PURPOSE: The purpose of this study was to identify the degree of attaining a smoking cessation goal when an agreement on means to achieve smoking cessation among male college student smokers was established. METHOD: This study was planned as a nonequivalent control group non-synchronized design and the sample was divided into an agreement group and a comparison group by convenience sampling in a college of G city. The data was analysed with SPSS Win10.0 using a Likelihood chi2-test, Odds ratio, Paired t-test and ANCOVA. RESULT: The theory that the degree of smoking cessation will be higher in the agreement group than the Comparison group was rejected (delta = 2.567, p = .055). The theory that nicotine dependency will be lower in the agreement group than the comparison group was supported (F = 3.965, p = .049); however, the theory that the number of cigarettes smoked per day will be lower in the agreement group than the comparison group was rejected (F = 1.342, p = .252). CONCLUSION: It has been shown that an agreement on means to achieve smoking cessation goals is a key factor to success in quitting smoking.
Universities ; Tobacco Use Disorder/rehabilitation ; Students/*psychology ; Smoking Cessation/*psychology ; Motivation ; Male ; Humans ; Adult

PURPOSE: This study examined the effectiveness of an Adolescent Motivational Interviewing Cessation program on smoking cessation change. The study was done with a nonequivalent control group pretest-posttest design. METHODS: The participants were 39 high school students from G city, who were in school from September 1 to October 30, 2009. The students were assigned to the experimental group (20) and participated in the motivational interviewing cessation program or to the control group (19) who did not participate. Data analyses involved chi2-test, independent t-test, Repeated Measures ANOVA, and utilized the SPSS program. RESULTS: The experimental group had significantly less daily smoking, nicotine dependence and smoking temptation in comparison to the control group. The experimental group had significantly higher stage of change in comparison to the control group. CONCLUSION: The results of the study indicate that a motivational interviewing cessation program delivered to adolescents who smoke is an effective method of encouraging cessation, and can be utilized as an effective nursing intervention for adolescents who smoke.
Adolescent ; Humans ; *Interviews as Topic ; *Motivation ; Program Evaluation ; Questionnaires ; *Smoking Cessation ; Tobacco Use Disorder/prevention & control/*psychology

PURPOSE: This study was done to evaluate the predictive value of aspects of the Transtheoretical model (TTM) of behavior change as applied to smoking cessation in a rural population. METHOD: A convenience sample was recruited from a public health center in a community. A total of 484 participants were recruited, including 319 smokers, 116 ex-smokers and 49 non-smokers. A cross-sectional and descriptive design was used in this study. Data was analyzed using descriptive statistics, frequency statistics, ANOVA and Logistic regression. RESULT: The major findings were 1) The participants were assessed at baseline for their current Stage of Change resulting in a distribution with 42.1% in Precontemplation, 24.1% in Contemplation, 9.7% in Preparation, 6.2% in Active, and 17.9% in the Maintenance stage. 2) There were statistically significant differences of processes of change, decisional balance and situational temptation across the stages of change. 3) The main factors that affect smoking cessation were age, number of years smoking, age when began smoking, self-liberation and negative/affective situations, which combined explained 33.2% of the smoking cessation. CONCLUSION: TTM variables measured prior to a smoking cessation program added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables.
Tobacco Use Disorder/psychology/rehabilitation ; Smoking Cessation/*psychology ; Rural Population ; *Models, Psychological ; Middle Aged ; Male ; Korea ; Humans ; Female ; Aged ; Adult

Nicotine, the primary psychoactive components of tobacco smoke, produce diverse neurophysiological and behavioral effects through several brain regions and neurochemical pathways. It acts as an agonist to activate and desensitize nicotinic acetylcholine receptors. Nicotinic signaling leads to activation of reward centers in the CNS, including the mesoaccumbens dopamine system, which ultimately leads to behavioral reinforcement and addiction. Indeed, the actions of nicotine on many systems, including brainstem cholinergic, GABAergic, glutaminergic, noradrenergic, and serotonergic systems, may help to mediate nicotine effects related to addiction. And many years of smoking induces neuroadaptations in acetylcholine and dopamine systems. Moreover, the long-term synaptic changes results in learned behaviors and memory which are associated with smoking. We reviewed the nicotinic synaptic mechanisms in midbrain dopaminergic areas. In summary, nicotine as obtained from tobacco interacts with multiple nicotinic acetylcholine receptor subtypes on dopamine, GABA, glutaminergic neuron to produce not only the acute positive reinforcement but also the synaptic changes associated with learning and memory.
Acetylcholine ; Brain ; Brain Stem ; Dopamine ; gamma-Aminobutyric Acid ; Learning ; Memory ; Mesencephalon ; Neurons ; Nicotine* ; Receptors, Nicotinic ; Reinforcement (Psychology) ; Reward ; Smoke ; Smoking ; Tobacco ; Tobacco Use Disorder*

