The role of smoking status on postoperative complications and survival in lung cancer patients presenting to M.D. Anderson Cancer Center

It is estimated that 50% of all lung cancer patients continue to smoke after diagnosis. Many of these lung cancer patients who are current smokers often experience tremendous guilt and responsibility for their disease, and feel it might be too late for them to quit smoking. In addition, many oncologists may be heard to say that it is 'too late', 'it doesn't matter', 'it is too difficult', 'it is too stressful' for their patients to stop smoking, or they never identify the smoking status of the patient. Many oncologists feel unprepared to address smoking cessation as part of their clinical practice. In reality, physicians can have tremendous effects on motivating patients, particularly when patients are initially being diagnosed with cancer. More information is needed to convince patients to quit smoking and to encourage clinicians to assist patients with their smoking cessation. ^ In this current study, smoking status at time of lung cancer diagnosis was assessed to examine its impact on complications and survival, after exploring the reliability of smoking data that is self-reported. Logistic Regression was used to determine the risks of smoking prior to lung resection. In addition, survival analysis was performed to examine the impact of smoking on survival. ^ The reliability of how patients report their smoking status was high, but there was some discordance between current smokers and recent quitters. In addition, we found that cigarette pack-year history and duration of smoking cessation were directly related to the rate of a pulmonary complication. In regards to survival, we found that current smoking at time of lung cancer diagnosis was an independent predictor of early stage lung cancer. This evidence supports the idea that it is "never too late" for patients to quit smoking and health care providers should incorporate smoking status regularly into their clinical practice.^

Factors associated with smoking cessation using the 2005 National Health Interview Survey

Objectives. The objective of this study is to compare the socio-demographic, behavioral, and access to care characteristics of smokers who have quit smoking for one or more years and current smokers who have made an attempt to quit smoking within the last year. ^ Methods. Data from the 2005 National Health Interview Survey (NHIS) were used to compare current smokers who have tried to quit (n=2747) and former smokers who have quit for one or more years (n=6194). The data was analyzed using STATA 9.0 to perform statistical calculations. ^ Results. Age, education, race and income were associated with smoking status. Respondents aged 65 and older were 36 times more likely to have quit smoking. Education and income had higher odds ratios among quitters (OR=1.27 and OR=1.21) and Non-Hispanic Whites were the most likely to have quit smoking compared to Hispanics and Blacks. Adults with health insurance coverage were 3.44 times more likely to have quit smoking. ^ Discussion. Existing research suggests that individual factors relating to demographics behavior and access to care can impact a smoker's ability to quit smoking. This paper discusses the factors that affect cessation and which populations would benefit from additional research and targeted smoking cessation programs. ^

Spit & lies: Does social desirability predict smoking cessation success?

This study examines the role of socially desirable responding (SDR) on smoking cessation program success. SDR is the tendency for individuals to give responses that put themselves in what they perceive to be a socially desirable light. ^ This research is a secondary analysis of data from Project Cognition, a study designed to examine the associations between performance on cognitive assessments and subsequent relapse to smoking. Adult smokers (N=183) were recruited from the greater Houston area to participate in the smoking cessation study. In this portion of the research, participants' smoking status was assessed on their quit day (QD), one week after QD, and four weeks after QD. Primary outcome measures were self-reported relapse, true cessation determined by biological measure, discrepancies between self-reported smoking status and biological assessments of smoking, and dropping out. ^ Primary predictor measures were the Balanced Inventory of Desirable Responding (BIDR) and self-reported motivation to quit smoking. The BIDR is a 40-item questionnaire that assesses Self-deceptive Enhancement (SDE; the tendency to give self-reports that are honest but positively biased) and Impression Management (IM; deliberate self-presentation to an audience). Scores were used to create a dichotomous BIDR total score group variable, a dichotomous SDE group variable, and a dichotomous IM group variable. Participants at one standard deviation above the mean were in the "high" group, and scores below one standard deviation were in the "normal" group. In addition, age, race, and gender were analyzed as covariates. ^ The overall findings of this study suggest that in the general population BIDR informs participants' self-reports and the IM and SDR subscales inform participants' behavior. BIDR predicted self-reported relapse in the general population and trended toward indicating that a participant will claim smoking cessation success when biological measures indicate otherwise. SDE interacted with motivation to predict biologically verified cessation success. There was no main effect for BIDR, IM, or SDE predicting drop out; however, IM interacted with age to predict participants' likelihood of drop out. Used in conjunction, the BIDR, IM subscale, and SDR subscale can be used to more accurately tailor smoking cessation programs to the needs of individual participants.^

