Abstract The current education policy in Finland tends to result in higher levels of education, and to avoid educational failures. The aim of the present study was to determine school predictors for later severe mental disorders requiring hospital treatment, and to determine whether or not severe mental disorders or smoking are associated with educational achievement. Educational attainments were analysed in the Northern Finland 1966 Birth Cohort (n = 12 058 born alive) using school performance and attained level of education. Data was collected using questionnaires as well as from national registers. Data on psychiatric morbidity was gathered from the Finnish Hospital Discharge Register. The case notes of all potential subjects were examined. Up to the end of 1994, a total of 387 subjects had received a DSM-III-R psychiatric diagnosis categorized as follows: schizophrenia (n = 89), other psychoses (n = 55), and non-psychotic disorders (n = 243). Smoking habits were assessed at 14 and 31 years by postal questionnaires. The association between exposure, confounding and outcome variables were analysed by cross-tabulations. Regression models were fitted and adjusted for confounding. Children not in their normal grade or not in normal school at the age of 14 years had a 2 to 8 times higher risk than those in the comparison category (with no psychiatric hospitalisation) to develop some form of mental disorders. Among adolescents with non-psychotic disorders, the means of school marks were lower than in the comparison category, but lower marks did not predict schizophrenia or other psychoses. 11% of the pre-schizophrenic boys had excellent mean school marks compared with only 3% of the comparison category (adjusted OR 3.8; 95% CI 1.6 - 9.3). Over half of all those with a hospital-treated mental disorder progressed beyond basic education, but few completed their tertiary education. Early schizophrenia, (i.e. onset before 22 years of age) as well as non-psychotic cases had an approximately 3- to 6- fold adjusted odds for staying in the basic level. Persons with psychoses with an onset at age 23 or later performed nearly as well as the comparison group. Adult smoking (at age 31) and prolonged smoking (at ages 14 and 31) were associated with an approximately 2- to 6- fold, adjusted odds for educational underachievement, but not smoking only at the age of 14. These results provide new information on the need for earlier therapeutic, rehabilitative and educational interventions directed at children with poor school performance as well as at mentally vulnerable and smoking young persons.

The development and implementation of municipal smoking-control bylaws in British Columbia during the 1990s was characterized by polarity and confrontation. Health sector professionals, members of the hospitality industry, community activists, and municipal politicians disagreed over the need for bylaws, types of establishments that should be regulated, and the degree of restriction. This research used narrative policy analysis to understand the factors that influenced the development of these bylaws in order to delineate a less confrontational process and ensure a more stable resolution. Narratives were collected from representatives of the main policy sectors in four communities throughout British Columbia. Victoria and Vancouver represented urban communities that were updating existing bylaws. Professional staff headed their top-down bylaw processes. In the rural communities of Squamish and Kimberley community volunteers attempted to introduce new bylaws through a bottom-up process. The narratives proved to be a rich source of information that would have been difficult to capture in any other manner. They offer a novel and fruitful means of engaging in policy analysis. The provincial government's tobacco-control strategy served as a backdrop for all policy processes, although it was experienced unequally in the four communities. Urban centres were more aware of provincial tobacco-control initiatives and accessed provincial resources to a greater extent than did Kimberley and Squamish. Each policy sector was led by champions, but the nature of these groups and individuals greatly influenced their success. Those who were credible, persistent, and had access to decision makers were most likely to influence the policy-making process. The antagonism that distinguished the bylaw process was itself a determinant. In all communities, the discord reached a level where it precluded a fair and inclusive process. The bylaw debate was framed and reframed by different sectors. The ability of champions to reach policy makers and frame the debate in a way that was compelling played a significant role in the outcome. Finally, the narratives indicate that each community's “readiness” for policy change is a factor that must be considered. Community readiness was seen to comprise seven main components: (1) each policy sector's belief that a policy is worth adopting and their ability to successfully influence the public and policy makers; (2) the nature of a community—its size, demographics, and social norms; (3) the politicians involved and the ability of champions to understand the political process and reach policy makers; (4) the type of policy under consideration and its relationship to both previous statutes and social norms; (5) the ability of media to reflect sectoral interests and influence public knowledge and attitudes; (6) the temporal context in which the policy change was considered; and (7) a process that fits the needs and resources of the community. / Graduate

