Changes in smoking behavior after a myocardial infarction.

Among 383 myocardial infarction (MI) patients, 230 (mean age 54.2 yrs) smoked at the time of the MI. 40.6% had resumed smoking 6 mo after the MI, whereas 49.4% smoked at a 3–5 yr follow-up. Resumption of smoking within 6 mo was associated with increased anxiety and depression during the 1st weeks after discharge, less cardiac health knowledge, and less severe MI. In Ss who relapsed later, resumption was associated with decline in general cardiac health knowledge and in correct understanding of smoking as a risk factor. Long-term changes in smoking status were related to previous heart disease, premorbid work instability, age, and severity of MI. Antismoking counseling of MI patients should not be limited to health risks associated with smoking, and training in coping with negative affect without smoking may be valuable in promoting smoking cessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hospital smoking bans and employee smoking behavior: Results of a national survey

OBJECTIVE: To examine the impact of workplace smoking bans on smoking behavior of employees. PARTICIPANTS: A total of 1469 current or former smokers (intervention group) employed in smoke-free hospitals and 920 current or former smokers (comparison group) employed in non-smoke-free workplaces were surveyed to determine smoking behavior. DESIGN: This cross-sectional study is part of a larger, ongoing prospective study. The study design was quasi-experimental. We randomly selected sites consisting of a hospital and a corresponding community. Furthermore, we randomly selected subjects from hospitals and their corresponding communities. MAIN OUTCOME MEASURES: Postban quit ratio and progression along the stages-of-change continuum. METHODS: The Cox proportional hazards model was used to compare the postban quit ratio between the intervention and comparison groups. The Cochran-Mantel-Haenszel analysis of variance statistic was used to compare groups on the stages-of-change variables. RESULTS: Beginning with the smoking ban and continuing for 5 years after implementation, statistically significant differences in the postban quit ratio were observed between employees of smoke-free hospitals who were smokers and counterparts in the community (P<.001). Despite preban differences in smoking intensity, the overall difference in postban quit ratios remained significant even after multivariate adjustment for socioeconomic, demographic, and smoking intensity variables. For those sites that were 5 years postban, the quit ratio was 0.506 in smoke-free workplaces compared with 0.377 in workplaces where smoking was permitted. In all but 1 category, the intervention group was further along the stages-of-change continuum toward quitting smoking than the comparison group (P<.001). CONCLUSION: American hospitals' experiences with smoking bans, which directly affect more than 5 million workers, should be examined by other industries as a method of improving employee health. Workplace smoking bans could also be effective in saving lives, reducing health care costs, addressing safety concerns, and decreasing operating and maintenance expenses of employers.     

Changes in food intake and activity after quitting smoking.

Quitting smoking often results in weight gain. The causes of the gain are not known. The present study evaluated changes in calories, total sugars, sucrose, fat, protein, and nonsugar carbohydrates as well as changes in activity levels after quitting smoking. Ninety-five subjects were randomly assigned to either early (Week 2) or late (Week 6) quit dates. Subjects were assessed on weight, food intake, activity levels, and smoking levels at baseline, at Weeks 4 and 8, and at Weeks 12 and 26 postquit. The results indicated significant increases in calories, sucrose, and fats 2 weeks after the quit date. Changes for total sugars were less consistent. Activity levels did not change significantly. Early caloric increases predicted weight gain at 26 weeks for abstinent women. No relation was found for abstinent men, but interpretation of this finding is weakened by a small subsample size. Abstinent subjects gained over 9 lbs by 26 weeks postquit. Despite this gain, Week 26 results showed that caloric intake for abstinent women was approximately equal to that observed at baseline, whereas that for abstinent men had dropped significantly. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care and the poor: Psychological implications of restrictive policies.

Describes a field experiment with 180 women (mean age 25.9 yrs) visiting an urban welfare office to examine the possible effects of 2 aspects of restrictive Medicaid policies: (a) the loss of choice of providers and (b) adverse patient mix (i.e., when the majority of a provider's clients are Medicaid beneficiaries). Results indicate that health care presented within the context of not having a choice was derogated and that choice and patient mix combined to influence intentions to seek care. Ss who did not choose the health plan in a simulated choice, who had fewer choices than expected, and who did not accept restricted choice also had negative perceptions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid smoking and self-control in the modification of smoking behavior.

Investigated the efficacy of combining rapid smoking aversion and training in self-control skills for maintaining nonsmoking. 50 habitual smokers (26 males, 24 females; mean age 33 yrs) were assigned to a 3-wk treatment program emphasizing rapid smoking plus self-control, rapid smoking plus filler discussion, normal-paced (placebo) smoking plus self-control, or the placebo smoking procedure plus filler discussion. At the 13-wk follow-up, the performance of the combined rapid smoking plus self-control program was not superior to rapid smoking plus discussion. In fact, Ss in the combined program performed worse (had a higher mean smoking rate and a smaller percentage of abstinence) at both treatment termination and follow-up. Self-control did improve performance in placebo smoking Ss. Differences associated with self-control were not statistically significant. Rapid smoking was found to be significantly more effective than the placebo smoking when data from non-married treatment pairs were considered. Possible explanations for the negative impact of self-control on rapid smoking are outlined. Locus of control scores and extended experimenter–S contact after termination were not related to treatment performance. (20 ref) (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.     

