Magister Curationis - MCur / Research reported that it is very challenging for mental health care users to quit smoking and the risk of relapsing after quitting is high. However, tobacco dependence treatment is possible and potentially lifesaving for people. The delivery of tobacco dependence treatment by nurses is influenced by a variety of factors, including lack of knowledge and skills, limited professional leadership, and smoking within the profession. There is a strong link between mental illness and smoking-related diseases, including cancer, respiratory diseases and heart diseases that are linked with depression. There is a high incidence of cancer in people with bipolar mood disorder and schizophrenia due to smoking. In spite of this, smoking is regarded as part of the culture of psychiatric institutions and tobacco is seen as “necessary self- medication for the mentally ill”.

Magister Curationis - MCur / Research reported that it is very challenging for mental health care users to quit smoking and the risk of relapsing after quitting is high. However, tobacco dependence treatment is possible and potentially lifesaving for people. The delivery of tobacco dependence treatment by nurses is influenced by a variety of factors, including lack of knowledge and skills, limited professional leadership, and smoking within the profession. There is a strong link between mental illness and smoking-related diseases, including cancer, respiratory diseases and heart diseases that are linked with depression. There is a high incidence of cancer in people with bipolar mood disorder and schizophrenia due to smoking. In spite of this, smoking is regarded as part of the culture of psychiatric institutions and tobacco is seen as “necessary self- medication for the mentally ill”. Historically, cigarettes have been used for behavioural reinforcement within the psychiatric setting. Mental health nurses also have the highest rate of smoking behaviour, which is coupled with permissive attitudes towards smoking among Mental health care users. It is also reported that nurses lack knowledge regarding the interaction of tobacco dependence with treatment of mental disorders. Nurses are also regarded as role models and therefore, nurses’ beliefs and attitudes regarding the smoking behaviour of mental health care users have an influence on any smoking cessation interventions. The psychiatric institution where the researcher was employed had recently implemented a smoke-free policy in the wards. The aim of this study was to investigate the knowledge, attitude and practices of mental health nurses related to tobacco dependence among MHCUs in a psychiatric institution in the Western Cape. The researcher used a descriptive survey design to carry out this study at a selected government-funded tertiary psychiatric hospital in theWestern Cape, South Africa. The target population comprised all mental health nurses permanently employed at this institution (169) and all-inclusive sampling was used. Data was analysed using SPSS Statistics version 24. The findings of the study reveal mental health nurses had good knowledge on tobacco dependence among MHCUs and that they had positive attitudes regarding the need to combat tobacco dependence among MHCUs. This is revealed through their knowledge on the dangers of smoking to MHCUs. The quality of training influences knowledge, which in turn cultivates a positive attitude regarding the need to combat tobacco and smoking addiction among MHCUs. There is also difference between the attitudes of non-smokers and those of smokers regarding the treatment of nicotine and tobacco dependence in MHCUs. For instance, mental health nurses who smoke perceive smoking as a necessary element for creating relationships with their patients, and therefore they tend to have a relaxed attitude towards treating smoking addiction among patients. Those who do not smoke tend to perceive combating nicotine dependence as essential. A recommendation is that some form of training for mental health nurses is needed to cultivate positive attitudes towards strategies meant to curb smoking addiction.

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Cigarette smoking is the leading cause of preventable disease and is the cause of nearly 1 in 5 deaths in the United States. The prevalence of smoking has had a leveling off effect after many years of significant decline. Certain subgroups of the population, such as those with low income and certain illnesses, continue to smoke at disproportionately high rates. Reasons for these disparities in smoking rates are complex. Developing a better understanding of the issues related to persistent smoking particularly for those with medical illness and limited access to cessation resources can help focus interventions to help these high risk smokers quit. This dissertation includes a systematic review of the literature associated with hardcore smoking; an analysis of the reliability and validity of a self-efficacy instrument in a sample of low-SES, medically ill smokers; and the results of a cross-sectional, non-experimental study exploring the relationship between smoking-related factors and planning to quit in a sample of medically ill smokers. A sample of 70 current and recent smokers was surveyed at a free clinic. Quitting self-efficacy was measured using an instrument not previously tested in a rural, medically ill sample. Modifications to the survey were made based on qualitative interviews with smokers and a single question measuring self-efficacy was also tested. There was a high correlation among the self-efficacy measures (Spearman’s rho .99, p < .001) and between the longer instrument and the single question (Spearman’s rho .65, p < .001). Each measure demonstrated acceptable reliability and validity. In the study exploring potential factors associated with planning to quit, the number of prior quit attempts and confidence to quit explained 43% of the variance in those planning versus not planning to quit. Providing interventions focused on increasing confidence and experience with quit attempts can be effective in promoting a plan to quit in this group of smokers who, because of their medical illness, can benefit significantly from cessation. Research is needed to explore cessation outcomes when employing these targeted interventions with medically ill smokers in rural areas.

