Concern is mounting over the increase in prevalence and severity of overweight and obesity in children worldwide. Intrauterine life has been identified as a critical period for the development of overweight or obesity and other related chronic diseases. Prenatal exposure to maternal cigarette smoke (PEMCS) has consistently emerged as an important risk factor for excess weight in the offspring and is a targetable behaviour for prevention strategies. This study examines first the relationship between PEMCS and overweight status of children at 10 years of age and second, whether PEMCS is associated with distinct longitudinal BMI trajectories. Analyses include multivariate and multinomial logistic regression and longitudinal group based modeling methods. PEMCS was found to be a significant risk factor for overweight in children independent of birth weight and catch-up growth. However, PEMCS was not associated with BMI trajectory membership. Our results lend support to the paradigm of in-utero excess weight prevention.

Background: Hypertension is synonymous with high blood pressure, where blood exerts a great force on the arterial walls. Smoking cigarettes is known to cause negative health outcomes, specifically increase blood pressure. Adversely, physical activity is known to provide many health benefits, including the reduction of blood pressure. This study examines the impact of physical activity on the association between smoking and hypertension. Methods: Using secondary data from National Health and Nutrition Examination Survey (NHANES) 2007-2008, demographics of the population were described via descriptive statistics. Regressions were run using different models, controlling for various variables (age, ethnicity, sex, poverty to income ratio (PIR), body mass index (BMI), and interaction (smoking x physical activity)) to determine the association between smoking and hypertension. Odds ratios and 95% confidence intervals were used to determine statistical significance throughout all the analyses performed. Results: In total, 10,149 cases were included in the study analysis. 10.9% of the cases were smokers, 48.1% were physically activity, and 28.6% were hypertensive. OR’s for the various models observing smoking and hypertension were 1.48 (1.29, 1.69), 1.42 (1.22, 1.65), 1.37 (1.12, 1.67), and 1.36 (1.10, 1.68). In the final model which controlled for all variables including the interaction term, the OR was 1.12 (0.47, 2.67). Conclusions: Smokers had significantly higher rates of hypertension in all the models. The final model which observed smokers who were physical active found that the relationship between smoking and hypertension was no longer significant. This study suggests physical activity as a mode of intervention to reduce blood pressure in smokers.

Background: Planning has long been assumed to be an important element of any successful quit smoking strategy. However, recent research findings indicate that unplanned, or spontaneous quit attempts, may lead to more successful and longer cessation periods than planned attempts. This calls into question continued advice to plan and the validity of planning based behaviour change theories. Objectives: To: 1) assess the prevalence of planning; 2) identify the attributes of planners; 3) examine the association of planning and intentions to quit; 4) examine the association of planning and use of quit aids; and 5) examine the impact of planning on smoking cessation outcomes. Methods: Data from the longitudinal Ontario Tobacco Survey (OTS) were examined. Analyses consisted of 418 smokers who made a planned or unplanned quit attempt between their waves 4 and 5 survey response. Descriptive, bivariate, and multivariate analyses were conducted using specialized survey analysis procedures to account for the complex sampling and design features of the OTS. Multiple Imputation (MI) was used to fill in missing data to reduce bias. Results: The prevalence of planning among Ontario smokers who made a quit attempt in the past six months was 70%. Regression models indicated that women, smokers who felt that it would be “very hard to quit”, and those with intentions to quit in the next 6 months had higher odds of making a planned quit attempt. Individuals who made a planned quit attempt had increased odds for using a quit aid compared to those making unplanned attempts. Univariate regression models indicated that planned attempts did not result in higher odds ratios for being abstinent for at least one week and at least one month. Conclusions: The present results suggest that a majority of smokers who made a quit attempt did so with a plan. Planned quit attempts had higher odds use of any quit aid compared with unplanned attempts. Planning was not found to increase the odds of being abstinent compared to unplanned attempts. Although more research is needed, the current study contributes to the dialogue of planning and smoking cessation.

