Source: Masters Abstracts International, Volume: 47-03, page: 1572. Adviser: Alanna Morrison. Includes bibliographical references.

While smoking prevalence among the general Canadian population has declined to 17%, declining rates have not been achieved equitably across all sub-populations (Statistics Canada, 2011). Smoking prevalence is particularly high among blue-collar workers, and individuals employed in the construction industry have the highest smoking prevalence (34%, Conference Board of Canada, 2013). Though studies have attempted to understand these disparities and how to combat them, research is necessary to understand the social contexts in which construction workers smoke. This study sought to understand these contexts by exploring experiences and meaning of smoking. Semi-structured, in-depth interviews were conducted with 14 construction workers living and working in Southern Ontario. Qualitative inductive analysis was conducted in three phases: (1) simultaneous data gathering and generating nodes, (2) coding and subgroup analysis, and (3) limited theory development. Grounded theory approach to analysis identified six main categories encompassing various subthemes. These included: day-to-day workplace experiences, experience of smoking, reasons for smoking, sociability of smoking, mechanisms associated with continued smoking, and experiences with quitting or cutting back. Sub-group analyses identified differences between participants depending on age, skill level (unskilled worker versus skilled tradesperson), and job sector (residential versus commercial/industrial). Social theories and concepts identified in the literature review were referred to, including the Social Contextual model by Sorensen and colleagues (2004). A potential set of contextual factors and modifying mechanisms that may be impacting construction worker’s tobacco use on or off jobsites are presented. The findings indicate that smoking is a complex issue among construction workers. For many, smoking goes hand-in-hand with working. Smoking is a social experience, and common on worksites. Workers experience various smoking policies on different jobsites. Policies may or may not be followed or enforced. Smoking has different meanings for different workers. However, factors external to the workplace must also be considered (e.g. partner smoking status). Supports that could be offered in workplace contexts include incentives, coverage of quitting aids, and limiting smoking (e.g. smoke-free policy). These findings have implications for policy and practice. Further research, including collaborative intervention development, is necessary to address high and persistent rates of tobacco use among construction workers.

M.Phil. / The effects of an upper body resistance training (UBRT) programme on spirometry values are not well documented or researched. The sparse number of studies that have focussed on this topic have generated inconclusive data on the effects of UBRT on pulmonary function. The present investigation made use of an eight-week UBRT programme in order to evaluate whether this would yield significant changes with regards to the following spirometry values: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), 25% of forced expiratory flow (FEF-25), 50% of forced expiratory flow (FEF-50), 75% of forced expiratory flow (FEF-75), FEV1/FVC ratio, peak expiratory flow (PEF), peak inspiratory flow (PIF), vital capacity (VC), inspiratory vital capacity (IVC), FEV1/VC ratio, expiratory reserve volume (ERV) and minute ventilation (VE). The study made use of 36 sedentary but healthy male smokers (mean age: 33 years and 6 months), who were assigned into either a non-exercising control (CG) (n = 18) or exercising experimental (EG) (n = 18) group. A seven-day smoking analysis was recorded for both the EG and CG before and after the eight-week experimental period in order to control for any changes that might have occurred with regards to their smoking behaviour in an attempt to account for any changes in pulmonary function. The EG group were assigned to exercise for eight-weeks three times weekly on non-consecutive days using an UBRT programme. Their spirometry values were assessed at the commencement of and subsequent to the eight-week period. The EG¡¦s training programme consisted of latissimus-dorsi pulls, seated chest press, seated rows, seated shoulder press, shoulder shrugs, bent knee crunches and diagonal crunches. Each exercise was performed for three sets of 15 repetitions each. These exercises were performed at 50% 1-repetition maximum (1-RM) for the first week, at 60% 1-RM for the second and third week and at 70% 1-RM for the fourth week. Once each subject¡¦s 1-RM was reevaluated after four weeks, the same intensity progression was followed for the fifth (50% 1-RM), sixth (60% 1-RM), seventh (60% 1-RM) and eighth (70% 1-RM) weeks. The CG was instructed to not take part in any structured exercise throughout the eight-week period. The present investigation made use of the dependent and independent paired t-tests. The CG¡¦s FEV1/VC ratio increased significantly (p „T 0.05) by 2.97% and VC decreased significantly by 4.46%, while the EG¡¦s PEF and PIF increased significantly by 12.6% and 13.9%, respectively. No statistically significant changes were found in FVC, FEV1, FEV1/FVC ratio, FEF-25, FEF-50 and FEF-75, IVC, ERV and VE for both the EG and CG. Both groups indicated no statistically significant changes in daily cigarette consumption from the pre- to post-tests. The investigation concluded that eight weeks of UBRT was insufficient to result in significantly positive changes in the majority of pulmonary function variables, except for PIF, in sedentary male smokers. / Dr. L. Lategan

