Effectiveness of hospital-based smoking cessation

Study objectives: Smoking cessation for current smokers is a health-care imperative. It is not clear which approaches to smoking cessation are the most effective in the hospital setting and which factors predict long-term abstinence. We hypothesized that a hospital-based smoking cessation program involving behavioral modification and support would provide an effective intervention for smoking cessation. Design: Prospective cohort study. Setting: Smoking cessation clinics in a tertiary referral, cardiothoracic hospital. Patients or participants: Two hundred forty-three smokers and 187 never-smoker control subjects. Interventions: Smokers underwent specific sessions of individual counseling on behavioral modification, including written information, advice about quit aids, and support during the quit attempt. Abstinence was confirmed by exhaled carbon monoxide measurements. Measurements and results: Compared to never-smoker control subjects, smokers were more likely to have grown up with a smoking father or siblings, and to currently live or socialize with other smokers. Two hundred sixteen smokers attended at least two sessions of the smoking cessation program. Of these, 25% were unavailable for follow-up at 12 months and were assumed to be smoking. The point prevalence abstinence rate at 12 months was 32%. Independent factors associated with abstinence at 12 months were self-belief in quitting ability, having a heart condition, growing up without siblings who smoked, and increasing number of pack-years. Conclusions: This prospective study has demonstrated that this hospital-based smoking cessation program was as effective as programs in other settings. Social and psychological factors were associated with a greater chance of abstinence.

Professional development: A never ending story

The author discusses the need for continuing profession development and outlines her personal learning plan. The role of the Pharmaceutical Society of Australia is also examined. (non-author abstract)

Young women as smokers and nonsmokers: A qualitative social identity approach

The authors used a social identity perspective to explore young women's perceptions of smoking. They carried out 13 focus groups and 6 intercept interviews with women aged 16 to 28 years in regards to the social identities that might influence young women's smoking behavior. Three identities emerged: the cool smoker applied to the initiation of smoking; considerate smokers, who were older addicted smokers; and the actual and anticipated good mother identity, which applied to young women who quit smoking during pregnancy. These identities add to our understanding of the meaning of smoking within the lives of young women and might allow more focused initiatives with this group to prevent the progression to regular addicted smoking.

Gender differentials in the evolution of cigarette smoking habits in a general European adult population from 1993-2003

Background: Describe the recent evolution of cigarette smoking habits by gender in Geneva, where incidence rates of lung cancer have been declining in men but increasing in women. Methods: Continuous cross-sectional surveillance of the general adult ( 35 - 74 yrs) population of Geneva, Switzerland for 11 years ( 1993 - 2003) using a locally-validated smoking questionnaire, yielding a representative random sample of 12,271 individuals ( 6,164 men, 6,107 women). Results: In both genders, prevalence of current cigarette smoking was stable over the 11-year period, at about one third of men and one quarter of women, even though smoking began at an earlier age in more recent years. Older men were more likely to be former smokers than older women. Younger men, but not women, tended to quit smoking at an earlier age. Conclusion: This continuous ( 1993 - 2003) risk factor surveillance system, unique in Europe, shows stable prevalence of smoking in both genders. However, sharp contrasts in age-specific prevalence of never and former smoking and of ages at smoking initiation indicate that smoking continues a long-term decline in men but has still not reached its peak in women.

Never-married childless women in Australia: Health and social circumstances in older age

A growing proportion of women reach older age without having married or having children. Assumptions that these older women are lonely, impoverished, and high users of social and health services are based on little evidence. This paper uses data from the Older cohort of the Australian Longitudinal Study on Women's Health to describe self-reported demographics, physical and emotional health, and use of services among 10,108 women aged 73-78, of whom 2.7% are never-married and childless. The most striking characteristic of this group is their high levels of education, which are associated with fewer reported financial difficulties and higher rates of private health insurance. There are few differences in self-reported physical or emotional health or use of health services between these and other groups of older women. Compared with older married women with children, they make higher use of formal services such as home maintenance and meal services, and are also more likely to provide volunteer services and belong to social groups. Overall, there is no evidence to suggest that these women are a problem group. Rather, it seems that their life experiences and opportunities prepare them for a successful and productive older age. (c) 2005 Elsevier Ltd. All rights reserved.

'Occasional' and 'social' smokers: Potential target groups for smoking cessation campaigns?

Objective: To describe the characteristics [of self-described 'occasional' and 'social' Australian smokers. Design: Analysis of a national cross-sectional survey of smoking patterns, conducted in Australia in 2004. Setting and participants: Australian adults in 2004 who responded to a survey question about self-described smoking status. Main outcome measures: Demographic characteristics, patterns of alcohol and tobacco use, smoking cessation attempts in the past year, and interest in cessation. Results: Smokers who described themselves as 'occasional' and 'social' smokers comprised 29% of all smokers. A significant proportion of occasional and social smokers had been daily smokers, but the majority either believed that they had 'already quit' or had no intention of quitting smoking. Conclusions: Self-ascribed occasional and social smokers potentially represent an important target group for cessation. These types of smokers may be more resistant to public health messages regarding cessation because they do not view their smoking behaviour as presenting a high risk.

Zero-dimensional noise:the best mask you never saw

The transmission of weak signals through the visual system is limited by internal noise. Its level can be estimated by adding external noise, which increases the variance within the detecting mechanism, causing masking. But experiments with white noise fail to meet three predictions: (a) noise has too small an influence on the slope of the psychometric function, (b) masking occurs even when the noise sample is identical in each two-alternative forced-choice (2AFC) interval, and (c) double-pass consistency is too low. We show that much of the energy of 2D white noise masks extends well beyond the pass-band of plausible detecting mechanisms and that this suppresses signal activity. These problems are avoided by restricting the external noise energy to the target mechanisms by introducing a pedestal with a mean contrast of 0% and independent contrast jitter in each 2AFC interval (termed zero-dimensional [0D] noise). We compared the jitter condition to masking from 2D white noise in double-pass masking and (novel) contrast matching experiments. Zero-dimensional noise produced the strongest masking, greatest double-pass consistency, and no suppression of perceived contrast, consistent with a noisy ideal observer. Deviations from this behavior for 2D white noise were explained by cross-channel suppression with no need to appeal to induced internal noise or uncertainty. We conclude that (a) results from previous experiments using white pixel noise should be re-evaluated and (b) 0D noise provides a cleaner method for investigating internal variability than pixel noise. Ironically then, the best external noise stimulus does not look noisy.