Review Related Literature

Steve Sussman, Ping Sun

Ping Sun Tobacco induced diseases 5 (1), 3, 2009

In this paper, an empirical review of 64 teen tobacco use cessation studies is provided. Examined

include program contents, delivery modalities, number of contacts, and expected quit rates. In

addition, means of recruitment and retention of smokers in programming are discussed. Also,

promising contemporary methods of teen smoking cessation are examined, including use of

pharmacologic adjuncts, electronic technology, and cigarette price increases (and no smoking

policy). Conclusions are made regarding implications for developing and implementing teen

tobacco use cessation programs.

Freda Patterson, Caryn Lerman, Vyga G Kaufmann, Geoffrey A Neuner, Janet Audrain-McGovern

(2009) Cigarette smoking among college students is a critical public health problem.

In this article, the authors review available research on cigarette smoking practices among college

students and suggest directions for future research. Studies show that smoking by college students

is associated with being White, living in housing where smoking is permitted, using alcohol and

other substances, and having a lower psychological sense of well-being. Depression, life

satisfaction, and coping style are also related to college smoking, but the causal relationship

remains unclear.Although a large proportion of college students have made an attempt to quit

smoking, only a minority actually succeed. Most study designs examining college smoking have

been cross-sectional, descriptive, or both. Thus, conclusions regarding predictors of smoking

that can identify psychological and socioenvironmental determinants of smoking among college

students. Such information could inform the development of smoking prevention and cessation

interventions targeted to the college student population.

John A Ambrose, Rajat S Barua

(2009). The effect of Smoking Cigarettes in student.

The Cigarette smoking (CS) continues to be a major health hazard, and it contributes significantly

to cardiovascular morbidity and mortality. Cigarette smoking impacts all phases of atherosclerosis

from endothelial dysfunction to acute clinical events, the latter being largely thrombotic. Both

active and passive (environmental) cigarette smoke exposure predispose to cardiovascular events.

Whether there is a distinct direct dose-dependent correlation between cigarette smoke exposure

and risk is debatable, as some recent experimental clinical studies have shown a non-linear relation

to cigarette smoke exposure. The exact toxic components of cigarette smoke and the mechanisms

involved in CS-related cardiovascular dysfunction are largely unknown, but CS increases

inflammation, thrombosis, and oxidation of low-density lipoprotein cholesterol. Recent

experimental and clinical data support the hypothesis that cigarette smoke exposure increases

oxidative stress as a potential mechanism for initiating cardiovascular dysfunction.

Sarah Bowen, Alan Marlatt

(Marlatt & Gordon 2010), on smoking-related urges and behavior.

Marlatt’s “urge surfing” technique (Marlatt & Gordon, 2010), on smoking-related urges and

behavior. Undergraduate smokers (N= 123) who were interested in changing their smoking, but

not currently involved in a cessation program, participated in a cue exposure paradigm designed

to elicit urges to smoke.They were randomly assigned either to a group receiving brief

mindfulness-based instructions or to a no-instruction control group. Results suggest that groups

did not differ significantly on measures of urges. However, those in the mindfulness group smoked

significantly fewer cigarettes over a 7-day follow-up period as compared to those in the control

group. These findings suggest that the mindfulness techniques may not initially reduce urges to

smoke but may change the response to urges. The study provides preliminary data for future studies

examining both mechanisms and effectiveness of mindfulness-based interventions for cigarette

smoking.

The WHO Framework Convention on Tobacco Control (WHO FCTC) was adopted by the World

Health Assembly in May 2003 and as of April 2014 has been ratified by 178 countries (1). The

WHO FCTC aims to protect present and future generations from the devastating health, social,

environmental and economic consequences of tobacco consumption and exposure to tobacco

smoke (2). As of 2012, 79% of Parties reported strengthening their existing legislation or adopting

new tobacco control legislation after ratifying the Convention. Additionally, over half of the

Parties to the WHO FCTC reported having developed and implemented comprehensive tobacco

control strategies, plans and programmes as required in Article 5.1 of the Convention (3). The

WHO FCTC is described as an evidence-based treaty, implying that there is considerable research

evidence that implementation of the measures contained in the Convention will result in such
outcomes as a reduction in both tobacco use and exposure to second-hand smoke (SHS), ultimately

reducing tobacco-related morbidity and mortality. The Treaty has a specific public health objective

of reducing morbidity and mortality due to tobacco use. However, there are time lags throughout

the process from ratification of the WHO FCTC, the promulgation of the Treaty-compliant tobacco

control legislation, and actual implementation and enforcement of the law. There is also a time lag

from when the policies are implemented until behaviour changes in tobacco use (i.e. cessation or

non-initiation by youth) are seen on a large scale within a country. There is also the time lag

between behaviour change and the accrual of health benefits. Among smokers who quit, a

reduction in risk of cancer may take about a quarter of a century to manifest, with the most

immediate health benefit being a reduction in the risk of heart disease. At the population level,

reduction in overall mortality may begin to show up about quarter of a century after

implementation of tobacco control policies and reach full impact in about half a century (4).