RESUMO Moraes MA. Avaliação da implantação do Programa de Controle do Tabagismo no Hospital Santa Cruz – São Paulo-Capital. 2006. "Tese de Doutorado – Faculdade de Saúde Pública da USP". Objetivo: Realizou-se o presente estudo com a finalidade de avaliar as intervenções aplicadas no Programa de Controle do Tabagismo do Hospital Santa Cruz e sua eficácia na diminuição da prevalência do tabagismo. Métodos: Pesquisa avaliativa longitudinal, do tipo painel, realizada para o cumprimento do objetivo estabelecido, sendo seu objeto constituído pelas intervenções organizacionais, educativas e físicas desenvolvidas no referido programa. Utilizaram-se dados da pesquisa sobre perfil do fumante do Hospital Santa Cruz realizada no final do ano de 2001 e início de 2002 e reaplicada em 2004 para obter a prevalência do tabagismo. Realizou-se, também, outra pesquisa sobre a percepção dos funcionários deste hospital que, vivenciaram as aplicações das referidas intervenções, utilizando-se, em outubro de 2005, um questionário composto por 19 questões estruturadas em 6 seções, em que foram sujeitos da pesquisa 498 funcionários. Aplicaram-se testes estatísticos não paramétricos para verificar diferenças entre as variáveis sociodemográficas dessa última pesquisa. Resultados: Como principais resultados, as análises demonstraram que a opinião dos pesquisados, referentes às fases de intervenções aplicadas ao programa, mostrou-se bastante favorável, pois as porcentagens relativas à participação desses colaboradores nas ações desenvolvidas no programa variaram de 74,3% a 99%. Conclusões: A avaliação de estrutura/processo/resultado permitiu concluir que o Programa de Controle do Tabagismo do Hospital Santa Cruz mostrou-se eficaz tendo em vista apresentar uma estrutura adequada em relação à capacidade instalada, alcançar as metas programadas na sua avaliação de processo e, como resultado final, ter diminuído em 52,91% a prevalência do tabagismo entre seus colaboradores. Descritores: Tabagismo, Avaliação, Programas de Saúde. / SUMMARY Moraes M.A. Evaluation of the implementation of the Tobacco Control Program at the Santa Cruz Hospital – São Paulo – Capital; 2006 "Dissertation of the Doctoral Degree Program – College of Public Health - USP". Objective: The present study was carried out with the objective of evaluating the interventions applied in the Tobacco Control Program at the Santa Cruz Hospital (HSC) and their effectiveness in decreasing the prevalence of tobacco use. Methods: A longitudinal evaluation study of the panel type was carried out to achieve the established objective, with the purpose of investigating the organizational, educational and physical interventions developed in the abovementioned program. Research data on the tobacco user profile, obtained by the Santa Cruz Hospital at the end of 2001 and beginning of 2002, were applied again in 2004 to find out the tobacco use prevalence. Another investigation was also conducted concerning the perception of the hospital staff that experienced the application of the interventions by means of a questionnaire composed of 19 structured questions divided into 6 sections and answered by 498 employees in October 2005. Non-parametric statistical tests were applied to identify differences between the sociodemographic variables of the last study. Results: The main results shown in the analyses were that the opinion of the study subjects regarding the intervention phases applied in the program was quite favorable, since the percentages regarding participation of these employees in the actions developed in the program varied between 74.3% and 99%. Conclusions: The evaluation of the structure/process/result allowed us to conclude that the Tobacco Control Program of the Santa Cruz Hospital was successful, presenting an adequate structure for the installed capacity, achieving the programmed targets in its process evaluation and, as end result, decreasing by 52.91% the prevalence of tobacco use among staff members. Descriptors: Tobacco use, Evaluation, Health Programs.