Family history of smoking and young adult smoking behavior.

Compared the smoking behavior and smoking-related beliefs of 816 young adult smokers who did and did not have a family history of cigarette smoking (FHS). Those with an FHS smoked more cigarettes in a typical day, smoked for more years, perceived themselves as more addicted to cigarettes, had more positive beliefs about the psychological consequences of smoking, and reported stronger pleasurable relaxation motives and stimulation motives for smoking compared with their peers who had no FHS. Thus, smokers with an FHS were more committed smokers and viewed smoking as having more positive psychological benefit than did their peers without an FHS. Such individual differences may be mediated through both social–environmental and genetically influenced mechanisms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of anticipated job loss on employee behavior.

Compared the behavior (i.e., productivity, absenteeism, and lateness) of 100 employees who knew that they were to be laid off or not laid off. No significant changes in the absenteeism, lateness, or production were found in either group during the 3-mo period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in energy balance following smoking cessation and resumption of smoking in women.

Caloric intake, resting metabolic rate (RMR), leisure-time physical activity, and sensitivity and preference for sweet taste were prospectively examined in 7 female smokers across 3 weeks during periods of normal smoking (Week 1), complete cessation (Week 2), and resumption of smoking (Week 3). Energy balance changed significantly across weeks, as caloric intake increased (largely as a result of alcohol consumption) and RMR decreased during cessation, followed by decreased caloric intake and increased RMR with resumption of smoking. Activity and taste sensitivity and preference remained unchanged. Smoking cessation may thus cause rapid change in energy balance, which is quickly reversed on resumption of smoking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social influence and selection effects in the context of smoking behavior: Changes during early and mid adolescence.

Objective: This article examined the contribution of selection and influence processes in smoking behavior similarity among friends, and changes in these processes during early and mid adolescence. Design: Data from 1886 Dutch high school students in the control group of the European Smoking prevention Framework Approach (ESFA) study were used. Changes in selection and influence were examined during three successive waves using structural equation modeling. Main Outcome Measures: Smoking behavior of adolescents, best friends, parents, and siblings. Results: Most support was found for selection of reciprocal (pwave1,2,3 wave1,2 wave3 = 0.25), although these effects decreased over time. Support for influence was only found among nonreciprocal (desired) friends during the last wave (pwave3 wave2 wave1,3 > 0.05) and siblings (pwave1,2 wave3 = 0.16), but influence diminished over time. Conclusion: Smoking-based selection processes decreased over time while the influence of friends increased. Smoking prevention programs should focus on the structure of peer environments besides promoting social influence skills. During early adolescence parents and siblings should be targeted, while during mid adolescence, the focus should shift toward the adolescents and their dynamic peer environment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality influences on change in smoking behavior.

Objective: To investigate associations between personality traits in early adulthood (and changes in them) and change in smoking status. Design: Prospective, longitudinal study of a general-population birth cohort. Main Outcome Measures: We measured smoking at ages 18, 26, and 32, and personality at ages 18 and 26 using the Multidimensional Personality Questionnaire (Tellegen & Waller, in press). We assessed personality’s ability to predict future smoking, and assessed how changes in personality traits relate to change in smoking status. Results: Higher aggression and alienation at age 18 predicted smoking at 26; higher self-control and traditionalism at age 18 predicted nonsmoking at 26; and higher alienation at age 26 predicted persistence of smoking to age 32. Personality change between 18 and 26 was associated with change in smoking behavior; those who stopped smoking decreased more than others in negative emotionality and increased more in constraint. Conclusion: These findings suggest that interventions fostering personality change may be effective in reducing smoking and indicate appropriate targets for such antismoking interventions in young people. In particular, high alienation predicted smoking persistence, perhaps due to resistance to existing antismoking messages; we discuss approaches that may overcome this. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is smoking automatic? Demands of smoking behavior on attentional resources.

The role of attention in the production of smoking behavior was investigated. Experienced and novice smokers were asked to perform a reaction time (RT) task under 4 conditions: while smoking (smoking), while mimicking all aspects of smoking except inhaling (pseudosmoking), while simply holding a cigarette (holding), and while not smoking (baseline). Experienced smokers' RTs increased during the pseudosmoking and holding conditions compared with baseline but did not differ between the smoking and baseline conditions, suggesting that attentional resources were not required for typical smoking behavior but were required to alter or inhibit smoking behavior. Novice smokers' RTs were slower during both the smoking and pseudosmoking conditions but not the holding condition, suggesting that novice smokers require the use of resources to smoke. Experiment 2 demonstrated that the differences in RT across conditions could not be explained by differences in urges. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A comparison of excessive and rapid smoking in the modification of chronic smoking behavior.

