Some metals and metalloids make significant contributions to the harmful effects of tobacco consumption although understanding the mechanisms involved in toxicity is hampered by the lack of information on their chemical and valence species, both in tobacco and in smoke. This research addresses the speciation of the metals and metalloids most frequently implicated, particularly those elements that exist in nature in multiple valence states, namely arsenic (As) and chromium (Cr), there being considerable differences in toxicity with oxidation state. A strategy was devised to overcome some of the problems that have thwarted earlier attempts at speciation. Firstly tobacco plants were cultivated under controlled conditions in compost burdened with high levels of metals and metalloids resulting in leaf with up to 250 µg g⁻¹ As, although Cr uptake was less successful. Secondly valence speciation even at the exceptionally low concentrations of As and Cr in smoke from unburdened tobacco was achieved with XANES analysis using the exceptionally bright Diamond synchrotron source. This revealed that combustion of tobacco has a marked effect on valence speciation with As(III), the reduced form of As, dominating (and persisting) in condensate of tobacco smoke while ash is dominated by the oxidised form, As(V). Chromium also appears to be present in smoke mainly as reduced Cr(III) species. HPLC-ICPMS analysis of arsenic indicates the dominance of inorganic over organic species (~4:1). Other metals were investigated in less detail. These findings establish that arsenic is present in smoke in its most toxic form and represents a significant risk to health. Conversely smokers appear to be exposed to the less harmful species of chromium. These results support a recent WHO report that includes As but not Cr in a list of four metals and metalloids recommended for regulation in crops and commercial products in the interests of public health.

Syftet med denna studie var att skapa förståelse för hur man kan motivera individer med utländsk bakgrund till att sluta använda tobak. Studien undersökte vilka uppfattningar dessa individer kan ha om tobaksrelaterade hälsorisker och vilka anledningarna kan vara till att dessa individer röker. Metoden som användes är av kvalitativ ansats, som är induktiv och tolkande. Datainsamling skedde med hjälp av systematiska litteraturöversikter som analyserades med hjälp av en metaetnografi. Resultatet visar att individer med utländsk bakgrund underskattar tobaksrelaterade hälsorisker och har en positiv inställning till tobak. Familjeutmaningar, stress, ångest, nöje och lycka är de ledande motiven för tobaksbruk bland dessa individer. Brist på kunskap om tobaksrelaterade hälsorisker leder till mindre motivation till att sluta röka. Slutsatsen av denna studie påvisar att för att kunna motivera individer med utländsk bakgrund till att sluta röka är det viktigt att utveckla insatser för att öka deras kunskaper om tobakens hälsorisker.

Submitted in full fulfilment of the requirements for the degree of MASTER OF COMMERCE (Marketing) at the UNIVERSITY OF THE WITWATERSRAND 2015 / With an increase in the concern over the harmful effects of smoking traditional tobacco cigarettes, there has been an increase in the use of a smoking alternative considered to be a healthier option, namely the e-cigarette. Thus, it is of interest to understand certain factors surrounding the novelty, and this research has been conducted in terms of evaluating the predictors of the diffusion of innovations on consumer resistance towards the e-cigarette among South African university students, with the primary purpose being to research a gap in the South African e-cigarette market, and to utilise the results to better understand the overall market. The gap in prior research has been identified as what appears to be a lack of information regarding the South African e-cigarette market, and in particular, the predictors of consumer resistance, including relative advantage, compatibility, complexity, trialability, observability, and perceived risk. The study undertook a quantitative methodology in which 400 students from the University of the Witwatersrand were asked to complete a self-administered questionnaire. Data analysis was conducted using SPSS 22 and AMOS for structural equation modelling. The results indicate that three of the six hypotheses are supported. Thus, indicating that marketers should focus on applying relative advantage, complexity, and perceived risk to marketing strategies. This study contributes to existing literature and contextual knowledge regarding consumer resistance and the diffusion of innovation. The results further provide marketing practitioners with a better understanding on how to limit consumer resistance and how to improve product diffusion of the e-cigarette, subsequently improving the rate of adoption. However, future research is necessary for corroboration. / MT2017

