No description available.

Bakgrund: Tobaksrökning är den största och vanligaste orsaken till sjukdom. Över en miljon svenskar röker. Behandling med rökavvänjning har visat sig vara den mest effektiva metoden för att uppnå ett rökfritt liv. Syfte: Att undersöka hur personer som deltar i rökavvänjningskurser inom primärvården uppfattar dessa kurser. Ett ytterligare syfte var att undersöka om det finns skillnader i uppnådd rökfrihet mellan personer som får rådgivning individuellt respektive i grupp. Metod: Studien är en deskriptiv enkätstudie med 27 deltagaresom deltar/ deltagit i rökavvänjning i syfte att sluta röka. Resultat: Den främsta anledningen till att deltagarna slutade röka var för att de ville, det var deras beslut. Stöd i grupp och i allmänhet var bra med kursen och det var viktigt att vara starkt motiverad för att lyckas sluta. Det fanns ett stort intresse för att utföra lungfunktionstest. Få personer träffade, och ville träffa, andra yrkeskategorier än sjuksköterska/distriktssköterska. Bästa tiden för rådgivningvar på eftermiddagen. Det fanns ingen skillnad i rökfrihet mellan dem som deltagit i grupp respektive individuell rådgivning då alla deltagarna har blivit rökfria under kursen. Slutsats: Gruppstöd, god information, den egna viljan samt stark motivation och hjälp till motivation ansågs vara en förutsättning för lyckad rådgivning. Det kunde ej utrönas huruvida individuell rådgivning eller rådgivning i grupp påverkade rökfrihet. Då rådgivningen i hela Uppsala län baseras på samma underlag och inga tidigare utvärderingar finns bör ytterligare studier göras som utvärderar insatsen. / Abstract: Smoking tobacco is the greatest and most common cause of disease. More than a million Swedes smoke. Treatment with smoking cessation courses has proved to be the most efficient method to attain a life without smoking. Aim/purpose: To study how people who participate in smoking cessation courses provided by primary care perceived the courses. A secondary aim was to investigate whether there were any differences in attaining a nonsmoking life between participants in smoking cessation courses given individually or in groups. Method: The study is a descriptive survey study with 27 participants whose goal in participating in smoking cessation courses was to quit smoking. Results: The main reason for participants to quit smoking was that they wanted this themselves, it was their decision. Support from the group and in general was a positive aspect of smoking cessation courses and a strong motivation was considered important in order to succeed. An ample interest in performing pulmonary function tests was noted. Few participants met, or had interest in meeting, professionals other than nurse/district nurse. The ideal time to attend smoking cessation courses was during the afternoons. No difference was noted in success to quit smoking between courses given individually or in group, as all participants had quit smoking. Conclusion: Group support, good information, own will/motivation and help to be motivated were considered to be the makings of a successful course. It was not possible to conclude whether smoking cessation courses held individually or in group affected success in quitting to smoke. As all smoking cessation courses in Uppsala County are based on the same material and no prior evaluation has been made, further research in this field is recommended.

Sammanfattning Bakgrund Kronisk obstruktiv lungsjukdom orsakas ofta av rökning, vilket anses av de flesta vara en självförvållad sjukdom. Konsekvenserna av detta blir att patienter med KOL ofta upplever skuld och skamkänslor. Syfte Syftet med denna litteraturstudie är att beskriva patienters erfarenhet av skuld och skam vid kronisk obstruktiv lungsjukdom. Metod I litteraturstudien granskades åtta vetenskapliga artiklar för att få en kunskap om patienternas känslor kring sin sjukdom. Innehållsanalys användes med ett deduktivt förhållningssätt där data bearbetades för att identifiera mönster och teman. Resultat Två huvudkategorier; skuld och skam var från början definierade och under analysen identifierades en tredje; stigmatisering. Dessa kunde senare delas in i tre olika nivåer; individ, familj/omgivning och sjukvård. Konklusion Denna studie ger sjuksköterskan en bättre förståelse för vilka känslor som kan uppstå vid en ofta självförvållad sjukdom som KOL. Den visar också vikten av att möta patienterna med empati, respekt och höja deras känsla av värdighet och moral.

