On March 8, 2012, Global Bridges presented the webinar "Women and Smoking," which featured Ivana Croghan, Ph.D., coordinator of the Mayo Clinic Nicotine Dependence Center's Research Program.
Bread Software
Real time simultaneous collaborative editing platform.
Bread is a fully responsive real time collaborative editing platform. Bread can be installed on any Windows or Linux OS and can be easily embeded within any application making it fully collborative,co-authoring solution and helps your ussers to create and share business documents & notes on the go.
Here we present recommendations on how to choose a topic to your essay and you can also find a list of the most common topics students are asked to write at the colleges. The following article will help you https://essay-academy.com/account/blog/how-to-write-essay-topics
My thoughts on Agile and how it helps in successful product delivery as guest speaker for Graduate level course : Innovations and Entrepreneurship in the Information Industry taught by Nancy Gilby
A short presentation made after the workshops with Polish students who were engaged in a process of inventing a new product. Polish teachers showed them the whole process of inventing, designing and launching a new product onto a market.
Barriers and unintended consequences How poor regulation of low-risk alternat...Clive Bates
A shirt presentation to Georgian health experts on the dangers of excessive regulation of safer alternatives to smoking causing perverse unintended consequences.
Bread Software
Real time simultaneous collaborative editing platform.
Bread is a fully responsive real time collaborative editing platform. Bread can be installed on any Windows or Linux OS and can be easily embeded within any application making it fully collborative,co-authoring solution and helps your ussers to create and share business documents & notes on the go.
Here we present recommendations on how to choose a topic to your essay and you can also find a list of the most common topics students are asked to write at the colleges. The following article will help you https://essay-academy.com/account/blog/how-to-write-essay-topics
My thoughts on Agile and how it helps in successful product delivery as guest speaker for Graduate level course : Innovations and Entrepreneurship in the Information Industry taught by Nancy Gilby
A short presentation made after the workshops with Polish students who were engaged in a process of inventing a new product. Polish teachers showed them the whole process of inventing, designing and launching a new product onto a market.
Barriers and unintended consequences How poor regulation of low-risk alternat...Clive Bates
A shirt presentation to Georgian health experts on the dangers of excessive regulation of safer alternatives to smoking causing perverse unintended consequences.
Who are the Smokers and what Factors Influence Smoking among Amassoma Communi...iosrphr_editor
Smoking is prevalent among Nigerians. This study identified the smokers and related factors among Amassoma Community in South-South Nigeria. Questionnaires were administered randomly within the community to 260 consenting respondents; Data was analyzed with SPSS version 20. Respondents were Males (73.6%), aged 18-45 years (77.5%), single (45.7%), married (37.8%); with secondary/tertiary education (68.1%); Civil Servants (13.4%) ); Students (26%); Drivers (12.2%); Christian (72.4%) and Ijaw tribe (54.7%).64.6%.had ever smoked at prevalent initiation age of 16-25 years (74.5%); current smokers were 86.0%; 97.2% also took alcohol; 43.3% always smoked for relaxation; 48.9% always smoked to have fun with their friends; 58.20% sometimes smoked in order to fit into the social circle; Gender, Age group and Education were associated with past (p<0.05)>0.05) smoking history; marital status and average annual income had no correlation with both past and present history of smoking (p>0.05). Smoking cessation outreaches should target the identified vulnerable groups in order to substantially lower the smoking prevalence in this community.
A crisis of fat? - Background informationXplore Health
This guide provides background information on obesity, its causes, consequences and treatment, as well as providing an insight into the ethical, legal and social aspects associated with this disease.
Smoking is a practice in which a substance is burned and the resulting smoke breathed in to be tasted and absorbed into the bloodstream. A variety of plant materials are smoked, most commonly associated with tobacco as smoked in a cigarette, cigar, or pipe. Tobacco contains nicotine, an alkaloid that is addictive and can have both stimulating and tranquilizing psychoactive effects. Infertility is “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse” (WHO).
Erectile dysfunction (ED) is the inability to get or keep an erection firm enough to have sexual intercourse. It's also sometimes referred to as impotence. An erection starts from brain; something you saw, feel, smell, heard or thought makes your nerves send chemical messages to the blood vessels in phallus.
