DOCSLIB.ORG

CRAVING REGULATION TRAINING and SMOKING 2 3 4 5 Brief Training in Regulation of Craving Reduces Cigarette Smoking 6 7 Richard B

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
CRAVING REGULATION TRAINING and SMOKING 2 3 4 5 Brief Training in Regulation of Craving Reduces Cigarette Smoking 6 7 Richard B 1 Running head: CRAVING REGULATION TRAINING AND SMOKING 2 3 4 5 Brief training in regulation of craving reduces cigarette smoking 6 7 Richard B. Lopez, Ph.D. 8 Department of Psychology, Bard College, Annandale on Hudson, NY, USA 9 10 Kevin N. Ochsner, Ph.D. 11 Department of Psychology, Columbia University, New York, NY, USA 12 13 Hedy Kober, Ph.D.* 14 Departments of Psychiatry & Psychology, Yale University, New Haven, CT, USA 15 16 17 Word Count: 4,751 words (main text) 18 Tables: 2 19 Figures: 4 20 21 Funding: This research was supported by grants R01 DA022541 (to KO) and K12 DA00167 (to 22 HK) from the National Institute on Drug Abuse. These funding sources had no other role other 23 than financial support. 24 25 Acknowledgments: The authors would like to thank Peter Mende-Siedlecki and Katherine 26 Remy for their help with early stages of implementation, and Chukwudi Onyemekwu, Steff 27 Lyon, Daniel Bogart, Natalie Porter, Linh Tchang, and Colleen Doyle for their help with 28 screening and running participants. 29 30 Author contributions: K.O and H.K designed the study; R.L. and H.K. conducted analyses. The 31 manuscript was written by R.L. and H.K, and edited by KO. The final manuscript was approved 32 by all authors. The authors report no conflicts of interest. 33 34 35 This manuscript has been submitted for peer review, so please 36 consult this preprint for revised versions to be posted in the future 37 CRAVING REGULATION TRAINING AND SMOKING 2 1 Abstract 2 Craving is an important contributing factor in cigarette smoking and has been added as a 3 diagnostic criterion for addiction DSM-5. Cognitive-behavioral therapy and other treatments that 4 incorporate craving regulation strategies reduce smoking and likelihood of relapse. Although this 5 suggests that the regulation of craving is an important mechanism underlying smoking cessation, 6 it is unclear whether targeted interventions that train smokers to regulate craving can directly 7 impact real-world smoking behaviors. Across two pilot studies (N=33; N=60), we tested whether 8 a brief computer-delivered training session in the cognitive regulation of craving altered 9 subsequent smoking behaviors in daily life. Participants were first randomly assigned to either a 10 no training (control) group, or one of two Regulation of Craving Training (ROC-T) conditions. 11 Next, all participants came into the lab and those assigned to ROC-T conditions were trained to 12 implement a cognitive strategy to regulate their craving, by either focusing on the negative 13 consequences of smoking, or by distracting themselves. Then, these participants underwent 14 ROC-T during which they practiced using the strategy to regulate their craving during cue 15 exposure. Participants’ smoking was subsequently assessed via daily diaries for 3-6 days, and via 16 self-report up to 1-month follow-up. Across both studies, ROC-T conditions were associated 17 with significant reductions in average cigarettes smoked per day, with effects persisting through 18 follow-up. These results confirm that the regulation of craving is an important mechanism of 19 smoking cessation, and can be targeted via easily-administered training procedures, such as 20 ROC-T. 21 22 Keywords: Craving, regulation, smoking, computer-delivered training 23 24 CRAVING REGULATION TRAINING AND SMOKING 3 1 Cigarette smoking remains the most prevalent cause of preventable morbidity and 2 mortality in the world, including in developed countries like the United States (Centers for 3 Disease Control and Prevention (CDC), 2008). On average, smoking kills 1,200 Americans 4 every day, accounting for 480,000 deaths per year (National Center for Chronic Disease 5 Prevention and Health Promotion (US) Office on Smoking and Health, 2014), far exceeding 6 deaths from AIDS, murders, suicide, car crashes, alcohol, and all illicit drugs—combined 7 (Mokdad, Marks, Stroup, & Gerberding, 2004). As far as morbidity, recent estimates indicate 8 that approximately 14 million US adults had smoking-related medical conditions (Rostron, 9 Chang, & Pechacek, 2014). Moreover, smoking is associated with significant economic costs, 10 including medical expenses and lost worker productivity; in the US alone these costs exceed 11 $289 billion (National Center for Chronic Disease Prevention and Health Promotion (US) Office 12 on Smoking and Health, 2014). And despite increased awareness of the negative health 13 consequences of smoking, leading to marked declines in smoking rates over the past four 14 decades (i.e., 42.4% of US adults in 1965 to only 15.5% in 2016; Jamal et al., 2018), the 15 coronavirus pandemic has halted this trend (Altria Group Inc., 2021) and smoking has been 16 linked to increased severity of COVID-19 (Patanavanich & Glantz, 2020; Purkayastha et al., 17 2020). 