PURPOSE: This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI). METHODS: This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks. RESULTS: At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (p<.001), nicotine dependence (p<.001), CO levels (p<.001), and smoking cessation rates (p<.001). CONCLUSION: The results indicate that the smoking cessation program including telephone counseling and text messaging using stages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.
Adult ; Carbon Monoxide/analysis ; Counseling/*methods ; Female ; Hospitals, University ; Humans ; Male ; Middle Aged ; Myocardial Infarction/*psychology ; Outpatients ; *Program Evaluation ; Self Efficacy ; *Smoking Cessation ; Telephone ; Text Messaging ; Time Factors ; Tobacco Use Disorder

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

Nicotine is the major substance that accounts for the addictive nature of smoking. Nicotine induces neurobiological and behavioral responses through diverse neurochemical mechanisms over the central nervous system. The brain reward system, particularly the dopaminergic pathway from the ventral tegmental area to nucleus accumbens, is central to understanding the behavioral reinforcement underlying substance addictions such as the addiction to nicotine. Nicotine acts as an agonist provoking activation or desensitization of nicotinic acetylcholine receptors in different brain areas including the brain reward system. Nicotine also indirectly influences the glutaminergic, GABAergic, noradrenergic, and serotonergic neurotransmission that lead ultimately to activation of the dopaminergic pathway in the brain reward system. Chronic exposure to nicotine activates neuroadaptation and associative learning with the nicotine-related stimulus through dopaminergic or cholinergic systems, which can lead to nicotine dependence or withdrawal. In sum, the neurobiological processes described above are deeply involved in the basis of nicotine dependence and underlie the frequent failure of attempts to quit smoking. In this review we discuss the neurobiological mechanisms of nicotine addiction focusing on the roles of the nicotinic acetylcholine receptor.
Brain ; Central Nervous System ; Dopamine ; Learning ; Nicotine ; Nucleus Accumbens ; Receptors, Nicotinic ; Reinforcement (Psychology) ; Reward ; Smoke ; Smoking ; Synaptic Transmission ; Tobacco Use Disorder ; Ventral Tegmental Area

Nicotine is the major substance that accounts for the addictive nature of smoking. Nicotine induces neurobiological and behavioral responses through diverse neurochemical mechanisms over the central nervous system. The brain reward system, particularly the dopaminergic pathway from the ventral tegmental area to nucleus accumbens, is central to understanding the behavioral reinforcement underlying substance addictions such as the addiction to nicotine. Nicotine acts as an agonist provoking activation or desensitization of nicotinic acetylcholine receptors in different brain areas including the brain reward system. Nicotine also indirectly influences the glutaminergic, GABAergic, noradrenergic, and serotonergic neurotransmission that lead ultimately to activation of the dopaminergic pathway in the brain reward system. Chronic exposure to nicotine activates neuroadaptation and associative learning with the nicotine-related stimulus through dopaminergic or cholinergic systems, which can lead to nicotine dependence or withdrawal. In sum, the neurobiological processes described above are deeply involved in the basis of nicotine dependence and underlie the frequent failure of attempts to quit smoking. In this review we discuss the neurobiological mechanisms of nicotine addiction focusing on the roles of the nicotinic acetylcholine receptor.
Brain ; Central Nervous System ; Dopamine ; Learning ; Nicotine ; Nucleus Accumbens ; Receptors, Nicotinic ; Reinforcement (Psychology) ; Reward ; Smoke ; Smoking ; Synaptic Transmission ; Tobacco Use Disorder ; Ventral Tegmental Area

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

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

OBJECTIVETo investigate the health status and intention of quitting smoking in factory workers, so as to provide scientific evidence for smoking control.

METHODSA cross-sectional survey was carried out on smoking behavior, self-reported health status (SRHS), and intention of quitting smoking in 668 Guangzhou factory workers with different job types. Fagerstrom Test for Nicotine Dependence (FTND) was used on current smokers. Logistic regression model was used to analyze the association of SRHS, difficulty of quitting smoking (DQS) with some risk factors.