<p>Tobacco smoking during pregnancy and lactation is a common habit and accounts for a significant percentage of fetal morbidity and mortality worldwide. The offspring is as a result exposed to nicotine through the blood and the milk of the mother. Nicotine is thus expected to interact with the developing fetus and the offspring of mothers who smoke or use NRT for smoking cessation, resulting in the interference with normal fetal and neonatal lung development. Maternal cigarette smoke or nicotine exposure produces adverse effects in the lungs of offspring, these include / intrauterine growth retardation, low birth weight, premature birth, reduced pulmonary function at birth, and a high occurrence of respiratory illnesses after birth. This study aimed at investigating&nbsp / the effects of maternal nicotine exposure during gestation and lactation on lung development in the offspring / to establish whether tomato juice can have protective effects on the fetal lung&nbsp / development and function in the offspring / and to determine if nicotine cases premature aging of the lungs of the offspring. It was therefore shown that maternal exposure to nicotine during&nbsp / gestation and lactation ad no significant effect on the growth parameters of the offspring. Maternal nicotine exposure during gestation and lactation had no effect on the growth parameters of&nbsp / the offspring, but resulted in compromised lung structure and function. The morphometric results demonstrated decrease in alveolar number, increase in alveolar size, and decrease in lung&nbsp / parenchyma of the nicotine exposed animals showing a gradual deterioration of the lung parenchyma. Structural alterations include emphysematous lesions, where the latter was&nbsp / accompanied by an increase in alveolar size (Lm), and a decrease in the tissue volume of the lung parenchyma. Thickening of alveolar walls was also evident and serves as an indication of&nbsp / remodeling of the extracellular matrix, also a characteristic of emphysema. A consequence of the gradual deterioration of the lung parenchyma is a decrease in the alveolar surface area available for gas exchange. The present study showed that the emphysematous lesions were conceivably a result of a reduced rate of cell proliferation accompanied by the increase in&nbsp / senescent cells numbers in the alveolar walls of the exposed offspring. The data of this study suggests that maternal nicotine exposure during gestation and lactation induces premature&nbsp / aging of the lungs of the offspring rendering the lungs of the offspring more susceptible to disease later in life. Since these structural changes occurred later in the life of the offspring and long&nbsp / after nicotine withdrawal, it is suggested that it is programmed during gestation and lactation. Smoking and NRT result in an increased load of oxidants in the mother and fetus. It also reduces&nbsp / the level of anti-oxidants and thereby compromising the ability of the mother to protect the fetus. It is hypothesized that this oxidant-antioxidant imbalance will program the lungs to age&nbsp / prematurely. The supplementation of the mother&rsquo / s diet with tomato juice, rich in lycopene, other anti-oxidants such as vitamin C, as well as phytonutrients protected the lungs of the offspring&nbsp / against the adverse effects of maternal nicotine exposure. This supports the hypothesis mentioned above. The study further showed that the effects of grand-maternal nicotine exposure during gestation and lactation on the lungs of the F1 offspring is also transferred to the F2 offspring. This is most likely via the paternal and maternal germ line. Since tomato juice supplementation of the mother&rsquo / s diet with tomato juice prevented&nbsp / the adverse effects of maternal nicotine exposure on the lungs of the offspring, it is conceivable that it will prevent transfer of these changes to the F2 generation.&nbsp / </p>

This paper describes the distribution of dependence criteria and diagnoses in a sample of 14- to 24-year-olds from Munich, Germany (n = 3,021; 71% response rate), evaluates differences between nondependent and dependent smokers and examines associations of smoking with other substances, affective and anxiety disorders. Assessment was made using the M-CIDI. The lifetime prevalence of DSM-IV nicotine dependence in the total sample is 19%, rising to 52% among regular smokers. No gender differences were seen in the progression from regular smoking to nicotine dependence, although men were more likely than women to initiate regular use. Analysis of daily cigarette use identified a significant dose-response relationship with the number of endorsed DSM-IV dependence criteria with unsuccessful cut-backs being the most prevalent criterion. As compared to nondependent smokers, dependent smokers were more likely to associate negative health effects with smoking and to have a desire to change and attempt a change in their pattern of use. Regular use of nicotine was found to be significantly associated with other substance and nonsubstance disorders, although dependent regular use was more strongly associated with these disorders than nondependent regular use. These results indicate that daily smoking is a behavior which is resistant to change despite an expressed desire and repeated cut-back attempts. Although initiation of regular smoking among nonsmokers does not occur frequently after the early twenties, the risk for dependent smoking among regular users persists into adulthood and is associated with a range of mental disorders.

The impact of CYP2A6 and CYP2B6 genetic variation on nicotine metabolism, tobacco use behaviours, and nicotine biomarkers was investigated in a group of Alaska Natives (n = 400). CYP2A6 and CYP2B6 allele frequencies were unique and associations of CYP2A6 genotype and CYP2A6 activity (plasma and urine trans 3’-hydroxycotinine/cotinine (3HC/COT) ratios) were robust. Notably, this population possessed a more rapid rate of CYP2A6 activity (higher plasma 3HC/COT) when compared to CYP2A6 wild-type individuals in other ethnic groups (ANOVA P < 0.001). Also demonstrated was a significant difference in urine total nicotine equivalents by CYP2A6 activity median split (t-test P < 0.01), the first evidence of nicotine titration by CYP2A6 activity within a light smoking population. Overall, this population possessed a distinctive pattern of CYP2A6 and CYP2B6 variant frequencies and a faster rate of nicotine metabolism, which may in part explain higher levels of tobacco use prevalence and tobacco-related disease risk.

