Magister Artium (Psychology) - MA(Psych) / The study investigated three aspects related to smoking, namely, smoking behaviour, risk perception and attitudes to anti-smoking legislation. The theoretical framework of the study was the Information-Motivation-Behavioural (IMB) skills model. The study was a quantitative one, making use of a cross-sectional survey design to obtain data about the three variables of interest. Responses to statements about risk perception and attitudes to anti-smoking legislation in the questionnaire were arranged on a three-point Likert scale. The inferential statistics used were one-sample t-tests and Chi-square analyses. The results showed an overall smoking prevalence of 16%, with twice as many females than males being smokers in the sample. 'Coloured' students in both genders had the highest smoking rate compared to all other race groups. The knowledge of the health risks of smoking were very high, however smokers had a lower perception of risk compared to non-smokers. Moreover, while there was a fair amount of support for anti-smoking legislation among smokers, smokers tended to show less support for legislation than non-smokers, especially to those parts of the legislation that affect them more directly. The results of the study indicate a clear connection between smoking behaviour and the effect it has on both risk perception as well as attitudes to anti-smoking legislation in individuals. / South Africa

This study explored whether a relationship exists between smoking behaviors and racial discrimination induced anger among Black adolescents. Participants consisted of 134 Black adolescents from 14 to 18 years of age who frequently visited a recreation center in the Northeast. Forty-four participants were males and 90 were females. All participants were administered a modified version of the CAGE questionnaire, a background information questionnaire, and a measure designed to assess the extent to which they feel angry because they had been discriminated against. Only age was found to be predictive of scores on the CAGE. Only gender was found to be predictive of smoking frequency. The Black Anger Measure (BAM) was significantly correlated with smoking behaviors. Some implications for theory, research and practice are suggested.

The psychosocial and cultural predictors of cigarette smoking were examined among a sample of 175 African-American adults. Participants completed a self-report inventory containing the Beck Depression Inventory, the Perceived Stress Scale, the Speilberger State-Trait Anxiety, the African-American Acculturation Scale, and questions regarding their smoking, demographics, and risk-taking tendencies.

Objective: To assess occupational tobacco use and the impact of a tobacco-free policy in the Central Appalachia, an environment characterized by high tobacco use and production. Methods: This study was an Internet-based survey conducted on 2,318 university employees. Descriptive, chi-square, and logistic regression statistics were performed. Unadjusted and adjusted odds ratios (AOR) with respective 95 % confidence intervals (CI) were reported. Results: The survey response rate was 50.8 %; of the respondents, 9.0 % were current smokers. Smoking prevalence among faculty, administrators/professionals, and clerical/support staff was 6.1, 8.1, and 13.1 %, respectively. While those respondents aged 30-39 years showed a significantly increased likelihood of being a current smoker (AOR 5.64, 95 % CI 1.31-9.26), knowledge that secondhand smoke is harmful (AOR 0.22, 95 % CI 0.07-0.70) and support for tobacco-free policy (AOR 0.11, 95 % CI 0.04-0.27) decreased the likelihood. Conclusion: Low tobacco use among faculty and administrators confirmed the relationship between tobacco use and socio-economic status, even in a tobacco-producing environment. Disaggregation of tobacco use data assists the public health community in the efficient allocation of efforts and resources for cessation programs to reduce tobacco use in such environments.

Objective: To assess occupational tobacco use and the impact of a tobacco-free policy in the Central Appalachia, an environment characterized by high tobacco use and production. Methods: This study was an Internet-based survey conducted on 2,318 university employees. Descriptive, chi-square, and logistic regression statistics were performed. Unadjusted and adjusted odds ratios (AOR) with respective 95 % confidence intervals (CI) were reported. Results: The survey response rate was 50.8 %; of the respondents, 9.0 % were current smokers. Smoking prevalence among faculty, administrators/professionals, and clerical/support staff was 6.1, 8.1, and 13.1 %, respectively. While those respondents aged 30-39 years showed a significantly increased likelihood of being a current smoker (AOR 5.64, 95 % CI 1.31-9.26), knowledge that secondhand smoke is harmful (AOR 0.22, 95 % CI 0.07-0.70) and support for tobacco-free policy (AOR 0.11, 95 % CI 0.04-0.27) decreased the likelihood. Conclusion: Low tobacco use among faculty and administrators confirmed the relationship between tobacco use and socio-economic status, even in a tobacco-producing environment. Disaggregation of tobacco use data assists the public health community in the efficient allocation of efforts and resources for cessation programs to reduce tobacco use in such environments.