Changes in smoking behaviour among young women over life stage transitions

Objective: To examine changes in smoking behaviour among young women over four life stages: leaving home; employment or attending college or university; marriage; and parenthood. Methods: Young women participating in the Australian Longitudinal Study on Women's Health completed postal questionnaires in 1996 and 2000. Results: Unmarried women who moved out of their parents' home between 1996 and 2000 had higher odds of adopting smoking than those who had not lived with their parents at either time (OR 1.8, 95% Cl 1.2-2.6). Married women had lower odds of resuming smoking after quitting (OR 0.4, 95% Cl 0.2-0.7) than unmarried women. Women who were pregnant in 2000 had higher odds of quitting smoking (OR 3.8, 95% Cl 2.5-5.6) and women who were pregnant in 1996 and not in 2000 had higher odds of starting to smoke again (OR 3.2, 95% Cl 1.6-6.2) than women who were not pregnant. The odds of being a current smoker or adopting smoking were significantly greater for women who binge drank alcohol or used cannabis and other illicit drugs. Conclusions: Adoption, maintenance and cessation of smoking among young women is strongly related to major life stage transitions, illicit drug use and alcohol consumption. Implications: Life changes such as marriage and actual or contemplated pregnancy provide opportunities for targeted interventions to help women quit smoking and not relapse after having a baby. Legislation to control smoking on licensed premises would reduce the social pressure on women to smoke.

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.

Impact of a cognitive-behavioral weight control program on body weight, diet quality, and smoking cessation in weight-concerned female smokers

Many people use smoking as a weight control mechanism and do not want to quit because they fear weight gain. These weight-concerned smokers tend to be female, are significantly less likely to stop smoking, are less likely to join smoking cessation programs, and will relapse more often than smokers who are not weight-concerned. Research suggests that a woman’s confidence in her ability to control her weight after quitting relates positively with her intention to quit smoking. Likewise, success in smoking cessation has been associated with increased self-efficacy for weight control. It has been shown that success in changing one negative health behavior may trigger success in changing another, causing a synergistic effect. Recently research has focused on interventions for weight-concerned smokers who are ready to quit smoking. The present study investigated the effect of a cognitive based weight control program on self-efficacy for weight control and the effect on smoking behavior for a group of female weight concerned smokers. Two hundred and sixteen subjects who wanted to lose weight but who were not ready to quit smoking were recruited to participate in a 12-week, cognitive-behavioral weight control program consisting of twelve one-hour sessions. Subjects were randomly assigned to either (1) the weight-control program (intervention group), or (2) the control group. Results of this study demonstrated that subjects in the intervention group increased self-efficacy for weight control, which was associated with improved healthy eating index scores, weight loss, increased self-efficacy for quitting smoking, a decrease in number of cigarettes smoked and triggered positive movement in stage of change towards smoking cessation compared to the control subjects. For these subjects, positive changes in self-efficacy for one behavior (weight control) appeared to have a positive effect on their readiness to change another health behavior (smoking cessation). Further study of the psychological variables that influence weight-concerned female smokers’ decisions to initiate changes in these behaviors and their ability to maintain those changes are warranted.

Experiences of COPD patients with existing smoking cessation programs and their preferences for improvement - a qualitative analysis

BACKGROUND: Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). For current smokers who are diagnosed with COPD, their first treatment option is to stop smoking. Motivation is necessary for long-term smoking cessation; therefore, when designing smoking cessation programs, the patients' needs and preferences should be considered. We focused on COPD patients' experiences with existing smoking cessation programs and evaluated their preferences for the improvement of these programs. METHODS: We conducted 18 guideline-based interviews with COPD patients between April and June 2014 in Germany. Each patient with COPD, who was a current or past smoker and had made at least one attempt to quit smoking in the past 5 years, was included in the study. We audiotaped, verbatim transcribed, and evaluated the interviews, using content analysis. RESULTS: The patients had broad and different experiences with pharmaceutical, behavioral, and alternative approaches that supported or negatively influenced the smoking cessation process. Pharmaceuticals were viewed as an expensive alternative with many side effects although they helped to stop cravings for a few moments. Furthermore, the bad structure and impersonal content of the seminars for smoking cessation negatively influenced group cohesion, and therefore degrading the patients' motivation to stop smoking. Alternative methods, such as acupuncture and hypnosis were mostly ineffective in smoking cessation, but in some cases, served as motivational strategies. CONCLUSION: Negative experiences with smoking cessation were explained by the patients' lack of motivation or resolution. Other negative experiences, such as the structure of seminars for smoking cessation and the high price of pharmaceuticals should be addressed through policy changes to increase the patients' motivation to quit smoking.

