407,087 research outputs found

    Long-Term Consequences of Fetal and Neonatal Nicotine Exposure: A Critical Review

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    Cigarette smoking during pregnancy is associated with numerous obstetrical, fetal, and developmental complications, as well as an increased risk of adverse health consequences in the adult offspring. Nicotine replacement therapy (NRT) has been developed as a pharmacotherapy for smoking cessation and is considered to be a safer alternative for women to smoking during pregnancy. The safety of NRT use during pregnancy has been evaluated in a limited number of short-term human trials, but there is currently no information on the long-term effects of developmental nicotine exposure in humans. However, animal studies suggest that nicotine alone may be a key chemical responsible for many of the long-term effects associated with maternal cigarette smoking on the offspring, such as impaired fertility, type 2 diabetes, obesity, hypertension, neurobehavioral defects, and respiratory dysfunction. This review will examine the long-term effects of fetal and neonatal nicotine exposure on postnatal health

    Understanding decisions to use e-cigarettes or behavioural support to quit tobacco: a qualitative study of current and ex-smokers and stop smoking service staff.

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    AIM: To examine factors influencing current and ex-smokers' decisions to use e-cigarettes or behavioural support, including potential impacts of any differences in perspectives between smokers and their local stop smoking services (SSSs). DESIGN: Semi-structured qualitative interviews followed by framework analysis, with the 'capability', 'opportunity', 'motivation' and 'behaviour' (COM-B) model of behaviour change used to frame findings. SETTING: SSSs and surrounding local areas in England. PARTICIPANTS: Interviewees (nĀ =Ā 46) were current or recent smokers (nĀ =Ā 29) and SSS staff or stakeholders (nĀ =Ā 17). MEASUREMENTS: Interview topic guides explored influences on smokers' choice of quit method and characteristics of support offered by local SSSs. FINDINGS: Current and ex-smokers showed a range of views on potential risks from long-term vaping, which appeared to be particularly relevant for the capability dimension of COM-B. These different attitudes to vaping appeared to be linked to variations in people's perceived capability to assess evidence around e-cigarettes' safety. Motivations for using or avoiding e-cigarettes and SSSs often appeared to overlap: attitudes to both e-cigarettes and nicotine replacement therapy from SSSs often reflected personal experiences and views on whether switching from smoking to these alternatives represented successful quitting or simply ongoing nicotine addiction. For smokers, opportunities to use e-cigarettes or SSSs appeared to be largely determined by perceived time requirements. Furthermore, interviews with SSS professionals suggested that opportunities to access SSSs for ex-smokers who were now regular vapers may be being influenced by different e-cigarette policies adopted in individual areas. CONCLUSIONS: In England, smokers' decisions to use e-cigarettes and local stop smoking services appear to be determined by varied influences across the COM-B framework. Both smokers and stop smoking service professionals display diverse views about potential risks from e-cigarettes, which has relevance for the provision of behavioural support as well as the uptake of vaping

    Socioeconomic inequalities in childhood exposure to secondhand smoke before and after smoke-free legislation in three UK countries

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    Background: Secondhand smoke (SHS) exposure is higher among lower socioeconomic status (SES) children. Legislation restricting smoking in public places has been associated with reduced childhood SHS exposure and increased smoke-free homes. This paper examines socioeconomic patterning in these changes.<p></p> Methods: Repeated cross-sectional survey of 10 867 schoolchildren in 304 primary schools in Scotland, Wales and Northern Ireland. Children provided saliva for cotinine assay, completing questionnaires before and 12 months after legislation.<p></p> Results: SHS exposure was highest, and private smoking restrictions least frequently reported, among lower SES children. Proportions of saliva samples containing <0.1 ng/ml (i.e. undetectable) cotinine increased from 31.0 to 41.0%. Although across the whole SES spectrum, there was no evidence of displacement of smoking into the home or increased SHS exposure, socioeconomic inequality in the likelihood of samples containing detectable levels of cotinine increased. Among children from the poorest families, 96.9% of post-legislation samples contained detectable cotinine, compared with 38.2% among the most affluent. Socioeconomic gradients at higher exposure levels remained unchanged. Among children from the poorest families, one in three samples contained > 3 ng/ml cotinine. Smoking restrictions in homes and cars increased, although socioeconomic patterning remained.<p></p> Conclusions Urgent action is needed to reduce inequalities in SHS exposure. Such action should include emphasis on reducing smoking in cars and homes

