Students' knowledge about tobacco one year after receiving the PAL smoking prevention program

A review of literature revealed that the control of cigarette smoking could do more to improve health than any other single action in the field of preventive medicine. In Ontario, since 1989, both Public Health Units and Boards ofEducations have been mandated to provide educational studies related to tobacco use prevention. Even given this fact, there has been an increase in smoking behaviQurs at an earlier age and in females in particular. Smoking prevention progralns must use the most effective means to assist students to obtain the knowledge and skills required to remain or becom'e nonsmokers. In the Niagara Region, PAL smoking prevention programs are offered in some, but not all, schools. As a form of program evaluation, this research sought to determine if students who had PAL could answer correctly a greater number of smoking-related questions than students who did not have this program. Findings reported that students who had PAL in Grade 6 were able to correctly answer more knowledge-based questions (at a statistically significant level), could provide ways to refuse cigarettes at a greater rate, and were able to provide more reasons for remaining nonsmokers. Students who had smoking prevention programming re,ported smoking behavio'urs at a lower rate than those who did not receive this type of program.

The influence of familial smoking behaviours on adolescent smoking behaviours

The ability to identify adolescents who are at risk for becoming smokers may prove useful in developing effective smoking prevention programs. The purpose of this stUdy was to assess the importance of familial smoking behaviours on adolescent smoking patterns. The results were based on responses to The Grade 7 Lincoln County Smoking Survey designed by Chudzik and Partington (1994), and are a part of the "Peer Assisted Learning Program· (PAL) presented by the Niagara Regional Health Services Department, with the cooperation of a local Board of Education (Region of Niagara). The results indicate that 12% of the total group of 450 Grade 7 student respondents were current smokers at the time the data were collected (13% males and 11% females), while more than 37% of individuals indicated that they had tried smoking previously. Of the individuals who were classified as smokers, 11% reported that they smoked because their parents smoked, but only 6% reported that they smoked because their siblings smoked. More concerning, however, is the finding that 4% of smokers reported that they felt pressured to smoke by their relatives. In a society that is becoming increasingly concerned about health, it is also alarming to observe that only 50% of the respondents within this sample reported that there were no smokers (parents/siblings) in their homes. The results also indicate that 33% percent of respondents had grandparents who continued to smoke, and 53% of respondents indentified other relatives who continued to smoke.

An impact evaluation of the Ontario ban on smoking in schools and on school property : does the ban on smoking influence high school students' intentions to smoke cigarettes?

The Ontario Tobacco Control Act of 1994 imposed a total ban on smoking in schools, and on school property for every school in the province. The imposition of this policy created problems for school administrators. For instance, students who were smoking on walkways and properties adjacent to school boundaries, clashed with neighbouring property owners who were angry about the resulting damage and disruption. The enforcement of this policy consumes valuable resources at each school; therefore, knowledge about the impact of the policy is important. If effective, this policy has the potential to improve the health of students over their lifetime, by preventing or delaying smoking behaviour. Alternatively, an ineffective policy will continue to create administrative problems for the school and serve no legitimate purpose. Therefore, knowledge about the impact of the smoking ban policy on students' smoking intentions assists policy makers and school administrators in their understanding of the policy's impact within the schools. This research provided an impact evaluation of the ban on smoking in schools and on school property in Ontario. A total of 2069 students, from five high schools, in the Niagara Region, provided complete responses to a survey, designed to test whether smoking intentions were affected by the imposition of the policy. The study used Ajzen's theory of planned behaviour (Ajzen, 1991), specifically, the perceived behavioural control measure, to gain some understanding of students' perceptions of control over smoking imposed by the ban. The findings indicate the policy has the potential to influence students' overall smoking intentions. The ban on smoking policy was found to be a significant predictor of the smoking intentions of high school students. As well, attitude, social norms, and perceptions of control were significant predictors of smoking intentions. Exploratory findings also indicated differences between the control beliefs of students from different high schools, indicating potential differences in the enforcement of the smoking ban between schools. The findings also support the utility of the theory of planned behaviour as a methodology for evaluating the influence of punitive policies. This research study should be continued by utilizing the full theory of planned behaviour, including two phases of data collection and the measurement of actual smoking behaviour.

