Psychosocial stress and coping in smokers who relapse or quit.

Selected responses and coping skills in 23 male and 21 female adult smokers and ex-smokers were evaluated in 4 situational contexts: general social competence, smoking-specific high-risk-for-relapse situations, social anxiety, and relaxation. Results show that quitters coped better than relapsers with intrapersonal (e.g., negative mood) smoking-specific situations. Quitters had lower heart rates than relapsers during relaxation and intrapersonal situations and had lower anxiety scores at the end of the procedures. Women showed more stress and less confidence in their ability to cope than men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Desire and efforts to quit smoking among cigarette smokers in Wisconsin

This research studied the desire and attempts of cigarette smokers in Wisconsin to quit smoking. Data were based on the 1993 Wisconsin Division of Health's Behavioral Risk Factor Surveillance System (BRFSS). Among the 23% of respondents who were current smokers, 79% said they wanted to quit smoking and 60% said they had quit smoking for a day or more in the preceding year. High rates of wanting to quit and having tried to quit were found in all demographic subgroups of smokers studied. Compared to lighter smokers, heavy cigarette smokers (20 or more cigarettes per day) were less likely to have tried quitting in the past year, but were almost as likely to want to quit. These results demonstrate the great demand for smoking cessation services among smokers in Wisconsin and support for efforts to increase the use and effectiveness of these interventions.     

Debunking myths about self-quitting: Evidence from 10 prospective studies of persons who attempt to quit smoking by themselves.

This article examines data from 10 long-term prospective studies (N?>?5,000) in relation to key issues about the self-quitting of smoking, especially those discussed by S. Schachter (see PA, Vols 58:7407 and 68:10809). When a single attempt to quit was evaluated, self-quitters' success rates were no better than those reported for formal treatment programs. Light smokers (20 or less cigarettes per day) were 2.2 times more likely to quit than heavy smokers. The cyclical nature of quitting was also examined. There was a moderate rate (mdn?=?2.7%) of long-term quitting initiated after the early months (expected quitting window) of these studies, but also a high rate (mdn?=?24%) of relapsing for persons abstinent for six months. The number of previous unsuccessful quit attempts was unrelated to success in quitting. Finally, there were few occasional smokers (slips) among successful long-term quitters. We argue that quitting smoking is a dynamic process, not a discrete event. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anxiety sensitivity and panic reactivity to bodily sensations: Relation to quit-day (acute) nicotine withdrawal symptom severity among daily smokers making a self-guided quit attempt.

The current investigation explored the main and interactive effects of panic attacks in response to laboratory-induced bodily sensations and anxiety sensitivity in predicting acute nicotine withdrawal symptoms among daily smokers making a self-guided quit attempt. Participants were 99 daily smokers (58% women; Mage = 28.4 years, SD = 11.7) who completed a battery of questionnaires, a voluntary hyperventilation challenge, and a measure of nicotine withdrawal symptoms 12 hr after making a self-guided quit attempt. Results indicated that the interaction of anxiety sensitivity and panic responsivity to the challenge predicted quit-day nicotine withdrawal symptom severity above and beyond the main effects (p     

Symptoms of depression and survival experience among three samples of smokers trying to quit.

Symptoms of depression have been associated with increased smoking prevalence and failure to quit smoking in several cross-sectional and population-based studies. Few studies, however, have prospectively examined the ability of current symptoms of depression to predict failure to quit smoking in treatment-motivated smokers. Pretreatment depressed mood was assessed by 3 different methods in 3 separate samples, 2 of which comprised smokers receiving combined pharmacological and behavioral treatments and a 3rd in which smokers received self-help materials only. In all studies, time in days from quit day until the 1st cigarette was ascertained to document survival. Survival analyses showed that in all 3 studies survival time was significantly and negatively related to measures of even very low levels of pretreatment depressed mood. Results were replicated across 3 independent samples and were robust and uniformly clear, indicating that low levels of depressive symptoms assessed at baseline predict time to 1st cigarette smoked after attempted quitting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Debunking myths about self-quitting: Evidence from 10 prospective studies of persons who attempt to quit smoking by themselves": Reply.

Replies to the comments of S. Cohen et al (see record 1990-05833-001) concerning S. Schachter's (see record 1982-30809-001) study on smoking cessation. Schachter agrees that Cohen's data are evidence that self-selected, hard-core smokers are indeed hard-core smokers, but questions what this has to do with self-quitting over time in the general population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depressive symptoms and readiness to quit smoking among cigarette smokers in outpatient alcohol treatment.

