventions widely promoted in China. Economic concerns are one of the major barriers to a greater promotion of smoking cessation interventions in China. Objectives: The objective of this study was to use evidence on the effectiveness of physician counselling and nicotine replacement therapy (NRT) patches use from Western countries, with the most recent smoking data from China to predict the potential effectiveness and cost-effectiveness of physician counselling and NRT patch in the healthcare system in urban China. Methods: In Study 1, statistical analysis was conducted to estimate smoking and cessation rates in urban China. In Study 2, a Comparative Relative Assessment model was used to estimate the effectiveness and cost-effectiveness of physician counselling and NRT patch use for smoking cessation. Study 2 determined the estimates and costs of additional quitters and avoided lung cancer deaths from the implementation of physician counselling and NRT patch use in the healthcare system in urban China. Results: In Study 1, smokers intending to quit were significantly more likely to have quit at follow-up than those not intending to quit. A total of 35.4% of smokers in urban China reported visiting a doctor in the past 12 months. Smokers who visited a doctor were significantly more likely to intend to quit and to have quit smoking at follow- up compared to those who did not visit a doctor. In Study 2, brief counselling to all smokers visiting the healthcare system in China was the most effective and cost-effective smoking intervention by generating a total of 2.35 million quitters at $2.32-$7.73 per quitter. Smoking cessation counselling were found to be cost saving when compared with the total cost of lung cancer to Chinese society. The wide promotion of the NRT patch would be costly, requiring significant financial investments. Conclusions: Implementing smoking cessation counselling in the healthcare system in urban China will result in cost savings from lung cancer. The high retail price and low acceptance of NRT patches in China may be required to achieve a population-level impact from pharmaceutical interventions.

Thesis (Ph.D. in Nursing) -- University of Colorado at Denver and Health Sciences Center, 2006. / Typescript. Includes bibliographical references (leaves 144-159). Free to UCDHSC affiliates. Online version available via ProQuest Digital Dissertations;

Thesis (M.A.)--Carleton University, 1993. / Also available in electronic format on the Internet.

Thesis (M.Med.Sc.)--University of Hong Kong, 2004. / Also available in print.

Thesis supervisor: Steven M. Lily. Includes bibliographic references (p. 235-243).

Thesis (Ph.D.) - University of Queensland, 2005. / Includes bibliography.

Thesis (M.S.)--Georgia State University, 2006. / Title from title screen. Yu-Sheng Hsu, committee chair; Gengsheng (Jeff) Qin, Xu Zhang, committee members. Electronic text (116 p.) : digital, PDF file. Description based on contents viewed May 17, 2007. Includes bibliographical references (p. 61-67).

Although the adverse health effects of cigarette smoking are well known, many college students continue to initiate and maintain cigarette smoking. While some college students are making quit attempts, they have limited success. Past research has identified graduation as one life event around which college students plan to quit smoking. Therefore, the college senior may be at a reachable moment related to cessation interventions. It was one purpose of the present study to examine whether attitudes, self-efficacy, and subjective norms might influence a college senior's intention to quit smoking at graduation. Past research has also identified friends and peers as an influencing factor related to initiation and maintenance of student smoking. A second purpose was to examine the influence of peer group norms and strength of group identification on intentions to quit smoking among college seniors. The theory of planned behavior provided the theoretical framework for the study. Using a nonexperimental cross sectional design, data were collected from 573 undergraduate college seniors via a web-based survey. Sixty three percent of the respondents were female and thirty seven percent were male. Of respondents, 26.5% (n= 152) reported being current smokers (had smoked at least one cigarette in the last thirty days) and of the current smokers, 48.7% (n=74) were daily and 51.3% (n=78) were occasional smokers. Independent sample t–tests revealed that, although the original hypothesis (daily smokers would have more positive intentions toward quitting than nondaily smokers) was not supported, nondaily smokers did have more positive intentions to quit smoking than daily smokers. When intentions were examined by sex, no statistical difference was found between males and females in intentions to quit smoking at graduation. Multiple regression revealed that the attitude a smoker holds about quitting was the strongest predictor of quitting intentions, followed by the confidence in one's ability to quit (self-efficacy). The importance of the beliefs held by important others (subjective norms) about quitting was also predictive of intentions to quit, but to a lesser extent than attitudes and self-efficacy. Respondents chose a “most important peer group” (i.e. people I live with, other students in my major), which they used to answer survey questions related to peer group norms and strength of group identification. When group norms and strength of group identification variables were entered into multiple regression, the effects of group norms and group identification were not significant predictors. Strength of group identification was not found to be a moderating variable for group norms when predicting intentions to quit cigarette smoking. The present study used two concepts (subjective norms and group norms) to examine social influence on behavioral intentions. Future studies will be useful in establishing how social influences can best be conceptualized.

