A growing body of evidence has established that smoking and gambling frequently co-occur. Despite high rates of co-occurrence, few studies have attempted to examine the extent to which nicotine can directly affect gambling behaviour. This dissertation further explores the relationship between smoking and gambling through a secondary data analysis and two laboratory-based experiments. First, a secondary data analysis was conducted using epidemiological data collected from a gambling prevalence survey in Newfoundland and Labrador. The results from this analysis revealed several associations between smoking and past 12 month gambling. Significant relationships were found between smoking and problem gambling severity scores, use of alcohol/drugs while gambling, money spent gambling, use of video lottery terminals (VLTs), and reasons for gambling related to positive reinforcement/reward and negative reinforcement/relief. Experiment 1 consists of a laboratory investigation of the acute effects of nicotine on subjective and behavioural responses to VLT gambling among gamblers who smoke. Twenty-eight (15 male) regular gamblers who smoke daily took part in two double-blind laboratory sessions where subjective and behavioural responses to gambling were assessed following administration of nicotine inhalers (NI; 4mg deliverable) or placebo inhalers (PI). It was found that NI significantly decreased tobacco-related cravings but did not affect gambling-related cravings, VLT betting, or subjective responses. In Experiment 2, the acute effects of nicotine on subjective, physiological, and behavioural gambling responses were examined in VLT players who smoke following exposure to gambling-related cues. Thirty (20 male) VLT gamblers (identified as ‘moderate risk’ or ‘problem gamblers’) who smoke daily were assigned to a nicotine lozenge (NL; 4mg deliverable) or placebo lozenge (PL) condition. Subjective and behavioural responses were assessed at baseline, following lozenge administration, following neutral cues, and following gambling cues. It was found that NL significantly reduced tobacco-related cravings but didn’t affect gambling-related cravings, the decision to play a VLT, or other subjective responses. The aggregate findings of Experiments 1 & 2 indicate that acutely administered nicotine reduced tobacco-related cravings without increasing the reinforcing value of gambling. These results suggest that use of nicotine replacement therapies (NRT) may be a safe option for gamblers who are attempting to quit smoking.

Globally tobacco use and exposure to tobacco smoke represent some of the greatest risk factors for mortality. Best practice guidelines and standards of practice support nurses' provision of smoking cessation interventions. Nurses employed in primary health care settings interact with large numbers of people who smoke, and have the potential to significantly reduce tobacco use in the population. Evidence shows that nurses do not consistently implement smoking cessation interventions. The purpose of this cross-sectional study was to describe nurses' perceptions of factors that influence their intentions related to providing smoking cessation interventions in primary health care settings. A conceptual framework derived from the Theory of Planned Behavior and relevant empirical literature guided the study. A questionnaire measuring the concepts of interest was mailed to a random sample of Registered Nurses and Nurse Practitioners in Ontario. Responses of 237 eligible participants were available for analysis. Multiple regression analyses were used to examine the hypothesized relationships between nurses' attitudes, subjective norms and perceived behavioural control, and their intention to implement smoking cessation interventions, and the association between intention and practice related to smoking cessation. The Theory of Planned Behavior concepts explained up to 48.5% of variance in behavioural intention. Perceived behavioural control was most strongly associated with intention to provide smoking cessation interventions. Behavioural intention was correlated with smoking cessation practice. Analysis of responses to open-ended questions identified factors that facilitated (wish to improve patients' health, organizational support, access to resources, a perception of patient readiness to quit, and training in smoking cessation) and hindered (lack of time, lack of patient readiness, lack of support and resources, and lack of knowledge) nurses' provision of smoking cessation interventions. Overall, the study results suggest that nursing intention to engage in smoking cessation practices in primary health care settings was associated with organizational factors. Further research is required to explore how primary health care organizations can support nurses so that they fully realize their role in reducing the impact of tobacco use on the health of the people in Ontario.

No description available.

The Health Belief Model developed by Becker ( 1984) cited in Katzenellenbogen et al. ( 1999) guided this study. The model attempts to identify beliefs and the way they may interact to influence individuals' conscious decisions to undertake certain healthrelated actions. "The most important health beliefs that influence actions are thought to be: • The person's perceived vulnerability to a particular condition or illness, • The person' s perceptions of the severity or effects of the condition or illness, • The Person's perception of the efficacy, costs, and benefits of any proposed actions" (Katzenellenbogen, joubert & Karim, 1999: 169). The three points mentioned above guided systematically the whole study as follows: 1. The students' perceived vulnerability to a particular cond ition or illness in this case guided the researcher to describe and to understand students' personal perceptions of the risk of diseases they run by smoking or that they can cause to other people in their surroundings. It was also necessary to find out whether or not non-smokers were aware of the consequences in terms of diseases of being permanently exposed to tobacco smoke. 2. Once smokers as well as non-smokers have agreed that smoking increases the risk of diseases, the following step was to ensure whether or not they continue to neglect and run the same risk. because smoking consequences occur only after a long period of time. 3. The last step was to ensure that students who smoked could actually accept and put into practices some available strategies for giving up smoking. after being sensitised or on their own initiative, in order to remain in good health. / Thesis (M.Cur.)-University of Natal, Durban, 2001.

