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Biomedical subjects

Janet Audrain-McGovern

Publications and source records attributed to Janet Audrain-McGovern.

28 records · Page 2Linked to original sources
PubMed2003

Subjective effects of an initial dose of nicotine nasal spray predict treatment outcome.

RATIONALE: Nicotine nasal spray (NS) is recommended as one of five first-line smoking cessation products. A clinically convenient tool to identify smokers most likely to benefit from NS could assist healthcare practitioners in selecting the optimal treatment for individual patients. OBJECTIVES: To evaluate whether the subjective effects of an initial pre-treatment dose of NS predict 6 month abstinence rates following NS treatment for tobacco dependence. METHODS: One hundred and seventy-five smokers received an initial 1 mg pre-treatment dose of NS and completed a new measure of NS subjective effects (initial spray experience, ISE). This measure, together with demographic and smoking history variables, was examined as a predictor of 6-month point-prevalence (biochemically verified) abstinence rates. RESULTS: Factor analysis revealed positive and negative effects subscales of the ISE. Smokers with higher ratings of positive effects from the pre-treatment NS dose were significantly more likely to be abstinent at 6-month follow-up. These effects were partially mediated by reduction in urge to smoke. CONCLUSIONS: Pending additional validation in human laboratory and clinical studies, assessment of the acute positive subjective effects of initial NS delivery may be an efficient way to predict who will be successful with NS treatment for tobacco dependence.

Administration, Intranasal↗
PubMed2003

Predictors of attendance in a randomized clinical trial of nicotine replacement therapy with behavioral counseling.

Participant attendance at smoking cessation-counseling sessions is an important factor in treatment outcome. In this study, we examined the influence of demographic, psychological, and smoking history variables on attendance at a randomized clinical trial comparing transdermal nicotine and nicotine nasal spray that included seven sessions of behavioral group counseling. Of the 353 participants, 70.5% attended all seven sessions. Perfect attendance predicted abstinence from cigarettes at the end of treatment and at 6-month follow-up. In a logistic regression model, higher levels of education and higher body mass index were significant independent predictors of better attendance. There was a significant interaction between type of nicotine replacement (transdermal nicotine vs. nasal spray) and sex: females were less likely than males to have perfect attendance in the nasal spray group, but there was no sex difference in attendance for the transdermal nicotine group. These findings suggest that smokers with lower body mass index and less formal education may benefit from proactive counseling to address individual barriers to attendance at smoking cessation counseling. Additional research in this area would also be valuable to evaluate strategies to promote attendance in these high-risk groups.

Administration, Cutaneous↗
PubMed2003

Effecting behavior change: awareness of family history.

This article explores the use of family history of disease as a public health tool for risk stratification and improved disease prevention by drawing from previous research on women at moderate risk of developing breast cancer because of a positive family history. About one quarter to one third of women do not appear to be aware of the added risk a family history of breast cancer poses, and many women with a family history overestimate their risk. It is unclear whether risk perceptions are causally related to breast cancer screening in women with a family history. Exaggerated risk perceptions may not hinder breast cancer screening, unless accompanied by distress. Studies suggest that counseling women with a family history of breast cancer about their risk has a small and short-term effect on risk comprehension, a small effect on breast cancer screening, psychological benefits for some women, and unintended negative effects on screening for other women. Future research needs to consider the psychological, individual difference, and cultural variables that moderate counseling effects, recruitment biases, the prospective relationship between perceived risk and breast cancer screening, and whether risk perceptions and comprehension need to match objective risk to be an effective tool to promote screening.

Breast Neoplasms↗
PubMed2003

Tobacco use across the formative years: a road map to developmental vulnerabilities.

Different vulnerabilities are launched or play a more active role at different developmental stages and different ages. Furthermore, the interplay between developmental and biological, psychosocial, and environmental vulnerabilities is expected to differ across stages of smoking. This article focuses on the intersection of vulnerability associated with adolescence with tobacco-use vulnerability resulting from biological, psychological, and environmental characteristics of an adolescent. Recommendations include the following: (a) Effectively treat childhood and adolescent behavioral and emotional disorders that place adolescents at risk; (b) target programs toward specific high-risk subgroups; (c) incorporate training in self-control, affect regulation, and healthy coping strategies into educational programs and extracurricular activities; (d) encourage youth to develop healthy sources of success and satisfaction; (e) encourage communities and states to launch environmental, policy, and regulatory initiatives to protect youth from tobacco; (f) consider bold initiatives that will require fundamental changes in public attitudes, including monetary rewards for nonsmoking, heightened penalties for facilitating and engaging in underage smoking, and government subsidies for substitute pharmacological agents.