18 Moreover, smoking cessation rates remain disproportionately low (Babb, Malarcher, 19 Schauer, Asman, & Jamal, 2017; Dutra et al., 2008). Although recent figures indicate that 68% 20 of smokers express the desire to quit every year, and 55.4% make an effort to quit, only 7.4% are 21 successful (Babb et al., 2017). Why is quitting still an unattainable goal for so many smokers? 22 One important contributor to smoking is craving. Craving is defined in the DSM-5 as “a 23 strong desire,” and previously has been linked to smoking and relapse following quit attempts CRAVING REGULATION TRAINING AND SMOKING 4 1 (Allen, Bade, Hatsukami, & Center, 2008; Cooney et al., 2007; Doherty, Kinnunen, Militello, & 2 Garvey, 1995; Gass, Motschman, & Tiffany, 2014; Shadel et al., 2011; Shiffman et al., 1997). 3 Further, craving that arises following exposure to smoking cues – known as cue-induced craving 4 – has also been reliably linked to smoking and relapse in particular studies (e.g., Carpenter et al., 5 2009; Conklin et al., 2015; Waters et al., 2004) and across multiple studies in terms of robust 6 meta-analytic effects (Vafay & Kober, In Prep). Indeed, this type of craving may be especially 7 important when considering treatment programs (Ferguson & Shiffman, 2009). 8 Importantly, many models of addiction posit that the inability to exert control over cue- 9 induced craving underlies compulsive smoking and other drug-seeking behaviors (Everitt & 10 Robbins, 2005; Goldstein & Volkow, 2011; Koob & Le Moal, 2001). As such, cue-induced 11 craving, and especially its regulation, might serve as an important target of smoking cessation 12 interventions to improve outcomes. Indeed, a key feature of cognitive-behavioral therapies 13 (CBT) for smoking cessation (and addiction more broadly) is to train individuals to change their 14 natural or prepotent responses (e.g., craving) to appetitive and/or affective stimuli by using 15 cognitive strategies (e.g., considering their negative consequences). Further, use of such 16 strategies has been linked to reduced smoking in studies using ecological momentary assessment 17 (O’Connell, Hosein, Schwartz, & Leibowitz, 2007). 18 We and others have tested whether such strategies effectively reduce craving in 19 controlled laboratory settings. For example, in a CBT-based regulation of craving (ROC) task, 20 cigarette-smoking participants were instructed to focus on the negative consequences of smoking 21 while being exposed to smoking cues, and reported a significant reduction in craving (Kober, 22 Kross, Mischel, Hart, & Ochsner, 2010). Subsequent studies have replicated this result by 23 demonstrating that cigarette smokers can successfully implement this strategy via the ROC task CRAVING REGULATION TRAINING AND SMOKING 5 1 (Kober, Kross, et al., 2010; Luijten, van Meel, & Franken, 2011), and that regulation success 2 depends on the extent to which smokers recruit brain regions that were previously associated 3 with regulation of negative emotions (i.e., dorsolateral and ventrolateral prefrontal cortex; Buhle 4 et al., 2014; Kober, et al., 2010a). In turn, recruitment of these prefrontal regions was associated 5 with reduced activity in the ventral striatum and vmPFC (Kober et al., 2010b)—regions typically 6 linked to reward computation and the subjective experience of craving (e.g., see Diekhof, Kaps, 7 Falkai, & Gruber, 2012 for a meta-analysis). This CBT-based ROC task has also been 8 administered to methamphetamine users, who successfully diminished their craving when 9 employing the regulation strategy described above (Lopez, Onyemekwu, Hart, Ochsner, & 10 Kober, 2015). Similar findings have since been reported with other stimulant users, alcohol- 11 dependent individuals, and with food (Giuliani, Calcott, & Berkman, 2013; Giuliani, Mann, 12 Tomiyama, & Berkman, 2014; Naqvi et al., 2015; Suzuki et al., 2020; Volkow et al., 2010). 13 To build on this work, we developed Regulation of Craving Training (ROC-T) – 14 a training procedure based on the ROC task, in which participants practice using strategies to 15 regulate their craving over and over in the presence of cigarette cues. Here we tested whether this 16 brief, computerized training procedure is effective in reducing not only craving, but also 17 cigarette smoking in daily life. Specifically, we conducted two pilot studies: we recruited daily 18 smokers who were motivated to reduce or quit smoking and randomly assigned them to one of 19 three groups: two experimental groups that received ROC-T and a control group that did not 20 receive an intervention. Both ROC-T conditions were CBT-based, with participants in one 21 condition trained to engage in cognitive reappraisal by focusing on the negative consequences of 22 smoking when experiencing craving, as described above. In the other ROC-T condition, 23 participants were trained to cognitively distract themselves by bringing to mind something CRAVING REGULATION TRAINING AND SMOKING 6 1 completely different when they feel craving. Although less frequently used in addiction 2 treatment, distraction is also part of CBT (Beck, 2011). We included both strategies to test 3 whether they would be equally or differentially effective.