The arteries relax and open to let more blood to flow in; at the same time the veins close up. Thus pressure traps in within the corpus cavernosa; the penis expands and holds the erection.
When the inflow of blood stopped and veins open, penis reaches detumescence. Most people understand that smoking increases the risk for cardio-vascular, and lung disease. Many do not realize that smoking can also lead to problems with fertility and impotency in both male and female. Erectile dysfunction and pregnancy complication rates are also increased with smoking. Women who smoke – or are exposed to other people’s smoke – have an increased risk of infertility and are more likely to take longer to get pregnant.
In fact, passive smoking (inhaling someone else’s smoke) is only slightly less harmful to fertility than active smoking. Pregnant women who smoke can find it more difficult to quit if they have a partner who smokes.
Research shows it is much easier for people to stop smoking if they do it with their partner. Deciding to quit together is a great way to increase fertility and chances of having a healthy baby. Chemicals (such as nicotine, cyanide, and carbon monoxide) in cigarette smoke speed up the loss rate of eggs.
Unfortunately, once eggs die off, they cannot regenerate. This means that menopause occurs 1 to 4 years earlier in women who smoke (compared with non-smokers).
Webinar: Waterpipe use from the Middle East to Western CountriesGlobal Bridges
This presentation will discuss the epidemiology, toxicology, and harms of waterpipes, as well as what further research is needed and the challenges in providing treatment for those interested in quitting. Presented as a webinar for Global Bridges on 26 February, 2014.
Dr. Bianco: Humo de segunda mano y riesgos cardiovascularesGlobal Bridges
Los profesionales de la salud, incluso aquellos relacionados con la salud cardiovascular, son conscientes
que el tabaco es uno de los principales factores de riesgo para muchas enfermedades, pero la
mayoría de ellos no han sido entrenados para reconocer al consumo de tabaco como una adicción,
no son conscientes de los mecanismos por los cuales el consumo de tabaco y la exposición al humo
del tabaco causan daños cardiovasculares. La mayoría de ellos tampoco han sido entrenados sobre
cómo abordar al paciente fumador en su práctica clínica diaria y como usar los medicamentos para el
tratamiento de la dependencia al tabaco. Esta conferencia tiene la intención de informar a los asistentes
sobre todos estos temas y estimularlos a obtener más información sobre ellos.
Going mobile: the potential of mHealth for tobacco dependence treatmentGlobal Bridges
Erik Augustson, PhD, MPH, is the Program Director of the Tobacco Control Research Branch of the National Cancer Institute. He serves on a number of national committees in the United States to improve population-based tobacco control such as the Department of Health and Human Services eHealth and mHealth Cessation Interventions committee, Smoking Cessation Subcommittee of the DHHS, the National Tobacco Control Strategy Committee and the North American Quitline Consortium. In addition, Dr. Augustson serves as the federal co-lead on the Smokefree.gov Initiative which represents the first web and mobile based cessation resource developed by the United States federal government.
During this webinar, Dr. Augustson discussed the use of mHealth for health behavior interventions, particularly in tobacco dependence. MHealth has been defined as “health related services delivered by mobile communication devices,” which can be in the form of SMS messaging, smartphone applications, or the mobile web. This webinar focused on text-message based interventions such as NCI’s SmokefreeTXT and the opportunity to implement such interventions at an international level. Dr. Augustson has worked on mHealth interventions not only in the United States but also in China and shared preliminary results from program evaluations and discussed the future potential of mobile interventions to treat tobacco dependence on a population level.
WEBINAR: Secondhand Smoke: The Science and Big Tobacco's SmokescreenGlobal Bridges
Webinar presented for Global Bridges on February 27, 2013
By Dr. Richard Hurt, Director of Mayo Clinic Nicotine Dependence Center
The science behind the harmful effects of tobacco smoke will be reviewed in detail, including results from Dr. Hiryama’s landmark study of female Japanese lung cancer patients who are non-smoking wives of smoking husbands, as well as the most recent study showing that smoke-free workplace laws are associated with a reduction in the incidence of acute myocardial infarctions.
