Mimi Nichter
University of Arizona, Anthropology, Faculty Member
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Las mujeres y el tabaco: de la polıtica a la accio´ n Virginia Ernster,1 Nancy Kaufman,2 Mimi Nichter,3 Jonathan Samet4 y Soon-Young Yoon5 ... Los discos compactos, con interpre-taciones de artistas noveles femeninas, se comercia-lizan... more
Las mujeres y el tabaco: de la polıtica a la accio´ n Virginia Ernster,1 Nancy Kaufman,2 Mimi Nichter,3 Jonathan Samet4 y Soon-Young Yoon5 ... Los discos compactos, con interpre-taciones de artistas noveles femeninas, se comercia-lizan junto con paquetes de Virginia Slims. ...
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Objectives: The purpose of the study was to characterize practice patterns and tobacco cessation training for three types of complementary and alternative medicine (CAM) practitioners (acupuncture/Traditional Chinese Medicine [TCM],... more
Objectives: The purpose of the study was to characterize practice patterns and tobacco cessation training for three types of complementary and alternative medicine (CAM) practitioners (acupuncture/Traditional Chinese Medicine [TCM], chiropractic, and massage). Methods: Researchers administered a mail survey to all licensed acupuncturist, chiropractors, and massage therapists in Tucson, Arizona. N=356 practitioners responded (acupuncturists, n=63, chiropractors, n=56, massage therapists, n=237). Results: Most respondents practice more than one CAM modality (mean 2.6, SD 1.9) with acupuncturists practicing 4.8 (SD 1.9), chiropractors, 2.9 (SD 1.9) and massage therapists, 2.0 (SD 1.4). For example, over 50% of acupuncturists report using herbs, energy therapies, and nutritional counseling in practice. When asked if they had training in tobacco cessation, 64.5% report none. Respondents who report training, 19.9% had professional training (73% acupuncturists, 18% chiropractors, 7% massag...
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... use of the pill appeared to be related to 1) the delaying of a final decision about family ... can she manage to purchase milk or formula for her baby?" Another reason for not using pills while ... Women often start taking their... more
... use of the pill appeared to be related to 1) the delaying of a final decision about family ... can she manage to purchase milk or formula for her baby?" Another reason for not using pills while ... Women often start taking their pills on the wrong date, forgot to take them for a few days or ...
Background: Lay health advisors may play an important role in community-based tobacco cessation by providing advice and information about resources and support networks. Little is known about their experiences conducting brief cessation... more
Background: Lay health advisors may play an important role in community-based tobacco cessation by providing advice and information about resources and support networks. Little is known about their experiences conducting brief cessation interventions in diverse, real world settings. Objective: To examine the intervention activities of community members trained to conduct brief cessation interventions. Methods: Six-week follow-up interviews were completed by 81 participants of a large-scale, randomized controlled trial which compared methods of training community members to conduct brief tobacco cessation interventions. Semi-structured interviews were conducted between February 2005 and January 2006. Interview questions addressed characteristics and reactions to recent brief intervention experiences. All interviews were tape-recorded, transcribed, and coded using Atlas.ti 5.0. Results: Although some participants indicated that they used similar approaches with all smokers, the majori...
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Research Interests: Health Promotion, Focus Groups, Health Care, Health Education, Indonesia, and 15 moreBeliefs, Family Practice, Humans, Male, Physicians, Attitudes, Risk factors, Aged, Prevalence, Middle Aged, Questionnaires, Public health systems and services research, Diabetes complications, Risk Factors, and Cross Sectional Studies
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Research Interests: Poverty, Qualitative Health Research, Qualitative Research, Adolescent, Harm Reduction, and 13 morePregnancy, Humans, Smoking Cessation, Smoking, Weight Loss, Female, Adult, Breast feeding, Human Milk, Psychology and Cognitive Sciences, postpartum period, Tobacco use disorder, and Medical and Health Sciences
ICHTER ANTHROPOLOGY AND INTERNATIONAL HEALTH ith Asian studies the language of science ... ANTHROPOLOGY AND INTERNATIONAL HEALTH This One E7LB-3R6-5PX2 ... CULTURE, ILLNESS, AND HEALING Editors: MARGARET LOCK Departments of ...
