Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2010. / Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (leaves 69-80).

Thesis (M. Nurs.)--University of Hong Kong, 2006.

The present study examined various psychosocial variables that may influence success in a stop smoking program (QuitSmart) used by the North Texas Veterans Health Care Service (NTVHCS). The QuitSmart program utilizes the Stages of Change Model, with its focus on the last three stages (preparation, action, and maintenance). It was proposed that factors including shame-proneness, guilt, anger/hostility, depression, self-efficacy - both global and smoking situational, neuroticism, and level of nicotine dependence might individually or in combination predict attrition from the NTVHCS smoking cessation program. Results indicate that shame-proneness, guilt, anger/hostility, and depression did not individually predict attrition. Persons with high levels of smoking situational self-efficacy tend to utilize self-change strategies leading to greater success in smoking cessation. Participants with a psychological diagnosis, when combined with neuroticism and shame-proneness, appear to have more difficulty with cessation than those with only a medical diagnosis. Clinical implications and suggestions for change to the NTVHCS smoking cessation program are discussed.

BACKGROUND: We wanted to determine whether an intervention to enhance partner support helps as an adjunct to a smoking cessation program. METHODS: We undertook a meta-analysis of English-language, randomized controlled trials of smoking cessation interventions through July 2002 using the following data sources: Cochrane Tobacco Addiction Group specialized register, Cochrane controlled trials register, CDC Tobacco Information and Prevention Database, MEDLINE, Cancer Lit, EMBASE, CINAHL, PsycINFO, ERIC, PsycLIT, Dissertation Abstracts, SSCI and HealthSTAR, with reviews of bibliographies of included articles. Included were trials that assessed a partner support component with a minimum follow-up of 6 months. The outcomes measured were abstinence and biochemical assessment at 6 to 9 months and more than 12 months after treatment. Partner Interaction Questionnaire scores were primary and secondary outcomes. RESULTS: Nine studies (31 articles) met inclusion criteria. Partner definition varied among studies. All studies included self-reported smoking cessation rates, but there was limited biochemical validation of abstinence. For self-reported abstinence at 6 to 9 months after treatment, the Peto odds ratio (OR) = 1.08 (95% confidence interval [CI], 0.81-1.44) and at 12 months Peto OR = 1.0 (95% CI, 0.75-1.34). Sensitivity analysis of studies using live-in, married, and equivalent-to-married partners found a higher odds ratio at 6 to 9 months after treatment, Peto OR = 1.64 (95% CI, 0.5-4.64). Sensitivity analysis of studies reporting significant increases in partner support found at 6 to 9 months after treatment Peto OR = 1.83 (95% CI, 0.9-3.47); and at 12 months Peto OR = 1.22 (95% CI, 0.67-2.23). CONCLUSIONS: Interventions to enhance partner support showed the most promise for clinical practice when implemented with live-in, married, and equivalent-to-married partners. Such interventions should focus on enhancing supportive behaviors, while minimizing behaviors critical of smoking.

For the past quarter century, the public has been educated and warned about the dangers of smoking, and both smokers and health researchers have been in search of cost-effective, smoking cessation programs that will lead to long-term cessation. This study used a randomized experimental design to investigate the effectiveness of adding Web-based support materials to a nationally sponsored self-help smoking intervention. There was no significant increase in abstinence rates nor progression through the stages of change by those participants who had access to the Web site. However, there were some overall significant trends that suggested these self-help interventions were successful at decreasing daily rates of smoking and nicotine dependency, as well as tended to encourage repeated quit attempts. Although Web-based supports did not appear to increase the effectiveness of the nationally sponsored self-help intervention, this study demonstrated overall 12 week follow-up abstinence rates of 30-32%--greater than what might be expected, given average success rates of other self-help interventions. This study also supports the notion that women may face additional barriers to smoking cessation. Limitations and implications for future research are discussed.

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Copies of author's previously published articles inserted. / Bibliography: leaves 174-192. / xiii, 222 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 1994