The impact of tobacco control policies on university students' smoking in Ontario

Objective. Despite steady declines in the prevalence of tobacco use among Canadians, young adult tobacco use has remained stubbornly high over the past two decades (CTUMS, 2005a). Currently in Ontario, young adults have the highest proportion of smokers of all age cohorts at 26%. A growing body of evidence shows that smoking restrictions and other tobacco control policies can reduce tobacco use and consumption among adults and deter initiation among youth; whether young adult university students' smoking participation is influenced by community smoking restrictions, campus tobacco control policies or both remains an empirical question. The purpose of this study is to examine the relationship among current smoking status of students on university campuses across Ontario and various tobacco control policies, 3including clean air bylaws of students' home towns, clean air by-laws of the community where the university is situated, and campus policies. Methods. Two data sets were used. The 200512006 Tobacco Use in a Representative Sample of Post-Secondary Students data set provides information about the tobacco use of 10,600 students from 23 universities and colleges across Ontario. Data screening for this study reduced the sample to 5,114 17-to-24 year old undergraduate students from nine universities. The second data set is researcher-generated and includes information about strength and duration of, and students' exposure to home town, local and campus tobacco control policies. Municipal by-laws (of students' home towns and university towns) were categorized as weak, moderate or strong based on criteria set out in the Ontario Municipal By-law Report; campus policies were categorized in a roughly parallel fashion. Durations of municipal and campus policies were calculated; and length of students' exposure to the policies was estimated (all in months). Multinomial logistic regression analyses were used to examine the relationship between students' current smoking status (daily, less-than-daily, never-smokers) and the following policy measures: strength of, duration of, and students' exposure to campus policy; strength of, duration of, and students' exposure to the by-law in the university town; and, strength of, duration of, and students' exposure to the by-law in the home town they grew up in. Sociodemographic variables were controlled for. Results. Among the Ontario university students surveyed, 7.0% currently use tobacco daily and 15.4% use tobacco less-than-daily. The proportions of students experiencing strong tobacco control policies in their home town, the community in which their university is located and at their current university were 33.9%,64.1 %, and 31.3% respectively. However, 13.7% of students attended a university that had a weak campus policy. Multinomial logistic regressions suggested current smoking status was associated with university town by-law strength, home town by-law strength and the strength of the campus tobacco control policy. In the fmal model, after controlling for sociodemographic factors, a strong by-law in the university town and a strong by-law in students' home town were associated with reduced odds of being both a less-than-daily (OR = 0.64, 95%CI: 0.48-0.86; OR = 0.80, 95%CI: 0.66-0.95) and daily smoker (OR = 0.59, 95%CI: 0.39-0.89; OR = 0.76, 95%CI: 0.58-0.99), while a weak campus tobacco control policy was associated with higher odds of being a daily smoker (OR = 2.08, 95%CI: 1.31-3.30) (but unrelated to less-than-daily smoking). Longer exposure to the municipal by-law (OR = 0.93; 95%CI: 0.90-0.96) was also related to smoking status. Conclusions. Students' smoking prevalence was associated with the strength of the restrictions in university, and with campus-specific tobacco control policies. Lessthan- daily smoking was not as strongly associated with policy measures as daily smoking was. University campuses may wish to adopt more progressive campus policies and support clean air restrictions in the broader community. More research is needed to determine the direction of influence between tobacco control policies and students' smoking.