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Research Interests: Education, Participatory Research, Mobile Learning, Nutrition, Focus Groups, and 15 moreHealth Education, Life Style, Food and Nutrition, Adolescent Health, Mobile Phones, Adolescent, Community Based Participatory Research, Humans, Child, Arizona, Female, Male, Adolescents, Adolescent Behavior, and Medical and Health Sciences
Interventions tailored to individual smoker characteristics have increasingly received attention in the tobacco control literature. The majority of tailored interventions are generated by computers and administered with printed materials... more
Interventions tailored to individual smoker characteristics have increasingly received attention in the tobacco control literature. The majority of tailored interventions are generated by computers and administered with printed materials or web-based programs. The purpose of this study was to examine the tailoring activities of community lay health influencers who were trained to perform face-to-face brief tobacco cessation interventions. Eighty participants of a large-scale, randomized controlled trial completed a 6-week qualitative follow-up interview. A majority of participants (86%) reported that they made adjustments in their intervention behaviors based on individual smoker characteristics, their relationship with the smoker, and/or setting. Situational contexts (i.e., location and timing) primarily played a role after targeted smokers were selected. The findings suggest that lay health influencers benefit from a training curriculum that emphasizes a motivational, person-cente...
Research Interests: Education, Health Promotion, Qualitative Research, Community Health Workers, Interviews, and 15 moreHumans, Smoking Cessation, Program Development, Arizona, Role, Intervention, Female, Male, Young Adult, Follow-up studies, Aged, Middle Aged, Adult, Psychology and Cognitive Sciences, and Medical and Health Sciences
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Objective: To conduct formative research among smokers of different socio-economic statuses in Yogyakarta to identify perceptions of risk which link smoking to lung diseases and TB incidence/ relapse. Further, we wanted to assess... more
Objective: To conduct formative research among smokers of different socio-economic statuses in Yogyakarta to identify perceptions of risk which link smoking to lung diseases and TB incidence/ relapse. Further, we wanted to assess knowledge of the harm of smoking ...
Adolescence represents a uniquephase of the life span, a timemarkedby significant physical, emotional, andcognitivechanges. Itisatransitionalperiod, whenonemoves awayfromthedependentyearsofchildhoodtothethresholdofemergingadulthood.
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Why should we expect the illiterate villager to adjust to the way of thinking of the educated man? Why should he alter his perception of the world to understand us?
Is development a one-sided process of duplication?
It is perfectly... more
Why should we expect the illiterate villager to adjust to the way of thinking of the educated man? Why should he alter his perception of the world to understand us?
Is development a one-sided process of duplication?
It is perfectly possible for an educated man to adapt ...
ABIM started as the bibliography of Jan Meulenbeld's A History of Indian Medical Literature, and was first published on the internet as a set of HTML files in 2002. In the course of 2007 a new website for ABIM and EJIM, the... more
ABIM started as the bibliography of Jan Meulenbeld's A History of Indian Medical Literature, and was first published on the internet as a set of HTML files in 2002. In the course of 2007 a new website for ABIM and EJIM, the Electronic Journal of Indian Medicine, was created by Roelf ...
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Research Interests: Health Promotion, Medical Education, Family, Cultural Competency, Indonesia, and 15 moreTobacco, Developing Countries, International Cooperation, India, Curriculum, Humans, Smoking Cessation, Tobacco Cessation, Smoking, Asia Pacific, Lessons Learned, Public health systems and services research, Pilot Projects, Community Based Mental Health Services, and Community health services
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This paper discusses the training of nurses in smoking cessation as part of routine patient care in Turkey. Formative research was carried out prior to training to identify challenges faced by smokers when trying to quit. Site visits to... more
This paper discusses the training of nurses in smoking cessation as part of routine patient care in Turkey. Formative research was carried out prior to training to identify challenges faced by smokers when trying
to quit. Site visits to government hospitals and cessation clinics were conducted to observe health care provider-patient interactions involving behavior change.Four culturally sensitive cessation training workshops for nurses (n = 54) were conducted in Istanbul.Following training, nurses were debriefed on their experiences delivering cessation advice. Challenges to cessation counseling included lack of time and incentives for nurse involvement; lack of skills to deliver information about the harm of smoking and benefits of quitting; the medicalization of cessation through the use of pharmaceuticals; and hospital policy which devalues time spent on cessation activities. The pay-for-performance model currently adopted in hospitals has de-incentivized doctor participation in
cessation clinics. Nurses play an important role in smoking cessation in many countries. In Turkey, hospital policy will require change so that cessation counseling can become a routine part of nursing practice, incentives for providing cessation are put in place, and task sharing between nurses and doctors is clarified. Nurses and doctors need to receive training in both the systemic harms of smoking and cessation counseling skills. Opportunities, challenges and lessons learned are highlighted.