Descriptive evaluation of smoking cessation

Introduction: The Northern Alliance HARP smoking cessation program provides support to chronic disease participants who desired to quit smoking. This is an individualised program with pharmacotherapy and behavioural support, delivered by specialist clinicians.

Aims: The aims of this descriptive evaluation were to explore factors that affect abstinence rates, record those rates, and describe the impact of anxiety, depression, self-efficacy, quality of life and motivation on quit rates at three months.

Methods: Data was collected prospectively from clients enrolled in the service. Participants were assessed for abstinence at three months, six months and one year by carbon monoxide (CO) monitoring and self-reporting. Factors predictive of quitting were analysed using logistic regression; factors with a p value < 0.05 and 95% CI not containing one were considered statistically significant.

Results: 103 clients were assessed and 86 were enrolled in the program. The odds of successful quitting at three months CO verified was higher amongst completers of the program compared to non-completers (OR = 6.6, 95% CI = 2.03–21.57, p = 0.002). The probability of sustained quitting at one year was over 18 times higher in the group who completed the program (n = 16/21 completers and n = 1/4 non-completers) (OR 18.5, 95% CI, 2.32–147.34, p = 0.006). No other factors predicted quitting.

The rate of quitting was 28.7% at three months, 19.5% at six months and 10.3% at one year, CO verified. Measures of anxiety and depression, self-efficacy, quality of life and motivation did not influence either the quit rate or the likelihood of completing the course of treatment at three months.

The effects of a woman-focused, woman-held resource on preventive health behaviors during pregnancy : the pregnancy pocketbook

We evaluated the effectiveness of a woman-held pregnancy record ('The Pregnancy Pocketbook') on improving health behaviors important for maternal and infant health. The Pregnancy Pocketbook was developed as a woman-focused preventive approach to pregnancy health based on antenatal management guidelines, behavior-change evidence, and formative research with the target population and health service providers. The Pregnancy Pocketbook was evaluated using a quasi-experimental, two-group design; one clinic cohort received the Pregnancy Pocketbook (n = 163); the other received Usual Care (n = 141). Smoking, fruit and vegetable intake, and physical activity were assessed at baseline (service-entry) and 12-weeks. Approximately two-thirds of women in the Pregnancy Pocketbook clinic recalled receiving the resource. A small, but significantly greater proportion of women at the Pregnancy Pocketbook site (7.6%) than the UC site (2.1%) quit smoking. No significant effect was observed of the Pregnancy Pocketbook on fruit and vegetable intake or physical activity. Few women completed sections that required health professional assistance. The Pregnancy Pocketbook produced small, but significant effects on smoking cessation, despite findings that indicate minimal interaction about the resource between health staff and the women in their care. A refocus of antenatal care toward primary prevention is required to provide essential health information and behavior change tools more consistently for improved maternal and infant health outcomes.

One device, two doses

Ms Breathless is a 59-year-old lady living with chronic obstructive pulmonary disease (COPD) for several years now, and quit smoking over 20 years ago. She sometimes experiences symptoms of breathlessness, and an unrelenting productive cough, particularly when she comes in contact with dusty places, second-hand smoke, or when her allergies and hay fever play up. Apart from these triggers, her symptoms are well maintained with her inhalers glycopyrronium bromide (Seebri) and indacaterol (Onbrez), and she has been using them for about nine months. Ms Breathless is otherwise healthy, and not taking any other medicines.

