Pathway to health: Cluster-randomized trail to increase fruit and vegetable consumption among smokers in public housing.

Objectives: Examine the effectiveness of an intervention to increase fruits and vegetables (FV) consumption among smokers. Design: Cluster-randomized trial of 20 public housing developments; 10 randomly assigned to an FV intervention and 10 to a smoking cessation intervention. Main outcome measures: Usual (past 7 days) and past 30 days change in daily FV intake at 8 weeks and 6 months postbaseline. Results: Greater increases were seen in the FV group. At Week 8 and Month 6, the FV group had consumed 1.58 (p = .001) and 0.78 (p = .04), respectively, more daily FV servings in the past 7 days than the cessation group. At the same time points, the FV group had consumed 3.61 (p = .01) and 3.93 (p = .01), respectively, more FV servings in the past 30 days than the cessation group. Completing more motivational interviewing sessions (p = .02) and trying more recipes (p = .02) led to significantly greater increases at Month 6 among FV participants. Conclusions: Motivational interviewing counseling and lifestyle modification through trying out healthy recipes may be effective in helping a high-risk population increase their FV intake. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting Youth Access to Tobacco: The Role of Youth Versus Store-Clerk Behavior and Issues of Ecological Validity.

Twenty-one 15- to 17-year-olds attempted to purchase cigarettes in 232 stores in the manner that confederates typically do in access studies, as well as in the manipulative ways (e.g., lying about their ages) that youth smokers do, thereby modeling youth access to tobacco within versus outside of studies, respectively. Youth typical-research versus manipulative behavior was contrasted with clerk behavior (requests for youth ID cards) to examine the relative contributions of both to youth access to tobacco for the 1st time. Results revealed that clerk behavior was the strongest predictor of cigarette sales to youth and hence underscore the need for interventions with merchants. Sales nonetheless were higher under youth-manipulative conditions and thereby highlight the low ecological validity of access research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Twelve-Week Outcomes From an Investigation of High-Dose Nicotine Patch Therapy for Heavy Smokers With a Past History of Alcohol Dependence.

This study reports findings from an investigation of the efficacy of high-dose nicotine patch (NP) therapy for heavy smokers with a past history of alcohol dependence. One hundred thirty participants were randomly assigned to 42 mg or 21 mg of transdermal nicotine for 4 weeks, followed by an 8-week dose titration. Follow-up assessments were conducted at 4 and 12 weeks. Differences between dose conditions were nonsignificant, although unexpectedly, outcomes favored participants in the 21-mg NP condition. Nicotine abstinence at follow-up was related to longer length of alcohol abstinence at time of enrollment. Future research should investigate ways to improve smoking quit rates in this population, including more frequent counseling sessions and/or other pharmacotherapies. These investigations should focus primarily on smokers in early alcohol recovery. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subjective responses to intravenous nicotine: Greater sensitivity in women than in men.

Although approximately 45% of smokers in the United States are women, the influence of sex on nicotine dependence remains incompletely understood. Evidence from preclinical and clinical studies has indicated that there are significant sex differences in nicotine's effects. The authors' goal in this report was to determine whether men and women differ in their acute response to intravenous nicotine, which has not been examined in previous studies. Twelve male and 12 female smokers received saline followed by 0.5 mg/70 kg and 1.0 mg /70 kg nicotine intravenously. In response to nicotine, women, as compared with men, had enhanced ratings for drug strength, head rush, and bad effects. Women and men experienced similar suppression of smoking urges by nicotine as assessed by the Brief Questionnaire on Smoking Urges. Nicotine-induced heart rate and systolic and diastolic blood pressure increases were also similar in magnitude in men and women. The findings, consistent with those of several previous studies, support greater sensitivity of female smokers to some but not all of the subjective effects of nicotine. Further studies are warranted to examine the role of this differential nicotine sensitivity to development of nicotine dependence and response to nicotine replacement treatments in men and women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Characterizing nicotine withdrawal in pregnant cigarette smokers.

Maternal smoking is a leading preventable cause of poor pregnancy outcomes and infant morbidity and mortality. Whereas pregnancy has been thought of as a "window of opportunity" when women are more motivated to change health behaviors such as smoking, only 20% of pregnant women quit smoking upon learning they are pregnant and remain abstinent at the end of the pregnancy. Greater understanding of possible obstacles to smoking during pregnancy, such as nicotine withdrawal, is needed. The symptoms of nicotine withdrawal have been well characterized in nonpregnant smokers, but there has been only 1 report conducted during pregnancy, and that was a retrospective study. The aim of the present study was to characterize nicotine withdrawal and craving in pregnant cigarette smokers. These data were collected as part of prospective clinical trials assessing the efficacy of voucher-based incentives to promote abstinence from cigarette smoking during pregnancy and postpartum. The authors examined results from the Minnesota Nicotine Withdrawal Scale (J. R. Hughes & D. K. Hatsukami, 1998) in 27 abstainers (reported no or very low levels of smoking, which was confirmed biochemically) and 21 smokers (smoked at >80% of their baseline smoking level) during the first 5 days of a cessation attempt. Abstainers reported more impatience, anger, and difficulty concentrating than did smokers. The results also suggest that pregnant smokers generally may have elevated baseline levels of withdrawal, which need to be considered in the design and analysis of future studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive–behavioral therapy to reduce weight concerns improves smoking cessation outcome in weight-concerned women.

