Role of cadherins in the transendothelial migration of melanoma cells in culture

This study examines the nature and extent of the relationship between stress levels and intentions to participate in a worksite smoking cessation program among male current smokers (n = 220) employed in an automobile manufacturing plant. A plantwide survey was conducted which measured job stress, nonjob stress, smoking behavior, and intent to participate. The results of polychotomous logistic regressions suggest that among the current smokers in this plant, job and nonjob stress were positively associated with workers' intentions to participate in a worksite smoking cessation program. Thus, contrary to the popular notion that stress diminishes the motivation to quit, employees under high levels of stress may be most receptive to educational interventions intended to persuade smokers to commit to quitting.     

Worksite characteristics and changes in worksite tobacco-control initiatives. Results from the COMMIT study

Few studies have prospectively examined the characteristics associated with worksite adoption of tobacco-control initiatives. Data were collected as part of the Community Intervention Trial (COMMIT) for Smoking Cessation, which conducted interventions in 11 communities. This smoking cessation intervention was based on community organization principles and delivered through multiple community channels, including worksites, health care providers, the media, and cessation resources. This article reports results from telephone interviews of intervention community worksites having 50 or more employees, conducted at baseline and the end of the intervention period. Among worksites that responded to both baseline and final surveys, 83% had not adopted a smoke-free policy at baseline, and 61% did not offer any cessation aid or quitting resources at baseline. By the final survey, 34% of those with no smoking ban at baseline had become smoke-free, and 36% of those offering no cessation assistance at baseline were offering cessation resources at the follow-up. The prevalence of policy adoption was higher among worksites employing more female employees and offering other health-promotion activities; manufacturing businesses were significantly less likely than businesses other than service and wholesale/retail businesses to adopt policies. Adoption of cessation programs was significantly more likely among worksites employing 100 to 249 workers, compared with those employing 50 to 99 workers; those predominantly employing men; those offering other types of health-promotion activities; and those with a higher rate of turnover. These results provide important information about the characteristics of worksites likely to engage in tobacco-control efforts. Health educators and others may choose to target those worksites most ready for adoption of tobacco control policies and programs, as indicated by these findings.     

Factors associated with participation, attrition, and outcome in a smoking cessation program at the workplace.

Of 66 24–58 yr old smokers in 2 worksites, 67% participated in a smoking cessation program. 55% completed the program. Of those, 29% had quit smoking by posttest, and 17% were abstinent at the 6-mo follow-up. Different variables predicted participation, attrition, and outcome. Significant predictors of smokers who participated were length of cessation in previous abstinence attempts, number of years they smoked, and belief regarding personal vulnerability in contracting a smoking-related disease. Levels of pretest carbon monoxide and attitudes regarding adoption of smoking restrictions in the worksite predicted attrition. Posttest cessation was related to nicotine levels of cigarette brand smoked at pretest and pretest beliefs regarding postcessation weight gain. Abstinence at the 6-mo follow-up was predicted by number of co-workers who smoked and pretest concerns related to postcessation weight gain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of a smoking cessation program for hospital patients

BACKGROUND: Hospitalization may be an opportune time to change smoking behavior because it requires smokers to abstain from tobacco at the same time that illness can motivate them to quit. A hospital-based intervention may promote smoking cessation after discharge. METHODS: We tested the efficacy of a brief bedside smoking counseling program in a randomized controlled trial at Massachusetts General Hospital, Boston. The 650 adult smokers admitted to the medical and surgical services were randomly assigned to receive usual care or a hospital-based smoking intervention consisting of (1) a 15-minute bedside counseling session, (2) written self-help material, (3) a chart prompt reminding physicians to advise smoking cessation, and (4) up to 3 weekly counseling telephone calls after discharge. Smoking status was assessed 1 and 6 months after hospital discharge by self-report and validated at 6 months by measurement of saliva cotinine levels. RESULTS: One month after discharge, more intervention than control patients were not smoking (28.9% vs 18.9%; P=.003). The effect persisted after multiple logistic regression analyses adjusted for baseline group differences, length of stay, postdischarge smoking treatment, and hospital readmission (adjusted odds ratio, 2.19; 95% confidence interval, 1.34-3.57). At 6 months, the intervention and control groups did not differ in smoking cessation rate by self-report (17.3% vs 14.0%; P=.26) or biochemical validation (8.1% vs 8.7%; P=.72), although the program appeared to be effective among the 167 patients who had not previously tried to quit smoking (15.3% vs 3.7%; P=.01). CONCLUSIONS: A low-intensity, hospital-based smoking cessation program increased smoking cessation rates for 1 month after discharge but did not lead to long-term tobacco abstinence. A longer period of telephone contact after discharge might build on this initial success to produce permanent smoking cessation among hospitalized smokers.     