Load more

Recommended publications
  • 19Th Century Tobacco Spreads Around the World As a Commercial Crop
    86 87 BCE –19th Century Tobacco spreads around the world as a commercial crop. 6000 BCE 1493 Circa 1600 1633 1700s 1769 1800 1862 Americas First cultivation of the Christopher Columbus and his crew India Tobacco is fi rst introduced. Turkey Death penalty is imposed for Africa/Americas African slaves are New Zealand Captain James Canada Tobacco is fi rst grown US First federal tobacco tax tobacco plant. return to Europe from the Americas smoking. forced to work in tobacco fi elds. Cook arrives smoking a pipe, and commercially. is introduced to help fi nance the 1600s is promptly doused in case he is Civil War. with the fi rst tobacco leaves and Europe Snuff becomes the most Circa 1 BCE China Philosopher Fang Yizhi 1634 a demon. 1833 seeds ever seen on the continent. popular mode of tobacco use. points out that long years of smoking China Qing dynasty decrees a UK Phosphorus friction matches are Americas Indigenous Americans A crew member, Rodrigo de Jerez, is 1876 “scorches one’s lung.” smoking ban, during which a violator introduced on a commercial scale, Korea Foreign cigarettes and HISTORY begin smoking tobacco and using seen smoking and is imprisoned by Circa 1710 1771 is executed. The ban is not to protect France A French offi cial is making smoking more convenient. matches are introduced. tobacco enemas. the Inquisition, which believes he is Russia Peter the Great encourages 1603 health, but to address the inequality condemned to be hanged for Americas Huron Indian myth: possessed by the devil. his courtiers to smoke tobacco Japan Use of tobacco is well- of trade with Korea.
    [Show full text]
  • Tobacco and the Developing World July 2019
    ASH Fact sheet: Tobacco and the Developing World July 2019 SUMMARY • Around 1.1 billion people aged 15 and over smoke, with 80% living in LMICs (low and middle income countries). Tobacco growing and consumption have become concentrated in the developing world where the health, economic, and environmental burden is heaviest and likely to increase. • Evidence shows that the number of smokers in LMICs has been rising and is likely to continue rising without the enforcement of stringent tobacco controls. Adolescent smoking is also considerably high in LMICs, over four times the level in the UK. • The health burden of smoking is disproportionately high in the developing world. By 2030, it is estimated that tens of millions of people in the developing world would have died from tobacco consumption. The majority of child deaths from second-hand smoke also occur in Africa and South-East Asian alone. • Smoking in the developing world has been shown to reinforce poverty as already deprived smokers spend less on healthcare, children’s education, food, and clothes. • Almost all tobacco farming now takes place in low and middle-income countries. This causes massive environmental damage such as mass deforestation and air pollution, and the industry’s poor safety practices leave tobacco farmers – many of which are children – prone to developing serious life-threatening illnesses. • Transnational tobacco companies have been shown to target women and children in developing countries. They also undermine efforts to curb the harms of tobacco through litigation
    [Show full text]
  • The Long Tobacco Road: a History of Smoking from Ritual to Cigarette
    The Long Tobacco Road: A History of Smoking from Ritual to Cigarette Humans first came into contact with tobacco plants about 18,000 years ago when migrant Asiatic people first crossed the Bering Strait and spread across the continents known today as the Americas, where tobacco is native. The 18,000- year-old evolution of humans’ relationship with tobacco has seen wide dissemination both of the plant’s cultivation and of the practice of smoking, a kind of physiological stimulation long sought-after, but only relatively recently reviled—and only very recently understood at a chemical level. In fact, aside from its social aspect, tobacco has been celebrated for its medicinal and ritualistic characteristics throughout most of its history. Even to the present day, smoking—particularly that of the ubiquitous cigarette—remains pervasive in many cultures, “so commonplace as to appear a natural act” instead of, say, a bad habit (Gately 2001). But landmark scientific research begun in the 1940s detected a possible correlation between the rise in cigarette smoking and the rise in cases of lung cancer. Their conclusions would have a profound impact on the culture and politics of tobacco manufacture and advertising—and while some of the smoking public has heeded their warnings, others have been more reluctant. Lung cancer may be a troubling reality, but what of that “perfect type of perfect pleasure,” as Oscar Wilde put it? (Parker-Pope 2001). Pre-Columbian Tobacco There are 64 species of the genus Nicotiana but only two, rustica and tabacum, are used by the modern tobacco industry. The widespread cultivation of these species began as far back as 5000 B.C., and their genetic origin is the Andes Mountains near Peru or Ecuador.
    [Show full text]
  • Final Programme FINAL PROGRAMME
    Permanent Secretariat World Conference on Tobacco or Health [email protected] | wctoh.org Final Programme 16TH WORLD CONFERENCE ON TOBACCO OR HEALTH | TOBACCO AND NON-COMMUNICABLE DISEASES | FINAL PROGRAMME 2 WELCOME TO THE 16TH WORLD CONFERENCE ON TOBACCO OR HEALTH On behalf of the Organising Committee and Emirates Cardiac Society, we are honoured to invite you to the 16th World Conference on Tobacco or Health (WCTOH) which will be held from 17 to 21 March 2015 in Abu Dhabi, the capital city of the United Arab Emirates (UAE). The Conference is a call for a collective resolution to fight tobacco by working together and integrating tobacco control into two broad agendas for achievement of our common health and development goals. The Conference theme of “Tobacco and Non-Communicable Diseases” highlights the fact that tobacco use is the most alarming risk factor for diseases causing millions of deaths every year and contributing to the enormous burden of NCDs all over the world. Through the implementation of the WHO Framework Convention on Tobacco Control (FCTC) and MPOWER, considerable progress has been made since the WCTOH 2012 in Singapore, but many challenges remain. The Conference format will include panel discussions, symposia, posters, workshops and post-graduate courses on the many aspects of the tobacco epidemic and will highlight the efforts being made to control it through the WHO FCTC and MPOWER. Tracks on «New Emerging Products and Challenges, the Post-2015 Development Agenda, the Supply and Demand Side of the Tobacco Industry and the Globalisation of Tobacco Industry Interference» will give all participants the opportunity to discuss the current situation and come up with proposals on how to accelerate tobacco control in all countries.
    [Show full text]
  • The Use of Tobacco
    Available online at www.annclinlabsci.org 178 Annals of Clinical & Laboratory Science, vol. 40, no. 2, 2010 A Note from History: The Use of Tobacco Steven I. Hajdu1 and Manjunath S. Vadmal2 1 Westlake Village, California 2 Department of Pathology, University of Southern California, Los Angeles, California Keywords: tobacco, nicotine, smoking, cigarettes, bronchiogenic carcinoma, history of medicine There is no written record in reference to tobacco in the throat, and mental depression. Decanted prior to the 15th century. However, it is generally liquor of boiled tobacco was used internally to treat acknowledged that indigenous Americans used indigestion, aches in the belly, and urinary tobacco as a medicine and smoked tobacco. In obstruction. Ashes of burned tobacco were mixed 1492, Christopher Columbus (1451-1506) and his with hog grease and applied as an ointment to crew, when returning to Europe from the Americas, ulcerated skin, warts, and dermal cancer. Smoking brought the first tobacco leaves and seeds into tobacco was claimed to improve body odor and to Europe. In 1560, Jean Nicot (1530-1600), French prevent the plague. Persons of all ages and classes diplomat and importer, introduced tobacco in smoked excessively during the great epidemics. France and Portugal. By the end of the 16th Smoking tobacco was believed to calm the nerves century, tobacco use had became a custom among and relieve anxiety by purging the brain. Smoke fashionable people in Europe and tobacco was blown into the ear cured earache and when applied being exported to India, China, and Japan [1,2]. to the anus relieved constipation and bloody Tobacco is an annual plant belonging to the discharge.