O tabagismo tem sido considerado um problema de saúde pública mundial pela Organização Mundial da Saúde. São previstas, para 2020, mais de dez milhões de mortes no mundo por doenças tabaco-relacionadas. Torna-se, portanto, importante aprimorar formas de tratamento aos fumantes que queiram parar de fumar e busquem ajuda por não se sentirem capazes de conseguí-lo sozinhos. O objetivo da presente proposta foi investigar se a efetividade de um programa de tratamento com base na terapia cognitivo-comportamental, associada à medicação, seria mais efetivo do que a literatura reporta para a abstinência/recaída. O critério de efetividade foi a cessação do tabagismo auto-referida pelos participantes em seis meses de tratamento. Foram avaliados 61 fumantes, com idades variando entre 18 a 60 anos, de ambos os sexos. Estes fumantes foram divididos em três grupos: pacientes que não pararam de fumar (grupo 1 ), abstinentes (grupo 2) e que recaíram (grupo 3). Os resultados demonstraram que, desta população, 78,7% estavam abstinentes ao final de seis meses de tratamento. Antes, eles fumavam, em média, por 24,6 anos, 22,6 cigarros por dia; 62,3% estavam no estágio de contemplação de acordo com Prochaska. Os motivos mais freqüentes citados para a recaída foram estresse (61,9%) e ansiedade (19%). A média geral do Fagerström foi de 4,18 (tolerância baixa), sendo que o grupo 1 apresentou o grau de tolerância menor da amostra. 77,4% dos fumantes manifestaram estar satisfeitos com o tratamento, sendo que os motivos maiores de satisfação foram o apoio psicológico e a interação com o grupo. O índice de Saúde Geral da amostra é compatível com a população geral; o Inventário Beck de Depressão (BDI) mostrou níveis maiores de depressão nos grupos 1 e 3. Foram propostos indicadores de maior risco de recaída: número de anos que o participante fuma (maior), número de cigarros fumados por dia (menor), ter fumado sempre a mesma quantidade de cigarros por dia, morar com outros fumantes, teores baixos de nicotina no cigarro em relação ao médio e alto, ausência de tentativas anteriores para cessar de fumar, freqüência baixa de participação nas sessões de tratamento, utilizar o cigarro como estimulante, fumar quando entusiasmado, quando não consegue permanecer em locais onde o fumo é proibido, quando refere ter dó de si próprio, quando manifesta pouca satisfação em relação ao trabalho e à vida. A Curva de sobrevida de Kaplan-Meier demonstrou que 49,7% desta amostra devem permanecer em abstinência por um ano, índice maior do que reporta a literatura revisada. Propõe-se a realização de estudo randomizado, com uma população maior, para validar os indicadores propostos e a efetividade comparativa do programa. / Tobaccoism has been considered as a World Public Health problem according to the World Health Organization. More than 10 million deaths in the world caused by problems related to tobacco is the prevision for 2020. Therefore, it is important to improve ways of treatment for smokers who would like to quit smoking and search for help for not being able to do so by themselves. The purpose of this present proposal was to check whether the effectiveness of a treatment based on Cognitive-Behavior Therapy associated with medication was better than the literature reported to abstinence/relapse. The effectiveness criterion was the self- mentioned smoking cessation by the participants in 6 months of the treatment. 61 smokers aged 18-60 years both male and female were evaluated. These smokers were divided into three groups: patients who did not give up smoking (group 1), the abstinence smokers (group 2) and the relapse ones (group 3). The results showed that by the end of 6 months of treatment 78,7% of this population had become abstainers. At first, as an average they smoked for 24,6 years, 22,6 cigarettes a day; 62,3% was on contemplation stage according to Prochaska. The most frequent mentioned causes for the relapse were stress (61,9%) and anxiety (19%). Fagerström general average was 4,18 (low tolerance) so that group 1 showed a lower degree of tolerance of the sample. 77,4% of the smokers mentioned to be happy with the treatment due to the psychological support and group interaction as main reasons. The General Health Index of the sample is compatible with general population and the Beck Depression Inventory (BDI) showed higher levels of depression in groups 1 and 3. Indicators of higher relapse risk were suggested: the participant smoking time (higher), how many cigarettes a day (lower), having always smoked the same quantity of cigarettes a day, living with another smokers, low nicotine in the cigarette in relation to the medium and high ones, absence of previous attempts to stop smoking, low frequency of participation in the meetings for treatment, using the cigarette as a stimulant, smoking when the smoker is excited, when he can\'t help remaining where smoking is forbidden, when the smoker mention to be sorry for himself, when the smoker presents no pleasure in relation to work and life. The Kaplan-Meier survival curve showed that 49,7% of this sample must continue in abstinence for one year, a higher index than the reported revised literature. It is suggested to perform randomized studies, with a bigger population, to validate the appointed indicators and the comparative effectiveness of the program.

Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-10-31T23:00:32Z No. of bitstreams: 1 LauraCury_dissert.pdf: 453805 bytes, checksum: 7eaccabaffe132f003b0b92e9db63548 (MD5) / Made available in DSpace on 2018-10-31T23:00:32Z (GMT). No. of bitstreams: 1 LauraCury_dissert.pdf: 453805 bytes, checksum: 7eaccabaffe132f003b0b92e9db63548 (MD5) Previous issue date: 2018-03-14 / Tobacco is one of the leading causes of premature death in the world and its dependence is maintained by nicotine and determined by biological, behavioral, psychological and sociocultural processes. Intensified consumption makes abstinence symptoms more probable to appear. The social factors that contributed to the experimentation become less motivating and the dependence happens to be controlled by the avoidance of the symptoms of the abstinence. The continued use of the cigarette causes changes in brain physiology that makes its cessation process something continuous and complex. Some triggers identified as abstinence-hindering refer to deficits in social skills. The term HS is used to designate learned behavioral capacities that involves social interactions. The present study was conducted from February to March 2017 and evaluated and correlated degree of nicotine dependence and social skills in sixty smokers patients hospitalized by vascular surgery team at a general hospital in the interior of the State of São Paulo, with the purpose of suggesting a therapeutic group where the deficits in social skills found in this study will be able to be work on. A descriptive type of search was performed. Participants were approached and invited to participate in the research whose data were analyzed quantitatively. Of the 60 participants, 23 were women and 37 were men, mean age was 62.85 years, with 52.51 years using cigarette. Only 18.33% tried to stop smoking and the beginning of use for them were at 10.33 years. Only 21.66% of the dependents did not have a smoker's family member, and 5% reported that their support group were non-smoker. According to the Fagerström test for nicotine, the majority of the evaluated patients have low and medium degree of dependence (adding up the two values). For social skills, the total scores for both genders correlate with the Fagerström test, which shows that the more dependent the more socially skilled, which may mean that the tobacco user feels socially skillful without being, if it is so, largely from a social skills training as part of the smoking cessation treatment. / O tabaco é uma das principais causas de morte prematura no mundo e sua dependência é mantida pela nicotina e determinada por processos biológicos, comportamentais, psicológicos e socioculturais. O consumo intensificado torna possível o surgimento dos sintomas de abstinência. Os fatores sociais que contribuíram para a experimentação passam a ser menos motivadores e a dependência passa a ser controlada pela evitação dos sintomas da abstinência. O uso contínuo do cigarro causa alterações na fisiologia cerebral que farão o processo de cessação do mesmo ser contínuo e complexo. Alguns gatilhos identificados como dificultadores da abstinência referem-se a déficits em habilidades sociais. O termo HS é utilizado para designar capacidades comportamentais aprendidas que envolvem interações sociais. O presente trabalho foi realizado de fevereiro à março de 2017 e avaliou e correlacionou grau de dependência de nicotina e habilidades sociais em sessenta pacientes tabagistas internados pela equipe de cirurgia vascular em um hospital geral do interior do Estado de São Paulo com o intuito de sugerir um grupo terapêutico para que os déficits em habilidades sociais encontrados sejam trabalhados posteriormente. Foi realizada uma pesquisa do tipo descritiva. Os participantes foram abordados e convidados a participar da pesquisa cujos dados obtidos foram analisados quantitativamente. Dos 60 participantes, 23 eram mulheres e 37 eram homens, de idade média de 62,85 anos, com 52,51 anos de uso de cigarro. Apenas 18,33% tentaram parar de fumar e o início do uso foi aos 10,33 anos. Apenas 21,66% dos dependentes não possuíam nenhum familiar também tabagista e 5% referiu que o grupo de apoio não era fumante. Segundo o teste Fagerström para Nicotina a maioria dos avaliados encontra-se com grau de dependência baixa e média (somando-se os dois valores). Quanto as habilidades sociais os escores totais para ambos os gêneros correlacionam -se com o teste de Fagerström, o que mostra que quanto mais dependente mais habilidoso socialmente, o que pode significar que o usuário do tabaco se sinta habilidoso socialmente sem o ser, beneficiando-se assim, largamente de um treino de habilidades sociais como parte do tratamento de cessação do tabagismo.