to quit. Site visits to government hospitals and cessation clinics were conducted to observe health care provider-patient interactions involving behavior change.Four culturally sensitive cessation training workshops for nurses (n = 54) were conducted in Istanbul.Following training, nurses were debriefed on their experiences delivering cessation advice. Challenges to cessation counseling included lack of time and incentives for nurse involvement; lack of skills to deliver information about the harm of smoking and benefits of quitting; the medicalization of cessation through the use of pharmaceuticals; and hospital policy which devalues time spent on cessation activities. The pay-for-performance model currently adopted in hospitals has de-incentivized doctor participation in
cessation clinics. Nurses play an important role in smoking cessation in many countries. In Turkey, hospital policy will require change so that cessation counseling can become a routine part of nursing practice, incentives for providing cessation are put in place, and task sharing between nurses and doctors is clarified. Nurses and doctors need to receive training in both the systemic harms of smoking and cessation counseling skills. Opportunities, challenges and lessons learned are highlighted.
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Since economic liberalization in 1991, India has been experiencing rapid economic growth and a shift to consumer culture, making it fertile ground for marketers of consumer goods. Historically, sales of beauty products in India had been... more
Since economic liberalization in 1991, India has been experiencing rapid economic growth and a shift to consumer culture, making it fertile ground for marketers of consumer goods. Historically, sales of beauty products in India had been limited by high taxation, restricted consumer choice, and high levels of poverty; post-liberalization, the country was therefore seen as a market with immense, albeit untapped, potential. However, even as beauty industry reports tout the potential for growth, nearly three decades after liberalization, per capita sales of beauty products continue to be some of the lowest in the world. Little is known about why beauty products remain stubbornly resistant to aspirational marketing efforts. Meanwhile, scant social scientific attention has been paid to the creation and marketing of tastes and desires by the beauty industry in India and women's engagement with those desires. In this article, we present ethno-graphic depth on how local beauty cultures affect understandings of bodily aesthetics to create hybrid beauty practices and on how marketing efforts seek to channel these practices into consumer behavior. We examine some of the major points of contingent difference linked to low volumes of cosmetics sales in India and explore the approaches adopted by advertisers and marketers of beauty products to convert such difference into new imaginaries that foster mass consumption.
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INTRODUCTION Indonesia has one of the highest male smoking rates in the world (67%) and secondhand smoke (SHS) exposure occurs in over 70% of households. To date, little research has investigated community recognition of the harms of... more
INTRODUCTION Indonesia has one of the highest male smoking rates in the world (67%) and secondhand smoke (SHS) exposure occurs in over 70% of households. To date, little research has investigated community recognition of the harms of secondhand smoke and support for a smoke-free homes (SFH) policy. This work discusses the development and implementation of a community-based SFH intervention attempting to establish SFH as a new social norm. METHODS Research was conducted in Yogyakarta, Java. A proof-of-concept study ascertained the feasibility of mounting a community-based SFH initiative in urban neighborhoods. Educational materials on SHS were developed and pretested. An intervention was piloted and evaluated in the homes of 296 smokers residing in 4 communities. Health promotion officers and community health volunteers were trained to implement SFH. RESULTS Prior to the intervention, 11% of smokers did not smoke inside their home; post-intervention 54% of smokers did not smoke inside their home. The Yogyakarta District Health Office has supported large scale implementation of smoke-free homes. To date, 135 urban communities have declared themselves as having SFH. CONCLUSIONS This is the first community-based SFH initiative to be carried out in SouthEast Asia. The SFH movement redefines smoking cessation as a health issue of women and children, ties family welfare to core cultural values, and offers women a leadership role in tobacco control. The sustainability of SFH in Yogyakarta has been achieved by working closely with multiple levels of government and has contributed to shifts in tobacco control policy in Indonesia.