The authors examined whether length of alcohol abstinence and depressive symptoms were related to motivational readiness to consider smoking cessation among patients in alcohol treatment. Participants were adults (N = 253) enrolled in a smoking cessation trial. Controlling for gender, depressive symptoms, and nicotine dependence, hierarchical regression analysis of readiness scores revealed a significant interaction of days since last drink and depressive symptoms. It was found that a greater number of days since last drink was associated with greater readiness, but only among patients with low scores on the Center for Epidemiologic Studies Depression Scale (L. S. Radloff, 1977). The findings suggest that alcoholic smokers with low depressive symptoms are more receptive to quitting smoking after sustained alcohol abstinence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping hospitalized smokers quit: New directions for treatment and research.

To date, relatively little work has been done to develop or evaluate effective inpatient quit-smoking treatment programs. However, there is growing interest in programs that motivate and assist the hospitalized smoker to quit smoking and remain abstinent. This article represents the rationale for hospital-based smoking treatment programs and introduces a practical minimal-contact treatment model based on extensive studies of primary-care-based and self-help interventions, on a limited number of inpatient studies, and on several prominent theories of health behavior change. Recent controlled and exploratory studies of inpatient interventions are reviewed, including programs for the general medical population and programs for special patient groups such as patients hospitalized for cardiovascular disease, pulmonary disease, cancer, and drug or alcohol dependency. Major findings are summarized, and recommendations are given for future treatment and research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tailoring information to enhance quitting in smokers with low motivation to quit: three basic efficacy questions

Penclomedine is a multi-chlorinated alpha-picoline derivative that has demonstrated activity in several murine breast cancer models and is currently in clinical testing for use against solid tumors. This study evaluates the metabolism of penclomedine in several in vitro hepatic models, including microsomes, fresh liver slices, and the isolated perfused rat liver (IPRL). Both human and mouse liver slices as well as human and mouse liver microsomes under aerobic conditions resulted in limited metabolism of penclomedine to several oxidized metabolites, including penclomic acid, 4-demethylpenclomic acid, and 4-demethylpenclomedine. Microsomes under anaerobic conditions vigorously produced mainly reduced metabolites, primarily penclomedine dimers. This is in contrast to in vivo data, which showed rapid metabolism of penclomedine to primarily 4-demethylpenclomedine. The IPRL preparation, however, metabolized 50 microM penclomedine 90% within 90 min, producing primarily 4-demethylpenclomedine and penclomic acid. These were formed in roughly equimolar amounts and did not undergo significant further metabolism over 4 hr. Numerous highly polar biliary metabolites were also found. The IPRL preparation thus seems to most accurately reflect the in vivo situation.     

Truth and investment: Lies are told to those who care.

Participants discussed paintings they liked and disliked with artists who were or were not personally invested in them. Participants were urged to be honest or polite or were given no special instructions. There were no conditions under which the artists received totally honest feedback about the paintings they cared about. As predicted by the defensibility postulate, participants stonewalled, amassed misleading evidence, and conveyed positive evaluations by implication. They also told some outright lies. But the participants also communicated clearly their relative degrees of liking for the different special paintings. The results provide new answers to the question of why beliefs about other people's appraisals do not always correspond well with their actual appraisals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acute impact of the September 11 tragedy on smoking and early relapse rates among smokers attempting to quit.

The September 11, 2001, terrorist attacks on the United States had widespread behavioral and emotional impacts. At the time of the terrorist attacks, 462 smokers from the Washington, DC, area had been entered into a study comparing scheduled versus ad lib dosing regimens for nicotine inhalers. Mean smoking rates the week following September 11 were only slightly higher than mean smoking rates the week prior to September 11. Increases in smoking rates following the terrorist attacks, however, were significantly associated with scores on the Impact of Events Scale-Revised (Pearson's r = .25, p = .01). Although the terrorist attacks were associated with acute increases in smoking and early relapse rates, the effect was relatively small and modestly associated with retrospective reports of the event's emotional impact. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship among alcohol use, depression, smoking behavior, and motivation to quit smoking with hospitalized smokers.