PURPOSE: The purpose of this study was to identify the effects of a smoking cessation program on the amount of smoking and nicotine dependence and the self-efficacy of smoking cessation for smoking workers. METHODS: The total number of subjects was 38 smokers and was divided into two: 16 smokers were placed in the experimental group and 22 in the control group. A nonequivalent control group pretestposttest design was used. The smoking cessation program consisted of two sessions and was implemented for two hours daily for five days. Data was analyzed by using the SPSS/WIN 11.0 program with Chi2-test, t-test or Mann-Whitney U and ANCOVA. RESULTS: After the treatment, those belonging to the experimental group showed a significantly decreased amount of smoking, a decreased nicotine dependency and increased self-efficacy compared to the control group. CONCLUSION: The smoking cessation program was effective for diminishing the amount of smoking, decreasing nicotine dependence and improving self-efficacy. Therefore, this program is recommended as a smoking cessation strategy for adult smokers.
Adult ; Chi-Square Distribution ; Female ; Humans ; Male ; Patient Education as Topic ; *Self Efficacy ; Smoking/*psychology ; Smoking Cessation/*methods/psychology ; Tobacco Use Disorder/*prevention & control

PURPOSE: The purpose of this study was to identify the effectiveness of public health center smoking cessation counseling program using the transtheoretical model on the process of change, smoking temptation, decisional balance and stage change transition. METHODS: A nonequivalent control group non-synchronized design was used for this study. The study population was 115 adult smokers. The counseling program was administered to the experimental group and a smoking cessation program from the Korean Ministry of Health & Welfare was administered to the control group. Descriptive analysis, chi-square-test, t-test, and ANCOVA were used with the SPSS 12.0 program to analyze the data. RESULTS: After treatment with this program, the experimental group showed significantly higher scores for process of change (t=4.148, p<.001), smoking temptation (t=-2.988, p=.003), and stage change transition (chi-squre=5.871, p=.031) compared to the control group. Experimental group members also showed significantly lower score for Pros of smoking (t=-3.151, p=.002). CONCLUSION: The findings indicate that this program could have positive effect on process of change, smoking temptation, decisional balance and stage transition for adult smokers. Based on these findings, the authors suggest additional counseling program focusing on smokers in specific stages.
Adult ; Aged ; Community Health Centers ; *Counseling ; Demography ; Female ; Humans ; Male ; Middle Aged ; Models, Psychological ; Program Evaluation ; Questionnaires ; Smoking Cessation/methods/*psychology ; Tobacco Use Disorder/psychology

PURPOSE: The purpose of this study was to identify nicotine dependence, smoking-related attitude, and subjective norms across the stages of change for smoking cessation among adult smokers in a rural area. METHOD: The subjects were 276 current smokers (male=243, female=33). There were 3 stages of change for smoking cessation: pre-contemplation, contemplation, and preparation stage. Data was collected by an interview or self-reporting from February 12th to March 5th 2004, and analyzed with frequency, percentage, chi-square-test, Fisher's exact probability test, ANOVA, and Scheffe test using the SPSS-PC program. RESULT: According to the stages of change, 114(41.3%) current smokers were in pre-contemplation, 110(39.9%) in contemplation, and 52(18.8%) in the preparation stage. There was a higher percentage of males than females (chi-square=8.99, p=.011) in the preparation stage. The mean score of the smoking-related attitude (F=7.43, p=.001) and subjective norm(F=27.41, p=.001) were both lowest in the pre-contemplation stage and increased positively during the stages of change for smoking cessation. CONCLUSION: Based on these findings, the authors recommend that community-based smoking cessation programs should be developed by considering the intention or motives of current smokers and should be initiated in the preparation stage and primarily for male groups.
Adult ; Aged ; Aged, 80 and over ; Attitude to Health ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Motivation ; Nicotine ; Questionnaires ; Rural Population ; Smoking Cessation/*psychology ; Tobacco Use Disorder/*psychology

