Understanding Emerging Adults’ Decision-Making Process When Selecting a Smoking Cessation Approach: A Grounded Theory Study

Rates of cigarette smoking have been markedly reduced in recent decades, but young adults (or emerging adults) continue to have the highest rate of tobacco use in Ontario, Canada. Though preventing smoking initiation is optimal, positive outcomes of cessation early in the lifespan make it clear that cessation support for smokers in this age group is critical. Despite research into the effectiveness of quitting approaches and smokers’ preferred approaches to quitting, it remains largely unclear how smokers characterized as emerging adults (Arnett, 2000) make and act upon “real-world” decisions about which cessation approach to use. To learn more about this important aspect of the quitting process, this study investigated emerging adults’ experiences of choosing their approach to quitting. Twenty-six recent quitters between the ages of 19-29 participated in semi-structured interviews. Grounded theory methods were used to develop a framework explaining the decision-making process successful quitters engaged in when choosing a smoking-cessation approach. The newly proposed “Choosing How To Quit” Framework shows a decision making process that includes three distinct phases: Awareness of Approaches; Personal Reflection; Making a Choice. Successful emerging-adult quitters chose a quitting approach by drawing on a variety of sources for information and exploring personal facets including their past experiences, real-life daily-living considerations and an understanding of their present and future-selves. The Framework offers emerging adults and cessation supporters new realistic avenues to consider or explore when making the decision about a cessation approach, potentially leading to a greater likelihood of success. As a preliminary theory, the CHQ Framework requires further investigation, including into which components may be most essential to the decision-making process

Contraband tobacco on post-secondary campuses in Ontario

In Ontario 27% of young adults smoke, and annual surveillance data suggests tobacco use is plateauing after years of decline. The availability of inexpensive contraband tobacco products maybe contributing to this situation. Limited research has been conducted on the use of contraband tobacco and despite the increasing availability of contraband 'Native cigarettes', no studies to date have examined their use among young adults. Accordingly, this study examines: (a) what proportion of cigarette butts discarded on post-secondary campuses are contraband; and (b) whether the proportion of contraband butts varies between colleges and universities, across seven geographical regions in the province and based on proximity First Nations reserves. In March and April 2009, discarded cigarette butts were collected from the grounds of 25 post-secondary institutions across Ontario. At each school, cigarette butts were collected on a single day from four locations. The collected cigarette butts were reliably sorted into five categories according to their filtertip logos: legal, contraband First NationslNative cigarettes, international and suspected counterfeit cigarettes, unidentifiable and unknown. Contraband use was apparent on all campuses, but varied considerably from school to school. Data suggest that contraband Native cigarettes account for as little as 1 % to as much as 38 % of the total cigarette consumption at a particular school. The highest proportion of contraband was found on campuses in the Northern part of the province. Consumption of Native contraband was generally higher on colleges compared to universities. The presence of contraband tobacco on all campuses suggests that strategies to reduce smoking among young adults must respond to this cohort's use of these products

Predictive Value of Biomarkers for Normal and Pathological Ageing in a Rat Model

Sub-optimal diets are widely known to be associated with disease. This study investigated two questions: first, whether a Western affluent diet affects long-term health in the rat, and second, whether, and to what extent, early changes in blood biomarkers can predict specific pathologies. A rat model was used in which animals were fed from weaning either a control diet or a high fat, low protein, energy dense Western affluent diet. Rats were harvested at either 12 or 18 months, and at these time points blood samples were taken and various clinical biomarkers measured using a hospital analyser or by ELISA. Predictive biomarkers should show small changes at early time points and larger changes at later time-points, and be associated with disease(s). Tissues were examined for overt pathology, and data were mined to establish links between pathologies and specific blood markers that might be used predictively. Results showed that the Western affluent diet is associated with ill-health, with a relative risk of developing disease 4.5 times higher than for the control diet. Furthermore we conclude that triacylglycerol, HDL cholesterol, the ratio of total cholesterol to HDL cholesterol, creatinine and alanine aminotransferase were good predictors of disease as across the cohorts they showed altered levels before the clinical development of pathologies, in agreement with our hypothesis

Prevalence of Bovine Aortic Arch Variant in Patients with Aortic Dissection and its Implications in the Outcome of Patients with Acute Type B Aortic Dissection

Objective/Background: To investigate the prevalence of bovine arch (BA) among patients with type A and B aortic dissection, and to provide insight into the implication of this variation on the outcome of patients with acute or subacute type B aortic dissection (a/sTBAD). Methods: This retrospective cohort analysis includes patients with a/sTBAD admitted between January 2006 and December 2016. Computed tomographic angiograms (CTAs) of patients referred because of type A aortic dissection were also re-evaluated with regard to the presence of BA. As a control group, 110 oncological patients who had undergone a chest CTA for disease staging during the study period were enrolled. A total of 154 patients with a/sTBAD and 168 with type A aortic dissection were identified during the study period. Results: An overall prevalence of 17.6% for BA variants was revealed. The comparison between patients with aortic dissection and the control group showed no statistically significant difference in BA prevalence (17.7% vs. 17.3%; p = 1.0). No statistically significant difference in BA prevalence was observed when comparing patients with type A aortic dissection with those with type B aortic dissection (16.6% vs. 18.8%; p = .66). During a median follow-up period of 27.8 months, 30 patients died. The mortality rate among patients presenting a BA variant was 34.5%, whereas among patients without, it was 16.0% (p = .04). Multivariate analysis revealed the presence of a BA as an independent predictor of mortality (adjusted odds ratio 3.4, 95% confidence interval 1.2-9.8). Conclusion: The BA should be considered as a predictor of the outcome for patients with type B aortic dissection. (C) 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved