Browsing by Subject "tobacco"
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Item Application of the bioecological model and health belief model to self-reported health risk behaviors of adolescents in the united states(2009-05-15) Fleary, Sasha A.Health risk behaviors are responsible for the majority of morbidity and mortality among adolescents. Researchers have identified three sources of risk-taking in adolescents ? dispositional, ecological and biological. The Bioecological Model incorporates these three sources of risk-taking, however it lacks explanatory power. For this reason, this thesis focused on explaining risk perception of health risk behaviors (smoking cigarette, alcohol and marijuana use), and health risk behaviors by integrating the Bioecological Model with a more specific Health Belief Model. The relationship between risk perception and health risk behavior was also investigated as a first step in understanding adolescent decision-making using the Health Belief Model. Adolescents from a suburban Indiana area were asked to complete the Adolescent Health Risk Behavior Survey which assessed egocentrism, self-esteem, social norms, risk perceptions, and the incidence and prevalence of health endangering behaviors. Hierarchical linear regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain risk perception of health risk behaviors. Hierarchical logistic regression was used to determine the ability of the systems in the Bioecological Model and their specific variables to explain health risk behaviors and to moderate the relationships between risk perception and health risk behaviors. Based on the results, it was confirmed that the Bioecological Model is important in understanding adolescent?s risk perception of health risk behaviors, and their self-reported health risk behaviors. It is also important in understanding the relationship between risk perception and health risk behaviors. Adolescent Variables, Microsystem, and Mesosystem were significant in predicting adolescent risk perception of all health risk behaviors examined, and self-reported smoking cigarette behavior and marijuana use. Adolescent variables and Microsystem were the only systems to predict adolescent self-reported alcohol use. The relationship between risk perception and reported smoking cigarette behavior was moderated by Adolescent Variables, Microsystem and Mesosystem, however for alcohol use the path was moderated by Adolescent Variables and for marijuana use the path was moderated by the Mesosytem. Results of this thesis imply the importance of considering the contribution of Bioecological Model variables when implementing prevention intervention programs specific to adolescent health risk behaviors.Item Associations Between Chronic Pain and Use of Pharmacotherapy for Smoking Cessation(2012-10-19) Zale, EmilyChronic pain and tobacco dependence are two highly prevalent and comorbid conditions. The rate of smoking among persons in pain may be greater than twice the rate observed in the general population. Smokers tend to experience more adverse pain-treatment outcomes than do nonsmokers, and there is mounting evidence to suggest that smokers with comorbid pain disorders may have more difficulty abstaining from tobacco. The main goal of the current study was to examine cross-sectional relations between chronic pain status and past use of pharmacotherapy for smoking cessation. We also tested associations between chronic pain status and frequency of past quit attempts. Data were derived from a nationally-representative survey of households in the continental United States. After adjusting for sociodemographic factors, substance use, mood and anxiety disorders, and number of attempts to quit smoking, smokers with chronic pain were found to be 1.67 times more likely to endorse past use of pharmacotherapy for smoking cessation, relative to smokers with no chronic pain. Chronic pain status was not associated with number of past attempts to quit smoking. These data suggest that smokers with chronic pain are motivated to quit smoking, and may be particularly amenable to pharmacologic intervention. Results are discussed with regard to clinical implications and directions for future research.Item Types and Gender Composition of Social Networks: Their Influence on Adolescent Substance Use(2015-01-22) Jacobs, Wuraola OThis dissertation presents three separate studies designed to examine how the different factors and determinants known to influence adolescent alcohol and tobacco use and the gender compositions of different adolescent network types are associated with alcohol and tobacco use among adolescents. Additionally, the similarities and/or differences in networks of adolescent substance users and non-users are also examined. First, a systematic review of empirical studies (n=48) employing social network analysis to examine adolescents? alcohol, tobacco, and other drugs (ATOD) use behavior will be presented discussing: (a) how this body of literature examined gender differences in ATOD use, (b) whether these network studies examine the gender composition of these adolescents? networks, and (c) what network affiliation types are used to characterize adolescent networks. Secondly, descriptive characteristics and network analysis of the social networks of 10th grade substance using and non-using adolescents will be presented. Employing a bounded whole network approach, data was collected from 1,707 10th graders in a school district in Los Angeles, California. The students were asked different network questions in order to generate different network types. The network types elicited from these network questions are: Friendship, Admiration, Succeed, Popularity, and Romantic networks. Attributes and network characteristics of users and non-users across these five different networks are presented and the commonalities and/or differences are described also. Lastly, using data from the same students, a quantitative analysis of the associations between interpersonal (e.g. age, gender) and interpersonal (e.g. parent and sibling substance use) factors, network measures, and gender composition of the networks and their alcohol and tobacco use will be discussed. These associations are then further examined across the five different types of networks mentioned above. Prior to this study, research studies employing social network analysis did not attempt to examine the gender composition of the networks in which adolescents are embedded; and only a few other studies used networks other than friendship networks to characterize adolescent social networks. Thus, this study represents the first step towards addressing these limitations associated with examining how adolescents? social networks facilitate or constrain their substance use behavior and filling these apparent conceptual gaps.