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Background: This paper describes a pioneering effort to introduce smoking cessation into Indonesia's medical school curriculum, and the first ever attempt to fully integrate tobacco control in all four years of medical school anywhere in... more
Background: This paper describes a pioneering effort to introduce smoking cessation into Indonesia's medical school curriculum, and the first ever attempt to fully integrate tobacco control in all four years of medical school anywhere in Southeast Asia. The development, pretesting, and piloting of an innovative modular tobacco curriculum are discussed as well as the challenges that face implementation. Methods: In-depth interviews were conducted with medical school administrators and faculty in four medical colleges to determine interest in and willingness to fully integrate tobacco cessation into the college curriculum. A tobacco focused curriculum review, student focus groups, and a survey of medical students (n = 579) assessed current exposure to information about tobacco and interest in learning cessation skills. A modular tobacco curriculum was developed and was pretested, modified, piloted, and evaluated. Qualitative research was conducted to identify potential challenges to future curriculum implementation. Results: Fifteen modules were successfully developed focusing on the relationship between tobacco and specific organ systems, diseases related to smoking, the impact of tobacco on medication effectiveness, and information on how to explain to patients about effects of tobacco on their health condition. Lecturers and students positively evaluated the curriculum as increasing their competency to support cessation during illness as a teachable moment. Systemic challenges to implementing the curriculum were identified including shifts in pedagogy, decentralized curriculum decision-making, and frequent lecturer turnover. Discussion: A fully integrated tobacco curriculum for medical schools was piloted and is now freely available online. An important lesson learned in Indonesia was that a tobacco curriculum must be flexible enough to be adjusted when shifts in medical education take place. The curriculum is a resource for medical colleges and expert committees in Southeast Asia deliberating how best to address lifestyle factors undermining population health.
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Background: Results of the Global Adult Tobacco Survey in Kerala, India found that 42 % of adults were exposed to second hand smoke (SHS) inside the home. Formative research carried out in rural Kerala suggests that exposure may be much... more
Background: Results of the Global Adult Tobacco Survey in Kerala, India found that 42 % of adults were exposed to second hand smoke (SHS) inside the home. Formative research carried out in rural Kerala suggests that exposure may be much higher. Numerous studies have called for research and intervention on SHS exposure among women and children as an important component of maternal and child health activities. Methods: Community-based participatory research was carried out in Kerala. First, a survey was conducted to assess prevalence of SHS exposure in households. Next, a proof of concept study was conducted to develop and test the feasibility of a community-wide smoke free homes initiative. Educational materials were developed and pretested in focus groups. After feasibility was established, pilot studies were implemented in two other communities. Post intervention, surveys were conducted as a means of assessing changes in community support. Results: At baseline, between 70 and 80 % of male smokers regularly smoked inside the home. Over 80 % of women had asked their husband not to do so. Most women felt powerless to change their husband's behavior. When women were asked about supporting a smoke free homes intervention, 88 % expressed support for the idea, but many expressed doubt that their husbands would comply. Educational meetings were held to discuss the harms of second hand smoke. Community leaders signed a declaration that their community was part of the smoke free homes initiative. Six months post intervention a survey was conducted in these communities; between 34 and 59 % of men who smoked no longer smoked in their home.
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Background: This paper describes a pioneering effort to introduce tobacco cessation into India's undergraduate medical college curriculum. This is the first ever attempt to fully integrate tobacco control across all years of medical... more
Background: This paper describes a pioneering effort to introduce tobacco cessation into India's undergraduate medical college curriculum. This is the first ever attempt to fully integrate tobacco control across all years of medical college in any low and middle income country. The development, pretesting, and piloting of an innovative modular tobacco curriculum are discussed as well as challenges that face implementation and steps taken to address them and to advocate for adoption by the Medical Council of India.
Little research has focused on women's exposure to secondhand smoke (SHS) in LMICs, local perceptions of SHS risk to women and children, and women's attempts to limit exposure to tobacco smoke in their households. This paper describes a... more
Little research has focused on women's exposure to secondhand smoke (SHS) in LMICs, local perceptions of SHS risk to women and children, and women's attempts to limit exposure to tobacco smoke in their households. This paper describes a community based survey in Indonesia that investigated these issues as one step in a movement to initiate community wide household smoking bans. The survey found high levels of exposure to SHS, high levels of awareness among both women and men that SHS placed women and children at risk for illness, a very low percentage of households having indoor smoking rules, great interest on the part of women to participate in a communitywide ban, and a promising level of male smoker agreement to comply with such a ban. Women expressed a low sense of self efficacy in individually getting their husbands to quit smoking in their homes, but a strong sense of collective efficacy that husbands might agree to a well-publicized and agreed-upon community household smoking ban. Men and women expressed concern about the social risk of asking guests not to smoke in their homes without a communitywide ban and visible displays communicating their participation in this movement. The smoke free initiative described requires the participation of doctors in community education programs, and is attempting to introduce household smoking bans as a way of turning tobacco control into a family health and not just a smokers' health issue.