Evaluating three self-help smoking cessation interventions for post-secondary smokers : a randomized controlled trial on six Ontario campuses

Objective. Smoking prevalence is highest among the young adult cohort. Postsecondary students are no exception. Although many students intend to quit smoking, no research has established what methods best promote reductions in, or complete abstinence from smoking. This randomized controlled trial examined the effectiveness of three self-help smoking cessation interventions. Method. On six post-secondary campuses, 483 smokers who voluntarily accessed Leave The Pack Behind (a tobacco control initiative) were randomly assigned to one of three smoking cessation interventions: One Step At A Time (a 2-booklet, *gold standard' program for adults); Smoke|Quit (a newly-developed 2-booklet program for young adult students); and usual care (a 'Quit Kit' containing a booklet on stress management, information about pharmacological quitting aides and novelty items). All participants also received one proactive telephone support call from a peer counsellor. During the study, 85 participants withdrew. The final sample of 216 students who completed baseline questionnaires and 12-week follow-up telephone interviews was representative of the initial sample in terms of demographic characteristics, and smokingquitting- related variables. Results. Whether participants quit smoking depended upon treatment condition, ^(2, N=2\6) = 6.34, p = .04, with Smoke|Quit producing more successfijl quitters (18.4%) than One Step At A Time (4.5%) or the Quit Kit (1 1.4%). On average, participants had quit 53.46 days, with no significant difference across treatments. Selfefficacy also increased. Use of the intervention or other quitting aides was not associated with treatment condition. Among the 191 participants who did not quit smoking, treatment condition did not influence outcomes. Overall, 46.2% had made a quit attempt. Significant decreases in weekly tobacco consumption and increases in self-efficacy to resist smoking were observed from baseline to follow-up. Conclusion. Post-secondary institutions represent a potentially final opportunity for age-targeted interventions. Self-help resources tailored to students' social and contextual characteristics will have considerable more impact than stage-only tailored interventions. Both reduction and abstinence outcomes should be emphasized to positively support students to stop smoking.

An exploration of the experience of implementing the second step violence prevention curriculum in one primary general learning disabilities class /

Violence has always been a part of the human experience, and therefore, a popular topic for research. It is a controversial issue, mostly because the possible sources of violent behaviour are so varied, encompassing both biological and environmental factors. However, very little disagreement is found regarding the severity of this societal problem. Most researchers agree that the number and intensity of aggressive acts among adults and children is growing. Not surprisingly, many educational policies, programs, and curricula have been developed to address this concern. The research favours programs which address the root causes of violence and seek to prevent rather than provide consequences for the undesirable behaviour. But what makes a violence prevention program effective? How should educators choose among the many curricula on the market? After reviewing the literature surrounding violence prevention programs and their effectiveness, The Second Step Violence Prevention Curriculum surfaced as unique in many ways. It was designed to address the root causes of violence in an active, student-centred way. Empathy training, anger management, interpersonal cognitive problem solving, and behavioural social skills form the basis of this program. Published in 1992, the program has been the topic of limited research, almost entirely carried out using quantitative methodologies.The purpose of this study was to understand what happens when the Second Step Violence Prevention Curriculum is implemented with a group of students and teachers. I was not seeking a statistical correlation between the frequency of violence and program delivery, as in most prior research. Rather, I wished to gain a deeper understanding of the impact ofthe program through the eyes of the participants. The Second Step Program was taught to a small, primary level, general learning disabilities class by a teacher and student teacher. Data were gathered using interviews with the teachers, personal observations, staff reports, and my own journal. Common themes across the four types of data collection emerged during the study, and these themes were isolated and explored for meaning. Findings indicate that the program does not offer a "quick fix" to this serious problem. However, several important discoveries were made. The teachers feU that the program was effective despite a lack of concrete evidence to support this claim. They used the Second Step strategies outside their actual instructional time and felt it made them better educators and disciplinarians. The students did not display a marked change in their behaviour during or after the program implementation, but they were better able to speak about their actions, the source of their aggression, and the alternatives which were available. Although they were not yet transferring their knowledge into positive action,a heightened awareness was evident. Finally, staff reports and my own journal led me to a deeper understanding ofhow perception frames reality. The perception that the program was working led everyone to feel more empowered when a violent incident occurred, and efforts were made to address the cause rather than merely to offer consequences. A general feeling that we were addressing the problem in a productive way was prevalent among the staff and students involved. The findings from this investigation have many implications for research and practice. Further study into the realm of violence prevention is greatly needed, using a balance of quantitative and qualitative methodologies. Such a serious problem can only be effectively addressed with a greater understanding of its complexities. This study also demonstrates the overall positive impact of the Second Step Violence Prevention Curriculum and, therefore, supports its continued use in our schools.