Although explicit attitudes have traditionally been used in predictive models of health behaviour, recent theorizing suggests that implicit attitudes might be more useful in predicting socially undesirable or addictive behaviours. In Studies 1 through 3, smokers’ explicit and implicit attitudes were examined to compare the predictive utility of each. Results confirmed that implicit attitudes are better at predicting impulse-driven behaviours, such as smoking consumption. Consequently, implicit attitudes also predict whether a quit attempt will be successful. In contrast, explicit attitudes are better at predicting deliberative outcomes, such as having intentions to quit, and making planned quit attempts. Extending these findings, in Studies 4 and 5, the effectiveness of a novel affirmation intervention designed to break the association between smoking and stress-reduction is evaluated. Preliminary results demonstrate that an affirmation intervention designed to break the smokers’ reliance on smoking as a means of coping with stress can have beneficial and sustainable effects in cessation outcomes. The impact on smokers’ implicit attitudes as a possible mediating role is discussed. Implications for more effective health interventions are also discussed.

Background: Planning has long been assumed to be an important element of any successful quit smoking strategy. However, recent research findings indicate that unplanned, or spontaneous quit attempts, may lead to more successful and longer cessation periods than planned attempts. This calls into question continued advice to plan and the validity of planning based behaviour change theories. Objectives: To: 1) assess the prevalence of planning; 2) identify the attributes of planners; 3) examine the association of planning and intentions to quit; 4) examine the association of planning and use of quit aids; and 5) examine the impact of planning on smoking cessation outcomes. Methods: Data from the longitudinal Ontario Tobacco Survey (OTS) were examined. Analyses consisted of 418 smokers who made a planned or unplanned quit attempt between their waves 4 and 5 survey response. Descriptive, bivariate, and multivariate analyses were conducted using specialized survey analysis procedures to account for the complex sampling and design features of the OTS. Multiple Imputation (MI) was used to fill in missing data to reduce bias. Results: The prevalence of planning among Ontario smokers who made a quit attempt in the past six months was 70%. Regression models indicated that women, smokers who felt that it would be “very hard to quit”, and those with intentions to quit in the next 6 months had higher odds of making a planned quit attempt. Individuals who made a planned quit attempt had increased odds for using a quit aid compared to those making unplanned attempts. Univariate regression models indicated that planned attempts did not result in higher odds ratios for being abstinent for at least one week and at least one month. Conclusions: The present results suggest that a majority of smokers who made a quit attempt did so with a plan. Planned quit attempts had higher odds use of any quit aid compared with unplanned attempts. Planning was not found to increase the odds of being abstinent compared to unplanned attempts. Although more research is needed, the current study contributes to the dialogue of planning and smoking cessation.

As some references suggested that tobacco smoking behavior increases the risk of persistent pain and poorer recovery, but some demonstrated that nicotine decreased pain sensitivity. Both contrary conclusions make clinicians confused on how to manage the patients with tobacco smoking habit. This study conducted a retrospective way to evaluate the relationship between acute postoperative pain management and tobacco smoking behavior. This study included 511 Patients underwent general surgery were assigned to smokers or non-smokers. Site of surgery, type and duration of anesthesia were extracted from the anesthetic record. Information regarded each patient's gender, age, preoperative weight, past medical history, postoperative course, all non-opiate sedatives and opiate analgesics used in the first 72 hours were collected and recorded. Morphine administered via a patient-controlled analgesia (PCA) device was the preferred method of analgesia for these patients. Anesthesia was standardized. Exclusion criteria included the patients underwent major thoracic cardiovascular surgery, the patients with significant lung lesion, the patients with conscious disturbance, and the patients with allergic history to morphine. The results showed that of the sense of pain, the smoking group in the second day the pain scores significantly higher than non-smoking group (p<0.001), indicated that smoking patients were had more pain than non-smoking patients after surgery. And of the analgesic drug effects, the smoking group in the second and third day analgesic doses and the total analgesic doses were significantly higher than non-smoking group (p<0.023), showed that smoking patients significantly used more analgesic than non-smoking group after surgery. Smoking was associated with pain indeed existence.

Thesis (M.S.)--University of Alabama at Birmingham, 2009. / Title from PDF title page (viewed on Feb. 2, 2009). Includes bibliographical references (p. 35-48).

Thesis (M. Phil.)--University of Hong Kong, 2009. / Includes bibliographical references (leaves 132-153). Also available in print.

Thesis (Ph. D.)--University of Queensland, 2002. / Includes bibliographical references.

published_or_final_version / Nursing Studies / Master / Master of Nursing