Introduction: Despite advances in evidence-based smoking cessation approaches, quit rates in people with mental health conditions who smoke have not increased over the past decade. This research explored the role of family or peers in promoting smoking cessation in this population, using three specific aims; 1) examine the association between family or peer views on tobacco use and smoking cessation, 2) identify pathways through which family or peer factors influence smoking cessation, and 3) identify social barriers and facilitators to seeking cessation support when quitting. Methods: We used data from the Population Assessment of Tobacco and Health Study and collected qualitative data from people with mental health conditions who currently smoke or quit within the last five years. Data were analyzed using logistic regression modeling, structural equation modeling, and rapid qualitative analysis. Results: Having family or peers with positive or neutral views on tobacco use significantly reduced the odds of quitting smoking. Higher intentions to quit and changes in smoking behavior mediated the relationship between supportive family or peer behaviors and quitting smoking. Quitting together and encouragement from family or peers were perceived as supportive, while nagging the individual undermined quitting success. Except for individuals who regarded autonomy highly or were not ready to stop smoking, stronger social relationships and tailored support increased willingness to involve family members in cessation interventions. Conclusions: Supportive family or peer attitudes and behaviors can positively influence smoking cessation in people with mental health conditions who smoke. Ways to identify ideal family or peer support partners to involve in cessation interventions are proposed.

Lung cancer is the leading cause of cancer-related mortality worldwide. The main risk factor associated with lung cancer is cigarette smoking. Research through the years suggests that nicotine in cigarettes promotes lung cancer by activating signaling pathways that lead to cell proliferation, cell survival, angiogenesis, and metastasis. Nicotine’s cellular actions are mediated by its cognate receptors, nicotinic acetylcholine receptors (nAChRs). Here, I describe the expression levels of all known human nAChR subunit genes in both normal and lung cancer cells. Of note, the genes encoding the α5, α3, and β4 subunits (CHRNA5/A3/B4) are over-expressed in small cell lung carcinoma (SCLC), the most aggressive form of lung cancer. This over-expression is regulated by ASCL1, a transcription factor important in normal lung development and lung carcinogenesis. The CHRNA5/A3/B4 locus has recently been the focus of a series of genetic studies showing that polymorphisms in this region confer risk for both nicotine dependence and lung cancer. I show that CHRNA5/A3/B4 depletion results in decreased SCLC cell viability. Furthermore, while nicotine promotes SCLC cell viability and tumor growth, blockade of α3β4 nAChRs inhibits SCLC cell viability. These results suggest that increased expression and function of nAChRs, specifically the α3β4α5 subtype, potentiate the effects of nicotine in SCLC. This dual hit from the carcinogens in tobacco and the cancer-promoting effects of nicotine, may provide a possible mechanism for the increased aggressiveness of SCLC. In addition, nAChRs can be activated by the endogenous ligand, acetylcholine, which acts as an autocrine/paracrine growth factor in SCLC. Increased function of α3β4α5 nAChRs in SCLC could also potentiate acetylcholine’s mitogenic effects. This mechanism, combined with other known autocrine/paracrine growth loops in SCLC, may help explain the ineffectiveness of available therapies against SCLC. In an effort to add to the current arsenal against SCLC, I screened a 1280-compund library using a bioluminescence-based viability assay I developed for high-throughput applications. Primary screening, followed by secondary and tertiary verification, indicate that pharmacologically active compounds targeting neuroendocrine markers inhibit SCLC cell viability.