In a study of aversive control of smoking behavior, 27 females and 18 males (mean age, 30.9 yrs; mean yrs as a smoker, 13.1; mean baseline cigarettes/day, 31.6) were randomly assigned to rapid smoking, excessive smoking, or control conditions. Ss attended 6 treatment sessions over a 1-wk period. Prescribed smoking was carried on in both the laboratory and outside environment. A breath test measuring concentration of carbon monoxide in the bloodstream was used as a check on the reliability of self-reports. Overall, there was a statistically reliable treatment effect, according to measures of percentage reductions in smoking and Ss maintaining total abstinence. However, treatment effect had disappeared at 12-mo follow-up. Experimental and control groups showed considerable relapse independent of condition, with only 20% of Ss remaining abstinent. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Initiation of cigarette smoking: Is it related to parental smoking behavior?

Investigated 2 theories of parent-child smoking patterns: (a) that although there is a direct relationship between the cigarette smoking of parents and their teen-aged children, the observed influences are only transitory and do not endure to adulthood, and (b) the identification theory which predicts that a young adult's smoking behavior is directly related to his parents' smoking behavior. The smoking behavior and family stability of 251 undergraduates and their parents were studied. Results support the identification interpretation of the father-son smoking pattern, as father-son smoking behaviors were directly related in intact families. The variable of family intactness was a highly relevant moderator of the parent-son smoking pattern. The mother and daughter smoking patterns remained enigmatic. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Drinking and smoking behavior of hospitalized medical patients

In a sample of hospitalized medical patients, problem drinking was found to be associated with heavy smoking.     

Changes of smoking habits and cough in men smoking cigarettes with 30% NSM tobacco substitute

The effects of smoking cigarettes with 30% of the tobacco replaced by NSM tobacco substitute, which lowered their tar and nicotine delivery, were studied by comparing them with the effects of conventional cigarettes in a controlled crossover trial lasting 20 months. Chest symptoms, cigarette consumption, and forced expiratory volume in one second (FEV1) were measured each month. Two-hundred men began the trial and 159 completed it. The test cigarettes were acceptable to all but one of the men. In a subsample of 35 men estimates of nicotine intake were obtained from monthly analyses of cigarette stubs. On changing from NSM to control cigarettes six of the 17 men, who were accustomed to low nicotine, kept their nicotine intake down by some change in smoking habit. Before the crossover and this change in smoking habit the men smoking NSM cigarettes had a small but significant reduction of cough. Cigarettes containing 30% NSM and delivering only 1 mg of nicotine are likely to be acceptable to smokers and may reduce coughing. Further trials are needed to confirm these findings and establish what long-term effects such cigarettes may have on smokers' health.     

Effects of self-monitoring on normal smoking behavior.

16 Os unobtrusively monitored 16 undergraduates' smoking frequency and duration throughout base-rate, experimental, and return-to-base periods. In the experimental period, Ss self-monitored either their frequency of smoking or not smoking. Smoking frequency and duration were significantly affected by such self monitoring, indicating that self-monitoring is a reactive data-gathering procedure. (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interaction of temperamental resistance to control and restrictive parenting in the development of externalizing behavior.

Child temperament and parental control were studied as interacting predictors of behavior outcomes in 2 longitudinal samples. In Sample 1, data were ratings of resistant temperament and observed restrictive control in infancy-toddlerhood and ratings of externalizing behavior at ages 7 to 10 years; in Sample 2, data were retrospective ratings of temperament in infancy-toddlerhood, observed restrictive control at age 5 years, and ratings of externalizing behavior at ages 7 to 11 years. Resistance more strongly related to externalizing in low-restriction groups than in high-restriction groups. This was true in both samples and for both teacher- and mother-rated outcomes. Several Temperament?×? Environment interaction effects have been reported previously, but this is one of very few replicated effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations between personality and smoking behavior in preadult subjects.

Results from 562 high school and junior high school students cross-validated and extended the generality of earlier work with 1462 adults. In both studies, smoking status, on the basis of self-report information, and personality scores derived from peer ratings, showed smokers significantly (p     

Needs assessment and implementation of an employee assistance program: promoting a healthier work force

1. The functions of a continuous quality improvement tool used by Deming--the Plan, Do, Check, Act Cycle--can be applied to the assessment, implementation, and ongoing evaluation of an Employee Assistance Program (EAP). 2. Various methods are available to assess the need for an EAP. As much data as possible should be collected to qualify and quantify the need so that management can make an informed decision and develop measures to determine program effectiveness. 3. Once an EAP is implemented, it should be monitored continually against the effectiveness measures initially developed. Using a continuous quality improvement process, the occupational health nurse and the EAP provider can establish a dynamic relationship that allows for growth beyond the original design and increased effectiveness of service to employees.