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Student dropout can be conceptualized as a decision-making process, consisting of different phases. Based on previous literature on student dropout, decision-making, and action-phases, we proposed that the process of developing dropout intentions includes the following phases: non-fit perception, thoughts of quitting/changing, deliberation, information search, and a final decision. In the present cross-sectional study, we empirically investigated if the assumed phases can be distinguished from each other, if the phases follow the presumed order, and whether each phase is associated with certain characteristics. Furthermore, we considered a strict separation between quitting studies completely and changing a major. For this purpose, we analyzed data of N = 1005 students (average age of 23.0 years; 53% female; 47% male) from a German University. By using confirmatory factor analyses, we found the supposed factor structure for the different phases concerning both kinds of dropout, quitting studies, and changing majors. In each process, structural equation modelling indicated positive relations between adjoining phases. The factor values correlated to a substantial amount with an assortment of variables associated with student dropout. On a theoretical level, the conception of different phases of student dropout helps to get a better understanding of regulatory processes in the context of student dropout. [ABSTRACT FROM AUTHOR]

Dropout from upper secondary education is a persistent educational problem, particularly among first-generation immigrant youth. This study examined factors associated with intentions to dropout to gain further insight into the process of leaving upper secondary education. The analyses of 1299 Norwegian first-year upper secondary school students' (88% native Norwegians, 12% first-generation immigrants) self-reported intentions to quit school, loneliness, and peer victimization in school showed that first-generation immigrants experienced higher levels of loneliness than native Norwegians. In contrast, there were no differences in the levels of peer victimization and intentions to quit between native Norwegians and first-generation immigrants. However, loneliness showed a significantly stronger association with intentions to quit among first-generation immigrants. The results underscore the importance of tackling first-generation immigrants' loneliness in school to reduce their intentions to quit upper secondary education and thus potentially improve conditions for school completion. [ABSTRACT FROM AUTHOR]

There are many studies on how smoking cigarettes is harmful to health, but research on how smoking cessation improves mental health is insufficient. The purpose of this study was to examine long-term effects of smoking cessation on depressive symptoms, resilience, coping skills, and serotonin levels in Korean adults. This was a longitudinal study that followed up on periodically participants for 2 years after the initial smoking cessation intervention. A total of 164 smokers participated within this study. Of these, 15 maintained smoking cessation for 504.93 ± 182.82 days. On the other hand, 148 participants failed to maintain smoking cessation. Depressive symptoms decreased and resilience increased significantly over 2 years in the 15 abstainers. Smoking cessation, in total, decreased depressive symptoms by 32.9% (p =.015) and also increased resilience by 37.5% (p =.012). Smoking cessation also explained for 9% of total positive interpretation at the 1-year follow-up, and 7.3% of total self-criticism at the 2-year follow-up. Serum serotonin did not change over the course of 2 years in both abstainers and smokers but did decrease in the short-term for those who maintained smoking cessation. Platelet serotonin increased over 6 months among smokers. [ABSTRACT FROM AUTHOR]

Introduction: In contrast to tobacco smoking, electronic cigarette ("vaping") advertisement had been approved in the United Kingdom (UK) in January 2013. Currently, there are an estimated 3.2 million UK e-cigarette users. The impact of e-cigarette advertisement on tobacco use has not been studied in detail. We hypothesised that e-cigarette advertisement impacts on conventional smoking behaviour. Methods: A cross-sectional structured survey assessed the impact of e-cigarette advertising on the perceived social acceptability of cigarette and e-cigarette smoking and on using either cigarettes or e-cigarettes (on a scale of 1 to 5/'not at all' to 'a lot'). The survey was administered between January to March 2015 to London university students, before and after viewing 5 UK adverts including a TV commercial. Results: Data were collected from 106 participants (22 ± 2 years, 66% male), comprising cigarette smokers (32%), non-smokers (54%) and ex-smokers (14%). This included vapers (16%), non-vapers (77%) and ex-vapers (7%). After viewing the adverts, smokers (2.6 ± 1.0 vs. 3.8 ± 1.1, p = 0.001) and non-smokers (3.2 ± 0.7 vs. 3.7 ± 0.8, p = 0.007) felt smoking was more socially acceptable, compared to before viewing them. Participants were more likely to try both e-cigarettes (1.90 ± 1.03 to 3.09 ± 1.11, p < 0.001) and conventional cigarettes (1.73 ± 0.83 to 2.27 ± 1.13, p < 0.001) after viewing the adverts compared to before. Vapers were less likely to smoke both an e-cigarette, and a conventional cigarette after viewing the adverts. Conclusion: E-cigarette advertising encourages both e-cigarette and conventional cigarette use in young smokers and non-smokers. The adverts increase the social acceptability of smoking without regarding the importance of public health campaigns that champion smoking cessation. [ABSTRACT FROM AUTHOR]