Six-month outcomes of a multi-campus smoking cessation contest

Background: Up to 40% of North American post-secondary students smoke at least occasionally, and most want to quit. Given students' preferences for free, easy-to-access, self-directed, convenient cessation methods, a motivational, incentive-based cessation contest may be an effective way to assist students to quit. The current study describes 3- and 6-month outcomes experienced by post-secondary student smokers who entered the 'Let's Make A Deal!' contest. Methodology: Contestants from five university campuses who chose to quit completely ('Quit For Good') or reduce their tobacco consumption by 50% ('Keep The Count') were invited to participate in a study of the contest. Three and six months after registration, participants were contacted by phone to assess their smoking and quitting behaviours. Qualitative and quantitative measures were collected, including weekly tobacco consumption, efficacy to resist temptations to smoke, use of quitting aids, and strategies to cope with withdrawal. Quitting was assessed using 7-day point prevalence and continuous abstinence. Results: Seventy-four (64.9%) of the 114 participants recruited for the study completed the follow-ups. Over 31 % of participants who entered Quit For Good and 23.5% of participants who entered Keep The Count were identified as quitters at the 6-month follow-up. Among the quitters, 45.5% experienced sustained abstinence from smoking for the 6-month duration of the study. Keep The Count contestants reduced their tobacco consumption by 57.2% at 3-month follow-up and sustained some of this reduction through to the 6-month follow-up. Qualitative data provides insights into how quitters coped with withdrawal and what hampered continuing smokers' efforts to quit. Significance: A motivational, incentive-based contest for post-secondary students can facilitate both smoking cessation and harm reduction. The contest environment, incentives, resources, and "buddies" provide positive structural and social supports to help smokers overcome potential barriers to quitting, successfully stop smoking, and manage potential triggers to relapse. The contest cessation rates are higher than the typical 5-7% associated with unassisted quitting.

Decision analysis of the effectiveness of lung cancer screening using autofluorescence bronchoscopy and computed tomography

Background: Lung cancer (LC) is the leading cause of cancer death in the developed world. Most cancers are associated with tobacco smoking. A primary hope for reducing lung cancer has been prevention of smoking and successful smoking cessation programs. To date, these programs have not been as successful as anticipated. Objective: The aim of the current study was to evaluate whether lung cancer screening combining low dose computed tomography with autofluorescence bronchoscopy (combined CT & AFB) is superior to CT or AFB screening alone in improving lung cancer specific survival. In addition, the extent of improvement and ideal conditions for combined CT & AFB screening were evaluated. Methods: We applied decision analysis and Monte Carlo simulation modeling using TreeAge Software to evaluate our study aims. Histology- and stage specific probabilities of lung cancer 5-year survival proportions were taken from Surveillance and Epidemiologic End Results (SEER) Registry data. Screeningassociated data was taken from the US NCI Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), National Lung Screening Trial (NLST), and US NCI Lung Screening Study (LSS), other relevant published data and expert opinion. Results: Decision Analysis - Combined CT and AFB was the best approach at Improving 5-year survival (Overall Expected Survival (OES) in the entire screened population was 0.9863) and in lung cancer patients only (Lung Cancer Specific Expected Survival (LOSES) was 0.3256). Combined screening was slightly better than CT screening alone (OES = 0.9859; LCSES = 0.2966), and substantially better than AFB screening alone (OES = 0.9842; LCSES = 0.2124), which was considerably better than no screening (OES = 0.9829; LCSES = 0.1445). Monte Carlo simulation modeling revealed that expected survival in the screened population and lung cancer patients is highest when screened using CT and combined CT and AFB. CT alone and combined screening was substantially better than AFB screening alone or no screening. For LCSES, combined CT and AFB screening is significantly better than CT alone (0.3126 vs. 0.2938, p< 0.0001). Conclusions: Overall, these analyses suggest that combined CT and AFB is slightly better than CT alone at improving lung cancer survival, and both approaches are substantially better than AFB screening alone or no screening.