    [Show full text]
  • 1. Production, Composition, Use and Regulations
    pp051-120-mono1-Section 1.qxd 29/04/2004 11:06 Page 53 1. Production, Composition, Use and Regulations 1.1 Production and trade 1.1.1 History The common tobacco plants of commerce had apparently been used for millenia by the peoples of the Western hemisphere before contact with Europeans began in 1492. The plants were cultivated by native Americans in Central and South America. Tobacco often had religious uses as depicted in Mayan temple carvings (Slade, 1997). The start of the spread of tobacco from the Americas to the rest of the world invariably seems to date back to 11 October 1492, when Columbus was offered dried tobacco leaves at the House of the Arawaks, and took the plant back with him to Europe (IARC, 1986a). Presumably, the technique of smoking was picked up at the same time. The plant was named ‘nicotiana’ after the French ambassador to Portugal, who is said to have introduced it to the French court. The tobacco grown in France and Spain was Nicotiana tabacum, which came from seed that originated in Brazil and Mexico. The species first grown in Portugal and England was Nicotiana rustica, the seed coming from Florida and Virginia, respectively (IARC, 1986a). Although claims were made that tobacco had been used earlier in China, no convin- cing documentation for this exists, but it is clear from Table 1.1 (IARC, 1986a) that tobacco was used widely and that a number of early societies discovered the effects of a self-administered dose of nicotine independently of each other, which implies that the plant was widely distributed, at least throughout the Americas.
    [Show full text]
  • Tobacco Control and Prevention
    TOBACCO CONTROL AND PREVENTION American College of Physicians A Policy Monograph 2010 TOBACCO CONTROL AND PREVENTION A Policy Monograph of the American College of Physicians May 13, 2010 This paper, written by Ryan Crowley, was developed for the Health and Public Policy Committee of the American College of Physicians: Richard Neubauer, MD, FACP, Chair; David Fleming, MD, FACP, Vice-Chair; David L. Bronson, MD, FACP; Robert M. Centor, MD, FACP; Robert A. Gluckman, MD, FACP; Richard P. Holm, MD, FACP; Mark Liebow, MD, FACP; Mark E. Mayer, MD, FACP; Robert McLean, MD, FACP; Kenneth Musana, MBchB, MSC, FACP; P. Preston Reynolds, MD, FACP; Matthew Rudy, Student; and Baligh Yehia, MD, Associate. It was approved by the Board of Regents on 12 April 2010. i How to cite this paper: American College of Physicians. Tobacco Control and Prevention. Philadelphia: American College of Physicians; 2010: Policy Monograph. (Available from American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.) Copyright ©2010 American College of Physicians. All rights reserved. Individuals may photocopy all or parts of Position Papers for educational, not-for-profit uses. These papers may not be reproduced for commercial, for-profit use in any form, by any means (electronic, mechanical, xerographic, or other) or held in any information storage or retrieval system without the written permission of the publisher. For questions about the content of this Policy Monograph, please contact ACP, Division of Governmental Affairs and Public Policy, Suite 700, 25 Massachusetts Avenue NW, Washington, DC 20001-7401; telephone 202-261-4500. To order copies of this Policy Monograph, contact ACP Customer Service at 800-523-1546, extension 2600, or 215-351-2600.