published_or_final_version / Nursing Studies / Master / Master of Nursing

This study aimed to use the Transtheoretical Model of behaviour change (Prochaska and DiClemente, 1983) to investigate the process of smoking initiation in a cross-section of high school adolescents in urban KwaZulu-Natal. This aim was informed by the increase in incidence of smoking among adolescents, who represent a particularly vulnerable population to smoking (Orlandi and Dalton, 1998). The Transtheoretical Model has proved successful in changing problem health behaviours (prochaska and DiClemente, 1983) and lends itself to be a suitable framework for investigating smoking acquisition in adolescents (Werch and DiClemente, 1994). An extensive review of the causes and correlates of smoking uptake and past intervention evaluations suggests that the core constructs of the TTM (Decisional Balance, Temptation and Stage of Acquisition) can be complemented by other another variable, Perceived Social Norms (informed by the Theory of Planned Behaviour, Fishbein and Ajzen, 1975, as cited in Pitts, 1996), to provide a more holistic explanation of smoking acquisition. Alcohol use, parental smoking and certain demographic factors are also found to be salient factors in this process. Findings showed that the perceived cons of smoking were constant across stages and seemed to have no effect on stage membership. Stage differences were explained almost entirely in terms of pros, which increased drastically with later stages. Perceived social norms increased with a later stage, confirming a tentative theoretical relationship between the Transtheoretical Model and Theory of Planned Behaviour. Lack of expressed intention to smoke by participants questions the validity of using the rational decision-making Transtheoretical Model to investigate a process not informed by decision-making. European language speakers were found to be a particularly vulnerable group to smoking, while African language speaking girls show very low rates of smoking. High religiosity was found to be a protective factor, while alcohol use was strongly associated with smoking. Maternal smoking was strongly associated with smoking, but only in girls. No difference in stage was found between schools and grades. The study should be replicated using a longitudinal design to determine the causal relationship between factors and smoking and to further investigate the applicability of the Transtheoretical Model in smoking acquisition. / Thesis (M.A.)- University of KwaZulu-Natal, Pietermaritzburg, 2004

This dissertation explores the cultural practice of smoking and its connection to social relations from the beginning of cigarette mass production in Montreal in 1888 to the First World War. It uncovers the norms of smoking etiquette and taste, their roots in gender, class and race relations and their use in reproducing these power relationships. It argues that these prescriptions reflected and served to legitimize beliefs about inclusion, exclusion and hierarchy that were at the core of nineteenth century liberalism. Liberal ideals of self-control and rationality structured the ritual of smoking: from the purchase of tobacco; to who was to smoke; to how one was supposed to smoke; to where one smoked. These prescriptions served to normalize the exclusion of women from the definition of the liberal individual and to justify the subordination of the poor and cultural minorities. Furthermore, even while these prescriptions were at their height, an emergent group of beliefs began to recast notions of respectable smoking around new ideals of speed and ungendered universality. This challenge was not only part of the transition from bourgeois to mass consumption, it was the roots of a transformation of the liberal order in the years previous to the First World War.

Thesis (Ph.D. in Human Medical Genetics) -- University of Colorado at Denver and Health Sciences Center, 2005. / Typescript. Includes bibliographical references (leaves 166-195).

