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<p>The Community Intervention Trial for Smoking Cessation (COMMIT) was one of the largest health promotion interventions in North America. Using 11 pairs of matched intervention and control communities, the U.S. National Cancer Institute sought to establish the viability of a community-based approach to smoking cessation, with the expectation of significant impacts on cessation rates amongst heavy smokers during the four years of intervention.</p> <p>The evaluation components of the COMMIT trial relied primarily on the use of surveys to document quantitative changes in attitudes, beliefs and behaviours. A complementary ancillary qualitative evaluation was conducted by the author in the only Canadian intervention site in the trial in Brantford, Ontario. Depth interviews and focus groups were conducted with 45 members of a Smokers' Network established by COMMIT. Subsequently, 35 intervention staff, researchers and community influential were interviewed. Transcripts were coded and analyzed using qualitative analysis software.</p> <p>Several objectives guided the qualitative evaluation study in Brantford: 1) establish the degree to which the COMMIT met the needs of smokers for assistance in quitting; 2) identify the factors that inhibited or facilitated program success; and 3) consider the implications for community mobilization for smoking cessation. Findings in each of these areas are discussed.</p> <p>This work seeks to contribute to knowledge development in health promotion at the level of theory and method, as well as substantively in terms of the design and implementation of community health promotion interventions. A critical-interpretive methodology is advanced as being consistent with the 'new' health promotion, based on a review of the literature on social theory which also argues for an explicit critical and emancipatory orientation to theory and practice in health promotion. These approaches are applied to the examination of a community-level smoking cessation intervention. Chapter 9 contains a critical sociological examination of the nature of tobacco control, drawing upon the work of Goffman.</p> / Doctor of Philosophy (PhD)

Background/Objectives: The first objective of this study is to assess the relationship between cigarette access and smoking behavior in 15-17 year old students. The second objective of this study is to assess the relationship between media and smoking behavior in those students. The third objective of this study is to observe whether the smoking rate will increase if subjects have both access and exposure to the tobacco product. I propose to use the youth survey data to test the impact of exposure to smoking-related media messages and the difficulty of acquiring tobacco products. I hypothesize that there is positive relationship among youth access to tobacco products, exposure to tobacco ads/promotions on social networking sites and active smoking. Methods: I examined National Youth Tobacco Survey data from 2014 and a total number of 1293 subjects as a secondary analysis. Results: The students with one or more than one method of accessing tobacco had higher odds compared to students with no access (OR = 70.12; 95% CI: 47.71–103.07; p &lt; 0.0001 for only one method; OR = 240.22; 95% CI: 160.25–360.09; p &lt; 0.0001 for more than one method). Moreover, the association between exposure to tobacco ads via internet, newspaper, point stores and movies/TV and smoking behavior was significant at both moderate and heavy exposure levels (OR = 1.44; 95% CI: 1.08–1.92; p = 0.014 for moderate exposure group; OR = 1.82; 95% CI: 1.26–2.62; p = 0.002 for heavy exposure group). The multivariable model, which shows the effect of the combination of these two factors, it states access to tobacco products was significantly positively associated with an increased smoking rate (OR = 69.06; 95% CI: 47.03-101.40; p &lt; 0.001 for only one access group; OR = 241.78; 95% CI: 160.49–364.22; p &lt; 0.001 for more than 1 access group). However, the severity of media exposure was not significantly associated with the increased odds of cigarette smoking among adolescents (OR = 1.14; 95% CI: 0.80-1.62; p = 0.470 for moderate exposure group; OR = 1.39; 95% CI: 0.81–2.40; p = 0.227 for heavy exposure group). Conclusion: I provided further evidence that exposure to tobacco messages and have access to tobacco products can increase the smoking rates among youth. These findings could be a result of better diagnosis and reporting, but the increase may also be due to other risk factors in the population. These findings may have implications for further and more aggressive counseling for teenagers. These effects should be further explored in a larger population of adolescents. Intervention methods should be designed to help the public understand the benefits of reducing adolescent’s exposures to tobacco smoke. / Epidemiology