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Objective: To develop and test messages and a mobile phone delivery protocol designed to influence the nutrition and physical activity knowledge, attitudes, and behavior of adolescents. Design: Nine focus groups, 4 classroom discussions,... more
Objective: To develop and test messages and a mobile phone delivery protocol designed to influence the
nutrition and physical activity knowledge, attitudes, and behavior of adolescents. Design: Nine focus groups, 4 classroom discussions, and an 8-week pilot study exploring message content, format, origin, and message delivery were conducted over 12 months using a multistage, youth participatory
approach. Setting: Youth programs at 11 locations in Arizona.
Participants: Recruitment was coordinated through youth educators and leaders. Eligible teens were 12-18 years old and enrolled in youth programs between fall 2009 and 2010.
Phenomenon of Interest: Adolescent preferences for messages and delivery of messages. Analysis: Qualitative data analysis procedures to generate themes from field notes. Results: One hundred seventy-seven adolescents participated in focus groups (n ¼ 59), discussions (n ¼ 86), and a pilot study (n ¼ 32). Youth preferred messages with an active voice that referenced teens and recommended specific, achievable behaviors; messages should come from nutrition professionals delivered
as a text message, at a frequency of # 2 messages/day. Conclusions and Implications: More than 300 messages and a delivery protocol were successfully developed and tested in partnership with adolescents. Future research should address scalability of texting interventions; explore dose associated with changes in knowledge, attitudes, and behaviors; and offer
customized message subscription options. Key Words: adolescents, mobile health, diet, health education, community-based participatory research.
nutrition and physical activity knowledge, attitudes, and behavior of adolescents. Design: Nine focus groups, 4 classroom discussions, and an 8-week pilot study exploring message content, format, origin, and message delivery were conducted over 12 months using a multistage, youth participatory
approach. Setting: Youth programs at 11 locations in Arizona.
Participants: Recruitment was coordinated through youth educators and leaders. Eligible teens were 12-18 years old and enrolled in youth programs between fall 2009 and 2010.
Phenomenon of Interest: Adolescent preferences for messages and delivery of messages. Analysis: Qualitative data analysis procedures to generate themes from field notes. Results: One hundred seventy-seven adolescents participated in focus groups (n ¼ 59), discussions (n ¼ 86), and a pilot study (n ¼ 32). Youth preferred messages with an active voice that referenced teens and recommended specific, achievable behaviors; messages should come from nutrition professionals delivered
as a text message, at a frequency of # 2 messages/day. Conclusions and Implications: More than 300 messages and a delivery protocol were successfully developed and tested in partnership with adolescents. Future research should address scalability of texting interventions; explore dose associated with changes in knowledge, attitudes, and behaviors; and offer
customized message subscription options. Key Words: adolescents, mobile health, diet, health education, community-based participatory research.
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Objectives Female smoking is predicted to double between 2005 and 2025. There have been numerous calls for action on women's tobacco use over the past two decades. In the present work, evidence about female tobacco use, progress,... more
Objectives Female smoking is predicted to double between 2005 and 2025. There have been numerous calls for action on women's tobacco use over the past two decades. In the present work, evidence about female tobacco use, progress, challenges and ways forward for developing gendered tobacco control is reviewed. Methods Literature on girls, women and tobacco was reviewed to identify trends and determinants of tobacco use and exposure, the application of gender analysis, tobacco marketing, the impact of tobacco control on girls and women and ways to address these issues particularly in low-income and middle-income countries.
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The 3 aims of Project Quit Tobacco International are to design a tobacco curriculum for medical colleges, develop culturally appropriate approaches to clinic and community-based tobacco cessation, and to build tobacco research and... more
The 3 aims of Project Quit Tobacco International are to design a tobacco curriculum for medical colleges, develop culturally appropriate approaches to clinic and community-based tobacco cessation, and to build tobacco research and training networks within India and Indonesia as a prototype for other countries. This article describes pilot interventions being launched in 10 medical colleges in these 2 countries to (a) integrate tobacco into their 4-year training programs, (b) establish illness-specific cessation clinics, and (c) involve colleges in community outreach efforts to promote smoke-free households. This article reports on lessons learned, challenges faced, and successes realized to date.