Dissertation submitted in partial compliance with the requirements for the Masters Degree in Technology: Homoeopathy, Technikon Natal, 2001. / The purpose of this double blind placebo controlled study was to evaluate the efficacy of a homoeopathic complex (Avena sativa 03, Ignatia amara 04, Daphne indica 06, Nux vomica 06, Caladium seguinum 060, Nicotinum 060 and Nicotiana tabacum 060) in helping people to stop smoking with reference to the Goldstein typology of cigarette smokers in terms of the number of cigarettes smoked per day / M

Abstract Oral diseases are, to a notable extent, behavioral diseases. The concept of lifestyle makes it possible to study behavior in a broad sense. The aim was to study the association of lifestyle with oral health and dental health behavior. All of the 1,012 55-year-old citizens of Oulu were invited to a clinical examination, and 780 of them participated. A lifestyle variable to measure health orientation was constructed. Smoking, alcohol consumption, dietary habits and physical activity were used as indicators of lifestyle. The association of lifestyle with dental caries, periodontal health, denture stomatitis and dental health behavior was studied with a cross-sectional design. An unhealthy lifestyle was associated with a higher number of dental decay, periodontal pockets and a higher prevalence of denture stomatitis. Lifestyle accounted for a large part of the differences between socioeconomic groups and between men and women in number of dental decay and periodontal pockets. An unhealthy lifestyle was associated with an increased prevalence of denture stomatitis in yeast carriers. A higher toothbrushing frequency and the use of extra cleaning methods were related to healthier lifestyle. Socioeconomic status was more important than lifestyle as a determinant of dental visits. Smoking was associated with higher lactobacillus counts and the presence of yeasts in saliva. Lifestyle explained a great part of the differences between the socioeconomic groups and between men and women in oral health. It seems that part of the association between oral and general health can be explained by lifestyle. It is important to control for general lifestyle when the biological connections between oral and general health are studied.

No description available.

Magister Artium - MA / Hookah pipe use is widely viewed as a safe alternative to cigarette smoking rather than a potential health-risk. In fact, for young people hookah pipe use may represent an initial stage of later addiction and the transition to cigarette smoking. Furthermore, studies conducted abroad, suggest that the use of the hookah pipe firstly started as a cultural phenomenon, and secondly, as with cigarette smoking, the hookah pipe has become a social phenomenon. Despite these challenges, studies provide sufficient evidence that hookah pipe use is a potential health risk. The primary aim of the study was to compare male and female university students’ knowledge, risk perceptions and behaviours concerning hookah pipe smoking. A quantitative methodological approach, with a cross-sectional design, was used to conduct the research study. A final self-selected sample of 389 participants voluntarily participated in this study. The final sample included 64% females and 36% males with a mean age of 22.2 years; with the mean age for first-time hookah pipe smoking was 15.7 years. The instrument used was a self-administered questionnaire constructed from The College Health Behavior Survey (2010-2011) which was developed at the University of Missouri-Columbia. Descriptive quantitative results were conducted using Statistical Package for Social Sciences (SPSS version 20) and presented. The results suggest 70% of hookah pipe users daily smoke the hookah pipe with more than 20% smoking on campus. This was similar for males and females. Users perceived the hookah pipe to be less harmful and less addictive than cigarette smoking. Furthermore, smoking the hookah pipe is considered socially acceptable and is also smoked in the family home. Implications for policy are stated.

Introduction: An active area of tobacco regulatory science research focuses on examining the effects of varying the nicotine content of cigarettes as part of a potential national policy to lower their nicotine content levels to reduce addiction potential. The present study examines differences in the behavioral effects of reduced nicotine content cigarettes related to their menthol status. Menthol is the only cigarette flavoring that is still legally permissible according to Food and Drug administration regulations. Methods: Participants were 26 current adult smokers from three populations especially vulnerable to tobacco use and addiction (economically disadvantaged women, opioid-dependent individuals, individuals with affective disorders) dichotomized as menthol (n=11) or non-menthol (n=15) smokers. Participants completed 14 experimental sessions following acute smoking abstinence (CO<50% baseline level). Across sessions, participants smoked four Spectrum research cigarettes (22nd Century Group, Clarence, NY) with varying nicotine content levels (0.4mg/g, 2.4 mg/g, 5.2 mg/g, 15.8 mg/g) or their usual brand cigarette. Research cigarettes were mentholated or non-mentholated corresponding to participants usual brand. Upon completion of smoking, participants completed tasks measuring reinforcing efficacy, subjective effects, topography, and withdrawal and craving measures. Repeated Measures Analysis of Variance was used for all analyses (p<.05). Results: Main effects of menthol status, as well as interactions of nicotine dose and menthol were noted across subscales of subjective effects and direct assessments of reinforcing efficacy. Usual brand mentholated cigarettes produced a profile of equal or greater relative reinforcing effects than usual brand non-mentholated cigarettes, while mentholated research cigarettes produced a profile of effects that fell below (i.e., lower relative reinforcing effects compared to usual brand or non-mentholated cigarettes) those of non-mentholated research cigarettes. Conclusions: Mentholated research cigarettes produce a lower profile of reinforcing and subjective effects, without discernible differences in smoking topography. The potential impact of mentholation on reinforcing efficacy and subjective effects should be considered when using Spectrum research cigarettes.

