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.

The vast majority of smokers who manage to quit do so without the assistance of a facilitated cessation program. Since the majority of focused anti-smoking efforts are directed at facilitated programs, there is an apparent gap in service of the population at risk. Also, the sharp decline in smoking prevalence indicates a changing demographic dynamic. It is probable that those persons still smoking comprise a different population type than did smokers of a decade ago. A reexamination of major strategies for self-quitting is strongly indicated.The purpose of this thesis was to apply what was known about addictive behavior to a self-guided quitting process. Major variables guiding this effort were learning theory, theory of self-change, empirically demonstrated methods of cessation, and psychosocial effects on lifestyle change.The knowledge gained during the process was incorporated into a menu approach that emphasized personal responsibility for the quitting process and allows for choices that serve to tailor the program to the individual's needs. The end result was a quitters' guide, desktop published and prepared in a small quantity for pilot purposes. This guide was evaluated by persons with particular expertise in addictive behavior, especially smoking cessation. An ammended product was then presented to smokers and/or former smokers for further feedback. A journal of the process that detailed both difficulties and successes was also included. / Fisher Institute for Wellness

The purpose of this research was to compare and contrast the components and characteristics of selected widely available smoking cessation programs.To reach this goal, an evaluation form was developed after an extensive review of the literature which addressed the structure, duration, techniques, issues which were discussed, success rates and availability of the programs. This form was tested for content validity by a jury of experts and was used to review each of thirteen selected smoking cessation programs. The reviews were conducted by the author using program materials received from the sponsoring organizations. Any questions which could not be answered with these materials were answered through a telephone interview with a representative of the sponsoring organization.Once the reviews were completed, the information was transferred to table form and to a database so that collective data could be generated. The following conclusions were drawn from the table and the data generated: the existing smoking cessation programs appear to have been developed utilizing suggestions offered in to use similar program techniques, and a great deal of variance exists in terms of success rates and cost. / Department of Physiology and Health Science

This paper presents the results of a focus group study exploring older individuals' perceptions of older drivers. The study extends the stereotype research of Joanisse, Gagnon, and Voloaca (2012b), further investigating the terms used to describe older drivers. Also explored were the ways older adults perceive age versus health in their considerations of driving. Three focus groups (N=24) were conducted with former and current drivers, 64 years and older, living in Asheville, North Carolina. Participants showed positivity in their descriptions of older drivers as "slow" and "cautious" and believed they adapted their driving behavior as aging demanded. Participants showed heterogeneity in their acceptance of the health issues that threatened their continued driving ability. The importance of context in understanding stereotypes of older adults is illustrated. Results are discussed in terms of ingroup/outgroup theory in line with the proposed model.

In Canada, nicotine replacement therapy (NRT) is a best practice for adult smoking cessation, but it is not recommended for use by youth smokers. Previous research has indicated that more than 20 percent of high school-aged smokers in Canada had used NRT, despite the cross-Canada requirement that youths under the age of 18 have a physician’s prescription to purchase NRT. The goal of this study was to examine both student and school-level characteristics associated with use of NRT by youths. Data from 29,296 grade 9 to 12 students who participated in the 2008-2009 National Youth Smoking Survey (YSS) were combined with Canadian census and built environment data in multilevel logistic regression models. The associations between lifetime and current NRT use with student characteristics (i.e., smoking status, social smoking connections) were examined alongside school environment factors such as urban/rural location and pharmacy density within a one kilometre radius of schools. In 2008-2009, 21.1% of youth smokers in Canada had ever used NRT and 5.1% were currently using NRT. Odds of NRT use were highest among daily smokers, boys, youths who had made multiple quit attempts, and youths who self-identified as smokers. Attending a school located within an urban area increased youths’ odds of NRT use, whereas higher density of pharmacies surrounding a school was inversely associated with NRT use. This study is the first to identify significant between school differences in NRT use. It also reveals that many youths are using NRT in the absence of a quit attempt. Further research is needed to identify school characteristics that impact NRT use, and understand how youths are accessing NRT.