Introduction: Smoking is often used as a maladaptive weight control strategy among college-age females who have increased weight concerns. Many perceived benefits accrued from smoking including enhanced mood, reduced anxiety, and weight control can also be achieved through physical activity. The purpose of this study was to examine the effects of a novel behavioral task (body-image exposure task) that was designed to elicit weight concerns on urge to smoke among college-age female smokers who vary in levels of physical activity. Methods: Using a cue-reactivity paradigm, 16 sedentary and 21 physically active college-age female smokers were exposed to a pilot tested body-image exposure session. Self-reported urge and smoking topography variables were obtained before and after the exposure session along with measures of body dissatisfaction, positive and negative affect, and physical-appearance related anxiety at the two time-points. Results: Paired sample t-test showed significant increases in self-reported urge (p &lt;.01) and quicker latency to first puff (p &lt;.01) at post test for the entire sample. Significant differences were not seen in the other topography variables of puff duration, puff number, and inter-puff interval. Results of partial correlation indicated lower self-reported urge at post-test was associated with increased time engaging vigorous intensity physical activity (r =-0.44 ; p =.01). However, association between latency to first puff and physical activity was not significant (r=-.10; p=.62). The body-image exposure session also significantly increased body dissatisfaction (p &lt; .01), and anxiety related to physical appearance (p &lt; .01) while lowering positive affect at post-test (p &lt;.01). Baseline measures of depressive symptoms were significantly associated with increased self-reported urge at post-test (r= .59, p = .03) urge though this relationship was not significant after controlling for vigorous intensity of physical activity (r = .33; p = .07) showing the potential protective effects of physical activity on smoking urges. Conclusion: These results suggest that physical activity can be protective of smoking urges in a situation that increases weight concerns among young women and emphasizes the need to incorporate physical activity components along with cognitive behavioral therapy in tailoring smoking cessation interventions in this population. Future research should continue to explore effects of physical activity on reactivity to body-cues and explore variability in cue-reactivity as a result of physical activity. / Kinesiology

Objectives: With increasing utilization of cone beam computed tomography for diagnosis and treatment planning of complex dentomaxillofacial rehabilitation, more incidental findings of pathology in the maxillary sinus have been identified by clinicians. Part one of this article discusses the association between age, gender, ethnicity and dentition status in relation to prevalence of sinus pathology. The aim of this study is to expand the current knowledge base in regards to the prevalence of maxillary sinus pathologies in patients of Temple University Kornberg School of Dentistry and to determine if smoking and allergies have relationship with the prevalence of pathology. Materials and Methods: : Three hundred and sixty-three cone beam computed tomography scans taken were evaluated at Temple University Kornberg School of Dentistry Department of Oral and Maxillofacial Radiology between 2009 to July 31, 2013. Scans were classified into 1 of 5 categories based upon the type of sinus pathology detected. The categories of sinus findings were: healthy, mucosal thickening &gt; 3-4 mm, polypoidal mucosal thickening, partial opacification and complete opacification. Medical health questionnaires were reviewed for patient's social history such as smoking and systemic factors such as allergies. Chi-square statistical analysis using SAS was done to examine the relationship. Results: This study included a total of 363 subjects subdivided by gender into 203 females and 160 males. The subjects were further subdivided by ethnicity into 217 Caucasians, 86 African Americans, 35 Asians, and 25 Hispanics. Also, 129 of the subjects had a history of smoking, 98 had seasonal allergies, and 50 had environmental allergies. In addition 129 of the subjects had at least 1 type of sinus pathology. Chi-square analyses showed that there was no relationship between the prevalence of sinus pathology and allergy or smoking status. History of allergies was marginally higher in females and significantly higher in African Americans (p=0.007). History of smoking was higher in older subjects (p=0.0004), males (p=0.01) and Caucasians (p&lt;0.0001). Conclusions: This CBCT cross sectional study shows that there is no statistically significant correlation between prevalence of sinus pathology and smoking or allergy status. Further cohort studies are needed to determine if smoking or allergies may or may not contribute to sinus pathology. / Oral Biology