O tabagismo é o mais importante fator de risco de diversas doenças crônicas, incluindo a periodontite. Atualmente existe uma mobilização mundial contra o uso do tabaco. Embora cirurgiões-dentistas apresentem potencial para ajudar seus pacientes fumantes a abandonar o vicio, o papel do dentista na cessação do tabagismo ainda não está totalmente esclarecido. O objetivo deste estudo prospectivo de 12 meses foi verificar o efeito de um programa antitabágico multidisciplinar na cessação de tabagismo em fumantes com doença periodontal. Duzentos e um (201) sujeitos foram triados, e 93 foram incluídos e receberam tratamento periodontal não-cirúrgico. Simultaneamente, os indivíduos receberam terapia antitabágica, que consistiu em quatro palestras consecutivas ministradas por um médico e uma dentista, terapia cognitiva comportamental realizada por uma psicóloga, e terapia de reposição de nicotina e medicação, de acordo com necessidades individuais. Durante o tratamento periodontal, os dentistas motivaram ativamente os participantes a pararem de fumar, usando técnicas de entrevista motivacional. Aconselhamento e suporte adicionais foram fornecidos durante as visitas de manutenção após 3, 6 e 12 meses do término do tratamento periodontal. A condição de tabagista foi avaliada por meio de um questionário estruturado, e foi validada pela mensuração de monóxido de carbono expirado (CO). Também foi aplicado o Questionário de Tolerância de Fagerström para verificar a dependência à nicotina. Dentre os 52 indivíduos que permaneceram até o exame de 12 meses, 22(42,31%), 17(32,69%) e 17(32,69%) não estavam fumando após 3, 6 e 12 meses, respectivamente. A cessação de tabagismo foi associada aos níveis iniciais de CO (p = 0,03), nível de dependência nicotínica de acordo com o questionário de Fageström (p=0,01) e escore médio do questionário de Fagerström (p<0,001). Concluiu-se que a terapia antitabágica realizada por uma equipe multidisciplinar que inclui dentistas resultou em alta taxa de cessação de tabagismo. O abandono do hábito foi associado à exposição ao CO e à dependência nicotínica. / Smoking is the leading risk factor of several chronic diseases, including periodontitis. Nowadays, there is a world-wide mobilization against the use of tobacco. Although it is acknowledged that dentists have potential to help smoking patients to quit, their role in tobacco control is not completely defined. The aim of this prospective 12- month study was to evaluate the effect of a multidisciplinary smoking cessation program in quitting smoking in subjects with periodontal disease. Two-hundred and one (201) subjects were screened, and 93 were included and received non-surgical periodontal treatment during four weeks. Subjects also received smoking cessation therapy, which consisted of four consecutive lectures given by a physician and a dentist, psychologist-assisted cognitive behavioral therapy, nicotine replacement therapy and medication, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6 and 12 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Participants were further asked about their nicotine dependence, by means of the Fagerström Tolerance Questionnaire. Among the 52 individuals that remained up to the 12-months examination, 22(42.31%), 17(32.69%) and 17(32.69%) were not smoking at 3, 6 and 12 months, respectively. Smoking cessation was associated with baseline CO levels (p = 0.03), Fagerströms nicotine dependence level (p=0.01) and mean Fagerström test score (p<0.001). It is concluded that smoking cessation therapy performed by a multidisciplinary team including dentists resulted in high quit rates. Smoking cessation was associated with exposure to CO and nicotine dependence.

O tabagismo é o mais importante fator de risco de diversas doenças crônicas, incluindo a periodontite. Atualmente existe uma mobilização mundial contra o uso do tabaco. Embora cirurgiões-dentistas apresentem potencial para ajudar seus pacientes fumantes a abandonar o vicio, o papel do dentista na cessação do tabagismo ainda não está totalmente esclarecido. O objetivo deste estudo prospectivo de 12 meses foi verificar o efeito de um programa antitabágico multidisciplinar na cessação de tabagismo em fumantes com doença periodontal. Duzentos e um (201) sujeitos foram triados, e 93 foram incluídos e receberam tratamento periodontal não-cirúrgico. Simultaneamente, os indivíduos receberam terapia antitabágica, que consistiu em quatro palestras consecutivas ministradas por um médico e uma dentista, terapia cognitiva comportamental realizada por uma psicóloga, e terapia de reposição de nicotina e medicação, de acordo com necessidades individuais. Durante o tratamento periodontal, os dentistas motivaram ativamente os participantes a pararem de fumar, usando técnicas de entrevista motivacional. Aconselhamento e suporte adicionais foram fornecidos durante as visitas de manutenção após 3, 6 e 12 meses do término do tratamento periodontal. A condição de tabagista foi avaliada por meio de um questionário estruturado, e foi validada pela mensuração de monóxido de carbono expirado (CO). Também foi aplicado o Questionário de Tolerância de Fagerström para verificar a dependência à nicotina. Dentre os 52 indivíduos que permaneceram até o exame de 12 meses, 22(42,31%), 17(32,69%) e 17(32,69%) não estavam fumando após 3, 6 e 12 meses, respectivamente. A cessação de tabagismo foi associada aos níveis iniciais de CO (p = 0,03), nível de dependência nicotínica de acordo com o questionário de Fageström (p=0,01) e escore médio do questionário de Fagerström (p<0,001). Concluiu-se que a terapia antitabágica realizada por uma equipe multidisciplinar que inclui dentistas resultou em alta taxa de cessação de tabagismo. O abandono do hábito foi associado à exposição ao CO e à dependência nicotínica. / Smoking is the leading risk factor of several chronic diseases, including periodontitis. Nowadays, there is a world-wide mobilization against the use of tobacco. Although it is acknowledged that dentists have potential to help smoking patients to quit, their role in tobacco control is not completely defined. The aim of this prospective 12- month study was to evaluate the effect of a multidisciplinary smoking cessation program in quitting smoking in subjects with periodontal disease. Two-hundred and one (201) subjects were screened, and 93 were included and received non-surgical periodontal treatment during four weeks. Subjects also received smoking cessation therapy, which consisted of four consecutive lectures given by a physician and a dentist, psychologist-assisted cognitive behavioral therapy, nicotine replacement therapy and medication, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists during periodontal maintenance sessions at 3, 6 and 12 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and it was validated by exhaled carbon monoxide (CO) measurements. Participants were further asked about their nicotine dependence, by means of the Fagerström Tolerance Questionnaire. Among the 52 individuals that remained up to the 12-months examination, 22(42.31%), 17(32.69%) and 17(32.69%) were not smoking at 3, 6 and 12 months, respectively. Smoking cessation was associated with baseline CO levels (p = 0.03), Fagerströms nicotine dependence level (p=0.01) and mean Fagerström test score (p<0.001). It is concluded that smoking cessation therapy performed by a multidisciplinary team including dentists resulted in high quit rates. Smoking cessation was associated with exposure to CO and nicotine dependence.