Background: Across North America, smoking prevalence is highest among young adults (YAs). Understanding the cessation behaviours of YAs is critical given their higher smoking rates; however, there is a paucity of prospective studies on YA cessation from a population-based sample of smokers. Objectives: This study characterizes younger and older adult smokers as well as identifies the rate of making a quit attempt (QA) and smoking cessation among a representative sample of younger and older adult smokers. Guided by the Social Cognitive Theory (SCT), this study also examines the interpersonal predictors of moving toward smoking cessation among YAs. Methods: Self-report data on 592 YA and 2777 older adult smokers were compiled from the Ontario Tobacco Survey baseline and six-month follow-up interviews. Smoking cessation behaviour was measured as an ordinal variable: made no attempt to quit, made a QA that lasted for less than 30 days, and successfully quit for 30 days or longer. Design-based analyses examined the characteristics of young and older adult smokers. Making a QA and smoking cessation during a six-month follow-up period were modeled according to the SCT constructs while accounting for the complex study design. Results: Young adult smokers were more likely to be men with lower levels of addiction but greater self-efficacy and an intention to quit than their older counterparts. While YA smokers were more likely to make a QA than their older counterparts (25% vs. 17%, respectively), they were no more likely to succeed (14% vs. 10%, respectively). Having an intention to quit smoking and having made two or more lifetime number of QAs predicted making a QA; the use of smoking cessation aids or resources and having knowledge that stop smoking medications make quitting a lot easier also contributed to making an attempt to quit. Self-efficacy, use of smoking cessation aids or resources and having someone to support one‘s QA were positive predictors of quitting whereas having high levels of addiction was a negative predictor of cessation. Conclusions: Young and older adults are distinct types of smokers with different personal and smoking characteristics. Different factors predicted making a QA and smoking cessation among YAs. Smoking cessation interventions for YAs should provide social support and skills to build and maintain self-efficacy to quit. It is critical to ensure YA smokers have effective smoking cessation aids and services that are easily accessible and appropriate for this population. Future research is needed to understand long-term smoking cessation and relapse in this vulnerable population.

Research Doctorate - Doctor of Philosophy (PhD) / Despite the emergence of smoking care guidelines and best practice recommendations over the past 13 years, it has been suggested that smoking care is not routinely provided in hospitals. Although there is a relatively large body of evidence regarding the prevalence of patient smoking cessation after hospitalisation and the effectiveness of interventions to increase cessation levels, much less is known regarding the prevalence of best practice smoking care routinely provided in hospitals or the effectiveness of interventions to increase such care provision. This thesis seeks to address these deficiencies in the evidence base. In particular this thesis aimed to: 1. Examine the prevalence of hospital smoking care in the international and Australian contexts. This is addressed via a literature review of studies that have reported the level of smoking care delivered routinely in hospitals and a survey of hospital managers in New South Wales, Australia. 2. Examine the effectiveness of interventions to increase the routine delivery of smoking care in hospitals. This is addressed via a literature review of studies that have reported the effect of an intervention on smoking care levels, and via the implementation of a quasi-experimental study that was designed to increase the hospital-wide delivery of a broad range of smoking care elements. 3. Propose recommendations for future practice and research regarding the routine provision of hospital smoking care. This thesis consists of six chapters that address the above aims. Each of the chapters has been written as a relatively distinct report in the style of a journal article. The approach has been adopted to facilitate the reading of the thesis, and results in some repetition in some chapters. At the time of submission, two papers based on the chapters of this thesis have been published in peer-reviewed journals. A further two papers are under editorial review.

Dissertation (Ph.D.) -- University of Texas Southwestern Medical Center at Dallas, 2006. / Vita. Bibliography: pp. 246-266.

Thesis (M. Med. Sc.)--University of Hong Kong, 2005. / Also available in print.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.