The purpose of this study was to assess the status of worksite smoking policies in Indiana's manufacturing industries and to describe the relationship between policy, workforce size, and manufacturing type. Of the 493 questionnaires distributed, 181 (36.7%) were returned. Approximately 67% percent of the industries reported having some type of restrictive policy with the majority of those policies not allowing smoking at the worksite except in designated areas. Most policies were developed within the last five years and were implemented due to a concern for employee health. Workforce size was directly related to the prevalence of significant restrictions. Those companies employing greater then 100 employees were the most likely to have a policy whereas the employing less than 11 were the least likely to have a policy. Standard industrial classifications 34 (fabricated metal products) and 35 (machinery, except electrical) had less restrictive policies as compared to other S.I.C. classifications. A follow up on 10% (n=30) of the nonrespondents yielded similar results to those who did respond. / Department of Physiology and Health Science

This study investigated the relationship between smoking cessation and cognitive factors of attributional style, self-efficacy and locus of control. The roles of examined as they contributed to the prediction of smoking status. Questionnaires designed to measure these cognitivevariables, were administered to participants of smoking cessation programs at two times during the study; immediately before participation in the smoking cessation program and immediately after completion of the program. Smoking status was assessed at these times, as well as via telephone twice after the program's completion. Subjects were obtained from 16 American Cancer Society smoking cessation clinics in the Southern California area. The results of stepwise discriminant analyses of variance successfully predicted smoking status at end-of-clinic and follow-up periods, using a combination of demographic, smoking behavior and cognitive predictors. Cross-validations of the predictive models also were able to predict smoking status at end-of-clinic and follow-up. Additional analyses included stepwise discriminant demographic and smoking behavior variables styles, as well as demographic and smoking behavior Cognitive Factors 5 analyses of participants who relapsed at follow-up, and a comparison of those who completed the program versus those who dropped out prematurely. Both analyses resulted in obtaining significant discriminant functions. A final analysis compared pre- and post-treatment responses on the cognitive measures via a 2 X 2 multiple analysis of variance (group X time). A significant interaction between group and time of assessment was obtained. / Department of Counseling Psychology and Guidance Services

A descriptive study of cigarette smoking in a sample of Indian matriculation students was undertaken in Northern Kwa-Zulu Natal in order to establish the prevalence of cigarette smoking; reasons for developing cigarette smoking behaviour; to determine knowledge about and attitudes to cigarette smoking and also to establish students' awareness of antismoking organisations and to make recommendations based on the findings. Data was collected by the researcher who administered questionnaires at various schools previously under the jurisdiction of the House of Delegates, in the towns of Newcastle, Dannhauser, Glencoe and Dundee. There were 55 smokers in the sample (N =326), ie., a prevalence rate of 16,9%. Among the males 52 (36,1%) were smokers and 3 (1,8%) females smoked. Fifty four (98,2%) smokers had commenced smoking above the age of 10 years. Twenty seven (53%) smoked at home and 12 (24%) smoked at school. Experimentation occured among 46 (83,6%) smokers prior to actual smoking with 52 (94,5%) smokers having friends who also smoked. Advertisements influenced 10 (18,2%) smokers while 11 (20%) were influenced by teachers and 9 (16,7%) were influenced by family members. Smokers received more pocket money than non-smokers. More family members of the smokers were also smokers as opposed to non-smokers. Fourty nine (89,1%) smokers believed that smoking was harmful to themselves while 41 (74,5%) said it was also harmful to others. The association between smoking and lung cancer was well known by 49 (90,7%) smokers but the association with heart disease and other cancers was not as well known. There was very little awareness among both smokers and non-smokers about anti-smoking programmes and organisations. Alarmingly there was hardly any formal health education on the dangers of smoking in schools. The conclusions are that the prevalence of cigarette smoking among Indian matriculants in the study area was 16,9% and that teachers, friends, family members and advertisements are influential in cigarette smoking behaviour. There is a need for education on the dangers of smoking in schools; and parents and teachers must take congnisance about smoking at home and in schools. / Theses (M.Fam.Med.)-University of Natal, Durban, 1995.