Background: The tobacco epidemic causes a major burden to long-term global public health. Second hand smoke is one of the modifiable exposures causing adverse health effects to children; 40% of children in the world are regularly exposed to second hand smoke and children account for more than a quarter of all deaths from second hand smoke exposure. The global burden highlights the importance of implementation and enforcement of comprehensive smoke-free legislation. Despite smoke-free legislation having been shown to have a positive effect in reducing the prevalence of tobacco consumption and second hand smoke exposure, displacement of smoking from enclosed public places to homes after implementation of smoke-free legislation might increase second hand smoke exposure in children. Objectives: This systematic review aims to investigate the effect of smoke-free legislation on second hand smoke exposure in children and to explore the potential risk factors that may affect its effectiveness. Methods: Studies were searched in online electronic databases, PubMed and EMBASE Classic+ EMBASE 1980-via Ovid (from 1980 to 2014) under the Library website of the University of Hong Kong, by keyword search, hand search of references and Google Scholar for relevant articles published from 2004 to present. Observational studies assessing the effect of smoke-free legislation on second hand smoke exposure in children assessed from cotinine measured before and after the introduction of smoke-free legislation were included. Results: This systematic reviewed identified 8 relevant studies. 3 were assessed as good quality and 5 as average quality. All selected studies reported a decrease in the geometric mean of cotinine concentration after the implementation of smoke-free legislation, but only one of them showed that the reduction in cotinine concentration was significantly reduced from 0.3ng/ml to 0.2ng/ml. An increase in the percentage of cotinine concentrations below the limit of detection and a decrease in the percentage of harmful levels of cotinine concentration were also found. Lower socioeconomic status, more parental smokers and low level of home smoking restriction affected the reduction in second hand smoke exposure after implementation of smoke-free legislation. Conclusion: Smoke-free legislation has a positive effect towards reduction in second hand smoke exposure in children. There is no evidence supporting the possibility that smokers displace tobacco consumption from public areas to their homes after implementation of smoke-free legislation in Western settings. Whether more effort to encourage smoking cessation among parents and other family members living with children would be particularly effective in reducing the public health burden of tobacco consumption should be investigated. Further tobacco control strategies are suggested to work comprehensively with smoke-free legislation to further reduce the global burden of tobacco epidemic. / published_or_final_version / Public Health / Master / Master of Public Health

Smoking causes Type II diabetes (T2DM). However, there were limited research on the needs, concerns and intention of smokers with T2DM about quitting smoking. This study aimed to explore the behaviors and perceptions on smoking and quitting smoking in patients with T2DM. I conducted both qualitative and quantitative studies. The qualitative study involved T2DM patients who were current smokers or ex-smokers, and could communicate in Cantonese. Semi-structured focus group and individual in-depth interviews were conducted. The quantitative study was cross-sectional, using a standardized questionnaire to identify the intention to quit smoking, knowledge regarding the health risks of smoking and their determinants in T2DM smokers who (1) were aged 18 years or above; (2) can communicate in Cantonese; (3) had daily consumption of at least 2 cigarettes in the past 30 days; and (4) diagnosed with T2DM for at least 6 months with stable condition. Structured multiphase regression analyses were used to identify factors associated with intention to quit smoking and knowledge on the health impact of smoking. In the qualitative study, I recruited 22 current smokers and 20 ex-smokers with T2DM at data saturation. The current T2DM smokers did not quit smoking because of satisfaction with their current health status, misconceptions of no association between T2DM and smoking, and the perceived hazards of quitting. In contrast, ex-smokers had a positive evaluation of quitting smoking, accepted the quit advice from medical professionals and received more family support. Moreover, psychological addiction and weight gain after smoking cessation were the major barriers for T2DM patients to quit smoking. In the cross-sectional study, I recruited 526 smokers with T2DM from nine outpatient clinics specialized in diabetes. They scored on average 47.5 (95% CI=45.6-49.4) out of 0-100 in knowledge regarding health impact of smoking, and 389 (74%, 95% CI=70.3%-77.8%) of them were in pre-contemplation stage. The multiphase regression analysis showed that T2DM smokers with no intention to quit were those who smoked during alcohol drinking (OR=5.98, 95% CI=1.89-18.98, p=0.002). In contrast, those less likely associated with pre-contemplation stage were those who perceived a worse level of health (OR=0.41, 95%, CI=0.19-0.86, p=0.019), perceived greater importance of quitting (OR=0.67, 95% CI=0.58-0.78, p<0.0001), had higher confidence of quitting (OR=0.77, 95% CI=0.67-0.88, p<0.0001), or had more knowledge regarding health impact of smoking (OR=0.98, 95%, CI=0.97-0.999, p=0.035). In addition, a higher score on Decisional Balance Inventory-Cons of smoking (coefficient=1.61, 95% CI=0.56-2.66, p=0.003) or confidence in quitting was associated with a higher knowledge score (coefficient=1.30, 95% CI=0.59-2.01, p<0.001). Conclusively, this is the first study to assess the smoking behaviors and perceptions in patients with T2DM. Many T2DM smokers were reluctant to quit smoking due to inadequate knowledge of the health impact of smoking. Patient education, weight control and behavioral counseling are suggested as the critical components of an effective smoking cessation intervention for T2DM patients. / published_or_final_version / Nursing Studies / Master / Master of Philosophy