Background: Obesity is a rising social and economic burden. Patients with obesity often suffer from stigmatization and discrimination. Underrecognition of obesity as a disease could be a contributing factor. The present study aimed to compare attitudes towards obesity with other chronic diseases and to evaluate the recognition of need of professional treatment. Methods: Nine hundred and forty-nine participants (subgroups: general population, patients with obesity, nurses in training, nurses, medical students, physicians) were randomized to video teaching on obesity and control. Questionnaires on the burden and influence of obesity on daily life compared to other chronic diseases and the fat phobia scale (FPS) were answered. Results: Burden of obesity was rated low (4.2 ± 1.3; rank 9 of 11) compared to other diseases. Bowel cancer (5.5 ± 0.9) had the highest and caries the lowest (2.7 ± 1.4) estimated impact. Females (p = 0.011) and older people (p < 0.001) rated burden of obesity high whereas general population (p < 0.001) and control (p < 0.001) rated it low. Females (p = 0.001) and people with higher BMI (p = 0.004) rated the influence of obesity on daily life high; the general population (p < 0.001; reference physicians) and the control group (p < 0.001) rated it low. FPS was lowest in patients with obesity (3.2 ± 0.7) and highest in the general population (3.6 ± 0.4) and medical students (3.6 ± 0.5; p < 0.001; compared to physicians). Conclusions: Obesity is underestimated as a disease compared to other chronic diseases and attitudes towards obesity are rather negative in comparison. Video teaching showed positive effects so a focus in medical education and public campaigns should aim to improve prevention and treatment of obesity. [ABSTRACT FROM AUTHOR]

Objectives: To longitudinally investigate smoking cessation-related changes of quantitative computed tomography (QCT)-based airway metrics in a group of heavy smokers.Methods: CT scans were acquired in a lung cancer screening population over 4 years at 12-month intervals in 284 long-term ex-smokers (ES), 405 continuously active smokers (CS), and 31 subjects who quitted smoking within 2 years after baseline CT (recent quitters, RQ). Total diameter (TD), lumen area (LA), and wall percentage (WP) of 1st-8th generation airways were computed using airway analysis software. Inter-group comparison was performed using Mann-Whitney U test or Student's t test (two groups), and ANOVA or ANOVA on ranks with Dunn's multiple comparison test (more than two groups), while Fisher's exact test or chi-squared test was used for categorical data. Multiple linear regression was used for multivariable analysis.Results: At any time, TD and LA were significantly higher in ES than CS, for example, in 5th-8th generation airways at baseline with 6.24 mm vs. 5.93 mm (p < 0.001) and 15.23 mm2 vs. 13.51 mm2 (p < 0.001), respectively. RQ showed higher TD (6.15 mm vs. 5.93 mm, n.s.) and significantly higher LA (14.77 mm2 vs. 13.51 mm2, p < 0.001) than CS after 3 years, and after 4 years. In multivariate analyses, smoking status independently predicted TD, LA, and WP at baseline, at 3 years and 4 years (p < 0.01-0.001), with stronger impact than pack years.Conclusions: Bronchial dimensions depend on the smoking status. Smoking-induced airway remodeling can be partially reversible after smoking cessation even in long-term heavy smokers. Therefore, QCT-based airway metrics in clinical trials should consider the current smoking status besides pack years.Key Points: • Airway lumen and diameter are decreased in active smokers compared to ex-smokers, and there is a trend towards increased airway wall thickness in active smokers. • Smoking-related airway changes improve within 2 years after smoking cessation. • Smoking status is an independent predictor of airway dimensions. [ABSTRACT FROM AUTHOR]

