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Introduction: Recently there has been increasing interest in understanding and addressing health inequalities and enhancing the well-being of the population as a whole through anticipatory care and better health care delivery. The current study aimed to investigate the predictive relationships between smoking behaviour, physical health, and mental health in a deprived population using models of mediation. Method: Participants had attended a Keep Well health check, a national programme offering health screening, advice, referrals and signposting to individuals aged 45-64 living in deprived areas. Participants completed a questionnaire measuring smoking status, physical health (RAND general health subscale), mental health symptoms (GHQ-12), positive mental health (WEMWBS), and demographic information. Results: The current study found that smoking mediated the relationship between mental health problems and physical health, as well as mediating the relationship between positive mental health and physical health. Discussion: These findings suggest that by offering interventions to encourage individuals to stop smoking health care providers can hope to reduce mental health problems via direct effects but also via an indirect benefit of improvements in physical health. There are also opportunities to improve physical health via the direct effects of reducing mental health problems and increasing positive mental health, as well as the indirect effect of smoking.

Because tobacco smoking causes 430,000 U.S. deaths annually, wide-reaching smoking bans are needed. Bans reduce cigarette consumption, encourage cessation, protect nonsmokers from second-hand smoke, and promote an attitude that smoking is undesirable. Therefore, bans may prevent future generations from suffering many smoking-related health problems. The federal government has not implemented widereaching smoking bans so it falls on individual states, counties, or communities to devise appropriate smoking policy. To date, smoking policy has been determined by legislators, who may have conflicts that prevent them from acting in the publics best interest. However, this method of implementing smoking policy may be changing. In 2005, Washington residents voted by ballot initiative to strengthen existing state smoking regulations. In 2006, Arizona, Nevada, and Ohio residents voted by ballot initiatives to implement strict statewide smoking bans. This research presents a way to predict how residents of other states might vote if given the opportunity. Two research hypotheses are tested and accepted: a positive relationship between favorable votes and urbanness, and a preference favoring smoking bans where smoking regulations already exist. Finally, a projection is made that a smoking ban vote in Kentucky would yield favorable results, and a map showing projected county votes is provided.

The aim of this study was to test for prospective relationships between personality factors measured in elementary school and drinking, smoking, and binge eating during the first year of middle school. Data were collected among adolescents drawn from 23 elementary schools and 15 middles schools in central Kentucky. In a two-wave study, 1,906 children completed questionnaire measures in the spring of 5th grade and the spring of 6th grade. After controlling for sex, pubertal status, and prior engagement in addictive behaviors, it was found that urgency at wave 1 predicted drinking, smoking, and binge eating at wave 2, and low conscientiousness at wave 1 predicted drinking and smoking at wave 2. Risky behaviors during the first year of middle school predict subsequent life problems and subsequent diagnosable addictive disorders. The finding that those behaviors can be predicted by personality factors measured in elementary school indicates the value, for risk researchers and prevention specialists, of focusing efforts on children prior to the onset of adolescence.

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

Objective: The purpose of this dissertation was to examine which student- and school-level factors differentiated (1) susceptible never smokers from non-susceptible never smokers, (2) experimental smokers from never smokers, and (3) current smokers from experimental smokers among a nationally representative sample of Canadian students in grade 9-12. Methods: Student-level data from Canada???s nationally representative 2008-2009 Youth Smoking Survey (2008 YSS) were linked with school-level data from the 2006 Census, and one built environment characteristic, and examined using multi-level logistic regression analyses. Results: Overall as hypothesized in these three studies, student-level and school-level characteristics were associated with smoking susceptibility among never smokers, experimental smoking and current smoking. The likelihood of susceptibility among never smokers (P=0.0002), experimental smoking (P<0.0001) and current smoking (P<0.001) significantly varied across schools. This study identified that attending a school in an urban (AOR=0.62; 95% CI 0.46-0.82) setting or in a high socioeconomic status (SES) neighbourhood (AOR=0.88; 95% CI 0.79-0.98) was inversely associated with odds of a student being an experimental smoker (versus a never smoker) when adjusting for student-level characteristics. The number of tobacco retailers located within a 1-km radius of each school was associated with the odds of a student being a current smoker (versus an experimental smoker) (AOR 1.03; 95% CI 1.01-1.05) and also associated with a student being a susceptible never smoker (versus a non-susceptible never smoker) (AOR 1.01; 95% CI 1.00-1.02) when adjusting for student-level characteristics. Additionally, several student-level intrapersonal and social context characteristics were associated with smoking susceptibility, experimental smoking and current smoking. Conclusions: This study showed that the characteristics of the school a student attends may increase their likelihood of a student being in any of the smoking stages that were examined. Additionally, several student-level factors were also associated with the three smoking stages. Understanding these factors will provide more insight to guide stakeholders interested in developing anti-tobacco strategies that are responsive to the risk and protective factors of adolescents in different smoking stages.