Relationships among depression, alcohol use, and motivation to quit smoking were examined in a sample of 350 hospitalized smokers. Multivariate multiple regression and logistic regression analyses indicated that participants with depressed mood were more likely to have a history of problematic drinking. Participants with depressed mood and a history of problematic drinking were more likely to be nicotine dependent and anticipated greater difficulty refraining from smoking while hospitalized. Alcohol use in heavier amounts was associated with a decreased concern with negative aspects of smoking, whereas history of depression was associated with increased concern in that area. Finally, current drinking was associated with increased confidence in quitting in 1 month whereas depressed mood was associated with decreased confidence in quitting. Overall, depression and alcohol use had stronger associations with smoking-related variables than with smoking cessation motivation variables. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characteristics of underserved women who did and those who did not use a free/low-cost voucher as part of a mammography screening program

The effects of pneumoperitoneum on peak venous flow velocity in the common femoral vein and the vena cava have already been studied. The results suggested that venous stasis occurs during surgical pneumoperitoneum. This study determines the effects of pneumoperitoneum on the overall venous outflow resistance of the lower limbs. Venous outflow resistance was measured during surgical procedures by impedance plethysmography in 12 patients undergoing laparoscopic cholecystectomy, 4 patients undergoing laparoscopic herniorrhaphy, 4 patients undergoing conventional cholecystectomy, and 2 patients undergoing conventional herniorrhaphy. Venous outflow resistance did not change significantly during laparoscopic cholecystectomy or herniorrhaphy. No difference in venous outflow resistance between laparoscopic cholecystectomy and herniorrhaphy was found. During pneumoperitoneum, no obstruction to total lower limb venous outflow could be demonstrated, indicating that venous stasis in the limbs did not occur, and consequently, flow in the iliac and inferior caval veins was not compromised. Hypothetically, active vasodilatation resulting from mild compression may explain this. In our view, no special measures to prevent deep venous thrombosis have to be taken during laparoscopic procedures.     

Reaching out to the families of those who serve: The SOFAR project.

Families of those in the U.S. Army Reserves represent a population at risk for mental health problems. Strategic Outreach to Families of All Reservists (SOFAR) is a pro bono outreach program serving families with soldiers deployed in Afghanistan, Iraq, and Kuwait. Program components include prevention, intervention, and the production of educational materials. SOFAR negotiated with the reserves (a hierarchical system wary of mental health), recruited pro bono therapists, and oriented them to the needs of reservists' families. During the pilot phase, SOFAR participated in support services, direct services, and psychoeducation. The project is a pilot for a national program. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Bicentennial address: Benjamin Rush and those who came after him

In this Bicentennial year, the author takes a look at the early days of Amercan psychiatry, focusing on some of the great men who helped to form the discipline. These men have much to teach us in a time when the field is divided within and faces a crisis of public confidence without. We can learn much from men like Benjamin Rush, who although they were actively involved in the social movements of their day, remained always the physician. Dr. Braceland suggests that it is time for psychiatry to move back into the mainstream of medicine, retaining, of course, mastery of psychotherpeutic techniques and knowledge of psychodynamics. This move can best be accomplished by employing the principle of complementarity, the art of encompassing different approaches to problems and utilizing the essentials of each to arrive at workable solutions.     

Diffuse hair loss in women: the psychopathology of those who complain

Thirty-two women complaining of diffuse alopecia were examined by a psychiatrist. Seven of them were found to have severe, usually long-standing marital and sexual problems and two of them were overtly depressed. In a previous investigation the results of tests to assess the degree of hair loss of these seven women showed no significant difference from the values obtained in a control series of women. The psychopathology underlying this complaint is discussed and it is suggested that those women whose anxiety seems disproportionate to their degree of hair loss should be carefully questioned regarding depression and marital difficulties as these may cause them to be unusually sensitive to a hair loss which normally might not worry them sufficiently to seek further advice. They may then use their hair in a symbolic way to obtain help with their underlying problems.     

Adolescents who attempt suicide: A retrospective clinical chart review of hospitalized patients.

In a review of pediatric hospital admissions over 4 years, we identified 173 adolescents who had attempted suicide. Of these individuals, 104 (60.1%) were female and 69 (39.9%) were male. The age range was 10–20 years, with approximately 60% of the population being 17–20 years old. The three characteristics most often exhibited by an adolescent in the year prior to the attempt were alcohol use, drug use, and rebellion toward authority. Only 10% of the attempters were reported to have come from a harmonious family. Depression, impulsivity, and anger were the most predominant personality characteristics reported. The suicide attempts were usually precipitated by conflicts with a significant person, either a parent or a boy- or girlfriend, and were accomplished by drug overdose. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Teenage smoking, attempts to quit, and school performance

OBJECTIVES: This study examined the relationship between school performance, smoking, and quitting attempts among teenagers. METHODS: A logistic regression model was used to predict the probability of being a current smoker or a former smoker. Data were derived from the 1990 California Youth Tobacco Survey. RESULTS: Students' school performance was a key factor in predicting smoking and quitting attempts when other sociodemographic and family income factors were controlled. CONCLUSIONS: Developing academic or remedial classes designed to improve students' school performance may lead to a reduction in smoking rates among teenagers while simultaneously providing a human capital investment in their futures.