The impact of CYP2A6 and CYP2B6 genetic variation on nicotine metabolism, tobacco use behaviours, and nicotine biomarkers was investigated in a group of Alaska Natives (n = 400). CYP2A6 and CYP2B6 allele frequencies were unique and associations of CYP2A6 genotype and CYP2A6 activity (plasma and urine trans 3’-hydroxycotinine/cotinine (3HC/COT) ratios) were robust. Notably, this population possessed a more rapid rate of CYP2A6 activity (higher plasma 3HC/COT) when compared to CYP2A6 wild-type individuals in other ethnic groups (ANOVA P < 0.001). Also demonstrated was a significant difference in urine total nicotine equivalents by CYP2A6 activity median split (t-test P < 0.01), the first evidence of nicotine titration by CYP2A6 activity within a light smoking population. Overall, this population possessed a distinctive pattern of CYP2A6 and CYP2B6 variant frequencies and a faster rate of nicotine metabolism, which may in part explain higher levels of tobacco use prevalence and tobacco-related disease risk.

Hintergrund / Ziel der Studie: Im Bereich der Tabakentwöhnung existieren mittlerweile zahlreiche erprobte therapeutische Maßnahmen und Medikamente. Dennoch ist die Inanspruchnahme vorhandener Entwöhnungsangebote sehr dürftig. Es besteht die begründete Hoffnung, dass durch eine stärkere Einbeziehung der Hausärzte in den Bereich der Tabakentwöhnung eine Versorgungslücke geschlossen werden könnte. Die Studie soll Durchführbarkeit und Erfolg einer solchen Ausweitung des Anbieterkreises von Tabakentwöhnungsmaßnahmen im Hausarztbereich untersuchen. Unterschiedliche bereits vorhandene Therapieansätze werden hierbei hinsichtlich Effektivität und Effizienz in der allgemeinärztlichen Routineversorgung miteinander verglichen. Methoden: In Phase I der Studie werden bundesweit Patienten in mehr als 800 Arztpraxen an einem Stichtag per Fragebogen zu ihrer Gesundheit und ihrem Rauchverhalten befragt. In Phase II werden die in Phase I identifizierten entwöhnungswilligen Raucher in ausgewählten Arztpraxen für die Intervention rekrutiert und randomisiert vier Gruppen mit (idealerweise) jeweils 250 Personen zugeteilt: einer Bupropion SR (Zyban®)-Gruppe, einer Nikotinersatzmittel-Gruppe, einer Verhaltenstherapie-Gruppe und einer Kontrollgruppe. Die Behandlung erfolgt jeweils durch die Ärzte in ihren Praxen unter Supervision und mit Unterstützung durch Studienmonitore. Erwartete Ergebnisse: In Abhängigkeit von Merkmalen des Arztes und seiner Praxis auf der einen Seite sowie Merkmalen der betroffenen Patienten auf der anderen, sollte die Akzeptanz, Durchführbarkeit und Wirksamkeit der ausgewählten Therapieansätze unterschiedlich ausfallen. Insgesamt sollte jedoch jede Therapiebedingung gegenüber der Kontrollbedingung hinsichtlich ihrer Effektivität überlegen sein. Im 6-Monats Follow-up sollte die Zyban-Gruppe gegenüber allen anderen Gruppen die höchste Abstinenzquote aufweisen. Schlussfolgerung: Die Ergebnisse sollten Hinweise auf Möglichkeiten einer bedarfsgerechten, optimierten Allokation vorhandener Maßnahmen zur Tabakentwöhnung in der allgemeinärztlichen Versorgung liefern. / Background / aim of the study: Although a number of efficacious smoking cessation measures and medications do exist, only a small number of smokers (tobacco users) make use of them. A stronger engagement of general practitioners (GPs) in the field of smoking cessation might help to improve health care in this important area. The study will investigate feasibility and effectiveness of different readily available smoking cessation measures under routine conditions in primary health care practices. Method: In phase I of the study patients' health status and tobacco consumption are assessed by means of questionnaires provided on a nationwide appointed date in more than 800 general practices in Germany. In phase II selected practices offer smoking cessation treatments to identified smokers. Participants recruited will be randomly assigned to four groups ideally consisting of 250 subjects each: A bupropion SR (Zyban©) condition, a nicotine replacement therapy (NRT) group, a cognitive-behavioural treatment (CBT) group and a control condition. Treatments will be conducted by GPs in their practices under supervision of study monitors offering therapeutical and organisational support. Expected results: Acceptance, feasibility, and effectiveness of smoking cessation treatments offered will differ depending on GP and patient characteristics. Overall, success-rates (while success is primarily defined as abstinence from tobacco use) should be higher in all therapeutic conditions as compared to controls. In the 6-month follow-up abstinence rates are expected to be highest in the bupropion SR group. Conclusion: Results should yield indications for an improved allocation of available smoking cessation measures in primary care.