RESUMO Moraes MA. Avaliação da implantação do Programa de Controle do Tabagismo no Hospital Santa Cruz – São Paulo-Capital. 2006. "Tese de Doutorado – Faculdade de Saúde Pública da USP". Objetivo: Realizou-se o presente estudo com a finalidade de avaliar as intervenções aplicadas no Programa de Controle do Tabagismo do Hospital Santa Cruz e sua eficácia na diminuição da prevalência do tabagismo. Métodos: Pesquisa avaliativa longitudinal, do tipo painel, realizada para o cumprimento do objetivo estabelecido, sendo seu objeto constituído pelas intervenções organizacionais, educativas e físicas desenvolvidas no referido programa. Utilizaram-se dados da pesquisa sobre perfil do fumante do Hospital Santa Cruz realizada no final do ano de 2001 e início de 2002 e reaplicada em 2004 para obter a prevalência do tabagismo. Realizou-se, também, outra pesquisa sobre a percepção dos funcionários deste hospital que, vivenciaram as aplicações das referidas intervenções, utilizando-se, em outubro de 2005, um questionário composto por 19 questões estruturadas em 6 seções, em que foram sujeitos da pesquisa 498 funcionários. Aplicaram-se testes estatísticos não paramétricos para verificar diferenças entre as variáveis sociodemográficas dessa última pesquisa. Resultados: Como principais resultados, as análises demonstraram que a opinião dos pesquisados, referentes às fases de intervenções aplicadas ao programa, mostrou-se bastante favorável, pois as porcentagens relativas à participação desses colaboradores nas ações desenvolvidas no programa variaram de 74,3% a 99%. Conclusões: A avaliação de estrutura/processo/resultado permitiu concluir que o Programa de Controle do Tabagismo do Hospital Santa Cruz mostrou-se eficaz tendo em vista apresentar uma estrutura adequada em relação à capacidade instalada, alcançar as metas programadas na sua avaliação de processo e, como resultado final, ter diminuído em 52,91% a prevalência do tabagismo entre seus colaboradores. Descritores: Tabagismo, Avaliação, Programas de Saúde. / SUMMARY Moraes M.A. Evaluation of the implementation of the Tobacco Control Program at the Santa Cruz Hospital – São Paulo – Capital; 2006 "Dissertation of the Doctoral Degree Program – College of Public Health - USP". Objective: The present study was carried out with the objective of evaluating the interventions applied in the Tobacco Control Program at the Santa Cruz Hospital (HSC) and their effectiveness in decreasing the prevalence of tobacco use. Methods: A longitudinal evaluation study of the panel type was carried out to achieve the established objective, with the purpose of investigating the organizational, educational and physical interventions developed in the abovementioned program. Research data on the tobacco user profile, obtained by the Santa Cruz Hospital at the end of 2001 and beginning of 2002, were applied again in 2004 to find out the tobacco use prevalence. Another investigation was also conducted concerning the perception of the hospital staff that experienced the application of the interventions by means of a questionnaire composed of 19 structured questions divided into 6 sections and answered by 498 employees in October 2005. Non-parametric statistical tests were applied to identify differences between the sociodemographic variables of the last study. Results: The main results shown in the analyses were that the opinion of the study subjects regarding the intervention phases applied in the program was quite favorable, since the percentages regarding participation of these employees in the actions developed in the program varied between 74.3% and 99%. Conclusions: The evaluation of the structure/process/result allowed us to conclude that the Tobacco Control Program of the Santa Cruz Hospital was successful, presenting an adequate structure for the installed capacity, achieving the programmed targets in its process evaluation and, as end result, decreasing by 52.91% the prevalence of tobacco use among staff members. Descriptors: Tobacco use, Evaluation, Health Programs.