RESULTS(1) 65.0% (n = 348) male and 3.0% (n = 4) female workers were ever-smokers. 90.6% of male smokers usually smoked when getting together with friends or smokers, staying at home, or at leisure time, or just after a meal. (2) 10.7% of the daily smokers and ex-smokers had a worse SRHS than the general same-age people, which is significantly higher than 5.1% of the occasional smokers and those who were never smoking. The OR was 2.22 (95% CI 1.08 approximately 4.59) after adjusting age and education. (3) Of male daily smokers, 50.5% ever thought of quitting smoking. The proportions of ever-thought of quitting smoking were 73.3%, 50.0% and 37.2% respectively in those with better, pretty the same and worse SRHS than the general same-age people (P = 0.009). The proportions of DQS self-scored 30 or less, 31 to 60 and 60 or more were 26.9%, 24.9% and 48.2% respectively in male daily smokers. The OR for DQS (self-scored > 30 vs < or =30) increased with increasing number of colleague smoked and worked around, and with nicotine dependence.

CONCLUSIONDaily smokers and former smokers have worse SRHS than those who are occasional smokers or never smokers in male workers, and most of those with worse SRHS who ever thought of quitting smoking. The DQS is mainly significantly associated with number of colleague smoking and working around, and with nicotine dependence.

Adolescent ; Adult ; China ; Cross-Sectional Studies ; Female ; Health Status ; Humans ; Intention ; Logistic Models ; Male ; Middle Aged ; Occupational Health ; Smoking ; Smoking Cessation ; psychology ; Surveys and Questionnaires ; Tobacco Use Disorder ; epidemiology

PURPOSE: The purpose of this study was to investigate the stages of change in smoking cessation after a Coronary Artery Bypass Graft(CABG) and to identify the related factors. METHODS: The subjects (n=157) were patients who underwent a CABG in a university hospital from March 1998 to October 2005 and were smokers before the CABG. Data was collected viachart review and a telephone interview, and analyzed with descriptive statistics, Chi2 test, one-way ANOVA, and Kruskal-Wallis procedure by the SPSS/PC win 12.0 program. RESULTS: The subjects smoked for an average of 34 years (21 cigarettes per day) before surgery. Eleven percent of the subjects were in pre-contemplation, 6.4% in contemplation, 13.5% in preparation, 4.5% in action, and 64.5% in the maintenance stage. Nicotine dependence and selfefficacy were different among the groups with different stages of change in smoking cessation. Nicotine dependence was the lowest (p=0.00) and self-efficacy was the highest (p=0.00) in the maintenance stage. The number of subjects in pre-contemplation and contemplation significantly increased 6 years after surgery(p=0.05). CONCLUSIONS: To implement effective smoking cessation interventions for CABG patients, the intervention should be developed to accommodate individual readiness for smoking cessation, especially so for those who had a CABG more than 6 years previously.
Aged ; *Coronary Artery Bypass ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Regression Analysis ; Self Efficacy ; Smoking/prevention & control/*psychology ; Smoking Cessation/*methods ; Tobacco Use Disorder/prevention & control

PURPOSE: The purpose of this study was to investigate the effects of a community-based group smoking cessation program among adult smokers in a rural community. METHOD: The study design was quasi-experimental with a pre and posttest. A total of 55 adult smokers participated in the study. They were evaluated 1, 3, and 6 months after the program to identify the long-term effectiveness of the program. The program consisted of a total of 5 sessions provided twice a week. To test the effectiveness of the program, urine creatinine, expired air carbon monoxide, nicotine dependence, and smoking-related knowledge were used as dependent variables. Data was analyzed with the SPSS 10.0 program with a t-test, paired t-test, and Scheffe test. RESULT: Urine creatinine, expired air carbon monoxide, and nicotine dependence were significantly decreased after the program. Also, the rates of continuous abstinence were 81.8% at posttest, 65.5% at 1 month, 54.5% at 3 months, and 54.5% at 6 months follow-up. CONCLUSION: This community-based group smoking cessation program implemented by a nurse and smoking cessation counselors was effective for quitting smoking and decreasing urine creatinine and nicotine dependence. Therefore, this smoking cessation program could be recommended to induce smoking cessation as health promotion management in the rural community.
Adult ; Aged ; Breath Tests ; Carbon Monoxide/analysis ; Cotinine/urine ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Rural Population ; Smoking/prevention & control/*psychology ; Smoking Cessation/*methods ; Tobacco Use Disorder/*therapy ; Treatment Outcome

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