摘要:

Although smoking cessation continues to get most of the attention from both researchers and practitioners, treatment for smokeless tobacco (SLT) dependence gets little consideration. The reasons are varied, but essentially smoking is more prevalent, has greater public health implications, and has been the subject of clean air laws and environmental issues that have focused the attention on a burned tobacco, thereby leaving SLT with scant public health attention. This is unfortunate, because the sales of SLT products, especially moist snuff, have increased consistently over the past decade; regular use of these products can result in oral cancer, other negative effects on oral health, and nicotine dependence or addiction. This article will review some unique issues of SLT use that affect cessation and the empirical research on interventions.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The Public Health Service Guideline,Treating Tobacco Use and Dependence, contains a wealth of information regarding current treatment practices. Unfortunately, guidance for tailoring standardized treatments to meet the needs of specific ethnic subgroups is limited. This article highlights features unique to African American smokers, a necessary precursor to developing intervention programs that hold promise for improving outcomes.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Active and passive exposure to tobacco smoke during pregnancy and infancy is the most serious and preventable cause of adverse maternal, fetal, and infant outcomes in the United States. The multiple risks of tobacco exposure to mothers and infants are definitive, and the clinical and economic benefits of cessation have been documented. This article provides a synopsis of the state of the science and art in this specialized area and reviews the evidence for validity of patient assessment methods and the effectiveness of smoking cessation/reduction treatments for pregnant women. A synthesis of 4 topics is presented: (1) the validity of patient reports of smoking status and recent trends during pregnancy and postpartum; (2) definition of “Best Practice” smoking cessation methods for pregnant women; (3) the effect of dissemination of effective clinical practice methods among the 800,000+ pregnant US smokers each year; and (4) the evidence for the cost-benefit of improved maternal and infant outcomes from cessation.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Tobacco addiction among persons with serious mental illness (SMI) has been largely ignored. About 75 to 85% of persons with schizophrenia, bipolar disorder, and other SMI use tobacco; most will either die and/or have reduced quality of life because of tobacco-caused medical diseases. Tobacco addiction is the most common co-occurring disorder for the SMI population. A dramatic reduction in tobacco use in the general population has occurred during the past 40 years; however, there has been almost no reduction for smokers with SMI. The University of Medicine and Dentistry of New Jersey program targets smokers with SMI and provides outreach services, clinical treatment and research, and consultation to other community-based mental health treatment agencies in New Jersey. Clinical and research evidence supports motivation-based treatment, blending mental health and addiction treatment approaches, and integrating tobacco dependence treatment within mental health settings. The unique barriers and clinical issues for this population are described.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Millions of American girls and women have been drawn to smoking by an industry that has been clearly and systematically targeting women of all ages and life circumstances. Big tobacco’s well-timed marketing strategies skillfully link cigarette use to typical female values: independence, self-reliance, weight control, stress management, social progress and popularity, personal attractiveness, autonomy, self-fulfillment, youth, happiness, personal success, health, and active, vigorous, and strenuous lifestyles. Biologically speaking, women are especially vulnerable to the legion of health problems of tobacco use. Smoking is a critical hazard for women in their reproductive years, particularly when they are pregnant. The US Public Health Service 2000Clinical Practice Guidelineprovides helpful guidance and sound general recommendations for the treatment of women of all ages for tobacco use and dependence. Women and girls who smoke represent diverse subgroups of the population with unique issues and needs. The 2001 Surgeon General’s Report on Women and Smoking stresses the importance of multistrategy programs for treating female smokers. This approach includes antitobacco media campaigns, increases in tobacco prices, promotion of nonsmoking in public places, curbs on tobacco advertising and promotion, enforcement of legislation to reduce youth access to tobacco products, and effective tobacco use treatment programs.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Smoking among teenagers is a major public health problem, and the purpose of this article is to review the literature concerning etiological factors of teen smoking, effects of prevention programs on reducing rates of teenage smoking, and the efficacy of smoking cessation treatment. Peer, family, and intrapersonal factors all play a role in the continuum of initiation to regular use. Prevention programs focusing on social norms governing teenage smoking are particularly effective in reducing onset of smoking behavior. Finally, behavioral cessation programs have been shown to be effective in reducing teenage smoking. Future directions concerning prevention and cessation research are discussed.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Despite wide distribution of an evidence-based clinical practice guideline, the provision of treatment for tobacco use has been weak. The primary care setting is an ideal environment in which to implement the tobacco clinical practice guideline. It has been suggested that implementation of the guideline may be enhanced by adapting guideline recommendations into a stepped-care plus treatment-matching model; however, this model has yet to be tested. This article describes an ongoing investigation designed to evaluate (1) the feasibility of implementing this treatment model in a primary care environment, (2) efforts on identifying reasonable assessment methods, (3) primary care providers’ use of assessment data, and (4) the relationships between predictors and outcomes under differing treatment “step” conditions in primary care settings. Six primary care clinics are participating in this study comparing usual care, brief clinical intervention, and enhanced clinical intervention conditions. The last of these conditions is hypothesized to produce the best and most cost-effective outcomes. Recruitment is expected to continue until January 2004, being 65% complete as of this writing. Follow-up contacts will continue until April 2005. Results should provide information that will contribute to the ongoing development of primary care-based tobacco intervention approaches.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

One of the most effective disease prevention and health promotion strategies available is the treatment of tobacco dependence. The Agency for Healthcare Research and Quality (AHRQ) clinical practice guideline for treating tobacco use and dependence provides a number of recommendations for interventions by health care systems and providers, including that treatment be reimbursed, identification of tobacco users be institutionalized, and all patients be offered brief treatment and have more intensive treatment available to them. Unfortunately, these recommended interventions have not been routinely implemented. As part of a comprehensive approach to improving implementation, provider training is needed. Three models for training healthcare providers in brief tobacco treatment intervention (medical education, professional education, and community-based education) are described, a model for training providers in intensive tobacco treatment interventions is presented, and a rationale for a national training and certification program is made.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

This review summarizes recent trends and current patterns of tobacco use in the United States. Although adult smoking dropped between 1965 and 1990, from 50% to 28% of men and from 35% to 23% of women, the past decade has seen little further progress. In 2000, 25.7% of US men and 21.0% of women were smokers. Adolescent smoking has been declining since the late 1990s, but nearly 30% of high school seniors still smoke. In 2000, 4.4% of US men and 0.3% of women used snuff or chewing tobacco. Although adolescent smokeless tobacco use has declined in recent years, 14.8% of male high school students were current users in 2001. In 2001, 22.1% of male high school students and 8.5% of women students were current cigar smokers. Bidis and kreteks may be gaining popularity among young people, and more than 15% of adolescent smokers use these tobacco products. Despite recent progress, tobacco use remains prevalent in the United States. State and local governments need to invest adequate resources in the full range of tobacco control activities.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Comprehensive strategies are needed to prevent initiation of tobacco use, to help users quit, and to reduce morbidity, mortality and indirect social costs. Using an agent-host-vector model for disease, all forms of tobacco are the “agent,” whether they are manufactured by large companies or are traditional tobacco products. “Host” refers to tobacco users and everyone else because all are in some way adversely affected, including the unborn. The “vector” is the tobacco industry. The public needs truth, tobacco dependent victims require help, and the tobacco industry needs accountability and restraint.

ISSN:0002-9629    

出版商:OVID    

年代:2003

数据来源: OVID