Relationship between grade and stage of renal pelvic and/or ureteral tumor and associated bladder tumor

The use of proxy respondents in surveys designed to provide population estimates of smoking prevalence offers an inexpensive way to obtain these data. The accuracy of this information is examined in analyzing data from tobacco use surveys of adults conducted in 22 North American communities as part of the National Cancer Institute's Community Intervention Trial for Smoking Cessation. Proxy-reported smoking status was obtained in a cross-sectional telephone survey conducted from August 1993 to January 1994 (n = 99,682). Self-reported smoking status was obtained from an in-depth interview of a sample of the respondents aged 25-64 years enumerated from the telephone survey (n = 31,417). Discrepancy rates were calculated by comparing the proxy-reported and self-reported smoking statuses of a given individual (n = 10,226). In both surveys, respondents were categorized as current smokers (those who currently smoke and have smoked at least 100 cigarettes in their lifetime), recent quitters (< or = 8 years since cessation), long-term quitters (> 8 years since cessation), and never smokers. The overall discrepancy rate between the self-report and the proxy report was 5.4%. Self-respondents who were black, Hispanic, Asian, recent quitters, or aged 25-34 years were more likely to have inconsistent proxy reports. The authors estimate that the screener interview underestimated the true smoking prevalence by 0.1% when they corrected for smoking status discrepancies. These results confirm that proxy-reported smoking status is an accurate and effective means to monitor populationwide smoking prevalence of adults.     

Clinical and histological features of poor prognosis in cutaneous metastatic melanomas

OBJECTIVES: To describe the type and location of smokers on the grounds of smoke-free public hospitals and to observe the impact of introducing smoke-free signs in outdoor areas of the hospital grounds. DESIGN: Observation study of outdoor smoking behaviour before and after the introduction of outdoor smoke-free signs at one hospital (H1) and at the same two time periods at a nearby control hospital (H2), which already had some outdoor smoke-free signs at Time 1. SETTING: The John Hunter Hospital (H1) in Newcastle, Australia and a nearby control hospital, Maitland Hospital (H2) in 1991. SUBJECTS: All people in defined outdoor sites of the two hospitals on seven randomly selected days over two weeks before and after the policy change were coded as either "smoker" or "non-smoker" and as either "staff", "patient", or "visitor". The number of smokers observed in each site was measured as a proportion of all smokers observed on the grounds of that hospital. INTERVENTION: Introduction of outdoor smoke-free zones and signs at H1. RESULTS: Less than 10% of observed outdoor smokers in both hospitals were patients, 40% were visitors, and more than 50% were staff. Of outdoor smokers, 82% were observed less than 10 m from entrances to the hospital building at time 1. After the introduction of signs in H1, a 4-percentage point decrease (P < 0.05) occurred in the percentage of smokers observed in smoke-free zones at time 2 (from 32% to 28%), compared with a 2-percentage point decrease (P > 0.05 at time 2 in H2 (from 48% to 46%). DISCUSSION: This observation study of smoking behaviour in hospital grounds highlights the need to reduce smoking among staff and visitors near hospital entrances. Specific strategies are discussed, which are likely to enhance compliance and hence enable the effective introduction of smoke-free policies on hospital grounds.     