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Tobacco use is a leading cause of death and of poor pregnancy outcome in many countries. While tobacco use is decreasing in many high-income countries, it is increasing in many low-and middle-income countries (LMICs), where by the year... more
Tobacco use is a leading cause of death and of poor pregnancy outcome in many countries. While tobacco use is decreasing in many high-income countries, it is increasing in many low-and middle-income countries (LMICs), where by the year 2030, 80% of deaths caused by tobacco use are expected to occur. In many LMICs, few women smoke tobacco, but strong evidence indicates this is changing; increased tobacco smoking by pregnant women will worsen pregnancy outcomes, especially in resource-poor settings, and threatens to undermine or reverse hard-won gains in maternal and child health. To date, little research has focused on preventing pregnant women's tobacco use and secondhand smoke (SHS) exposure in LMICs. Research on social and cultural influences on pregnant women's tobacco use will greatly facilitate the design and implementation of effective prevention programs and policies, including the adaptation of successful strategies used in high-income countries. This paper describes pregnant women's tobacco use and SHS exposure and the social and cultural influences on pregnant women's tobacco exposure; it also presents a research agenda put forward by an international workgroup convened to make recommendations in this area.
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Lawrence Babb has called upon anthropologists studying Indian culture to more closely examine the relevance of great tradition Hindu concepts like karma for the practice of popular Hinduism. He suggests that karma is only one of many... more
Lawrence Babb has called upon anthropologists studying Indian culture to more closely examine the relevance of great tradition Hindu concepts like karma for the practice of popular Hinduism. He suggests that karma is only one of many explanations for misfortune in India, and that it is an ultimate explanation of misfortune, whereas Hindus are more inclined to think of more proximate causes. He notes that karma may serve as more than just a way to rationalize misfortune and take on or distance responsibility (e.g., "I inherited karma from a previous life"). It may also provide a sense of personal efficacy, since one can act to reduce one's karma. In other words, karmic reasoning may at once provide a model of misfortune in the past as well as a model for action in the present to influence the future. In this essay, we consider a case where a karmic reasoning is central to the actions of an Ayurvedic physician who sponsors a very elaborate and costly ritual. The reasons he gives for doing so lead us to reconsider the importance of two Hindu concepts: karma vipaka (the fruits of karma) and rna (debts) that one owes to persons, gods, and ancestors. The physician views his practice as social service and does not charge money to patients, but still sees his vocation as enmeshing him in the negative karma of his patients. The ritual is performed in order to counteract this karma, and also to pay off pending " debts" to the god Dhan-vantri by deceased practitioners within his family. The efficacy of the ritual is discussed broadly in terms of its meaning to participants and attendees' , its visceral affect, its social impact in a family quarreling over the cultural capital of hereditary knowledge, and its role in establishing cosmological order as well as the moral identity of the physician.
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Tobacco use is a leading cause of death and of poor pregnancy outcome in many countries. While tobacco use is decreasing in many high-income countries, it is increasing in many low-and middle-income countries (LMICs), where by the year... more
Tobacco use is a leading cause of death and of poor pregnancy outcome in many countries. While tobacco use is decreasing in many high-income countries, it is increasing in many low-and middle-income countries (LMICs), where by the year 2030, 80% of deaths caused by tobacco use are expected to occur. In many LMICs, few women smoke tobacco, but strong evidence indicates this is changing; increased tobacco smoking by pregnant women will worsen pregnancy outcomes, especially in resource-poor settings, and threatens to undermine or reverse hard-won gains in maternal and child health. To date, little research has focused on preventing pregnant women's tobacco use and secondhand smoke (SHS) exposure in LMICs. Research on social and cultural influences on pregnant women's tobacco use will greatly facilitate the design and implementation of effective prevention programs and policies, including the adaptation of successful strategies used in high-income countries. This paper describes pregnant women's tobacco use and SHS exposure and the social and cultural influences on pregnant women's tobacco exposure; it also presents a research agenda put forward by an international workgroup convened to make recommendations in this area.
