IntroductionAlthough web-based, multimedia smoking prevention programs have been tested in several high-income countries, their efficacy in Central and Eastern Europe is unknown. The aim of this trial was to assess the short-term effects of ASPIRA, among Romanian and Hungarian speaking ninth graders in Tirgu Mures, Romania. ASPIRA is the Romanian acronym for the translated and adapted version of ASPIRE, “A Smoking Prevention Interactive Experience,” an evidence-based smoking prevention program originally developed to prevent tobacco use among high school students in the United States.MethodsSixteen high schools in Tirgu Mures, Romania were randomized to receive five weekly sessions of the ASPIRA web-based, multimedia program or to a control condition. Socio-demographic data, psychosocial characteristics, and smoking behavior were collected from students at baseline and at 6 months. A hierarchical logistic regression analysis was conducted to test the efficacy of the intervention on smoking initiation and current smoking among 1369 students.ResultsNever-smoker students in the intervention arm were 35% less likely to report smoking initiation 6 months after the baseline assessment (OR = 0.65, 95%CI: 0.44–0.97). Reduced smoking initiation was observed most notably among students who were exposed to at least 75% of the ASPIRA program. There was no statistically significant effect of the intervention on current tobacco use (OR = 0.80, 95%CI: 0.44–1.46).ConclusionsASPIRA, an adapted version of the evidence-based, multimedia ASPIRE program that was originally developed and tested in the United States may decrease smoking initiation among multi-ethnic adolescents in Central and Eastern Europe.Implications(1). Web-based, multimedia smoking prevention programs may be effective tools to prevent smoking initiation among multi-ethnic adolescent communities in Central and Eastern Europe. (2). The degree of exposure is critical, only high exposure to the multimedia smoking prevention program is associated with reduced smoking initiation.
The goal of our study is to identify possible sources of aggressivity, such as the self-appreciation and modalities of coping used by the teenage participants. Our analysis refers to gender, self-image, coping modalities) and social variables (differences of support, class) of the surveyed teenagers. The used instruments were: Anger Expression Scale (Spielberger et al, 1985); Ways of Coping Scale (Lazarus & Folkman, 1985); Rosenberg Self-esteem Scale (Rosenberg 1965). The participants were 447 students of 11 th and 12 th grade, with a mean age of 17,4 years old. The results show a significant correlation between the level of self-appreciation, modalities of coping and level of aggressive expression. The inward or outward orientation of aggression shows differences depending on the subject's gender. Self-appreciation is more positive among boys and is strongly related to the expression of aggression and used coping modalities. There is also evidence of significant interaction between suppressed anger and self appreciation. Inwardly expressed anger was more associated with avoidant coping, and outwardly expressed anger with planful problem -solving, distancing and selfcontrolling. The offensive actions and type of study also show noteworthy interactions. Analysis of variance suggested that easier anger expression is indicative of the occurrence of hostile acts in the last six months. The general manifestation of anger and the outwardly expressed anger considerably interact with differences of the social support from their fathers perceived by our participants. The support of mothers was especially significantly related to suppressed anger.
INTRODUCTIONSymptoms of nicotine dependence among adolescents occur at an early stage in smoking onset and can be present even with low exposure to cigarettes. We aim to examine the early occurrence of symptoms of nicotine dependence and how they predict later smoking behavior.METHODSParticipants were ninety-four currently smoking 9th-graders attending high school in Targu Mures, Romania. They were followed for 6 months with two assessment points: baseline, and follow-up at 6 months. We assessed the following: 1) the number of smoked cigarettes in the last 30 days, 7 days, and 24 hours using the Minnesota Smoking Index; 2) vulnerability to addiction manifested in cessation difficulties, using the 9-item version of the Hooked On Nicotine Checklist (HONC), 3) loss of autonomy using the endorsement of at least one HONC item, and 4) dependence, using the modified Fagerström Tolerance Questionnaire (mFTQ). We performed statistical analysis with SPSS version 19, using paired-sample t-tests for comparing the differences between baseline and follow-up data. We also conducted linear regression analysis to demonstrate the predictive role of the assessed variables, such as the scores of the mFTQ and the HONC in maintaining smoking and reported smoking status.RESULTSRegression models indicated that baseline-measures for symptoms of dependence (β=0.64, p<0.001), vulnerability to addiction (β=0.47, p<0.001), and loss of autonomy (β=0.34, p<0.001) regarding smoking cessation were significant predictors of smoking, explaining 41.7% of the variability of the reported increase in cigarette consumption. At follow-up at 6-months, the three variables were responsible for 14.9% for the variance in cigarette consumption (R2=0.14, F(1,92)=16.05, p<0.01).CONCLUSIONSNicotine dependence at baseline and at follow-up show significant differences in the control group while in the intervention group the scores remained stable. The findings suggest that participation in the Romanian version of ASPIRE was protective against progression towards nicotine addiction.
Introduction. Smoking is an important public health issue nowadays. It causes a lot of diseases and represents also a source of carcinogenic substances. Recent studies showed an increased incidence of colorectal cancer in smokers. The aim of our study is to assess the association between smoking and colorectal cancer and to establish the prevalence of heavy smokers among the patients operated on for colorectal cancer.Methodology. We run a retrospective study of the charts belonging to the patients diagnosed with colorectal cancer and operated on in our department between 2004 and 2013. The patients were classified in smokers, former smokers and nonsmokers. The amount of tobacco was evaluated according to the number of smoked cigarettes per day, the smoking period, respectively the pack-years. The data were corroborated with the location of the tumor and analyzed using the online version of Graphpad.Results. From 982 patients diagnosed with colorectal cancer, we found 297 smokers (30.24%). Among these, 106 patients (35.69%) have smoked for over 30 years, at least 20 cigarettes per day, more than 30 pack-years. The number of heavy smokers was significantly greater (p=0.0001) in the group with rectal cancer compared to the group with colon cancer. The association of smoking with rectal cancer was also important (p=0.0015) among the former smokers.Conclusions. Smoking is related to higher incidence of colorectal cancer. Our data sustain the hypothesis of increased risk of developing rectal cancer in heavy smokers. We recommend the screening for colorectal cancer among the heavy smoker population.
Prospektív kutatásunk egy számítógépes prevenciós beavatkozás elvégzése után jelentkező dohányzási motiváció-átstrukturálódásokat elemzi. A résztvevőinket 16 marosvásárhelyi középiskola tanulóiból választottuk ki, összesen 1369, 15-16 év közötti serdülőt. Eredményeink szerint a dohányzó serdülők magasabb dohányzás melletti motiváció értékeket és kevesebb dohányzás elleni érveket mutatnak a nem dohányzó serdülőkkel szemben. A programban való részvétel eredményeként a dohányzó serdülők cigarettafogyasztása jelentősen csökken, így arra következtetünk, hogy a számítógépes prevenciós program sikeresen alkalmazható serdülő populáción.
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