The presentation also highlights Big Tobacco’s decades long public relations and media campaigns to deceive the public and create doubt and controversy about the harmful effects of secondhand smoke. These data come from previously secret tobacco industry documents made public as a result of the Minnesota Tobacco Trial of 1998 and the Department of Justice case that resulted in the conviction of Big Tobacco for violating the U.S. racketeering laws.
Global Bridges: Pharmacotherapy for Tobacco DependenceGlobal Bridges
May 2012: Dr. Richard Hurt, director of the Nicotine Dependence Center at the Mayo Clinic and chair of Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, discusses pharmacotherapy for tobacco dependence at a workshop in Jamaica.
Global Bridges: Farmacoterapia para la dependencia del tabaco (español)Global Bridges
On April 4, 2012, Global Bridges presented the webinar "Farmacoterapia para la dependencia del tabaco," which featured Dr. Richard Hurt, founder and director of the Mayo Clinic Nicotine Dependence Center and chair of Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment.
The Critical Importance of Health Care Worker Leadership in the Tobacco Contr...Global Bridges
Presentation by Eduardo Bianco, M.D., Framework Convention Alliance, Uruguay, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Pharmacotherapy for Tobacco Dependence -- Richard D. Hurt, M.D., Mayo ClinicGlobal Bridges
On April 4, 2012, Global Bridges presented the webinar "Pharmacotherapy for Tobacco Dependence," which featured Richard D. Hurt, M.D., founder and director of the Mayo Clinic Nicotine Dependence Center.
For the audio/video from this presentation, please visit http://www.youtube.com/watch?v=NqndR9wWfZo
Competence-Based Training for a National Stop-Smoking Service: An English Cas...Global Bridges
Presentation by Andy McEwen, Ph.D., National Centre for Smoking Cessation and Training, UK, at the 15th World Conference on Tobacco OR Health in Singapore.
Challenges in Expanding the Role of Health Care Providers and Delivering Trea...Global Bridges
Presentation by Lekan Ayo-Yusuf, D.D.S., M.P.H., Ph.D., regional director of the Global Bridges African region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Challenges to Tobacco Dependence Treatment in Europe -- Hayden McRobbie, M.B....Global Bridges
Presentation by Hayden McRobbie, M.B., Ch.B., Ph.D., Auckland University of Technology, New Zealand, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Challenges in Expanding the Role of Health Care Providers and Delivering Trea...Global Bridges
Presentation by Jagdish Kaur, MBBS, Union Health Ministry, India, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Challenges in Implementing Tobacco Dependence Treatment in Jordan and the Eas...Global Bridges
Presentation by Feras Hawari, M.D., a pulmonologist and the Global Bridges regional director for the Eastern Mediterranean region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Role of Health Care Systems and Providers in Changing Tobacco Dependence Trea...Global Bridges
Presentation by Gustavo Zabert, M.D., a pulmonologist and the Global Bridges regional director for the Latin American region, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Tobacco Dependence Treatment Training -- J. Taylor Hays, M.D.Global Bridges
Presentation by J. Taylor Hays, M.D., a Global Bridges co-investigator and professor of medicine at Mayo Clinic, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
Overview of Tobacco Treatment Provisions at a National Level -- Martin RawGlobal Bridges
Presentation by Martin Raw, UK Centre for Tobacco Control Studies and National Institute of Alcohol and Drug Policies, Brazil, at the Global Bridges Preconference at the 15th World Conference on Tobacco OR Health in Singapore.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Women and Smoking -- Ivana Croghan, Ph.D., Mayo Clinic
1. Smoking Among Women:
An Update
Ivana T. Croghan, Ph.D.
Associate Professor in Medicine
Mayo Clinic Nicotine Research Program
Global Bridges Webinar
08 March 2012
2. The Coming Epidemic
Rise in Smokers Worldwide
2 1.7
Billions of smokers
1.5
1.1
1
0.5
0
2000 2030
http://tobacco.who.int/en/treatment/index.html
3.