Dados da literatura indicam que os fumantes apresentam distúrbios psiquiátricos e psicológicos em maior frequência do que os não fumantes. Esses fatores podem contribuir para o início do tabagismo, bem como para sua manutenção, e induzir dificuldades no abandono. Entretanto, não existe na literatura nenhuma escala construída com a finalidade de avaliar as características emocionais de fumantes frente aos cigarros, de maneira simples e rápida. Este estudo teve como finalidade desenvolver uma escala que avaliasse o estado emocional geral dos fumantes em face ao uso do tabaco. Para tanto, fumantes que procuravam ambulatórios de cessação de tabagismo em hospitais públicos do Município de Ribeirão Preto foram submetidos a entrevistas padronizadas. Indivíduos não fumantes foram selecionados entre funcionários dessas mesmas instituições e entre acompanhantes e familiares dos fumantes. Inicialmente, níveis de Ansiedade, Depressão, Estresse Percebido, Autoestima e Solidão de um grupo de 120 fumantes (idade mediana: 54,6 anos; 74 mulheres) foram comparados com os de um grupo de 76 não fumantes (idade mediana: 45,5 anos; 47 mulheres). Os fumantes mostraram valores significantemente piores do que os não fumantes, em todas as medidas investigadas. Correlações entre os escores dessas medidas psicológicas, além da característica Apego aos Cigarros, foram feitas com as medidas do Teste de Dependência a Nicotina de Fagerström (TDNF) no grupo de fumantes. Os parâmetros psicológicos mostrando as melhores correlações com o TDNF foram selecionados para fazer parte de uma escala de 6 itens chamada Teste Emocional do Fumante (TEF). As pontuações do TEF deste grupo inicial e de uma amostra adicional de fumantes (n = 102; idade mediana= 52,6 anos; mulheres = 63) foram submetidas a análises psicométricas e testes de validação. O TEF mostrou uma estrutura consistente de dois fatores, ansiedade / depressão e apego aos cigarros. As pontuações de TEF apresentaram correlações significativas com o TDNF (r=0,418), número de cigarros defumados (r=0,299), tempo antes de sentir necessidade de um novo cigarro (r=-0,441) e prazer em fumar (r=0,346). A consistência interna do TEF foi maior do que a dos escores de TDNF (alfa de Cronbach: respectivamente 0,712 e 0,542). A confiabilidade teste-reteste do TEF foi excelente (coeficiente de correlação intraclasse=0,944). As pontuações de TEF superiores a 4 puderam distinguir fumantes de não fumantes com sensibilidade de 87,3% e especificidade de 92,7%. Pode-se concluir que o TEF é um instrumento simples que dá uma estimativa do status emocional relacionado ao tabagismo e pode definir um novo e valioso constructo da dependência do tabaco. O TEF tem potencial para se tornar uma ferramenta útil nas intervenções de cessação do tabagismo / Literature data show that smokers exhibit psychiatric and psychological abnormalities in higher frequency than non smokers. These factors may contribute to smoking beginning, as well as to its continuity, and bring obstacles for quitting. However, there is not in the literature any scale designed to evaluate the emotional features of smokers. This study aimed at developing a new scale to evaluate the overall emotional status of smokers in face of tobacco use. Smokers who look for treatment in public smoking cessation clinics of Ribeirão Preto city were submitted to standardized interviews. Non smokers were selected among workers from these facilities and companions and relatives from the smokers. Levels of Anxiety, Depression, Perceived Stress, Self Esteem, and Loneliness of a group of 120 smokers (median age: 54.6 years; 74 women) were compared with those of a group of 76 non smokers (median age: 45.5 years; 47 women). Smokers showed scores significantly worsen than non smokers regarding these measures. Correlations between these psychological scores, plus the feature Attachment to Cigarettes, and FTND counts were explored among smokers. Psychological features showing the best correlations with FTND were selected to be part of a 6 item scale called Smoker\'s Emotional Test (TEF). TEF scores of this initial group and of an additional sample of smokers (n=102; age= 52.6; women= 63) were submitted to psychometric analyses and validation tests. Results: TEF showed a consistent structure of two factors, Anxiety/Depression and Attachment to Cigarettes. TEF scores showed significant correlations with TDNF (r=0.418), number of smoked cigarettes (r=0.299), time to urge for a new cigarette (r=-0.441) and pleasure of smoking (r=0.346). The internal consistency of TEF was higher than that of FTND scores (Cronbach\'s alpha: respectively 0.712 and 0.542). The test-retest reliability of TEF was excellent (intraclass correlation coefficient=0.944). TEF scores higher than 4 could distinguish smokers from nonsmokers with sensitivity of 87.3% and specificity of 92.7%. In conclusion, TEF is a simple instrument that gives an estimative of smoking-related emotional status and may define a new valuable construct of tobacco addiction. TEF has the potential to become a useful tool in smoking cessation interventions.