    Integrating the promotion of physical activity within a smoking cessation programme: Findings from collaborative action research in UK Stop Smoking Services

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    Background: Within the framework of collaborative action research, the aim was to explore the feasibility of developing and embedding physical activity promotion as a smoking cessation aid within UK 6/7-week National Health Service (NHS) Stop Smoking Services. Methods: In Phase 1 three initial cycles of collaborative action research (observation, reflection, planning, implementation and re-evaluation), in an urban Stop Smoking Service, led to the development of an integrated intervention in which physical activity was promoted as a cessation aid, with the support of a theoretically based self-help guide, and self monitoring using pedometers. In Phase 2 advisors underwent training and offered the intervention, and changes in physical activity promoting behaviour and beliefs were monitored. Also, changes in clientsā€™ stage of readiness to use physical activity as a cessation aid, physical activity beliefs and behaviour and physical activity levels were assessed, among those who attended the clinic at 4-week post-quit. Qualitative data were collected, in the form of clinic observation, informal interviews with advisors and field notes. Results: The integrated intervention emerged through cycles of collaboration as something quite different to previous practice. Based on field notes, there were many positive elements associated with the integrated intervention in Phase 2. Self-reported advisorsā€™ physical activity promoting behaviour increased as a result of training and adapting to the intervention. There was a significant advancement in clientsā€™ stage of readiness to use physical activity as a smoking cessation aid. Conclusions: Collaboration with advisors was key in ensuring that a feasible intervention was developed as an aid to smoking cessation. There is scope to further develop tailored support to increasing physical activity and smoking cessation, mediated through changes in perceptions about the benefits of, and confidence to do physical activity

    Action stage of Changes in Smoking Behavior in Health Students in Kupang City

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    Health students are individuals who have a higher level of education and knowledge in the health field. However, around 37.3% of students in Indonesia, including health students, are smokers. Previous studies have shown student smokers' desire to quit smoking. This study describes changes in smoking behavior based on the action stage on health students in Kupang City in 2021. This type of research is qualitative with in-depth interview techniques. This study recruited nine health students who had a desire to change smoking behavior. This study found that four behavioral change processes (management contingency, helping relationships, counter conditioning, and stimulus control) play an essential role in the smoking cessation process in the action stage. Thus, the intervention needs to pay attention to the involvement of the four change processes in the action stage to encourage smokers to quit smoking altogether. Interventions also need to direct smokers to start the preparation phase for change, where intentions and commitment to action can be formed and become a foundation for smokers to initiate changes in smoking behavior

    Perspectives on financial incentives to health service providers for increasing breast feeding and smoking quit rates during pregnancy: a mixed methods study

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    Objective: To explore the acceptability, mechanisms and consequences of provider incentives for smoking cessation and breast feeding as part of the Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS) study. Design: Cross-sectional survey and qualitative interviews. Setting: Scotland and North West England. Participants: Early years professionals: 497 survey respondents included 156 doctors; 197 health visitors/maternity staff; 144 other health staff. Qualitative interviews or focus groups were conducted with 68 pregnant/postnatal women/family members; 32 service providers; 22 experts/decision-makers; 63 conference attendees. Methods: Early years professionals were surveyed via email about the acceptability of payments to local health services for reaching smoking cessation in pregnancy and breastfeeding targets. Agreement was measured on a 5-point scale using multivariable ordered logit models. A framework approach was used to analyse free-text survey responses and qualitative data. Results: Health professional net agreement for provider incentives for smoking cessation targets was 52.9% (263/497); net disagreement was 28.6% (142/497). Health visitors/maternity staff were more likely than doctors to agree: OR 2.35 (95% CI 1.51 to 3.64; p<0.001). Net agreement for provider incentives for breastfeeding targets was 44.1% (219/497) and net disagreement was 38.6% (192/497). Agreement was more likely for women (compared with men): OR 1.81 (1.09 to 3.00; p=0.023) and health visitors/maternity staff (compared with doctors): OR 2.54 (95% CI 1.65 to 3.91; p<0.001). Key emergent themes were 'moral tensions around acceptability', 'need for incentives', 'goals', 'collective or divisive action' and 'monitoring and proof'. While provider incentives can focus action and resources, tensions around the impact on relationships raised concerns. Pressure, burden of proof, gaming, box-ticking bureaucracies and health inequalities were counterbalances to potential benefits. Conclusions: Provider incentives are favoured by non-medical staff. Solutions which increase trust and collaboration towards shared goals, without negatively impacting on relationships or increasing bureaucracy are required