However, implementation of smoke-free policies has been shown to have more immediate health

effects in populations, including significant reductions in acute myocardial infarctions (AMI). This

will be discussed in more depth within the paper. A current review of the literature shows that

WHO FCTC Article 8, on protection from exposure to tobacco smoke, is one of the most widely

implemented and studied articles of the Convention. There is also some literature on the effect of

smoke-free policies on prevalence of tobacco use. However, the most extensive available evidence

is on the health effects of smoke-free policies, including on reduction in acute heart attacks from

implementation of these policies. This overview thus aims to cover the health effects of smoke-

free policies in line with Article 8 of the WHO FCTC.

(2009) While most college students and other young adults who smoke fall into the light and

intermittent smoking (LITS) category

they remain at risk for tobacco dependence and other adverse health effects from their smoking.

This study examines smoking patterns, tobacco dependence, and other health variables among

students at five universities to better understand how to identify and address tobacco use and

related risks in a college health clinic setting.

According to American journal of preventive medicine (2009)College students who engage in

occasional or social cigarette smoking are less likely to identify themselves as smokers and to

attempt to quit. This analysis aimed to determine: (1) the correlates of denying being a smoker

among students reporting smoking in the past 30 days and (2) if denying this label was related to

not attempting to quit smoking in the past 12 months.

Nicotine & Tobacco Research

(2012) Light and intermittent patterns of cigarette smoking are prevalent among U.S. college-aged

individuals.

According to Nicotine & Tobacco Research (2012) Light and intermittent patterns of cigarette

smoking are prevalent among U.S. college-aged individuals. It is unclear whether intermittent

smokers maintain their use over time or are transitioning to daily use or nonuse, and whether they

experience more adverse health outcomes than nonsmokers.This study examined the trajectories
of tobacco cigarette smoking, their predictors, and health outcomes among students (N = 1,253)

assessed during their first year of college (Y1) and annually thereafter (Y2, Y3, and Y4).In Y1,

3.4% smoked daily and 4.1% exhibited signs of dependence (first cigarette within 30 min of

waking). Growth curve modeling identified five distinct smoking trajectories. After stable

nonsmokers (71.5%wt), the low-stable smoking trajectory was the most common (13.3%wt),

outnumbering both low-increasing (6.5%wt) and high-stable smokers (5.5%wt) by 2:1 and high-

decreasing smokers (3.2%wt) by 4:1. The likelihood of maintaining a low level of smoking over

time was inversely related to Y1 smoking frequency. Few demographic, smoking, and alcohol use

characteristics measured in Y1 distinguished low-increasers from low-stable smokers or high-

decreasers from high-stable smokers. By Y4, high-stable smokers rated their health significantly

worse than all others except low-increasers. High-stable smokers had the most Y4 health problems

(i.e., provider visits for health problems and days of illness-related impairment), but only among

nonWhites.

According to Nicotine & Tobacco Research (2010) Less than half of college students who have

smoked in the past month identify themselves as smokers. Thus, we examined (a) how college

students define the term “smoker” and (b) how this definition impacts smoking behavior and

attitudes.We conducted 12 focus groups with a total of 73 college student smokers drawn from

survey participants at two colleges in Minnesota (a two-year technical college and a four-year

university). Each group was homogenous in terms of gender and school (two-year, four-year).The

majority (56.2%) were female, 49.3% attended a 2-year college, and 32.9% were regular smokers

(smoked ≥25 of the last 30 days). Participants described a “smoker” in terms of (a) smoking

frequency, ranging from smoking infrequently to smoking daily; (b) contextual factors, such that
smoking alone indicates being a smoker rather than smoking at parties; (c) time since initiation;

(d) whether one purchases cigarettes, such that “smokers” buy cigarettes while nonsmokers borrow

them; (e) addiction and being able to quit without great effort; (f) whether smoking is habitual;

and (g) personality and physical characteristic. These beliefs had implications on experiences in

quitting smoking, motivation to quit, and perceived barriers. Many participants indicated

confidence in being able to quit but believed that they were not “smokers” and thus did not need

to quit.College students use a broad range of criteria to define who is a smoker. These criteria

impact how motivated students are to quit smoking and their perception of needing to “quit

smoking.”