4. Current Smoking
Country Region Male Female
Youth Adult Youth Adult
Nigeria* Africa 5.6 9.0 1.3 0.2
Argentina Americas 21.1 32.4 27.3 22.4
Mexico Americas 26.3 24.8 27.1 7.8
USA Americas 9.7 31.2 7.9 23.0
Egypt Eastern Mediterranean 15.5 37.6 2.8 0.5
France Europe 13 33.3 16 26.5 17,317,750
Italy Europe 19.4 29.5 21.6 17.0
Ukraine Europe 27 50.0 12 11.3
India* Southeast Asia 5.8 24.3 2.4 2.9 35,095,609
Thailand Southeast Asia 20.1 45.6 3.8 3.1
China Western Pacific 2.7 52.9 0.8 2.4 32,153,396
Japan Western Pacific 2.1 38.2 1.8 10.9
More countries: http://www.who.int/tobacco/surveillance/policy/country_profile/en/
7. Profile of a Female Tobacco
User
Have role models who use tobacco
Have weaker attachment to parents/family
Have weaker commitment to school/religion
Stronger attachment to peers and friends
Perceive tobacco use prevalence to be higher then
what it really is
Less knowledge of adverse consequences of
tobacco use & nicotine addiction
Believe tobacco use can control weight, negative
mood and stress
Have positive image of tobacco users
Are risk takers
Rebellious
8. Hormones, Menstruation,
Reproduction
Antiestrogenic effect
↑ estrogen-deficiency disorder – e.g. osteoporosis
↓ estrogen-dependent disorder – e.g. endometrial cancer
↓ risk for uterine fibroids
Alters menstrual function
↑ risk for dysmenorrhea (painful menstruation)
↑ secondary amenorrhea (lack of menses)
↑ menstrual irregularity
Earlier age of natural menopause
More severe menopausal symptoms
↑ risk for conception delay (primary & secondary infertility)
9. Pregnancy
1 out of 10 (10.7%) female
smokers continue smoking through
pregnancy (can change based on race, ethnicity and age)
Of those who stop smoking during
pregnancy, 2 out of 3 (67%)
relapse at end of pregnancy
In the US, yearly cost of maternal
smoking is $366 million per year for
neonatal care
$740 per maternal smoker
10. Pregnancy
↑ risk of in utero:
Premature birth
Placenta previa
Abruptio placenta
Ectopic pregnancy
Spontaneous abortion
Preterm premature rupture of membranes
↑ intrauterine growth retardation
↓ physical stature
↓ intellectual development in children
↓ lung function
↑ risk of perinatal and infant death
↑ risk of SIDS through loss of neonatal hypoxia tolerance
11. Body Weight and Fat
Distribution
Tobacco use initiation is NOT associated with weight
loss
Continued tobacco use DOES attenuate weight gain
over time
Average weight of tobacco users is MODESTLY lower
than non-users
Tobacco cessation CAN be associated with weight
gain (6-12 pounds)
Female tobacco users have a more masculine pattern
of body fat distribution (higher waist-to-hip ratio)
12. Psychiatric Disorders
Female tobacco users are more likely to be depressed
↑ prevalence of tobacco use in people with:
Anxiety disorders
Bulimia
Attention deficit disorders
Alcoholism
Schizophrenia
↓ Parkinson’s
↑ ↓ Alzheimer’s
13. Other
Affects glucose regulation & related metabolic processes
↓ Bone density (↑ risk of hip fracture)
↑ risk of Graves’ ophthalmopathy (thyroid-related
disease)
↑ age-related macular degeneration
↑ risk for rheumatoid arthritis
↑ risk for osteoarthritis
↑ cataracts
↑ facial wrinkling
14. Female ↑ ovarian
Cancers cancer
↓ endometrial ↑ cervical
cancer cancer
↑ smoking
↑ breast ↑ vulvar
cancer risk cancer
15. Benefits of Quitting
Overall:
Women who quit smoking reduce their risk of infertility
Pregnant women who quit early in their pregnancy reduce the
risk of the baby being born too early and with an abnormally
low weight
Quitting smoking dramatically reduces the risk of developing
an illness caused by smoking
Reduces the risk of fractures that would be caused by
smoking in old age
For women who have already developed cancer:
Quitting smoking helps the body to heal and respond to
cancer treatment
Quitting reduces the risk of developing a second cancer
16. Benefits of Quitting (cont.)
Within a few hours:
The level of carbon monoxide in the blood begins to decline
The former smoker's heart rate and blood pressure, which were
abnormally high while smoking, begin to return to normal
Within a few weeks:
Women who quit smoking have improved circulation
Don’t produce as much phlegm
Don’t cough or wheeze as often
Significant improvements in lung function within several months of
quitting
Within 1-2 years:
The risk of death from heart disease is substantially reduced
5 years after quitting:
The risk of death from lung cancer and other lung diseases declines
steadily
17. Studies Review
Study In study Quit Rates (%)
Men Women Men women
*Bjornson et al (NG) 2448 1475 29 25
*Gourlay et al (NP) 823 658 25 18
*Glassman et al (Clonidine) 132 161 31 34
*Hall et al(Nortiptyline) 89 110 31 18
*Covey et al (naltrexone) 24 44 58 39
Dale et al (Bupropion 300) 77 79 51 38
Piper et al (Placebo) 78 111 23 21
Piper et al (Bupropion) 223 297 34 30
Piper et al (NL) 228 293 44 26
Piper et al (NP) 232 311 35 34
Piper et al (Bup+NL) 224 306 36 31
Piper et al (NP+NL) 235 311 42 38
Perkins et al CNS Drugs 15:391+, 2001;
Dale et al CHEST 119:1357+, 2001;
Piper et al NTR 12:647+, 2010
18. Why Do Females Have Lower Stopping Rates
& Higher Relapse Rates?
Negative mood during menstrual cycle phase
Women react more to triggers involving negative
emotions (conflict, stress) vs. men, who react more to
triggers involving positive situations (social events)
Women use more palliative coping strategies (men use
more active coping strategies)
Women have better outcomes in programs that emphasize
social support (men do better in self-management and
control groups)
19. Barriers to Tobacco Cessation
in Women
Intense withdrawal symptoms and cravings
Depression
Irritability
Anxiety
Lethargy
Tension
Weight changes
Lower mental concentration
Hormone influences
Phase of the menstrual cycle
High levels of emotional & physical dependence on
cigarettes
< high school education
Lack of social support
Lower self-efficacy
Living with a tobacco user
20. Barriers to Tobacco Cessation
in Women (cont)
Situations involving negative effects or stress
Lessened expectations about ability to quit
Cognitively less ready to stop smoking
Less confident in resisting temptation to smoke
<6 months of abstinence in past attempts
Previous failed cessation attempts
Depression
Weight gain concerns
Lower socioeconomic status
21. Smoking Cessation Intervention
Men and women have equal
number of previous quit
attempts
BUT
Women are less successful in
sustaining abstinence more
than 1 week
22. Interventions: What Do We
Know?
Self-help manuals are more popular and least effective among
women
Telephone quitlines are effective for females who are homebound
Females have greater success when receiving proactive calls
Brief physician advice is more effective in females (39% vs. 35%)
Tailored feedback by health care provider
More females visit doctors than males
Females are more responsive to personal interaction
More females than males use assisted methods for smoking cessation
More females have greater success in gradual approaches
Females who reduce gradually by scheduled smoking at regular intervals
have better success rates than those who self-taper or quit cold turkey
23. Multicomponent Intervention
Cognitive behavioral therapy incorporates strategies
to prepare and motivate smokers to stop smoking
Combining behavioral therapy with
pharmacotherapeutics
Multiple sessions, which provide long-term support
Cognitive behavioral approach
Prepare and motivate
Provide social support (e.g., “buddy system”)
Problem solving
24. Nicotine Dependence Center:
Treatment Program Data
3,398 patients (January 2004 – December 2005)
Ambulatory
1,156 females
983 males
Hospitalized
512 females
747 males
Croghan IT, Ebbert JO, Hurt RD, Hays JT, Dale LC, Warner N, Schroeder DR. Gender
differences among smokers receiving tobacco use interventions. Addictive Behaviors 34
(2009) 61-67.
25. Females vs. Males
Statistically significant differences
Males smoked more
Males more likely to be married
Males more likely to be more highly educated
Males more likely to have a history of alcoholism
Females more likely to have a history of depression
Tobacco abstinence outcome at 6 months:
After controlling for above variables – no difference
Croghan IT, Ebbert JO, Hurt RD, Hays JT, Dale LC, Warner N, Schroeder DR. Gender
differences among smokers receiving tobacco use interventions. Addictive Behaviors 34
(2009) 61-67.