Background: Current guidelines advise providers to assess smokers' readiness to quit, then offer cessation therapies to smokers planning to quit and motivational interventions to smokers not planning to quit.Objectives: We examined the relationship between baseline stage of change (SOC), treatment utilization, and smoking cessation to determine whether the effect of a proactive smoking cessation intervention was dependent on smokers' level of motivation to quit.Design: Secondary analysis of a multicenter randomized controlled trial.Participants: A total of 3006 current smokers, aged 18-80 years, at four Veterans Affairs (VA) medical centers.Interventions: Proactive care included proactive outreach (mailed invitation followed by telephone outreach), offer of smoking cessation services (telephone or face-to-face), and access to pharmacotherapy. Usual care participants had access to VA smoking cessation services and state telephone quitlines.Main Measures: Baseline SOC measured with Readiness to Quit Ladder, and 6-month prolonged abstinence self-reported at 1 year.Key Results: At baseline, 35.8 % of smokers were in preparation, 38.2 % in contemplation, and 26.0 % in precontemplation. The overall interaction between SOC and treatment arm was not statistically significant (p = 0.30). Among smokers in preparation, 21.1 % of proactive care participants achieved 6-month prolonged abstinence, compared to 13.1 % of usual care participants (OR, 1.8 [95 % CI, 1.2-2.6]). Similarly, proactive care increased abstinence among smokers in contemplation (11.0 % vs. 6.5 %; OR, 1.8 [95 % CI, 1.1-2.8]). Smokers in precontemplation quit smoking at similar rates (5.3 % vs. 5.6 %; OR, 0.9 [95 % CI, 0.5-1.9]). Within each stage, uptake of smoking cessation treatments increased with higher SOC and with proactive care as compared with usual care.Limitations: Mostly male participants limits generalizability. Randomization was not stratified by SOC.Conclusions: Proactive care increased treatment uptake compared to usual care across all SOC. Proactive care increased smoking cessation among smokers in preparation and contemplation but not in precontemplation. Proactively offering cessation therapies to smokers at all SOC will increase treatment utilization and population-level smoking cessation. [ABSTRACT FROM AUTHOR]

Smoking continues to be the leading cause of preventable death in the USA, despite the vast and widely publicized knowledge about the negative health effects of tobacco smoking. Data show that smoking cessation is often accompanied by weight gain and an improvement in insulin sensitivity over time. However, paradoxically, post-cessation-related obesity might contribute to insulin resistance. Furthermore, post-cessation weight gain is reportedly the number one reason why smokers, especially women, fail to initiate smoking cessation or relapse after initiating smoking cessation. In this Review, we discuss the metabolic effects of stopping smoking and highlight future considerations for smoking cessation programs and therapies to be designed with an emphasis on reducing post-cessation weight gain. [ABSTRACT FROM AUTHOR]

Previous studies have gauged support for implementing smoke-free multi-unit housing (MUH) policies in the United States, but none have specifically examined attitudes among racially and ethnically diverse elders living in low-income MUH. We surveyed a convenience sample of elders 62 years of age and older ( n = 807) across 24 low-income housing properties in Broward County, Florida in order to assess residents' smoking behaviors, exposure to second-hand smoke, and support for smoke-free policies. The study sample was ethnically and racially diverse with Hispanics comprising more than 61 % of the population, and 22 % identifying as Black or other races. Although close to 22 % of the sample were former smokers, only 9 % of residents reported being current smokers. The majority of residents surveyed supported no-smoking policies: 75 % support no-smoking policies for individual units; 77 % supported no-smoking policies in common areas; and, 68 % supported no-smoking policies in outdoor areas. Over 29 % of residents surveyed reported being exposed to secondhand smoke entering their units from elsewhere in their building. Residents who reported having a home smoking rule were more than twice as likely to support an indoor policy compared to residents who allowed smoking anywhere in their home (OR = 2.36; 95%CI 1.25-4.43; p ≤ 0.01), and nonsmoking residents were nearly three times as likely to support an indoor policy compared to smokers (OR = 2.89; 95%CI 1.44-5.79; p ≤ 0.01). Support for an indoor policy was not modified by age, gender, ethnicity or race. . This study demonstrates that elders living in low-income MUH properties overwhelmingly supported the implementation of smoke-free policies. [ABSTRACT FROM AUTHOR]