Women smokers concerned about weight gain (N?=?219) were randomly assigned to 1 of 3 adjunct treatments accompanying group smoking cessation counseling: (a) behavioral weight control to prevent weight gain (weight control); (b) cognitive–behavioral therapy (CBT) to directly reduce weight concern, in which dieting was discouraged; and (c) standard counseling alone (standard), in which weight gain was not explicitly addressed. Ten sessions were conducted over 7 weeks, and no medication was provided. Continuous abstinence was significantly higher at posttreatment and at 6 and 12 months of follow-up for CBT (56%, 28%, and 21%, respectively), but not for weight control (44%, 18%, and 13%, respectively), relative to standard (31%, 12%, and 9%, respectively). However, weight control, and to a lesser extent CBT, was associated with attenuation of negative mood after quitting. Prequit body mass index, but not change in weight or in weight concerns postquit, predicted cessation outcome at 1 year. In sum, CBT to reduce weight concerns, but not behavioral weight control counseling to prevent weight gain, improves smoking cessation outcome in weight-concerned women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assigned Versus Perceived Placebo Effects in Nicotine Replacement Therapy for Smoking Reduction in Swiss Smokers.

In this report, the authors explore the relationships of perceived treatment to outcome in a large, placebo-controlled trial of nicotine replacement treatment for smoking reduction. In the original study (J. F. Etter, E. Laszlo, J. P. Zellweger, C. Perrot, & T. V. Perneger, 2002), which was conducted in French-speaking Switzerland, smokers were randomly assigned to receive nicotine, matching placebo products, or no intervention. At the end of the 6-month study, participants were asked to guess whether they had received nicotine or placebo. In the present analysis, the authors examined the difference in smoking reduction between those who believed they had received nicotine and those who believed they had received placebo. Regardless of actual treatment, smokers who believed they had received nicotine had significantly better outcome than those who believed they had received placebo. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Motivating Impact of Informing Women Smokers of a Link Between Smoking and Cervical Cancer: The Role of Coherence.

This research assessed the role of having a coherent explanation of the link between smoking and cervical cancer in motivating women to stop smoking. In the 1st study, women were given a leaflet with either a detailed or a minimal explanation of the link or no leaflet. The leaflets were similarly effective at providing a coherent explanation. In a cross-sectional analysis, having a coherent explanation moderated the relationship between perceived vulnerability and intention: Higher perceived vulnerability to cervical cancer was associated with greater intention to quit smoking only amongst women with a more coherent explanation of the link between smoking and cervical cancer. This rinding was replicated in a 2nd study. These results are consistent with H. Leventhal et al.'s (1997) self-regulatory model, which suggests that motivation to change behavior depends not only on perceiving a threat but also on having a coherent model linking the behavior with the threat. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subjective and Reinforcing Effects of Smoking During Negative Mood Induction.

Two notions strongly held by many smokers are that negative mood increases smoking behavior and that this increase is due to the ability of smoking to alleviate negative affect. This study used a modified mood induction procedure to examine both the impact of smoking on induced mood, as well as the effect of induced mood on actual smoking behavior. Forty-eight smokers were randomly assigned to a smoking or a water-drinking comparison group. Each participant attended 3 sessions during which 1 of 3 mood states (positive, negative, or neutral) was induced. Contrary to expectation, smoking did not attenuate negative affect. However, negative mood induction subsequently quickened latency to smoke and increased number of puffs consumed ad lib. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immediate Antecedents of Cigarette Smoking in Smokers With and Without Posttraumatic Stress Disorder: A Preliminary Study.

Using ambulatory methods for 1 day of monitoring, the authors of this study investigated the association between smoking and situational cues in 63 smokers with posttraumatic stress disorder (PTSD) and 32 smokers without PTSD. Generalized estimating equations contrasted 682 smoking and 444 nonsmoking situations by group status. Smoking was strongly related to craving, positive and negative affect, PTSD symptoms, restlessness, and several situational variables among PTSD smokers. For non-PTSD smokers, the only significant antecedent variables for smoking were craving, drinking coffee, being alone, not being with family, not working, and being around others who were smoking. These results are consistent with previous ambulatory findings regarding mood in smokers but also underscore that, in certain populations, mood and symptom variables may be significantly associated with ad lib smoking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)