Adenocarcinoma arising in "J" pouch after total proctocolectomy for familial polyposis coli

Cigarette smoking has a major impact both on oral health and general systemic health. Because up to 70 percent of smokers see their dentists each year, the dentist is in a very powerful position to intervene with the smokers to help them stop smoking. I have suggested a four-step program for assisting patients to quit, based on the National Cancer Institute's suggested protocol for the dental office, which uses techniques shown in clinical trials to be effective for helping smokers quit. The core of the NCI program involves identifying smokers, advising them to quit, providing assistance to patients trying to quit, and following-up on patients as a means of enhancing success rates. Dentists who implement an effective smoking cessation program in their practices can expect to achieve quit rates up to 10 to 15 percent each year among their patients who smoke. Such a rate of success, if established nationwide and continued over a period of years, would markedly reduce the prevalence of smoking in the United States.     

Concurrent brief versus intensive smoking intervention during alcohol dependence treatment.

Alcohol dependent smokers (N=118) enrolled in an intensive outpatient substance abuse treatment program were randomized to a concurrent brief or intensive smoking cessation intervention. Brief treatment consisted of a 15-min counseling session with 5 min of follow-up. Intensive intervention consisted of three 1-hr counseling sessions plus 8 weeks of nicotine patch therapy. The cigarette abstinence rate, verified by breath carbon monoxide, was significantly higher for the intensive treatment group (27.5%) versus the rate for the brief treatment group (6.6%) at 1 month after the quit date but not at 6 months, when abstinence rates fell to 9.1% for the intensive treatment group and 2.1% for the brief treatment group. Smoking treatment assignment did not significantly impact alcohol outcomes. Although intensive smoking treatment was associated with higher rates of short-term tobacco abstinence, other, perhaps more intensive, smoking interventions are needed to produce lasting smoking cessation in alcohol dependent smokers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of growth factors on matrix synthesis by human nasal chondrocytes cultured in monolayer and in agar

OBJECTIVES: In this paper we describe the proportion of US adults who report receiving oral cancer screening and tobacco cessation counseling and assistance from dentists and other health professionals. METHODS: Data from the 1992 National Health Interview Survey (NHIS) Cancer Control Supplement, a nationally representative sample of 12,035 adults 18 years of age and older, are analyzed. RESULTS: In 1992, less than 10 percent of adults reported oral cancer screening by a dentist or hygienist within the past three years. White adults (10.1%, 95% CI = 9.3, 10.9) reported an oral cancer screening three times more frequently than black (3.2%, 95% CI = 1.9, 4.5) or Hispanic (3.4%, 95% CI = 2.1, 4.7) adults. About half of adult current smokers had seen a dentist within 12 months, and of those only 24.1 percent (95% CI = 21.7, 26.5) had been advised to quit smoking. Heavy smokers (two or more packs a day) were more likely to have been advised to quit than light (pack or less per day) or occasional smokers. A similar proportion (24.3%, 95% CI = 17.6, 31.0) of white adult men who reported using smokeless tobacco products had been told by a dentist to quit using tobacco. CONCLUSIONS: Results from this population-based survey indicate that cancer screening and tobacco cessation advice are underutilized in the dental practice. Increased patient awareness and implementation of screening and tobacco cessation interventions could improve oral cancer incidence and mortality and have a public health benefit for other tobacco-related morbidity and mortality as well.     

Do daily interactive voice response reports of smoking behavior correspond with retrospective reports?