Background: Since the discovery of oil in 1962, the United Arab Emirates (UAE) has experienced far-reaching social and economic changes. As a result, the physical and social environment of the UAE is moving away from the traditional Bedouin lifestyle to one that is more westernized. Given this recent trend toward a westernized lifestyle, chronic diseases are becoming more prevalent, impacting the rates of chronic disease among children, adolescents, and young adults residing in the UAE as well. Null hypothesis 1: There is no association between the level of physical activity and overweight/obesity, and hypertension. Null hypothesis 2: There is no association between the frequency of fruit and vegetable intake and overweight/obesity, and hypertension. Null hypothesis 3: There is no association between smoking status and overweight/obesity, and hypertension. Objectives: • to assess the prevalence of fruit and vegetable intake, physical activity, smoking, overweight/obesity, and hypertension among Arab college students in the UAE; • to determine the associations between fruit and vegetable intake, physical activity, smoking, overweight/obesity, and hypertension Methods: Participants included men and women college students of Arab descent attending the American University of Sharjah, UAE. A questionnaire was used to assess demographics, tobacco use, physical activity, and diet of participants. A qualitative food frequency questionnaire was used to assess frequency of fruit and vegetable consumption, including fruit juice, fruit, lettuce, white potatoes, beans, tomato sauce, vegetable soup, and other vegetables. Height, weight, and blood pressure were measured and BMI was determined. Results: The study sample included 145 men (n=73) and women (n=72) age 18-25 years. The prevalence of smoking was higher among men compared to women (65.8% vs. 30.6%; p<0.001). The prevalence of physical activity was higher among men compared to women (84.9% vs. 55.6%; p<0.001). The prevalence of overweight was higher among men compared to women (31.5 vs. 16.7%; p=0.01). The prevalence of obesity was higher among men compared to women (11.0 vs. 2.8%; p=0.01). The prevalence of high blood pressure was higher among men compared to women (56.9 vs. 17.1%; p<0.001). Among men and women, the contribution of fruit juice to the total daily frequency of fruit consumption was 57%. Of the total study population, 25.2% reported a frequency of fruit and vegetable intake ≥ 5 times/day. For women, frequency of fruit and vegetable intake had a significant negative association with physical activity. Among men, fruit and vegetable intake ≥ 5 times/day was found to be negatively associated with hypertension. A positive association was found between BMI and hypertension for men. Conclusions: The results of the study uphold the hypothesis that fruit and vegetable intake is inversely associated with hypertension among men. Compared to women, men exhibited a greater prevalence of high blood pressure, smoking, overweight/obesity, and physical activity. Men and women did not differ in the frequency of fruit and vegetable consumption. For the total study population, fruit juice contributed to 57% of the total fruit daily fruit intake. Women who reported engaging in physical activity were more likely to report a frequency of consumption of fruits and vegetables < 5 times per day. 65.8% of men and 48.4% of the total study population reported smoking either cigarettes or sheesha. Smoking was found to be more prevalent among students reporting a country of origin in middle and low income categories. More information is needed on the energy intake of college-age Arab women and their exercise patterns to determine if an intervention is warranted to prevent disordered eating. More information is needed on the consumption of fruit juice among this population to determine if an intervention is needed to promote intake of whole fruits and vegetables to replace fruit juice consumption. Interventions that target smoking habits among Arab college students need to incorporate sheesha smoking, since this habit was found to be common among both men and women.

Background: Breast and Gynecological cancers are a major public health problem. Smoking is associated with several chronic diseases including cancer. Other lifestyles of public health predispose many people to dyslipidemia, hypertension and obesity; risk factors for metabolic syndrome, and are associated with cancer. Objectives: The purpose of this study is to find if those who smoke, and have the metabolic syndrome, are more likely to have breast or gynecological cancers, and to find the distribution by education, having health insurance, race/ethnicity and socio-economic status. Methods: A case-control study of females aged 20 years and above who participated in the United States National Health and Nutrition Examination Survey (NHANES) 2001-2010. Results: Females who have smoked more than hundred cigarettes in life and still smoke; a) have a 42 percent less chance of having a breast cancer diagnosis (OR 0.58; 95% CI 0.36 – 0.93, p-value 0.025), and b) are 2.67 times as likely to report a cervical cancer diagnosis as females who have smoked less than hundred cigarettes in life (OR 2.67; 95% CI 1.72 – 4.13, p-value Conclusion: Smoking and metabolic syndrome are very important indicators of reproductive health and needs further study. Smoking cessation interventions should be an integral part of cervical cancer prevention programs especially targeted at younger females and females who live below the federal poverty level.