Tobacco use is the single most preventable cause of death, disability and disease in the world and is projected to be the leading cause of death and disability across all developed and developing countries by 2020. Nicotine, the primary active ingredient of cigarettes that contributes to physical dependence, acts on nicotine receptors in the central nervous system and leads to the release of neurotransmitters (such as dopamine). Like other drugs of abuse, nicotine is thought to produce reinforcing effect by activating the mesocorticolimbic dopamine system. A wide variety of cessation treatments of nicotine dependence is commercially available, yet only 2 general approaches have received empirical validation: behavioral intervention (including 5 As brief intervention) and pharmacotherapy. The evidences show that 5 As brief intervention is one of the most cost-effective treatments in clinical work for busy physicians. Three types of medications have been available in market for smoking cessation treatment: nicotine replacement treatment (NRT, i.e., transdermal patch, gum, inhaler, nasal spray, and lozenge), sustained release bupropion and varenicline. Varenicline, a novel alpha4beta2 nicotinic receptor partial agonist, is effective for tobacco dependence. Phase III trials suggest that it is more effective than NRT and bupropion SR. The safety profile of varenicline is excellent, with the most commonly occurring adverse events, nausea, typically mild and well tolerated. However, new safety warnings are added to the varenicline label because of post-marketing report including agitation, depression and suicidality. A causal connection between varenicline use and these symptoms has not been established.
Benzazepines ; adverse effects ; therapeutic use ; Bupropion ; therapeutic use ; Dopamine Uptake Inhibitors ; therapeutic use ; Humans ; Nicotinic Agonists ; adverse effects ; therapeutic use ; Quinoxalines ; adverse effects ; therapeutic use ; Smoking Cessation ; methods ; psychology ; Tobacco Use Disorder ; therapy ; Varenicline

OBJECTIVES: There is a controversy on the mechanism of nicotine dependence. Some suggest that the negative reinforcement such as withdrawal symptoms plays an important role, but others suggest that the positive reinforcement through the opioid-dopamine system plays an important role. Under the assumptions that the positive reinforcement and the opioid-dopamine interaction to have an important role in nicotine dependence, this study examined the effects of chronic naltrexone treatment on smoking behaviors, smoking urges to smoking cues and neuroendocrine responses to smoking. METHODS: In a randomized, placebo-control, double-blind design, voluntarily admitted regular smokers who wanted to quit smoking received naltrexone (13 persons) or placebo (12 persons) treatment for 2 weeks. Each week, naltrexone side effects, discomforts after the reduction of cigarette smoking, smoking urges to smoking cues, daily cigarette smoking amount, and expiratory carbon monooxide levels were checked. Also blood beta-endorphin, dynorphin, prolactin, ACTH, and cortisol levels were measured before and after smoking. RESULTS: Naltrexone treatment group showed significantly reduced smoking urges to smoking cues (p=0.036 at 2nd week), daily cigarette smoking amount (p=0.027 at 1st week), and expiratory CO levels (p=0.002 at 1st week, p=0.039 at 2nd week). Naltrexone treatment group also showed significantly increase cortisol level after smoking during the 1st week (p=0.048), and ACTH and prolactin level during the 2nd week (respectively p=0.010, p=0.009). But, the levels of beta-endorphin and dynorphin A were not different between the two groups. Discomfort profiles after the reduction of cigarette smoking, systolic and diastolic BP, and pulse rates were not different between the two groups. CONCLUSION: Longterm naltrexone treatment could be an effective tool used for the cessdtion of smoking. It was suggested that naltrexone blocks the positive reinforcement effects of smoking rather than the negative reinforcement effects of nicotine withdrawal.
Adrenocorticotropic Hormone* ; Analgesics, Opioid* ; beta-Endorphin ; Carbon ; Cues ; Dynorphins ; Heart Rate ; Hydrocortisone* ; Naltrexone* ; Nicotine* ; Prolactin* ; Reinforcement (Psychology) ; Smoke* ; Smoking* ; Substance Withdrawal Syndrome ; Tobacco Use Disorder

PURPOSE: The main purpose of this study was to investigate that the stages of change in smoking cessation behavior among coronary artery disease patients for six months progressed following the stages of change suggested by the transtheoretical model. METHOD: Subjects for this descriptive survey were 59 coronary disease patients who were smoking or who had stopped smoking for less than six months. RESULT: In the baseline, the distribution of the subjects' stages of change was as follows: pre-contemplation stage 25.4%, contemplation stage 25.4%, preparation stage 22%, and action stage 27.1%. After six months, more subjects in the contemplation(33.3%) and preparation stages(30.8%) progressed to the action stage than those of the pre-contemplation stage(0%). Eighty-one percent of the subjects in the action stage at baseline progressed to the maintenance stage. The relationship between the numbers of smoking cessation attempts for six months and stages of change at baseline was significant(p=.001). However, the relationships between self-efficacy and nicotine dependence at baseline and progression in stages of change after six months were not significant. CONCLUSION: Progression in the stages of change for six months among subjects corresponded to the stages of change suggested by the transtheoretical model. Hence, future development and evaluation of intervention programs should be tailored individually considering each patient's stage of change.
Tobacco Use Disorder/*complications/therapy ; Smoking Cessation/*psychology ; Models, Psychological ; Middle Aged ; Male ; Humans ; Coronary Arteriosclerosis/*complications ; Aged, 80 and over ; Aged ; Adult