Purpose: The purpose of this research program was three-fold. First it aimed to determine the effectiveness of smoking cessation interventions in increasing cessation rates in smokers with cerebrovascular disease and whether smoking cessation reduces stroke recurrence. Second it aimed to determine the prognostic influence of smoking and its association with stroke severity, disability, length of stay in hospital and mortality. Third it aimed to identify multi-level correlates of smoking cessation in Canadians who reported stroke symptoms in a large population based survey. Methods: Two systematic reviews and meta-analyses were performed to achieve the first objective. For the second objective, a retrospective cohort study was undertaken using variables from the Registry of the Canadian Stroke Network. Finally, the third objective was achieved by analyzing respondents from the Canadian Community Health Survey. Results: There is a paucity of intervention studies examining the effectiveness of smoking cessation in smokers with cerebrovascular disease. Most intervention studies that were found, failed to employ evidence-based approaches to smoking cessation. No evidence was found in regards to the effect of smoking cessation on stroke recurrence. We found smokers had strokes at a younger age compared to non-smokers. We found that in transient ischemic attacks and intracerbral haemorrhage, smoking was a significant predictor of stroke severity, disability, length of stay in hospital and 1 year mortality. Correlates of smoking cessation among Canadians who have experienced symptoms of a stroke included: higher education and income, implementation of household and vehicle smoking restrictions, access to a general practitioner and the use of smoking cessation pharmacotherapies and counselling support. Co-morbidities such as depression and alcohol consumption reduced the likelihood of successful cessation. Conclusions: This three-phase research program elucidated the gaps in intervention research for this population along with co-morbidities that hinder success in cessation. Smoking negatively impacted outcomes such as disability, hospital length of stay and mortality in patients with transient ischemic attacks and intracerebral haemorrhage strokes. Future interventions should take into account modifiable smoking cessation correlates in order to increase cessation rates in smokers with cerebrovascular disease.

Background: The health effects of sheesha smoking are not well addressed. Objective: To assess the association between sheesha tobacco smoking and gene expression pertinent to cancer. Methodology: Three linked studies were carried out: (1) investigation of gene expression in salivary cells before and after exposure to sheesha tobacco smoke in 15 participants; (2) a systematic review of the association between sheesha and cancer; and (3) a pilot survey to collect data on factors potentially relevant to the uptake and cessation of sheesha tobacco smoking. Results: In the short-term, sheesha smoking significantly reduced the expression of both xenobiotic metabolism genes and other genes known to have altered expression in tobacco related cancers in a range between 1.7 times and 55 times. The systematic review showed that sheesha may increase the risk of lung and esophageal cancers. The pilot survey identified misperceptions about safety, in line with other studies, an approach that could be used to investigate the characteristics of sheesha smokers on a larger scale, and specific issues to probe. Conclusion: High quality epidemiological evidence on long-term effects of sheesha smoking on cancer is lacking. However, sheesha smoking has short-term effects on the expression of genes known to be involved in tobacco-related cancers. This is of major concern given widespread misperceptions about the likely safety of sheesha tobacco smoking.

This cross-sectional study observed the association of smoke exposure and tuberculosis-related outcomes in Saskatchewan by individuals who had been exposed to someone with infectious TB. This study is unique in that we were quantifying the amount of smoke exposure that increases susceptibility to TB infection and/or active TB. Subjects who were at least 18 years old were enrolled into the study because they were contacts to infectious tuberculosis. The study involved a detailed interview. This interview involved questions on demographics, hair treatment (specifically, hair dying), tobacco smoke exposure, co-morbidities/risk factors, and alcohol consumption. After the interview was conducted, a small 10mg sample of hair was collected from each individual. This was to ensure a more accurate level of smoke exposure was attained. In total, 104 individuals were recruited to participate in this study. Linear regression analysis was used to compare cigarette consumption and nicotine concentration. A quadratic term was added to the linear model and the result was that reported cigarette consumption per day (x) was significantly associated with nicotine concentration (y) where y=0.91+1.35x-0.25x2 (p=0.001). A Fisher’s exact test was conducted to see if there was a relationship between smoking and TB disease; there was no statistically significant association between TB disease and smoking (OR= 3.28, 95%CI 0.37-29.1, p = 0.24). Logistic regression analysis was used to see if there was a relationship between smoking and TB infection. Of the five predictor variables, none were statistically significant. Smokers had an association with higher odds of TB infection (OR=2.03, 95%CI 0.71-5.80, p=0.19). Canadian-born Aboriginals had an association with lower odds of TB infection (OR=0.52, 95%CI 0.18-1.46, p=0.21). The results from this study could provide insight into creating a larger, more complex study involving TB and smoking.