This study focuses on comparing reports of cigarette consumption using an interactive voice response (IVR) system and the timeline follow-back (TLFB) method. As part of a smoking cessation trial, daily reports of cigarette use were collected using an IVR system and TLFB for 7 days after participants attempted to quit smoking. Reports of cigarette consumption were assessed for the entire sample (N = 381) and for the subset of nonabstinent participants (n = 129 smokers). The results revealed high correlations between reports of smoking behavior, as assessed by IVR and TLFB. Compliance with the TLFB was superior to compliance with the IVR system. This problem should be addressed if researchers wish to use an IVR system in future smoking cessation clinical trials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Work-site smoking policies: their population impact in Washington State

This article presents data from a population-based, random-digit dialing telephone survey of 1228 employed adults in Washington State, conducted 1989 through 1990. Eighty-one percent of men and 91% of women reported work-site smoking restrictions. Employees in work sites with no-smoking policies were less likely to be current smokers; men in work sites with policies restricting smoking smoked fewer cigarettes on both workdays and nonworkdays. Forty-eight percent of male and 53% of female smokers reported reduced smoking as a result of work-site policy. Work-site smoking policies, intended to protect against smoke exposure, may also reduce employee smoking.     

A community view of smoking cessation counseling in the practices of physicians and dentists

The practice norms of community physicians and dentists in the Lehigh Valley of Pennsylvania for counseling about smoking cessation were surveyed. In addition, 1,373 residents in the valley were interviewed by telephone about the smoking counseling behaviors of their dentists and physicians. These activities were conducted as part of the planning for an intervention by the Coalition for a Smoke-Free Valley, a coalition of 100 persons and organizations in the area. The survey response rate for 172 physicians was 77 percent, and for 103 dentists, it was 76 percent. More physicians than dentists advised patients to quit, counseled patients, provided materials, and helped the patient to set a quit date. However, there was a clear discrepancy between what physicians say they do and what smokers say they hear.     

Moderate intensity exercise as an adjunct to standard smoking cessation treatment for women: A pilot study.

Previous randomized controlled trials have not supported moderate intensity exercise as an efficacious adjunct to smoking cessation treatments for women; however, compliance with exercise programs in these studies has been poor. The purpose of this pilot study was to estimate the effects of moderate intensity exercise on smoking cessation outcomes under optimal conditions for exercise program compliance. Sixty previously sedentary, healthy, female smokers were randomized to an 8-week program consisting of brief baseline smoking cessation counseling and the nicotine patch plus either 150 min/week of moderate intensity exercise or contact control. Participants attended a median of 86.4% and 95.5% of prescribed exercise/control sessions, respectively. There was a moderate, though statistically nonsignificant, effect of exercise at post-treatment for objectively verified 7-day point prevalence abstinence (48.3% vs. 23.3%; OR = 3.07, 95% CI: 0.89–11.07) and prolonged abstinence (34.5% vs. 20.0%; OR = 2.11, 95% CI: 0.56–8.32). Effects were attenuated when controlling for potential confounders, and after a 1-month, no-treatment period. The findings provide a preliminary indication that, given adequate compliance, moderate intensity exercise may enhance short-term smoking cessation outcomes for women; however, a larger trial is warranted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Autoradiographic evidence that quinuclidinyl 4-(bromophenyl)-2-thienylglycolate (QBPTG) displays in vivo selectivity for the muscarinic m2 subtype

OBJECTIVE: To assess the effect of expanding the vital signs to include smoking status. DESIGN: We prospectively conducted exit interviews with patients at a general internal medicine clinic in Madison, Wisconsin, during a 16-month period from 1991 to 1993. METHODS: Patients were surveyed briefly before (N = 870) and after (N = 994) the implementation of a simple institutional change in clinical practice. This change involved training the staff in how to use progress notepaper with a vital sign stamp that included smoking status (current, former, or never) along with the traditional vital signs. Included in the survey were questions about whether the patient smoked, whether the patient was asked that day about smoking status (by a clinician or other staff), and, for smokers, whether they were urged to quit smoking and given specific advice on how to do so. RESULTS: After expansion of the vital signs, patients were much more likely to report inquiries about their smoking status on the day of a clinic visit (an increase from approximately 58% at baseline to 81% at intervention; P < 0.0001). The vital sign intervention was associated with significant increases in the percentage of smokers who reported that their clinician advised them that day to quit smoking (from approximately 49% at baseline to 70% during the intervention; P < 0.01) and in the percentage who reported that their clinician gave them specific advice that day on how to stop smoking (from approximately 24% at baseline to 43% during the intervention; P < 0.01). CONCLUSION: Expanding the vital signs to include smoking status was associated with a dramatic increase in the rate of identifying patients who smoke and of intervening to encourage and assist with smoking cessation. This simple, low-cost intervention may effectively prompt clinicians to inquire about use of tobacco and offer recommendations to smokers.     