Comparison of non-HDL cholesterol and waist circumference vs. triglyceride levels and waist circumference in predicting coronary heart disease risk

BACKGROUND: Dyslipidemia is recognized as a major cause of coronary heart disease (CHD). Emerged evidence suggests that the combination of triglycerides (TG) and waist circumference can be used to predict the risk of CHD. However, considering the known limitations of TG, non-high-density lipoprotein (non-HDL = Total cholesterol - HDL cholesterol) cholesterol and waist circumference model may be a better predictor of CHD. PURPOSE: The Framingham Offspring Study data were used to determine if combined non-HDL cholesterol and waist circumference is equivalent to or better than TG and waist circumference (hypertriglyceridemic waist phenotype) in predicting risk of CHD. METHODS: A total of3,196 individuals from Framingham Offspring Study, aged ~ 40 years old, who fasted overnight for ~ 9 hours, and had no missing information on nonHDL cholesterol, TG levels, and waist circumference measurements, were included in the analysis. Receiver Operator Characteristic Curve (ROC) Area Under the Curve (AUC) was used to compare the predictive ability of non-HDL cholesterol and waist circumference and TG and waist circumference. Cox proportional-hazards models were used to examine the association between the joint distributions of non-HDL cholesterol, waist circumference, and non-fatal CHD; TG, waist circumference, and non-fatal CHD; and the joint distribution of non-HDL cholesterol and TG by waist circumference strata, after adjusting for age, gender, smoking, alcohol consumption, diabetes, and hypertension status. RESULTS: The ROC AUC associated with non-HDL cholesterol and waist circumference and TG and waist circumference are 0.6428 (CI: 0.6183, 0.6673) and 0.6299 (CI: 0.6049, 0.6548) respectively. The difference in the ROC AVC is 1.29%. The p-value testing if the difference in the ROC AVCs between the two models is zero is 0.10. There was a strong positive association between non-HDL cholesterol and the risk for non-fatal CHD within each TO levels than that for TO levels within each level of nonHDL cholesterol, especially in individuals with high waist circumference status. CONCLUSION: The results suggest that the model including non-HDL cholesterol and waist circumference may be superior at predicting CHD compared to the model including TO and waist circumference.

Teaching sexual abuse prevention skills to two children with intellectual disabilities through game play

The current study examined the effectiveness of a sexual abuse prevention program developed locally for children with intellectual disabilities. The program package included a board game with informational storybooks that were designed to be used in a family setting. Additionally, this research sought to determine if parents could be effective at presenting the sexual abuse pr~vention materials to their children. A multiple baseline across behaviours design was used with two participants with a diagnosis of autism. Through role play scenarios as well as verbal knowledge tests, it was determined that the program was effective at teaching the participants the skills presented for self protection. It was also determined that the skills learned were generalized to scenarios that were untrained during the game play. Finally, with additional supports, it was determined that parents were able to effectively teach their children the required skills.

Patterns and correlates of tobacco use among young adults at college and university

This thesis describes college and university students' smoking behaviours and examines whether socioenvironmental and personal characteristics experienced during adolescence are differentially associated with their smoking participation. Results show more college students than university students currently smoke (37% and 21 % respectively) and more began smoking prior to post-secondary school (93% and 84% respectively). Early age of onset of alcohol use increased the odds of current smoking (main effect model, OR = 8.56 CI = 6.47, 11.33), especially for university students (interaction effect model, b = 2.35 CI = 7.50, 14.64). Lower levels of high school connectedness were associated with increased odds of current smoking but for university students only (interaction effect model, b = -0.15 CI = 0.84, 0.88). While limitations associated with convenience sampling and low response rate exist, this is the first Canadian study to examine college and university students separately. I t reveals that tobacco control programming needs to differ for college and university students, and early alcohol prevention and school engagement programs for adolescents may influence tobacco use. Given that both educational pathway and use of tobacco are associated with SES, future research may consider examining in more detail, SES-related socioenvironmental variables.

Tintype of Man Smoking a Cigar [n.d.]