Most adult smokers begin smoking during adolescence; nicotine dependence can develop relatively quickly and, once established, most smokers smoke for approximately 40 years. For adolescents dependent upon nicotine, cessation interventions are not well established. It is, therefore, essential that public health interventions focus on preventing initiation and maintenance and decreasing the prevalence of youth smoking. In spite of legislation to protect New Zealand adolescents, a large proportion continues to use tobacco at least weekly. Recent surveys have shown a slight decrease in cigarette smoking prevalence, overall, but, no reduction and marked increases have been reported within some subgroups. The overall aim of this research was to identify school and personal factors associated with secondary school students smoking. The specific research objectives included: a) identifying factors at the personal, family, peer, school and 'tobacco-genic' environment levels which were associated with regular and established cigarette smoking; b) describing the extent of smoke-free policy and health education programmes in secondary schools; and, c) evaluating the relations between cigarette smoking among students and potential protective factors, smoke-free policies and practices and health education programmes. The research was based on data from 3,434 secondary school students from 82 schools. The multi-stage sampling procedures and data analyses ensured that the results were able to be generalised to the New Zealand secondary school student population. Smoking was more prevalent amongst girls for all measures of smoking frequency and significant differences were found for smoking prevalence between ethnic groups and school decile. In terms of family influences, the smoking behaviours of parents were not associated with increased odds of smoking nor were perceived relationships between students and their parents, or exposure to SHS. In contrast, the smoking behaviour of siblings was associated with increased odds of smoking but it is likely that both student and sibling smoking are both influenced by the same processes within the family. Similarly, low levels of self-concept were not associated with increased odds for daily smoking. The smoking behaviour of a best friend was a pervasive risk factor as was a high level of disposable income, frequent episodes of unsupervised activities, and 'pro-smoking' knowledge. Being male, visiting a place of worship, and the intention to stay at school until after Year 13 reduced the odds of daily smoking among students. Multilevel models were used to identify school level effects. After adjusting for student, family and school characteristics significant between-school variance in smoking prevalence remained and this suggests that there are factors, arguably beyond the immediate control of the student or family that may influence a student�s smoking behaviour. The presence of a school effect also supports the WHO concept of 'health promoting schools' in that schools can make a difference to health outcomes. Understanding how the health promoting schools model has been interpreted and implemented in NZ schools, along with critique of the implementation of the amended legislation making all schools smoke-free, would be a pertinent 'next-step' in identifying characteristics of schools which are associated with decreased tobacco use.

Since the introduction of tobacco into New Zealand, smoking and smoking related illnesses have become more prevalent in the Maori population than New Zealand's general population. The aim of the present research was to investigate smoking from a Maori perspective. It was hoped this information would provide a better understanding of how Maori can become smokefree. The present research also investigated a number of possible benefits that could be obtained by Maori through becoming smokefree. These benefits were analysed through Mason Durie's Whare Tapa Wha model, a Maori holistic health model. Semi-structured in-depth interviews were conducted with four Maori people, two of whom were current smokers and two who were ex-smokers. Common themes emerged from these interviews including the social aspect of smoking for Maori and the influence of the enviroment on smoking behaviour. Suggestions were given to illustrate how the social aspect of smoking and the cycle that subsequently develops can be broken. Using the Whare Tapa Wha model and the personal accounts given, the benefits of breaking such a cycle were discussed. Lastly, the importance of nurturing smokefree environments, especially Maori environments, was outlined. The notion of being positive about becoming smokefree and the need to celebrate giving up smoking were highlighted throughout this research.

Thesis (Ph.D.)--University of Delaware, 2007. / Principal faculty advisor: Marian L. Palley, Dept. of Political Science & International Relations. Includes bibliographical references.