Smoking-specific weight gain concerns and smoking cessation in a working population.

Smoking cessation rates, progression in stage of change for smoking cessation, and serious quit attempts were examined over 2 years in a cohort of 242 men and women smokers (mean age 39.7 years, mean body mass index [BMI] 26.3) as a function of expressing concern about gaining weight because of quitting smoking. Participants were employees of 25 companies who were in a worksite health promotion program aimed at reducing risk factors for cardiovascular disease. Multivariate odds ratios (controlled for age, education, job class, sex, and BMI) for quitting smoking, attempting to quit smoking, and progressing in stage of change for smoking cessation as a function of weight concern were not significant. Interactions between sex and weight concern, and BMI and weight concern were also not significant. These findings, in a working, predominantly blue-collar population, and those of other studies, suggest that concern about gaining weight is, at best, a weak predictor of change in smoking behavior among most smokers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is weight gain after smoking cessation inevitable?

Weight gain after smoking cessation was studied in a naturalistic setting where (1) all smokers quit and (2) risk factors for postcessation weight gain were modified. Participants were 332 military recruits (227 men, 105 women), 86 of whom were smokers who quit during 6 weeks of basic training. Results showed no significant weight changes for smokers who quit. Pretest smoking rates and feat of weight gain were unrelated to changes in weight. Results suggest that an intensive program that limits access to alcohol and foods that are high in fat and that increases physical activity can attenuate weight gain after smoking cessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Notes on the intermediary form of incontinentia pigmenti

In a survey of a representative sample of 900 persons in Switzerland (excluding the Italian speaking parts comprising some 4-5 percent of the population), the smoking habits of the adult population were studied. Smokers were defined as persons smoking at least one cigarette or an equivalent weight of pipe tobacco or cigars per day. 51.8% of men and 29.0% of women over age 15 are smokers. Among male smokers of cigarettes only (42% of all men), over three quarters (77.6%) smoke ten cigarettes or more per day, i.e., a quantity found harmful to health; over one half (55.8%) smoke twenty or more cigarettes per day. Half of all female smokers smoke ten or more cigarettes, more than one in every four female smokers (28.8%) smoke twenty or more cigarettes per day. It is calculated that almost two thirds of all cigarettes sold in Switzerland are smoked by smokers of twenty or more cigarettes per day, and that almost three quarters are smoked by smokers of ten or more cigarettes. Among men, smoking habits are independent of social status, whereas among women, those with higher family incomes show more frequent smoking, but also more widespread cessation of smoking than with lower incomes. Thirty percent of adults having been smokers have given up the habit, so that among men and women above age 15, theree are now some 20% and 14% respectively, of ex-smokers. This corresponds to at least 700,000 former smokers in all of Switzerland. The trend to give up starts already in the group aged 15-24 (over 20% of men and women having ever smoked have given up) and becomes more marked with increasing age. A large part of male and female smokers would like to free themselves of the habit. 30% of male and 34% of female smokers indicate that they had tried seriously to stop smoking during the twelve months preceding the interview. Trying to give up was not significantly associated with intensity of smoking or social status. According to this survey, a majority of the population (57.6%) is in favor of reserving certain parts of restaurants to non-smokers, following the example of non-smokers-compartments in railway trains. In a situation where a non-smoker asks a co-worker in a closed room not to smoke, 78.3% take sides with the non-smoker, either by conceding to him a right to smoke-free air, or by demanding from the smoker to show consideration for the non-smoker. Only 10.9% demand from the non-smoker understanding for the smoker, or concede to the smoker a right to smoke at work. Women show more understanding for cause of the non-smoker than men. This difference is more marked among smokers and former smokers than among non-smokers. Inasmuch as the results of this study are comparable to those of earlier surveys conducted in Switzerland, ther is good agreement. The only exception is a significant increase of the proportion of former smokers in the past years.     

