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No abstract available. / Thesis (LL.M.)-University of Durban-Westville, 2002.

The purpose of the critical review is understood to be a critical reflection and comment on the work presented in the papers. The critical review is centred on the papers, as they form the substance of the submission, and the wider tobacco control literature. This review has not attempted to re-analyse the findings of the studies but attempts to draw wider lessons from the studies and to contribute to the future implementation of tobacco control policy and programmes. It will be claimed that the contribution to the research studies, the publications and the critical review represents a significant body of work and contribution to the advancement of knowledge in tobacco control. The aim of the thesis is to present and critically review six publications on the social de-normalisation of tobacco use, as it relates to public and private smoke-free environments and professional engagement in Scotland. The publications are treated as a coherent body of tobacco control research and draw upon three studies conducted over the period 1999-2007. Breathing Space Study 1: 1999-2002 evaluated an intervention which aimed to produce a significant shift in community norms towards non-smoking in a lowincome area. A process evaluation, as part of a quasi-experimental design, was undertaken in the intervention area, using a range of qualitative methods, including observation, in-depth interviews and focus groups. Papers 1 and 2 explore the context of health promotion professional practice in the development and implementation of tobacco control interventions in one disadvantaged community. The Qualitative Community Study 2: 2005-2007 aimed to explore the impact of the Scottish smoke-free legislation on attitudes and behaviour, at both individual and community levels, in four socio-economically contrasting localities in Scotland. A longitudinal qualitative evaluation was conducted using observation, in-depth interviews with smokers and ex-smokers, key stakeholders and focus groups. Papers 3 and 4 explore qualitative differences in the experience of smoke-free legislation in advantaged and disadvantaged communities, with particular consideration of the unintended consequences of the legislation for some smokers. The Smoke-free Homes Study 3: 2006-2007 aimed to describe changes in smoking behaviour and attitudes to smoking following implementation of the smoke-free legislation. It sought to identify the potential enablers and barriers to reducing SHS exposure in the home. A cross-sectional study was conducted using qualitative interviews. Papers 5 and 6 explore the changing discourses about second-hand smoke exposure, and the development of smoking restrictions in the home, with a particular focus on motivation to protect children. In addition, insight into the changing culture of professional practice in creating smoke-free homes was gained. Key findings A synthesis of key findings from these publications supports the identification of three major themes: the experience of power at each stage of the process of the social de-normalisation of tobacco use; the experience of stigmatisation of smoking as a consequence of policy; and health promotion practice as both barrier to and enabler of the implementation of smoke-free environments in the community and the home. The thesis also highlights the benefits and challenges of two research methodologies, process evaluation and qualitative longitudinal research (QLLR), in capturing both intended and unanticipated aspects of policy and practice implementation. This synthesis of the key findings that cut across the three studies has generated four research questions that are explored in this critical review: 1. How can policy be evaluated in community settings and in the home? 2. How do smokers, particularly disadvantaged smokers, engage with tobacco control policies and interventions? 3. Is professional practice a barrier or facilitator to understanding the impact of tobacco control policies and interventions? 4. What are some of the key unintended consequences of recent tobacco control policies? Conclusion This thesis contributes to knowledge through a critical account of the reshaping of smoking as a collective lifestyle, in both public and private domains. The social de-normalisation of tobacco use is experienced differently in advantaged and disadvantaged social contexts. Population tobacco control strategies may benefit from contextual adjustments, particularly for those smokers who live in areas of disadvantage and thus experience dual stigmatisation. Additionally, the effectiveness of future interventions would be enhanced by a more nuanced understanding of smoking behaviour, as a collective social practice, embedded in specific spaces, places and times.

Like adolescents, young adults are at risk of initiating tobacco use and escalating to daily use and tobacco dependence. However, not every young adult who uses cigarettes intermittently becomes tobacco dependent, and the time-course of those who transition to daily use varies widely. Individual differences likely contribute to the variability observed in patterns of tobacco use. This dissertation uses a multi-modal research approach to examine dimensions of impulsivity and alcohol use that are associated with vulnerability for escalation of cigarette smoking, and whether alcohol’s effects on behavioral disinhibition impact cigarette consumption. Study 1 investigated the associations between dimensions of trait impulsivity, alcohol use, and smoking behavior in a cross-sectional sample of young adults who varied in frequency of cigarette smoking. Study 2 expanded on the results of Study 1 by examining the separate and combined effects of impulsivity and alcohol use on escalation of tobacco use in a longitudinal study of young adults in their first three years of college to determine whether alcohol use and dimensions of impulsivity influenced trajectories of smoking behavior, and whether alcohol use and behavioral impulsivity changed across time as a function of tobacco use trajectories. Study 3 utilized a randomized, within-subject, placebo controlled design to examine whether alcohol-induced impairments in behavioral inhibition mediated the relationship between acute alcohol administration and ad-libitum cigarette consumption. Results from studies 1 and 2 indicated that alcohol use was associated with smoking frequency, and that dimensions of impulsivity (i.e. sensation seeking, lack of premeditation, and urgency) differentiated smoking groups. Study 3 found that acute alcohol increased smoking behavior, but alcohol impairment of inhibitory control did not mediate the relationship between alcohol and smoking consumption. Taken together, the results of these studies demonstrate that alcohol use and impulsivity play a significant role in tobacco use escalation, though more research is needed to determine the mechanism(s) that drive alcohol-induced increases in cigarette consumption.