Adaptation, Psychological↗
PubMed2003

Personality differences associated with smoking experimentation among adolescents with and without comorbid symptoms of ADHD.

This study evaluated differences in adolescent personality (novelty seeking, harm avoidance, and reward dependence), lifetime cigarette smoking, and symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) among 1051 youths enrolled in several public high schools in middle Atlantic towns in the United States in 2000 and 2001. Psychological and behavioral data were obtained via self-report on the Temperament and Character Inventory (personality), standard epidemiological survey items (smoking), and the Current Symptoms Scale (ADHD). The results indicated that adolescent "ever smokers" with high-normal symptoms of ADHD had the highest novelty seeking scores compared to all other study groups. These data highlight the greater "vulnerability" to smoking that is associated with novelty seeking and symptoms of inattention and hyperactivity. To the extent that novelty seeking and ADHD share cognitive and/or behavioral elements that may negatively impact upon youths' ability to attend to tobacco control communications, additional research on ways to adjust the delivery and content of smoking prevention and intervention program messages to meet the needs of these adolescents is warranted.

Adolescent↗
PubMed2003

Which adolescents are most receptive to tobacco industry marketing? implications for counter-advertising campaigns.

This study sought to identify adolescents most receptive to tobacco advertising based on individual differences in novelty-seeking personality and other key variables. Confidential self-report surveys were completed by 1,071 high school freshmen at 5 public high schools. The survey included validated measures of novelty-seeking personality, smoking habits, peer and family smoking, and tobacco advertising receptivity. Multiple logistic regression analysis was used to evaluate the independent associations of these variables and demographics with receptivity to tobacco advertising. Of the ninth graders, 44% had moderate to high levels of advertising receptivity and 54% had minimal to low levels of receptivity. Higher levels of receptivity were associated with ever smoking (odds ratio [OR] = 2.59, confidence interval [CI] = 1.99-3.39) and novelty-seeking personality (OR = 2.14, CI = 1.57-2.93). The association of novelty-seeking personality and tobacco advertising receptivity was most pronounced among adolescents who had never had a puff of a cigarette. Counter-advertising messages should consider individual differences in novelty-seeking, because novelty-seekers may be most receptive to tobacco industry promotional campaigns.

Adolescent↗
PubMed2003

Smoking progression and physical activity.

This study examined the relationship between changes in physical activity and changes in smoking among adolescents. We prospectively examined smoking progression, physical activity, demographic factors, and covariates in 978 high school students participating in a longitudinal cohort study of the predictors of smoking adoption. We used latent growth modeling with the parallel processes smoking progression and physical activity as our method, with smoking progression measured as an ordered categorical variable. Results indicated that higher levels of physical activity reduced the odds of progressing to smoking or a higher level of smoking by nearly 1.5 (1.44; P < 0.05). No race differences were found. However, being male increased the odds of smoking progression by 1.32 (P < 0.05). Higher levels of physical activity may reduce the risk of smoking during adolescence. Youth smoking prevention initiatives should incorporate strategies to promote physical activity to prevent smoking experimentation and escalation.

Adolescent↗
PubMedDate not supplied

Developmental heterogeneity in adolescent depressive symptoms: associations with smoking behavior.

OBJECTIVE: Previous research has indicated an association between smoking and depression in adolescents, although the nature of the relationship is controversial. We sought to understand this relationship better in a prospective study by investigating whether there are subpopulations of adolescents with different relationships between smoking and depressive symptoms. METHODS: Our sample was 925 adolescents attending one of five Northern Virginia high schools, grades 9 to 12. We used General Growth Mixture Modeling as our method because it allowed identification and characterization of depressive symptoms trajectories and assessment of the effects of trajectory on 12th grade smoking. We defined the binary variable 12th grade current smoking as smoking on 1 or more of the past 30 days and more than 100 cigarettes smoked in a lifetime, versus not having smoked in the past 30 days. RESULTS: We identified three trajectories: high, medium, and low depressive symptoms. For adolescents with high symptoms, 9th grade (baseline) smoking was associated with an overall deceleration of depressive symptoms, whereas for adolescents with moderate symptoms, baseline smoking was associated with an overall acceleration in depressive symptoms. Baseline smoking was not associated with rate of change in depressive symptoms for adolescents with low symptoms, nor was it associated with baseline depressive symptoms in any trajectory. CONCLUSION: These findings demonstrate that there is a relationship between smoking and depressive symptoms in adolescents, and that the relationship can vary by developmental trajectory, suggesting etiological heterogeneity.

Adolescent↗
PubMedDate not supplied

Cigarette smoking practices among American college students: review and future directions.

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 onset, maintenance, and cessation cannot be made. Future studies should use longitudinal designs 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.

Adolescent↗