An object-centred approach to encourage online participation in the context of behaviour change

Online groups rely on contributions from their members to flourish, but in the context of behaviour change individuals are typically reluctant to participate actively before they have changed successfully. We took inspiration from CSCW research on objects to address this problem by shifting the focus of online participation from the exchange of personal experiences to more incidental interactions mediated by objects that offer support for change. In this article we describe how we designed, deployed and studied a smartphone application that uses different objects, called distractions and tips, to facilitate social interaction amongst people trying to quit smoking. A field study with 18 smokers revealed different forms of interaction: purely instrumental interactions with the objects, subtle engagement with other users through receptive and covert interactions, as well as explicit interaction with other users through disclosure and mutual support. The distraction objects offered a stepping-stone into interaction, whereas the tips encouraged interaction with the people behind the objects. This understanding of interaction through objects complements existing frameworks of online participation and adds to the current discourse on object-centred sociality. Furthermore, it provides an alternative approach to the design of online support groups, which offers the users enhanced control about the information they share with other users. We conclude by discussing how researchers and practitioners can apply the ideas of interaction around objects to other domains where individuals may have a simultaneous desire and reluctance to interact.

Pilottitutkimus apteekkien yksilöllisestä tupakoinninvieroituspalvelusta

Apteekkien yksilöllinen tupakoinninvieroituspalvelu on tupakoinnin lopettamiseen motivoituneille asiakkaille tarkoitettu maksullinen erikoispalvelu, joka sisältää 4–6 tapaamista vieroitusohjaajana toimivan farmaseutin tai proviisorin kanssa. Palvelu sisältää asiakkaalle räätälöityä neuvontaa, henkilökohtaisen vieroitussuunnitelman sekä seurantajakson. Apteekkien yksilöllinen tupakoinninvieroituspalvelu perustuu Isossa-Britanniassa kehitettyyn palvelumalliin, ja sitä on tarjottu suomalaisissa apteekeissa vuodesta 2006. Tämä pro gradu -tutkielma käsittelee apteekkien yksilöllisen tupakoinninvieroituspalvelun pilottitutkimusta, joka toteutettiin Suomen Apteekkariliiton ja Helsingin yliopiston farmasian tiedekunnan sosiaalifarmasian osaston yhteistyönä ja se kuului osana Hengitysliitto Heli ry:n koordinoimaa tupakasta vieroituksen hankekokonaisuutta. Tässä pro gradu -tutkielmassa tarkastellaan pilottitutkimuksessa saadun asiakasaineiston avulla apteekkien yksilöllisen tupakoinninvieroituspalvelumallin toimivuutta, asiakkaiden kokemuksia palvelusta, asiakkaiden onnistumista tupaakoinnin lopettamisessa sekä asiakkaiden kyvykkyyden tunteen kehittymistä palvelun aikana. Tässä interventiotutkimuksessa oli mukana 14 apteekkia, jotka rekrytoivat yhteensä 36 palveluasiakasta. Ennen asiakkaiden rekrytointia apteekit perehdytettiin palvelun tarjoamiseen. Apteekit tiedottivat pilottitutkimuksesta paikallisen terveydenhuollon lääkäreitä ja muita terveydenhuollon ammattilaisia, jotka voivat ohjata asiakkaita palveluun. Sosiaali- ja terveysministeriön pilottitutkimukselle myöntämä rahoitus mahdollisti asiantuntijapalkkion maksamisen apteekeille ja palvelun tarjoamisen asiakkaille ilmaiseksi tai pientä omakustannusosuutta vastaan. Asiakkaiden tupakoimattomana pysymistä sekä kokemuksia tupakoinninvieroituspalvelusta kartoitettiin kyselylomakkeilla, jotka asiakkaat saivat täytettäväkseen palvelun alussa sekä noin 3 kuukauden kohdalla palvelun alkamisesta. Asiakkaiden taustatiedot kerättiin ensimmäisen tapaamisen yhteydessä erillisille taustatietolomakkeille ja palvelun aikana tehtyjä huomioita niille tarkoitetuille kaavakkeille. Ensimmäisen kyselylomakkeen palauttaneista 28 henkilöstä 20 ja toisen kyselylomakkeen palauttaneista 17 henkilöstä 13 oli pysynyt tupakoimattomana (55,6 % ja 36,1 % kaikista asiakkaista). Kaikki tupakoinnin lopettaneet käyttivät jotakin tupakasta vieroituslääkettä. Tupakoinnin lopettaneilla asiakkailla kyvykkyyden tunne oli keskimääräistä parempi sekä palvelun alussa että koko palvelun ajan. Asiakkaat pitivät palvelua tarpeellisena ja apteekin vieroitusohjaajalta saatua tukea tärkeänä. Asiakkaat kokivat myös palvelun saamisen apteekista tärkeäksi. Noin 32 % ensimmäiseen kyselyyn vastanneista ja 41 % toiseen kyselyyn vastanneista oli valmis maksamaan palvelusta. Heidän ilmoittamansa maksuvalmius oli keskimäärin noin 45 euroa (10–100 euroa). Muusta terveydenhuollosta lähetettiin palveluun vain vähän tai ei lainkaan asiakkaita. Tästä syystä apteekit rekrytoivat asiakkaita myös ilman kontaktia muuhun terveydenhuoltoon. Palvelun 36 asiakkaasta noin 36 % oli pysynyt tupakoimattomana 3 kuukauden kohdalla. Verrokkiryhmä jouduttiin jättämään tutkimuksesta pois verrokkihenkilöiden rekrytoinnin epäonnistuttua. Tulos on kuitenkin vertailukelpoinen kansainvälisiin tutkimuksiin, joissa on saatu vastaavanlaisia tuloksia. Apteekkien yksilöllisestä tupakoinninvieroituspalvelusta saattaa olla hyötyä tupakoinnin lopettamisessa siihen motivoituneille henkilöille ja erityisesti henkilöille, jotka käyttävät lisäksi tupakasta vieroituslääkettä. Asiakkaat kokivat palvelun tärkeäksi ja tarpeelliseksi, mutta heikko maksuvalmius asettaa haasteita palvelun tarjoamiselle apteekeissa. Yhteistyömallia muun terveydenhuollon kanssa tulisi kehittää.