This small black and white tintype photograph shows a young Black gentleman smoking a cigar. No date or location is provided. This tintype was in the possession of Iris Sloman Bell, of St. Catharines, Ontario. Relatives of the Sloman - Bell families are descended from former slaves from the United States who settled in Canada."Tintypes were the invention of Prof. Hamilton Smith of Ohio. They begin as thin sheets of iron, covered with a layer of black paint. This serves as the base for the same iodized collodion coating and silver nitrate bath used in the ambrotype process. First made in 1856, millions were produced well into the twentieth century. When tintypes were finished in the same sorts of mats and cases used for ambrotypes, it can be almost impossible to distinguish which process was used without removing the image to examine the substrate." Source: American Museum of Photography http://www.photographymuseum.com/primer.html

STRATEGIES FOR PREVENTION AND TREATMENT OF HEPATITIS C VIRUS INFECTION

Hepatitis C virus (HCV) is the causative agent of Hepatitis C, a serious global health problem which results in liver cirrhosis and hepatocellular carcinoma. Currently there is no effective treatment or vaccine against the virus. Therefore, development of a therapeutic vaccine is of paramount importance. In this project, three alternative approaches were used to control HCV including a DNA vaccine, a recombinant viral vaccine and RNA interference. The first approach was to test the effect of different promoters on the efficacy of a DNA vaccine against HCV. Plasmids encoding HCV-NS3 and E1 antigens were designed under three different promoters, adenoviral E1A, MLP, and CMV ie. The promoter effect on the antigen expression in 293 cells, as well as on the antibody level in immunized BALB/c mice, was evaluated. The results showed that the antigens were successfully expressed from all vectors. The CMV ie promoter induced the highest antigen expression and the highest antibody level. Second, the efficiency of a recombinant adenovirus vaccine encoding HCV-NS3 was compared to that of a HCV-NS3 plasmid vaccine. The results showed that the recombinant adenovirus vaccine induced higher antibody levels as compared to the plasmid vaccine. The relationship between the immune response and miRNA was also evaluated. The levels of mir-181, mir-155, mir-21 and mir-296 were quantified in the sera of immunized animals. mir-181 and mir-21 were found to be upregulated in animals injected with adenoviral vectors. Third, two recombinant adenoviruses encoding siRNAs targeting both the helicase and protease parts of the NS3 region were tested for their ability to inhibit NS3 expression. The results showed that the siRNA against protease was more effective in silencing the HCV-NS3 gene in a HCV replicon cell line. This result confirmed the efficiency of adenovirus for siRNA delivery. These results confirmed that CMV ie is optimum promoter for immune response induction. Adenovirus was shown to be an effective delivery vector for antigens or siRNAs. In addition, miRNAs were proved to be involved in the regulation of immune response.

Niagara Council on Smoking and Health Collection, 1974, 1977-2004, n.d.

NCOSH stands for Niagara Council on Smoking and Health. The former name of this group was Niagara Interagency Council on Smoking and Health. This group was established in 1976 to address the impact of tobacco on health.

Buried Treasure: The Economics of Leak Detection and Water Loss Prevention in Ontario

On average approximately 13% of the water that is withdrawn by Canadian municipal water suppliers is lost before it reaches final users. This is an important topic for several reasons: water losses cost money, losses force water agencies to draw more water from lakes and streams thereby putting more stress on aquatic ecosystems, leaks reduce system reliability, leaks may contribute to future pipe failures, and leaks may allow contaminants to enter water systems thereby reducing water quality and threatening the health of water users. Some benefits of leak detection fall outside water agencies’ accounting purview (e.g. reduced health risks to households connected to public water supply systems) and, as a result, may not be considered adequately in water agency decision-making. Because of the regulatory environment in which Canadian water agencies operate, some of these benefits-especially those external to the agency or those that may accrue to the agency in future time periods- may not be fully counted when agencies decide on leak detection efforts. Our analysis suggests potential reforms to promote increased efforts for leak detection: adoption of a Canada-wide goal of universal water metering; development of full-cost accounting and, pricing for water supplies; and co-operation amongst the provinces to promulgate standards for leak detection efforts and provide incentives to promote improved efficiency and rational investment decision-making.