Indonesia Reading culture from tobacco advertisements in http://tobaccocontrol.bmj.com/cgi/content/abstract/tc.2008.025809v1 Updated information and services can be found at: These include: Rapid responses... more
Indonesia Reading culture from tobacco advertisements in http://tobaccocontrol.bmj.com/cgi/content/abstract/tc.2008.025809v1 Updated information and services can be found at: These include: Rapid responses http://tobaccocontrol.bmj.com/cgi/eletter-submit/tc.2008.025809v1
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OBJECTIVE: To document smoking patterns among tuberculosis (TB) patients before diagnosis and following treatment, to identify smoking-related messages given by health professionals and DOTS providers and to identify predictors of smoking... more
OBJECTIVE: To document smoking patterns among tuberculosis (TB) patients before diagnosis and following treatment, to identify smoking-related messages given by health professionals and DOTS providers and to identify predictors of smoking relapse. DESIGN: A cross-sectional survey of 239 male TB patients completed DOTS-based treatment during 2005-2006. Subjects were interviewed at home using a semi-structured questionnaire. Female patients were excluded, as very few smoke.
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Research Interests: Epidemiology, Social Marketing, Tobacco, Economic policy, Survival Analysis, and 23 morePublic Health, Fiscal policy, Adolescent, Economy, Policy making, Complication, Humans, Toxicity, Developing Country, Smoking, Health Services, Legislation, Tobacco Use, Female, Tobacco Control, Aged, Prevalence, Middle Aged, Adult, Tobacco industry, World Health Organization, Framework Convention on tobacco control, and Passive Smoking
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Aims Previously reported research suggests a dependence syndrome for areca nut use, though well-designed studies are virtually non-existent. The goal of this study was to examine evidence of areca dependence in a sample of areca-only... more
Aims Previously reported research suggests a dependence syndrome for areca nut use, though well-designed studies are virtually non-existent. The goal of this study was to examine evidence of areca dependence in a sample of areca-only (i.e. no tobacco) chewers using modified measurement scales.Design A purposive sample of chewers, identified via local informants and advertisements, was surveyed from January to March of 2005.Setting Six villages in Dakshina Kannada District, Karnataka State, India.Participants Fifty-nine daily areca chewers who do not also currently use any form of tobacco.Measurements Questionnaires included modified versions of the Fagerström Tolerance Questionnaire, Cigarette Dependence Scale (CDS-5) and the Smokeless Tobacco Dependence Scale (STDS). Additional questions assessed demographic characteristics and patterns of use.Findings Approximately half of respondents reported 1–3 chews/day (mean = 1.9; SD = 0.98). The average number of chewing episodes/day was 4.4 (SD = 3.4) and the average number of nuts/day was 1.2 (SD = 1.1). Users’ typical chew lasts up to 20 minutes and includes spitting out the juices and rinsing the mouth with water. Overall, the levels of reported dependence symptoms were quite low, but approximately 44% of chewers endorsed at least one of the following items: continued use despite illness or mouth wounds, difficulty refraining from chewing in forbidden places, or craving during periods of abstinence. Approximately 15.4% of chewers reported at least one intentional quit attempt and a subset had summary scores indicative of dependence (13.6% had scores >16 on the CDS-5 and 5.3% had scores >11 on the STDS). Dependence scores were positively correlated with frequency of chews/day.Conclusions The symptoms of dependence observed in a subset of areca-only chewers warrant further investigation. Next steps should include well-controlled laboratory evaluation of dependence features.
Research Interests: Addiction, Mental Health, Consumption, Tobacco, Medicinal Plants, and 21 morePublic Health, Adolescent, India, Humans, Child, Topography, Female, Male, Drug Addiction, Young Adult, Social Environment, Chewing, Aged, Middle Aged, Questionnaires, Areca Nut, Arecoline, Adult, Mastication, Health surveys, and Substance-Related Disorders
Research Interests: Health Promotion, Focus Groups, Health Education, Tobacco, Self Efficacy, and 16 moreCommunity of Practice, Community Health Workers, Humans, Smoking Cessation, Female, Male, Patient Compliance, Follow-up studies, Middle Aged, Adult, Public health systems and services research, Curriculum and Pedagogy, Social Relationship, Intervention study, Health Workers, and Brief Intervention
Research Interests: Sociology, Anthropology, Indian studies, Focus Groups, Tobacco, and 18 moreAdolescent, India, Motivation, Social Science & Medicine, Students, Humans, Smoking, Indology, College Students, Smokeless tobacco, Male, Focus Group, Adolescent Smoking, Prevalence, Adult, Public health systems and services research, Tobacco Products, and Socioeconomic Factors