Estudo dos efeitos da exposição materna à nicotina na lactação sobre a função da medula adrenal e dos adipócitos de ratos machos e fêmeas

Alterações nutricionais, hormonais e ambientais nos períodos críticos do desenvolvimento como a gestação e/ou lactação podem influenciar a estrutura e a fisiologia de órgãos e tecidos, predispondo ao aparecimento de doenças na vida adulta. Esse fenômeno é conhecido como programação metabólica. O fumo materno na gestação/lactação tem sido associado ao sobrepeso/obesidade na infância e na vida adulta em ambos os sexos. Porém, estudos evidenciam diferenças entre os gêneros em resposta a exposição à nicotina. Já foi demonstrado que muitas mulheres param de fumar na gestação, mas a maioria destas volta a fumar na lactação. Anteriormente, mostramos que machos adultos cujas mães foram expostas à nicotina na lactação, desenvolveram obesidade central, hiperleptinemia e hipotireoidismo. Como a nicotina afeta a função adrenal e como catecolaminas e glicocorticóides têm efeitos bem conhecidos sobre o tecido adiposo, avaliamos a função da medula adrenal e o conteúdo de leptina no tecido adiposo e músculo de machos e fêmeas cujas mães foram expostas à nicotina na lactação. Dois dias pós-parto, implantamos minibombas osmóticas nas ratas lactantes dividas em: NIC infusão de nicotina (6mg/Kg/dia s.c.) por 14 dias, e C infusão de salina pelo mesmo período. Estas lactantes foram divididas de acordo com o sexo das proles. O sacrifício das proles de ambos os sexos ocorreu aos 15 (fim da exposição à nicotina) e 180 dias de vida. Aos 15 dias, os machos da prole NIC apresentaram aumento de MGV absoluta e relativa ao peso corporal (+72% e +73% respectivamente), hiperleptinemia (+35%), hipercorticosteronemia (+67%), maior peso adrenal (+39%), conteúdo de catecolaminas totais (absoluto: +69% e relativo: +41%), embora diminuição da enzima TH (-33%). Quando adultos, os machos programados exibiram maior massa corporal (+10%), MGV absoluta (+47%) e relativa (+33%), além de hiperleptinemia (+41%) e maior conteúdo de leptina no TAV (+23%). Esses animais também apresentaram hipercorticosteronemia (+77%), maior conteúdo de catecolaminas totais absoluto e relativo (+79% e +89% respectivamente) e de TH (+38%) embora tenham menor secreção de catecolaminas in vitro estimulada por cafeína (-19%) e maior expressão do ADRB3 no TAV (+59%). Em relação as fêmeas da prole NIC aos 15 dias de vida, estas apresentaram menor massa corporal (-6%) e hiperleptinemia (+41%) embora sem alteração da MGV. Aos 180 dias, as fêmeas da prole NIC apresentaram menor conteúdo de leptina no TAS (-46%) e maior conteúdo de leptina no músculo solear (+22%) e diminuição da expressão do ADRB3 no TAV (-39%). Concluímos que a nicotina materna afeta ambos, medula adrenal e tecido adiposo de forma gênero dependente, tanto em curto prazo (quando a nicotina está presente no leite materno), quanto em longo prazo (repercussões na vida adulta). De forma geral, as fêmeas da prole NIC apresentam alterações mais discretas do que os machos em ambos os períodos estudados.