Susceptibility to smoking has been widely measured in an effort to detect those teens who lack of a firm commitment to not smoke. This measure, however, has not been applied to Chinese-Canadian adolescents. The overall goal of this study was to understand susceptibility to smoking among Chinese-Canadian non-smoking teens. The dissertation includes three papers, each of which has addressed one of the three primary aims of this study. The first paper aims to document the prevalence of susceptibility to smoking among a sample of non-smoking teens in British Columbia, Canada, and to examine the factors that explain the variation in susceptibility to smoking. I employed a quantitative secondary analysis of data from the BC Youth Survey of Smoking and Health. More than one quarter of the respondents were found to be susceptible. The Chinese-Canadian adolescents appeared to have a similar rate of susceptibility to smoking as their White/Caucasian counterparts, even though the smoking prevalence was lower among Chinese-Canadian group than in White/Caucasian group. In the second paper, I explored non-smoking Chinese-Canadian adolescents’ views about the protective factors and the risk factors that might lead them to be susceptible to smoking. In this paper I report an analysis of four qualitative focus groups which included 24 Chinese-Canadian participants. Negative attitudes toward smoking, befriending non-smoking teens, being peer pressured not to smoke and a collectivist cultural perspective were identified as protectors that helped Chinese Canadian teens remain tobacco free in their adolescence. The teens argued that authoritarian parenting had both positive and negative effects on Chinese teens’ susceptibility to smoking. These findings enhanced our understanding of the role that an ethnic group’s culture might play in adolescent smoking. In the third paper, I use Chinese-Canadian teens’ perspectives to reconsider the operationalization of the measure of susceptibility to smoking. Avoiding absolute answers was viewed by the participants as a unique cultural style among Chinese-Canadian teens. They also commented on the ambiguity of using the term “smoking” in the smoking susceptibility measure. Further research is needed to gain a better understanding of the operationalization of the measure in this cultural group. / Applied Science, Faculty of / Nursing, School of / Graduate

Background: Tobacco marketing has been established as the main motivator for tobacco use among youth. A proliferation of tobacco promotional activities in retail stores has been observed yet little is known about its impact on adolescent smoking behaviours. The purpose of this study is to use secondary data to describe the prevalence of retail tobacco point-of-purchase (PoP) activities, examine its associations with adolescent smoking behaviours, and determine what ecological factors moderate the relationship between PoP activities and student smoking behaviours in British Columbia. Methods: This cross-sectional study surveyed grade 10-11 students from 22 randomly-selected schools in BC on student smoking behaviour and conducted observations in 57 retail stores on tobacco PoP activities located within a 1 km radius of these schools. Descriptive analysis was conducted on retail tobacco PoP variables. Individual data on smoking behaviour and school level data on retailers were linked to analyse the association between retail tobacco PoP activities and student smoking behaviour using logistic regression. Moderating effects of contextual factors were also examined. GIS maps were generated to illustrate study findings. Result: A moderate to strong presence of tobacco PoP activities was observed in all tobacco retail stores located in BC school neighbourhoods. Nearly all stores displayed cigarette products in a visible manner (98.25%) and posted tobacco control signage (94.74%). In this model, proportion of stores in the school neighbourhood with presence of tobacco advertising increased the odds of a student being a smoker (OR = 1.28-3.27). Proportion of stores in the school neighbourhood with presence of tobacco control signage decreased the odds of a student being a smoker (OR = 0.11-0.66). The odds of a student being a smoker increased if they resided on the island compared to living in the lower mainland (OR = 1.11-1.75). Discussion: Convenience stores exhibited more tobacco PoP activities than other store types. Retailers in the school neighbourhood that had tobacco advertisements and tobacco control signage exhibited both detrimental and protective effects on student smoking. This provides supportive evidence to ban tobacco advertising in retail stores and increase efforts for creating an anti-tobacco environment in neighbourhood retail stores. Maps generated served descriptive and hypothesis generating purposes. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

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.