BACKGROUND: Of the 22 known measures of nicotine dependence (ND), none capture the overall disease severity of physical dependence alone. Instead, they capture constructs related to dependence, such as perceived risk, psychological addiction, smoker motivations, or smoking related behaviors, but none of the measures include only physical withdrawal symptoms to capture physical dependence on nicotine. AIM: To develop a range of nicotine dependence measures that capture physical dependence on nicotine. METHODS: The final measures were developed in a cross-sectional study conducted in three phases: 1) candidate item development through literature review and cognitive interviews, 2) developing and pre-testing the survey, and 3) survey administration and psychometric evaluation to validate three distinct measures. The final survey was conducted at four health clinics and three high schools. Psychometric tests used to select the final measure items included inter-item correlations, sensitivity analyses done by subgroup, item-total correlations, convergent validity tests, and confirmatory factor analysis. The final measures were evaluated using confirmatory factor analysis (CFA), internal reliability, total score distributions, and convergent validity correlations. Relative validity analyses were also conducted using a ratio of F-Statistics to compare the ability of each new measure to differentiate dependent smokers as compared previous measures. RESULTS: The final sample included 275 smokers ranging from 14 to 76 years old (mean=30.9, SD=16.2), who smoked an average of 11.5 cigarettes per day (range=0-50, SD=9.4). The sample was 86.5% white and 57.5% male. The three new measures developed included: 1) the 4-item Withdrawal-Induced Craving Scale (WICS) used to capture severity of craving, the most common physical withdrawal symptom; 2) the 12- item Nicotine Withdrawal Symptom Checklist (NWSC), which measures both overall disease severity and the severity of a comprehensive list of individual physical withdrawal symptoms including withdrawal-induced craving, anger, anxiety, depression, headache, insomnia, loss of focus, restlessness, and stress; and 3) the 6-item brief NWSC (NWSC-b), a short measure which only captures overall disease severity. All of the new measures exhibited a unidimensional factor structure loading highly on a single factor (thought to be physical dependence). They also correlated highly (over 0.6) and significantly (p<0.001) to a battery of convergent validity indices including four widely used nicotine dependence measures: Hooked on Nicotine Checklist (HONC), the Autonomy Over Tobacco Scale (AUTOS), the Fagerström Test for Nicotine Dependence (FTND), and self-rated addiction. CONCLUSION: The WICS, NWSC, and NWSC-b provide three distinct validated tools that can be used by researchers, clinicians, and educators to track the progression of physical dependence on nicotine across a range of smoking behaviors and histories.

Nicotine dependence is hypothesized to be due to neuroadaptations that ultimately drive compulsive nicotine use. The studies in this thesis aim to understand how the “upregulation” of nicotinic acetylcholine receptors (nAChRs) caused by chronic exposure to nicotine contributes to nicotine reward and nicotine withdrawal. Previous studies have shown that chronic nicotine induces upregulation of nAChRs containing the α4 subunit (α4* nAChR) within the Ventral Tegmental Area (VTA), a brain region critical for the rewarding properties of all illicit drugs. Curiously, α4* nAChR upregulation occurs specifically in the inhibitory GABAergic neuronal subpopulation of the VTA. To determine if increased expression and activation of α4* nAChRs in VTA GABAergic neurons contributes to nicotine dependence behaviors, I devised a viral-mediated, Creregulated gene expression system that selectively expressed α4 nAChR subunits containing a “gain-of-function” point mutation (a leucine mutated to a serine residue at the TM2 9´ position: Leu9´Ser) in VTA GABAergic neurons of adult mice. Sub-reward doses of nicotine were sufficient to activate VTA GABAergic neurons in mice expressing Leu9´Ser α4 nAChR subunits in VTA GABAergic neurons (Gad2VTA: Leu9´Ser mice) and exhibited acute hypolocomotion upon initial injection of low doses of nicotine that developed tolerance with subsequent nicotine exposures compared to control animals. In the conditioned place preference procedure, nicotine was sufficient to condition a significant place preference in Gad2VTA: Leu9´Ser mice at low nicotine doses that failed to condition control animals. I conclude from these data that upregulating α4* nAChRs on VTA GABAergic neurons increases sensitivity to nicotine reward. In a separate study testing the hypothesis that overexpression of Leu9´Ser α4* nAChRs in VTA GABAergic neurons disrupts baseline behavior and promotes anxiety-like behaviors, I found that overexpressing Leu9´Ser α4* nAChRs in VTA GABAergic neurons had a minimal effect on unconditioned anxiety-like behaviors. Drug naïve Gad2VTA: Leu9´Ser and control mice failed to exhibit any behavioral differences in the open-field, marble burying test and elevated plus maze compared to control. Together, these data indicate that overexpression of the “gain-of-function” α4* nAChRs in VTA GABAergic neurons contributes to reward sensitivity without increasing susceptibility to nicotine withdrawal symptoms. My data indicates that nAChRs expressed in VTA GABAergic neurons may be a suitable target for the development of better smoking cessation aids.