26. Abstinence Rates: Females
vs. Males
Observed differences in tobacco abstinence outcomes between female
and male smokers may not be due to inherent differences
between genders, but rather may be explained by other
characteristics.
Individual assessment by tobacco treatment specialists allows for
the elicitation of these factors as potential barriers to the achievement
or maintenance of smoking abstinence. With this knowledge, the
skilled tobacco treatment specialist can develop an individualized
treatment plan.
Clinical treatment programs may be more adept at addressing
the needs of individual patients compared to the protocolized
interventions used in clinical trials.
Croghan IT, Ebbert JO, Hurt RD, Hays JT, Dale LC, Warner N, Schroeder DR. Gender
differences among smokers receiving tobacco use interventions. Addictive Behaviors 34
(2009) 61-67.
27. CONCLUSION:
Best smoking cessation program for female smokers is
MULTICOMPONENT
Behavioral support
Long-term follow-up
Pharmacotherapy
28. Contact
Mayo Clinic Nicotine Dependence Center
Research Program
200 First St. SW
Rochester, MN 55905
Phone: 800-848-7853
Fax: 507-266-7900
http://ndc.mayo.edu/
nicotineresearch@mayo.edu
Editor's Notes
Currently over 1 billion people smoke worldwide (1/3 world population) 5 million die per year (11,000 per day) 20% (200 million) of these are women 1 million women will die per year By 2030, 1.7 billion people will be smoking worldwide 8 million will die per year 2.5 million are expected to be women Worldwide men smoke nearly 5x as much as women but the ratios of female-to-male smoking prevalence rates vary dramatically across countries
In high-income countries, including Australia, Canada, the United States of America and most countries of western Europe, women smoke at nearly the same rate as men American and European regions – 1.6-2x differences However, in many low- and middle-income countries women smoke much less than men. SE Asia and Western Pacific – 9.3 -11.4x differences Tobacco use by women is becoming more socially acceptable in many countries as cultural norms change.
A side comment – one of the reasons you hardly ever see a table of this sort is because comparing percentages across countries can be misleading if you do not take into consideration the total population. (show actual numbers for China, India and France). What we should make note of when looking at these type of tables is that the low rates among women in certain countries is gradually rising as the acceptable social norms change . This can be seen in the rising rates among teens.
1.1 billion = 1/3 global population 5 million = 11,000 per day
ANTIESTROGENIC Effect – effects of smoking on hormone-related events seems to be more common among post-menopausal women than among premenopausal women Deficiency disorders – such as osteoperosis (which mainly occurs in postmenopausal women) Dependent disorders – such as endometrial cancer (which occurs mostly in postmenopausal women, rather than pre-menopausal)
10.7% of women continue to smoke during pregnancy 17.8% among Alaskan Natives/American Indian 13.9% among Hispanic white women 8.5% among white women 16.6% of those aged 15-19 smoke 18.6% of those aged 20-24 smoke
Smoking during pregnancy accounts for 20 to 30 percent of low-birth weight babies, up to 14 percent of preterm deliveries about 10 percent of all infant deaths. Maternal smoking has also been linked to asthma among infants and young children. The odds of developing asthma are 2X as high among children whose mothers smoke more than 10 cigarettes a day. If you stop smoking during pregnancy you can reduce the risk for many of the adverse reproductive outcomes: Conception delay, infertility, preterm premature rupture of membranes preterm delivery and lower birth weight
(? self medication? or common genetic factors between those who smoke and those who are prone to depression?) Although mechanisms for these associations are not known, we do wonder if smoking is a way in which these individuals manage their symptoms. For these individuals, smoking cessation may lead to manifestation/emergence of depression or other dysphoric mood states.
In addition, other illnesses not specific to females, but should also be noted. 90 percent of chronic obstructive pulmonary disease (COPD), 13 times more likely to die from COPD (emphysema and chronic bronchitis) Women who smoke also double their risk for developing coronary heart disease
Other cancers not specific to females, but should also be noted include: 80 percent of lung cancer deaths increased risk for developing cancers of the oral cavity, pharynx, larynx (voice box), esophagus, pancreas, kidney, bladder, and uterine cervix