The health care costs of smoking

BACKGROUND: Although smoking cessation is desirable from a public health perspective, its consequences with respect to health care costs are still debated. Smokers have more disease than nonsmokers, but nonsmokers live longer and can incur more health costs at advanced ages. We analyzed health care costs for smokers and nonsmokers and estimated the economic consequences of smoking cessation. METHODS: We used three life tables to examine the effect of smoking on health care costs - one for a mixed population of smokers and nonsmokers, one for a population of smokers, and one for a population of nonsmokers. We also used a dynamic method to estimate the effects of smoking cessation on health care costs over time. RESULTS: Health care costs for smokers at a given age are as much as 40 percent higher than those for nonsmokers, but in a population in which no one smoked the costs would be 7 percent higher among men and 4 percent higher among women than the costs in the current mixed population of smokers and nonsmokers. If all smokers quit, health care costs would be lower at first, but after 15 years they would become higher than at present. In the long term, complete smoking cessation would produce a net increase in health care costs, but it could still be seen as economically favorable under reasonable assumptions of discount rate and evaluation period. CONCLUSIONS: If people stopped smoking, there would be a savings in health care costs, but only in the short term. Eventually, smoking cessation would lead to increased health care costs.     

Characteristics of patients adhering to a hospital's no-smoking policy

OBJECTIVES: The purpose of this paper is to examine the characteristics of smokers who adhere to a hospital smoking ban, compared to those who do not. DESIGN: The data presented in this paper are baseline and discharge survey data collected among hospitalized smokers. SETTING: This study was conducted in two teaching hospitals in a northeastern city. PATIENTS/PARTICIPANTS: The subjects were 358 smokers who participated in a larger smoking intervention trial. MAIN RESULTS: Seventy-six percent of the subjects reported adhering to the smoke-free policy during their hospital stay. In a multivariate model, demographic factors that predicted adherence included being older, having shorter length of stay, not reporting recreational drug use in the previous 12 months, and not having alcohol-related problems. Smoking history variables that predicted adherence included having had at least 24 h of abstinence in the 7 days prior to hospitalization; self-efficacy variables (e.g., confidence in ability to quit smoking in 1 month and less anticipated difficulty refraining from smoking during hospitalization) also predicted adherence. CONCLUSIONS: Understanding the factors that predict adherence to health care policies can provide useful information for health promotion interventions in a medical setting. The implications of these findings are discussed.     

Ebola virus inhibits induction of genes by double-stranded RNA in endothelial cells

This study explored the effects of a complete smoking ban in a large British teaching hospital on nurses' smoking behaviour and their attitudes and views on the current policy and compliance with it. Questionnaires were distributed to a convenience sample of nurse smokers and ex-smokers 9 months after the introduction of the smoking ban. A response rate of 64.7% (n = 33) was achieved. The reported reduction in work-time cigarette consumption following the ban was not statistically significant (Wilcoxon test: P = 0.069). No reduction outside work was recorded. Six (21.4%) smokers claimed that the ban had been a reason for them to try to give up smoking. Two of three ex-smokers reported that the ban had played a role in their giving up. The respondents showed considerable agreement with their health educator and role model function. Support for the policy was, however, very limited and compliance with it was reported to be poor among patients as well as staff. Twenty (76.9%) of current smokers indicated their wish to give up, 11 (39.3%) of them believed their own determination to be an effective way to achieve this. These results would seem to indicate that smoking policies currently have limited impact on smoking behaviour. It is suggested that in future policies should aim at strengthening nurses' determination to give up as well as secure their support for the restrictions in order to assist them in changing their smoking behaviour.