A conditioning theory of tolerance postulates a mechanism of a conditioned compensatory response which both modulates the effect of the drug and produces cravings when the drug is not forthcoming. Using measures of heartrate and peripheral vasodilation the author investigated whether reactions opposite in direction to the effects of nicotine such as bradychardia and peripheral vasodilation could be elicited specifically with smokers who are presented with smoking-related stimuli. Due to confounding variables supportive data were not obtained. Recommendations are to conduct future experiments when there is a low differential temperature between the outside and inside, incorporating a more salient conditioned stimulus so control over the conditioned response could be stronger and including more subjects to aid statistical analysis.

A descriptive study of cigarette smoking in a sample of Indian matriculation students was undertaken in Northern Kwa-Zulu Natal in order to establish the prevalence of cigarette smoking; reasons for developing cigarette smoking behaviour; to determine knowledge about and attitudes to cigarette smoking and also to establish students' awareness of antismoking organisations and to make recommendations based on the findings. Data was collected by the researcher who administered questionnaires at various schools previously under the jurisdiction of the House of Delegates, in the towns of Newcastle, Dannhauser, Glencoe and Dundee. There were 55 smokers in the sample (N =326), ie., a prevalence rate of 16,9%. Among the males 52 (36,1%) were smokers and 3 (1,8%) females smoked. Fifty four (98,2%) smokers had commenced smoking above the age of 10 years. Twenty seven (53%) smoked at home and 12 (24%) smoked at school. Experimentation occured among 46 (83,6%) smokers prior to actual smoking with 52 (94,5%) smokers having friends who also smoked. Advertisements influenced 10 (18,2%) smokers while 11 (20%) were influenced by teachers and 9 (16,7%) were influenced by family members. Smokers received more pocket money than non-smokers. More family members of the smokers were also smokers as opposed to non-smokers. Fourty nine (89,1%) smokers believed that smoking was harmful to themselves while 41 (74,5%) said it was also harmful to others. The association between smoking and lung cancer was well known by 49 (90,7%) smokers but the association with heart disease and other cancers was not as well known. There was very little awareness among both smokers and non-smokers about anti-smoking programmes and organisations. Alarmingly there was hardly any formal health education on the dangers of smoking in schools. The conclusions are that the prevalence of cigarette smoking among Indian matriculants in the study area was 16,9% and that teachers, friends, family members and advertisements are influential in cigarette smoking behaviour. There is a need for education on the dangers of smoking in schools; and parents and teachers must take congnisance about smoking at home and in schools. / Theses (M.Fam.Med.)-University of Natal, Durban, 1995.

Background: The health effects of sheesha smoking are not well addressed. Objective: To assess the association between sheesha tobacco smoking and gene expression pertinent to cancer. Methodology: Three linked studies were carried out: (1) investigation of gene expression in salivary cells before and after exposure to sheesha tobacco smoke in 15 participants; (2) a systematic review of the association between sheesha and cancer; and (3) a pilot survey to collect data on factors potentially relevant to the uptake and cessation of sheesha tobacco smoking. Results: In the short-term, sheesha smoking significantly reduced the expression of both xenobiotic metabolism genes and other genes known to have altered expression in tobacco related cancers in a range between 1.7 times and 55 times. The systematic review showed that sheesha may increase the risk of lung and esophageal cancers. The pilot survey identified misperceptions about safety, in line with other studies, an approach that could be used to investigate the characteristics of sheesha smokers on a larger scale, and specific issues to probe. Conclusion: High quality epidemiological evidence on long-term effects of sheesha smoking on cancer is lacking. However, sheesha smoking has short-term effects on the expression of genes known to be involved in tobacco-related cancers. This is of major concern given widespread misperceptions about the likely safety of sheesha tobacco smoking.

Thesis (Ph. D.)--University of Hawaii at Manoa, 1996. / Includes bibliographical references (leaves 103-117). / Microfiche. / xiv, 117 leaves, bound ill. 29 cm

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.

v, 139 leaves : ill. / 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 Plant Pathology, 1972