Submitted by Adriana Ávila de Almeida null (celdrica2003@yahoo.com.br) on 2018-03-23T16:45:45Z No. of bitstreams: 1 Tese Final - Adriana Ávila de Almeida.pdf: 2506211 bytes, checksum: e38a3f026d55d541be0fd2ec9142a2a2 (MD5) / Approved for entry into archive by Silvana Alvarez null (silvana@ict.unesp.br) on 2018-04-03T21:06:34Z (GMT) No. of bitstreams: 1 almeida_aa_dr.sjc.pdf: 2506211 bytes, checksum: e38a3f026d55d541be0fd2ec9142a2a2 (MD5) / Made available in DSpace on 2018-04-03T21:06:34Z (GMT). No. of bitstreams: 1 almeida_aa_dr.sjc.pdf: 2506211 bytes, checksum: e38a3f026d55d541be0fd2ec9142a2a2 (MD5) Previous issue date: 2018-02-05 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Os carcinógenos do tabaco estão relacionados a diversos tipos de câncer incluindo o carcinoma de células escamosas (CCE) bucal. Aliado ao álcool, o tabaco contribui para o desfecho desfavorável destes casos. A susceptibilidade individual ao câncer pode estar relacionada a expressão das enzimas que metabolizam tais carcinógenos. O objetivo deste trabalho é avaliar a expressão dos genes CYP1A1, CYP1B1, CYP2A6 e CYP2E1 no CCE bucal por meio de qPCR. Foram coletadas amostras de 32 indivíduos com CCE e de 15 controles submetidos a cirurgias bucais por lesões benignas. Foram constituídos quatro grupos: Grupo CCE fumante (n=26), Grupo CCE não fumante (n=6), Grupo controle fumante (n=9) e Grupo controle não fumante (n=6). O Teste de Fagerström para Dependência a Cigarros (TFDC) foi usado para avaliar a dependência nicotínica (DN) e AUDIT para avaliação do consumo de etílicos. Houve diminuição da expressão do gene CYP1B1 nos casos de CCE comparados aos controles. Foram encontradas diferenças estaticamente significativas de expressão gênica de CYP1B1 entre os Grupos CCE fumante e controle fumante (p=0,0018), Grupo CCE não fumante e controle não fumante (p=0,0079) e CCE fumante com CCE não fumante (p=0,0385) e entre os quatro grupos (p<0,0001). Houve diminuição da expressão do CYP2A6 no Grupo CCE fumante em relação ao Grupo controle, mas apenas um paciente do Grupo controle expressou este gene. Houve aumento da expressão de CYP2E1 entre os Grupos CCE fumante e controle fumante (p=0,0424). Concluindo, foi encontrada grande variabilidade interindividual no estudo da expressão dos genes estudados. Houve maior expressão de CYP1A1 e CYP2E1 em amostras de indivíduos fumantes com CCE. Os genes CYP1B1 e CYP2A6 estavam menos expressos no Grupo CCE fumante em relação ao Grupo controle. Para os genes CYP1B1 e CYP2E1 foram encontrados valores significativos na correlação entre a expressão gênica e parâmetros demográficos e de perfil tabágico no Grupo controle fumante, e do AUDIT no Grupo CCE não fumante. O gene CYP2E1, além de estar relacionado ao metabolismo do álcool, também deve ser considerado importante marcador do metabolismo dos carcinógenos derivados do tabaco. / Tobacco carcinogens are related to various types of cancer, including oral squamous cell carcinoma (OSCC). Allied to alcohol, tobacco contributes to the unfavorable outcome of the cases. Individual cancer susceptibility may be related to an expression of the enzymes that metabolize such carcinogens. The aim of this work is to evaluate the expression of the genes CYP1A1, CYP1B1, CYP2A6 and CYP2E1 on OSCC by qPCR. Samples were collected from 32 individuals with OSCC and 15 controls submitted to oral surgeries due to benign lesions. There were four groups: Smoker SCC group (n = 26), nonsmoker SCC group (n = 6), Smoker control group (n = 9) and nonsmoker control group (n = 6). The Fagerström Test for Cigarette Dependence (TFCD) was used to evaluate nicotinic dependence (ND) and AUDIT for the evaluation of alcohol consumption. There was a decrease in CYP1B1 gene expression in cases of SCC compared to controls. (P = 0.0018); smoker CCE and non-smoker control (p = 0.0079); smoker SCC with nonsmoker SCC (p = 0.0385) and between the four groups (p <0.0001). There was a decreased expression in CYP2A6 in the smoker SCC Group compared to the control group, but only one control group patient expressed this gene. There was an increased expression of CYP2E1 between the smoking and nonsmoking SCC groups (p = 0.0424). In conclusion, large interindividual variability was found in the study of the expression of the genes studied. There was greater expression of CYP1A1 and CYP2E1 in samples from smokers with SCC. The CYP1B1 and CYP2A6 genes were less expressed in the smoker SCC Group. Significant values were found for the CYP1B1 and CYP2E1 genes in the correlation between a gene expression and a parameter and a non-smoker control group, non-smoker control group and AUDIT. The CYP2E1 gene, besides being related to alcohol metabolism, should also be considered an important marker of the metabolism of the carcinogens derived from tobacco. / 2016/08633-0