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According to the WHO, tobacco kills about half of its consumers, almost 7 million people a year, of whom nearly 1 million are passive smokers. Europe has a worryingly high level (28%) regarding the prevalence of smoking among people over the age of 15 and the adolescent segment. These issues make tobacco use an epidemic. The "Stop Smoking" National Program is coordinated by the Institute of Pulmonology "Marius Nasta" and is funded by the Romanian Ministry of Health, being implemented in 6 centres across Romania. The program aims to give smokers access to a complete treatment program to help them quit smoking, according to the recommendations of the World Health Organization and similar programs at the international level. The "Stop Smoking" program results have so far been evaluated only in terms of success rate, namely the percentage of abstinent patients at the end of the program (about 60% of all enrolled) and six months after quitting (about 40%). This study aimed to evaluate the effectiveness of the National Program ("Stop Smoking") as well as the impact of factors such as age, Fagerstrom score, number of cigarettes smoked daily, previous attempts to quit smoking, the number of months of abstinence in previous attempts and individual psychological counselling on the program performance. Results show that, in Bucharest centre, 74.8% of the total number of participants in the program was abstinent at the end of the program and 52.3% were abstinent six months after the conclusion of the program. [ABSTRACT FROM AUTHOR]

The objective of this paper was to identify the factors associated with moderate to high nicotine dependence in a sample of pregnant smokers from Romania. Data was collected through an ongoing cross-sectional pilot study from 130 pregnant smokers. The questionnaire included five main sections: socio-demographic information, medical and reproductive history, alcohol and smoking behaviors, emotional health and information regarding the relationship with the partner. Older age, first pregnancy, a negative screening for anxiety and depression, and negative partner interactions related to smoking were significantly correlated with increased odds of moderate to high nicotine dependence during pregnancy. In addition, high dyadic efficacy, low self-efficacy, high pregnancy-related anxiety, and a non-smoking life partner were correlated with increased odds of moderate to high nicotine dependence, although the results did not reach statistical significance. Once the level nicotine dependence is established, cessation treatment should target specific risks that are associated with this dependence. Maternal risk factors, spousal smoking status, and interactions in the couple hold promise in future tobacco cessation interventions. Future research should focus on both the prenatal smoking cessation and on postnatal relapse prevention among highly dependent women. [ABSTRACT FROM AUTHOR]

INTRODUCTION Symptoms 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. METHODS Participants 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 Fagerstrom 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. RESULTS Regression 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). CONCLUSIONS Nicotine 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. [ABSTRACT FROM AUTHOR]

Background: Evidence of patterns of nicotine dependence, although crucial for developing and implementing effective tobacco control strategies, is limited in the Eastern European countries. The purpose of this study was to evaluate the correlates of high nicotine dependence among adults in Poland, Romania, the Russian Federation and Ukraine.Methods: The data used in the current analysis is available from the Global Adult Tobacco Survey (2009-2011). Nicotine dependence was assessed using the Heaviness of Smoking Index (HSI), which covers two measures: reported cigarettes smoked per day and time to the first cigarette upon waking. Based on a six-point scale of HSI, nicotine dependence was categorized into low to moderate (score 0-3), and high dependence (score 4-6). Out of 31,936 completed interviews, we used data from 8229 daily smokers.Results: The study results indicate that more than 25 % of daily smokers were highly dependent on nicotine. Higher odds of high nicotine dependence were identified for males (OR = 1.5 in Poland and Romania, OR = 2.7 in Russia; p ≤ 0.001), people between 50-59 years of age (the highest odds in Romania; OR = 4.8; p ≤ 0.001) and those who had started smoking at a young age (the highest odds in Romania, OR = 5.0; p ≤ 0.001). Having fewer restrictions on smoking at home was significantly associated with a high level of nicotine dependence (the highest odds in Romania, OR = 3.0; p ≤ 0.001). A high proportion of the participants had no interest in quitting smoking, with a statistically significantly higher percentage observed among smokers highly dependent on nicotine compared to the less addicted (p ≤ 0.01).Conclusions: Smokers highly dependent on nicotine constitute a quarter of the Romanian group of daily smokers and even more in the remaining three analyzed countries. Similar patterns of nicotine dependence were observed in all of the investigated countries showing that male gender, younger age at the smoking onset, and fewer restrictions on smoking at home were significantly associated with higher nicotine dependence. The study highlighted the fact that a high proportion of the participants had no interest in quitting smoking. These results underscore importance of policy measures as well as prevention and cessation interventions for smokers who are highly dependent on nicotine, which need to take into account the social gradient in smoking patterns. [ABSTRACT FROM AUTHOR]