Several countries have introduced graphic warning images aimed at discouraging smoking. However, the images may be subject to an habituation effect. This study examined the effects of repeated exposure to an image of smoking-related mouth cancer in 24 smokers, 20 ex-smokers, and 39 individuals who had never smoked regularly. Participants viewed the warning image seven times over 7 to 14 days. Trend analysis showed that the smokers had high distress initially when viewing the image, followed by a significant lessening of image-related distress that leveled out over time. Nonetheless, viewing the image had a significant linearly increasing positive effect on their intention to quit smoking, with no sign that the effect of the image on intention was wearing out. The two groups of nonsmokers showed response patterns different from those of the smokers, including signs of habituation to the image. Other results showed a significant relationship between experiencing a high level of distress when viewing the image and having a negative attitude toward smoking. The implications of these findings are discussed in light of anti-smoking campaigns. [ABSTRACT FROM AUTHOR]

In December 1980, the Health Education Council launched a campaign designed to discourage children from taking up smoking. Advertisements on TV and in comics and magazines featured a battle between Superman and the evil Nick O'Teen as he attempted to recruit children to his army of smokers. Children were also encouraged to join Superman in his fight by signing a pledge not to smoke, in return for which they received a poster and badges featuring the superhero. This article examines the design, production, delivery and reception of the Superman vs. Nick O'Teen campaign in order to probe the multi-faceted nature of the making of healthy publics in 1980s Britain. Children constituted a particularly problematic public. On the one hand, they were thought to be vulnerable and easily led towards unhealthy lifestyle choices. But on the other, children were also recognised as agents who might convince adults, as well as their peers not to smoke. This ambivalent conceptualisation of the child as a potential victim of malign influences, or potential rational agent and force for good, is typical of the 1980s, a time when the meanings of the child as consumer, agent, and citizen were undergoing increased ideological debate. This campaign also took place as ideas about health education, its place within public health policy and practice, and its relationship with the public, were in flux. The battle between Superman and Nick O'Teen was thus not just about smoking, but about particular ways of seeing and interacting with healthy (and unhealthy) publics. [ABSTRACT FROM AUTHOR]

The article reports on the impact of sugar on health. It cites a study which unveils major impact of excessive sugar consumption on obesity levels which lead to heart problem and premature death. It highlights the differences between sugar and tobacco consumption. It indicates that the "Action on Sugar" campaign maintains that a similar effect could be achieved with sugar and tobacco used.

The author comments on the study titled "Effect of Gaining Insurance Coverage on Smoking Cessation in the Community Health Centers: A Cohort Study." The topics discussed include the effects of the Affordable Care Act (ACA) on patients, the possible implications of health insurance, and the tobacco cessation program for smokers.

The author comments on the observational study on the implications of global payment as well as accountable care on the use of tobacco cessation service in the U.S. The topics discussed include tobacco use as the prime cause of disability and death in the country, the incentives provided to employers and patients to stop smoking, and the percentage of American adults who smoke.

The article presents the author's views on an article on a randomized controlled trial to analyze the veteran smokers' level of motivation to quit under a proactive smoking cessation intervention. He opines that there was no difference in quit attempts between usual care groups and proactive groups in the study.

The article reports on the anti-smoking campaign of Public Health England which urges people to quit smoking for 28 days.

The article assesses the response of smokers to the content of anti-smoking advertisements in television using functional magnetic resonance imaging (fMRI).