The main focus of bone loss and Osteoporosis (OP) research has been limited almost entirely to women, but OP has become increasingly common in older men and the impact of hip fracture on mortality may actually be greater in men. OP is a major cause of morbidity and mortality in developed countries, at a cost that currently exceeds $10 billion per year in the United States (US) alone. Osteoporotic fractures affect 50 % of women and 20-30% of white men and 4% of black men over the age of 50 years. These statistics may even increase because of increasing life expectancy. Few studies focusing on Blacks have been published to date and very little is known regarding the bone health and the aetiology and prevalence of OP and fractures among older South African blacks. From the above information it is clear that OP is of considerable clinical and economic importance. Without information on the patterns and determinants of bone loss, the formulation of rational prevention and treatment strategies in these groups is not possible. The aim of the study described in this thesis was to investigate the influence of the dietary factors (iron, vitamin C, and protein) and lifestyle factors (alcohol and tobacco smoking) on osteoporotic fractures and bone mineral density in older South African black men using a case-control study design. Sixteen black male patients with fractures of the proximal femur, the proximal humerus or the distal radius and who conformed to the inclusion and exclusion criteria were included in the study. An equal amount of age-matched (K? years), apparently healthy black men with no previous fracture (of the proximal femur and humerus and distal radius), were recruited as a control group. Dual energy X-ray absorptiometry (DEXA) was used for the measurement of the lumbar vertebrae and the proximal femur (hip). Questionnaires were used to gather demographic and medical information, data on physical activity and dietary intakes. Anthropometric measurements and blood samples were taken. Appropriate biochemical analyses were done with standard methods. Both the cases and controls were osteoporotic according to the mean lumbar spine BMD determined in both groups. The BMD was only marginally lower in the cases than in the controls and therefore not statistically significant. The mean tobacco pack years of the cases (13.29) [95% CI: 4.44; 22.141 were almost double that of the controls (7.43) [1.83; 13.031 but it was not statistically significant (p=0.55). Tobacco pack years were negatively associated with BMD of the lumbar spine (p=0.008) even after controlling for possible confounding SUMMARY factors (p=0.001). Malnutrition, as indicated by the low dietary intakes of energy, protein, vitamin C, iron and low BMI, could play a role in the lower bone mineral density (BMD) observed in the cases. The mean protein intakes of the cases (56.1 19) [46.49; 65.741 were very low compared to the recommended 639 per day. This low protein intake was also significantly less compared to the controls (739) [58.28; 88.311. lron intake tended to be lower in the cases compared to the controls (p=0.09). lron intake was not associated with BMD, however, in the stepwise regression analysis; iron intake came out as a possible predictor of BMD of both the lumbar spine and hip, although it was not statistically significant. The BMI was c 19 kg/m2 in 50% of the cases and the controls. S-GGT, a marker of alcohol intake, was significantly increased in the cases with a mean value of 65.88ulL opposed to the 36.33UIL in the control group. S-GGT was the most important predictor of BMD in both the hip and the lumbar spine. There was a significant statistical correlation between lumbar spine BMD (p=0.04); hip BMD (p=0.02) and s-GGT. In conclusion it can be said that malnutrition played a vital role in the low BMD aggravated by the use of tobacco from a young age and alcohol in excessive amounts over weekends. From the results of this study it can be recommended that any intervention programme should focus on alcohol abuse, tobacco smoking and improvement in nutritional status. Children should be encouraged not to smoke and be educated on the detrimental effects of alcohol. It is important to address dietary risk factors associated with OP, namely to increase the overall nutrition of the South African black male with low cost protein and calcium products. Vitamin C enhances iron absorption and may be beneficial for bone collagen. The increased intake thereof by using seasonal fruit can therefore be recommended. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2004.

These results are interpreted as supporting an 'Arousal Modulation' model of cigarette smoking, i.e. smokers can use cigarette smoking as a device for controlling their level of arousal towards an 'optimum' by virtue of the biphasic stimulantdepressant dose response of nicotine and to some extent, by virtue of the effects of smoking behaviour in the absence of nicotine.

Bakgrund: Kvinnor som röker kan drabbas av minskad fertilitet och det kan ta längre tid för dem att bli gravida. Forskning visar att rökning i samband med graviditet bland annat kan leda till missfall, låg födelsevikt och plötslig spädbarnsdöd. En stor andel av dessa kvinnor är medvetna om riskerna rökning under graviditet kan medföra men trots det fortsätter de att röka. Om vårdgivaren är medveten om de bakomliggande faktorerna till kvinnornas rökbeteende kan hen erbjuda kvinnan en individanpassad omvårdnad. För att kunna erbjuda rätt vård är personcentrerad omvårdnad viktigt. Syfte: Syftet var att beskriva vad som gör att kvinnor fortsätter röka under graviditeten. Metod: Litteraturöversikt med en beskrivande design av både kvalitativa och kvantitativa studier. Resultat: Nio faktorer som påverkar kvinnans fortsatta rökbeteende under graviditeten har hittats. Faktorerna är: nikotinberoende, relationsrelaterade problem, stress, behov av egentid och avslappning, partnern, brist på kunskap och motivation, sociala nätverk, förträngning samt bristande stöd från vårdgivaren. Slutsats: Det är viktigt att sjuksköterskan förstår varför en kvinna väljer att röka under graviditetsperioden. Förstår sjuksköterskan vad som ligger bakom rökbeteendet hos den gravida kvinnan kan det bli lättare för hen att erbjuda rätt vård. / <p>+</p>

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