This thesis deals with the possibility of using psychological coaching as a support method for smoking cessation. The theoretical section provides an overview of key information on the topics of coaching and smoking, with an emphasis primarily on the aspects applied in the qualitative research project, the description of which constitutes the content of the empirical section. On the basis of the author's preconceived original design which, in addition to the diagnostic and evaluation phases, comprised the essential stage of the three-month long coaching of nine smokers in different stages of the cessation process, the author sought to map the potential benefits, advantages and other aspects of the use of coaching as an innovative method, thusfar not commonly included among the established alternatives offered as smoking cessation intervention techniques. Keywords: coaching, smoking, tobacco dependence, smoking cessation, quitting smoking

Introduction: Tobacco dependence is a chronic disorder that carries the risk of relapse at any time point during abstinence. It is a major health issue in the world and current pharmacotherapies have had limited efficacy. Therefore, development and validation of novel treatments are required. Objective: Investigate the novel neutral cannabinoid-1 receptor antagonist AM4113 on nicotine (main psychoactive ingredient in tobacco)-taking behaviour in animals. Methods: Using the nicotine intravenous- and food control- self administration paradigms, we tested the acute and chronic (10-days) effects of AM4113 on nicotine- and food-taking behaviour. Results: Acute AM4113 treatments (1-, 3-, 10-mg/kg) reduced nicotine self administration. Chronic AM4113 administration (10mg/kg) produced a sustained reduction of nicotine-taking behaviour during the course of the treatment. In the similar food control self administration experiments, AM4113 overall produced no effect. Conclusion: AM4113 can attenuate nicotine-taking behaviour and its effect is sustained under chronic treatment.

Introduction: Tobacco dependence is a chronic disorder that carries the risk of relapse at any time point during abstinence. It is a major health issue in the world and current pharmacotherapies have had limited efficacy. Therefore, development and validation of novel treatments are required. Objective: Investigate the novel neutral cannabinoid-1 receptor antagonist AM4113 on nicotine (main psychoactive ingredient in tobacco)-taking behaviour in animals. Methods: Using the nicotine intravenous- and food control- self administration paradigms, we tested the acute and chronic (10-days) effects of AM4113 on nicotine- and food-taking behaviour. Results: Acute AM4113 treatments (1-, 3-, 10-mg/kg) reduced nicotine self administration. Chronic AM4113 administration (10mg/kg) produced a sustained reduction of nicotine-taking behaviour during the course of the treatment. In the similar food control self administration experiments, AM4113 overall produced no effect. Conclusion: AM4113 can attenuate nicotine-taking behaviour and its effect is sustained under chronic treatment.

Success rate of tobacco dependence treatment among patients with and without a history of depression Introduction: Higher prevalence of smoking among depressive patients, as well as higher risk of depression in smokers, are well documented. Views on treatment of tobacco dependence in this subgroup of smokers are controversial. Aim: A/ To compare the abstinence rate among smokers with or without a history of depression receiving treatment for nicotine dependence at one year follow up. B/ Factors associated with treatment success were evaluated and analysed. Methods: A retrospective analysis of 1 730 smokers treated at our Centre for Tobacco-Dependent (CTD) between 2005 and 2010 was conducted. Patients were treated with a combination of psychobehavioural interventions and pharmacotherapy (nicotine replacement therapy, varenicline, bupropion or combinations). At one year follow-up smoking abstinence was biochemically validated by measuring expired CO. Results: 16.7 % (289/1730) of smokers currently, or had formerly, received treatment for depression. Based on the average Fagerström Test of Nicotine Dependence (FTND), most patients with a history of depression were heavily nicotine dependent with a score of 6.1, compared to 5.6 (p=0.010) among those without a history of depression. The CO validated success rate...

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TITLE: Evaluation of school-based prevention programme "Típni to I" AUTHOR: Marián Vanek DEPARTMENT: Department of Psychology SUPERVISOR: PhDr. Veronika Pavlas Martanová, Ph.D. ABSTRACT: This thesis deals with need assessment and formative outcome evaluation of school-based smoking prevention programme "Típni to I" which is designed for the pupils of 7th grade of elementary school. The main focus of evaluation was to obtain evidence of functional and nonfunctional parts of the programme with regards to needs of the target population and the KAB model. Combined qualitative-quantitative research design with participatory research paradigm was used. It is important to note that the author of the evaluation is at the same time member of the organization Česká koalice proti tabáku (ČKPT) which produces the evaluated programme. Self-made questionnaire, interviews with ČKPT lecturers and written products of the programme "Típni to I" were used to obtain empirical data. Questionnaire was assigned twice in experimental group (12 classes, 202 pupils), firstly before the programme implementation and then 2-3 weeks after realization of the prevention (pre-post design), no control group was used. Prevention programme proved to be effective in improving tobacco risks knowledge, communication skill to refuse cigarettes,...