Orientador: Dionei Ramos / Resumo: Estudos vem investigando a relação do nível da atividade física com a melhora da qualidade do sono de tabagistas, além da utilização do exercício físico para aumentar o sucesso da cessação do tabagismo. No entanto, faz-se necessário investigar a relação da qualidade do sono e sistema nervoso autônomo (SNA) de acordo com o nível de atividade física habitual de tabagistas, para promover a identificação de possíveis mecanismos responsáveis pelos distúrbios do sono desta população, além disso os efeitos do exercício físico no sucesso da cessação do tabagismo ainda é pouco compreendida indicando pequenas taxas de adesão e abstinência ao final do tratamento. Objetivos: Identificar a relação entre a qualidade do sono de tabagistas com o nível de atividade física habitual e modulação do SNA. Além disso, comparar dois tipos de exercícios associados à terapia cognitivo-comportamental (TCC) no sucesso da cessação do tabagismo. Métodos: Trata-se de dois estudos, sendo o primeiro transversal realizado com 42 tabagistas divididos em dois grupos de acordo com o percentil 50% do nível de atividade física de moderada à vigorosa (AFMV) avaliada por meio da acelerometria; onde a qualidade do sono foi avaliada por meio do questionário Mini-Sleep e a modulação do SNA por meio de índices da variabilidade da frequência cardíaca (VFC). Para as análises dos dados foi utilizado análise de covariância (ANCOVA) ajustado para idade, sexo, composição corporal, anosmaço, medicamentos beta-bloqueadores, ans... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Studies has been investigating the relationship of habitual physical activity with improved of sleep quality in smokers, in addition to using exercise to increase the success of smoking cessation. However, it is necessary to investigate the relationship between sleep quality and autonomic nervous system (ANS) according to the level of habitual physical activity of smokers, to promote the identification of possible mechanisms responsible for sleep disorders in this population. The effects of physical exercise on smoking cessation success, it is still poorly understood, indicating low adherence and abstinence rates at the end of treatment. Objectives: To identify changes in the sleep quality of smokers and its relation with habitual physical activity level and ANS modulation. Also, compare two types of exercise associated with cognitive behavior therapy (CBT) in successful smoking cessation. Methods: These are two studies, the first cross-sectional study conducted with 42 smokers divided into two groups according to the 50th percentile of the moderate-to-vigorous physical activity (MVPA) assessed by accelerometry; where the sleep quality was assessed using the Mini-sleep Questionnaire and the ANS modulation was assessed by indices of heart rate variability (HRV). For the analysis of possible mean differences analysis of covariance (ANCOVA) was used adjusting for age, sex, body composition, pack-years, beta-blockers, anxiety, and depression in log base 10. Correlations were made... (Complete abstract click electronic access below) / Doutor