    Investigating the influence of smoking on willed action and cognitive function in individuals with brain injury

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    Rationale: Smoking triggers dopamine release, particularly in the mesocorticolimbic dopamine system. Activation of this system has a major overlap with functioning of the frontostriatal circuitry, which has been labelled the 'willed action system'. 'Willed action' describes action that is non-automatic, internally generated, effortful, and involves conscious control. It is implicated in initiation and motivation. There is evidence that abstinence from smoking leads to acute impairments in a range of cognitive and motivational measures, many of which are associated with frontal / frontostriatal functioning. Aims: The current study aimed to investigate the effects of smoking on willed action in 18 brain-injured smokers. Method: A within-subjects cross-over design was utilised, to compare performance after an acute (>2 hours) period of abstinence from smoking with performance after smoking. The test battery included measures of reward responsivity (objective and subjective measures of motivation), initiation (verbal fluency), and working memory. Results: Reward responsivity was enhanced after a cigarette had been smoked compared to the abstinent condition. Additionally, performance on the card sorting task was particularly enhanced after smoking on the first occasion, i.e. when the task was novel. There was no significant enhancement on any other measure. Conclusion: The results suggest that reward responsivity is modulated by acute smoking status, suggesting a specific effect of nicotine on aspects of motivation. Enhancement of performance is particularly seen when the task is novel. These conclusions are partially in concordance with a willed action framework. Implications are discussed with reference to routine neuropsychological assessments, and a possible role for nicotine as a therapeutic agent for enhancing motivation after acquired brain injury

    Identifying Video Game Preferences Among Adults Interested in Quitting Smoking Cigarettes: Survey Study.

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    BACKGROUND: Smoking is the most prevalent cause of morbidity and mortality in the United States. Although most individuals who smoke express a desire to quit smoking, only a small percentage are successful. Serious games have become popular in health sectors as a potential avenue for delivering a scalable treatment that is both accessible and engaging for the smoking population. Several smoking cessation games have already been developed, but these games feature a broad range of gameplay elements and are not necessarily based on existing video game preferences in the general or smoking population. OBJECTIVE: To better inform treatment development, this study aims to evaluate video game genre preferences among treatment-seeking individuals who smoke (N=473). METHODS: Participants responded to a screening survey to enroll in a larger, serious game intervention for smoking cessation. During this screening survey, participants were asked to disclose their favorite video games, which resulted in 277 unique game titles. These titles were coded for genre categories based on publisher listings and game features. The genres were then analyzed for the frequency of reporting overall and across age groups. RESULTS: Action, Role-Playing, and Action-Adventure were the most reported genres among adults aged ā‰¤34 years; Action, Action-Adventure, and Logic were the most reported genres among adults aged 35-44 years; and Logic and Action were the most reported genres among adults aged ā‰„45 years. CONCLUSIONS: These data indicate that treatment-seeking individuals who smoke have different game preferences across age groups, and the data provide novel information to inform the development of future serious games targeting the smoking population that are tailored to the preferences of their age group. TRIAL REGISTRATION: ClinicalTrials.gov NCT03929003; https://clinicaltrials.gov/ct2/show/NCT03929003

    Systematic Review Knowledge, Attitude and Smoking Practice on Adolescent

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    Background: Cigarettes are a threat to today's adolescence. There are many types of cigarettes ranging from conventional cigarettes to electrical cigarettes. All that can interfere with adolescence health. The purpose of this systematic review is to know the results of previous research related to knowledge, attitude and practice of smoking in adolescents. Methods: The source of the article used is obtained from search through Proquest and EBSCO databases. Search articles are limited from 2012 until 2018. After the article was obtained, it reviewed until the stage of making systematic review. Results: Systematic review of 15 articles from the review of articles was illustrating the knowledge, attitude and action of smoking in adolescents in various countries. Conclusion: Based on the study it can be concluded that the majority of adolescent knowledge about smoking is good, the majority of smoking attitude is positive, and the majority of smoking action ia daily smokers
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