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Research Interests: Education, Social Networks, Ethnography, Poverty, Case Studies, and 27 moreHealth Education, Tobacco, Ethnology, Social Support, Public Health, Adolescent, Cultural Anthropology, Harm Reduction, Motivation, Pregnancy, Humans, Smoking Cessation, Smoking, Case Study, Female, Behavior change, Qualitative Study, Income, Reduction, Socioeconomic Status, Qualitative Data, Adult, Pregnant Women, Morals, Low Income, Gestation, and Socioeconomic Factors
Research Interests: Psychology, Action Research, Addiction, Politics, Qualitative Research, and 13 moreCultural Anthropology, Political Economics, Drug Use, Humans, Smoking, Drug Addiction, Interpersonal Relations, Dependency, Drug abuse, Social Conditions, Substance use and misuse, Psychological Models, and Substance-Related Disorders
Research Interests: Health Education, Indonesia, Tobacco, Social Support, Chronic illness, and 19 moreFeasibility Study, Motivation, Humans, Smoking Cessation, Diabetes mellitus, Smoking, Female, Feasibility Studies, Male, Health Professionals, Interpersonal Relations, Health Status, Clinical Sciences, Prevalence, Middle Aged, Visual Representation, Public health systems and services research, Diabetes complications, and Home Care Services
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Research Interests: Health Promotion, Family, Adolescent, Multidisciplinary, Humans, and 14 moreSmoking Cessation, Smoking, High School, Female, Tobacco Control, Focus Group, Family Environment, Questionnaires, Social Relation, Cross Section, Longitudinal Study, Cross Sectional Studies, Adolescent Behavior, and Cohort Studies
Research Interests: Psychology, Health Care, Tobacco, India, Medical Students, and 16 moreHumans, Smoking Cessation, Smoking, Tobacco Use, Female, Male, Health Professionals, Nursing Students, Adult, Cross Section, Health surveys, Developing nations, Addictive Behaviors, Cross Sectional Studies, Nursing Student, and Health Personnel
Cigarettes have been socially engineered to become potent symbols. Therefore, they need to be understood as cultural products invested with cognitive and emotional salience as well as nicotine delivery devices engineered to create a... more
Cigarettes have been socially engineered to become potent symbols. Therefore, they need to be understood as cultural products invested with cognitive and emotional salience as well as nicotine delivery devices engineered to create a population of dependent users. In this paper, we look at the symbolism of cigarettes, but unlike many researchers examining this topic, we attend as much to what tobacco users do with cigarettes as to what smoking means to them cognitively. Based on interviews with low-level smokers conducted on two college campuses, we suggest that students use tobacco in order to accomplish interactional goals and to structure social time and space that would otherwise be ambiguously defined. By conceptualizing this structuring activity as play, we gain valuable insights into early stages and trajectories of tobacco use among college students. Our conceptualization of smoking as play is not meant to trivialize low-level tobacco use. Much the opposite, we caution that the contexts in which low-level smoking takes place and the utility functions of such smoking must be taken seriously by researchers in light of current increases in tobacco use among college students.
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Research Interests:
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ABSTRACT: Background: The benefits of breastfeeding for infants and mothers have been well established, yet rates of breastfeeding remain well below national recommendations in the United States and even lower for women who smoke during... more
ABSTRACT: Background: The benefits of breastfeeding for infants and mothers have been well established, yet rates of breastfeeding remain well below national recommendations in the United States and even lower for women who smoke during pregnancy. Primary goals of this study were to explore contextual factors that contribute to breastfeeding intentions and behavior and to examine how smoking status affected women’s decision making about breastfeeding. Methods: This paper is based on a longitudinal qualitative study of smoking, pregnancy, and breastfeeding among 44 low-income women in the southwest U.S. who smoked during pregnancy. Each woman was interviewed 9 times; 6 times during pregnancy and 3 times postpartum using semistructured questionnaires. Interviews lasted 1 to 3 hours and were tape-recorded, transcribed, and analyzed. Results: Despite 36 (82%) respondents stating that they intended to breastfeed for an average duration of 8 months, rates of breastfeeding initiation and duration were much lower than intentions. By 6 months postpartum, only two women were breastfeeding exclusively. Conclusions: Women perceived that a strong risk of harming the baby was posed by smoking while breastfeeding and received little encouragement to continue breastfeeding despite an inability to stop smoking. The perceptions of the toxic, addictive, and harmful effects of smoking on breastmilk constitution and quantity factored into reasons why women weaned their infants from breastfeeding much earlier than the recommended 6 months. The results indicate a need for more consistency and routine in educating women on the relationship between smoking and breastfeeding and in promoting breastfeeding in spite of smoking postpartum. (BIRTH 35:3 September 2008)