Acute electronic cigarette use: nicotine delivery and subjective effects in regular users

Rationale Electronic cigarettes are becoming increasingly popular among smokers worldwide. Commonly reported reasons for use include the following: to quit smoking, to avoid relapse, to reduce urge to smoke, or as a perceived lower-risk alternative to smoking. Few studies, however, have explored whether electronic cigarettes (e-cigarettes) deliver measurable levels of nicotine to the blood. Objective This study aims to explore in experienced users the effect of using an 18-mg/ml nicotine first-generation e-cigarette on blood nicotine, tobacco withdrawal symptoms, and urge to smoke. Methods Fourteen regular e-cigarette users (three females), who are abstinent from smoking and e-cigarette use for 12 h, each completed a 2.5 h testing session. Blood was sampled, and questionnaires were completed (tobacco-related withdrawal symptoms, urge to smoke, positive and negative subjective effects) at four stages: baseline, 10 puffs, 60 min of ad lib use and a 60-min rest period. Results Complete sets of blood were obtained from seven participants. Plasma nicotine concentration rose significantly from a mean of 0.74 ng/ml at baseline to 6.77 ng/ml 10 min after 10 puffs, reaching a mean maximum of 13.91 ng/ml by the end of the ad lib puffing period. Tobacco-related withdrawal symptoms and urge to smoke were significantly reduced; direct positive effects were strongly endorsed, and there was very low reporting of adverse effects. Conclusions These findings demonstrate reliable blood nicotine delivery after the acute use of this brand/model of e-cigarette in a sample of regular users. Future studies might usefully quantify nicotine delivery in relation to inhalation technique and the relationship with successful smoking cessation/harm reduction.

Impacto das campanhas publicitárias contra o tabagismo no comportamento do consumidor

Todos os anos, milhares de pessoas morrem vítimas de doenças causadas pelo consumo de produtos derivados do tabaco, este é considerado a principal causa de morte evitável. O tabaco também colabora com as seis das oito principais causas de mortes entre fumantes e não fumantes a nível mundial. Algumas medidas governamentais como as campanhas publicitárias antitabagistas, buscam alertar, conscientizar e mudar o pensamento e o interesse coletivo neste tipo de produto e consequentemente, diminuir a taxa de consumo. Avaliar se as crenças, pensamentos e atitudes dos brasileiros são influenciados por este tipo de publicidade e se o comportamento relacionado a não fumar ou deixar de fumar é uma consequência da persuasão das mensagens antitabagistas, ajudam a conhecer o real impacto destas campanhas e sua eficácia. Através dos métodos de investigação quantitativo e qualitativo e das análises extensiva e semiótica, a pesquisa inquiriu 272 indivíduos brasileiros à respeito das advertências sanitárias e das campanhas publicitárias antitabagistas, classificando-os como não fumantes, ex-fumantes e fumantes, identificando os elementos visuais e textuais que compõem a narrativa publicitária de 5 anúncios antitabagistas. Após a análise, a pesquisa concluiu que as campanhas publicitárias coordenadas pelo INCA – Instituto Nacional de Câncer, denominadas campanhas antitabagistas, são eficazes para alertar e conscientizar os indivíduos sobre os males causados pelo consumo do cigarro mas ineficazes para influenciar suas atitudes e comportamentos. Embora estas consigam persuadir à crença nas mensagens, fazendo com que os indivíduos as vejam como verdadeira, isto não é suficiente para que a intenção de deixar de fumar torne-se um ato prático. Todos os anúncios possuem o mesmo formato e a maioria utilizou o mesmo percurso visual, equilíbrio, enquadramento, luz, ângulo e função do personagem. Todos possuem textos com funções identificadora, ancoragem e apoio e a narrativa conota o cigarro como algo negativo, prejudicial, mortífero e destruidor.