    [Show full text]
  • Tobaccotimes Spring 2013 DPH Tobacco Use Prevention and Control Program
    ISSUE 3 TobaccoTimes Spring 2013 DPH Tobacco Use Prevention and Control Program In this issue Tobacco Use in the Military p.1 Point of Sale Impact p.2 DMHAS Tobacco Enforcement Program p.3 Tips from Former Smokers II Protecting Pets p.4 CDC is building on the success of the Tips cam- paign by launching a new Tobacco Use in Uniform Many service members did not use tobacco until round of advertisements. they entered the service. Over one third of cur- The new campaign fea- Tobacco use has a detrimental effect on our mili- rent smokers in the military stated they started to smoke after joining. A DoD survey shows tures additional health tary. Tobacco affects military readiness and the health of their personnel and families, and places a some of the reasons why service members stat- conditions including huge burden on the Department of Defense (DoD) ed they began smoking: cigarettes are available chronic obstructive pul- and the Veteran’s Administration (VA) health care at many places on installations and that makes monary disease [COPD], system. The DoD spends an average of $1.6 billion it easy to smoke, most of their friends smoke, to asthma in adults, smoking dollars per year due to tobacco-related medical ex- relax, and to relieve stress and boredom. -related complications in penses. a person with diabetes Tobacco use has detrimental effects on military and population groups There has been a long history of tobacco use in the personnel. Tobacco use reduces a service including American Indi- military. Although smoking occurred in previous member’s physical fitness and endurance.
    [Show full text]
  • Doh Lung Cancer Screening Service Specifications
    DOH LUNG CANCER SCREENING SERVICE SPECIFICATIONS December 2018 Page 1 of 18 Document Title: DOH Lung Cancer Screening Service Specifications Document Ref. PH/NCD/LCSC/SR/0.9 Version: 0.9 Number: Approval Date: 20/12/2018 Effective Date: 20/12/2018 Document Cancer Prevention and Control Section, NCD, Public Health Division Owner: Applies to: Licensed Healthcare Providers in the Emirate of Abu Dhabi participating in the DOH’s Lung Cancer Screening Program Classification: Public 1. Purpose 1.1 This document sets the service specifications for DOH’s Lung Cancer Screening Program in the Emirate of Abu Dhabi; 1.2 It specifies the minimum service specifications to ensure that high-risk candidates screened for lung cancer receive quality and safe care and timely referral for diagnosis and/or treatment. 2. Scope These specifications apply to healthcare providers (facilities, professionals and laboratories) licensed by DOH in the Emirate of Abu Dhabi who are participating in DOH’s Lung Cancer Screening Program and specify: 2.1. Terms used in DOH Lung Cancer Screening Program; 2.2. Recommended roles, responsibilities of and services offered by healthcare providers (facilities and professionals) participating in DOH’s Lung Cancer Screening Program across the Emirate of Abu Dhabi; 2.3. Lung Cancer Screening Case mix. Page 2 of 18 3. Definitions Category Definition 3.1 Lung Cancer Screening The process for the early detection of lung cancer. It includes recruitment of individuals at a high risk of developing lung cancer, counseling of these individuals and low-dose computer topography aided screening by a multidisciplinary team. 3.2 LDCT Scan A procedure that uses low-dose computer topography (LDCT) radiation to make a series of very detailed pictures of areas inside the body in a spiral path.
    [Show full text]
  • Master Teza Analiza Tržišta Duvana I Duvanskih Proizvoda Sa Posebnim
    UNIVERZITET SINGIDUNUM DEPARTMAN ZA POSLEDIPLOMSKE STUDIJE I ME ĐUNARODNU SARADNJU MASTER TEZA ANALIZA TRŽIŠTA DUVANA I DUVANSKIH PROIZVODA SA POSEBNIM OSVRTOM NA ME ĐUNARODNU REGULATIVU DUVANSKE INDUSTRIJE Mentor Student prof. dr Nemanja Staniši ć Nikola Stevanovi ć 415213/2011 Beograd, decembar 2012. Sadržaj Uvodna razmatranja ........................................................................................................................ 6 Prvi deo: Duvan i duvanski proizvodi na tržištu .......................................................................................... 12 1.1.Uzgajanje duvana ................................................................................................................ 13 1.2.Trgovina duvanom .............................................................................................................. 16 1.3.Tipovi duvana ...................................................................................................................... 17 1.4.Duvanski proizvodi ............................................................................................................. 20 1.4.1.Tipovi duvanskih proizvoda ......................................................................................... 21 1.5.Nikotin ................................................................................................................................. 22 Drugi deo: Segmentacija tržišta duvana i duvanskih proizvoda ..................................................................... 24 2.1. Segmentcija
    [Show full text]
  • A HISTORY of the MEDICINAL USE of TOBACCO 1492 1860* by GRACE G
    A HISTORY OF THE MEDICINAL USE OF TOBACCO 1492 1860* by GRACE G. STEWART THE history of the medicinal use of tobacco before the Civil War has apparently not been documented in a single piece of writing. Yet, a review of publications on the subject shows that this plant was long used as orthodox medicine by the members of the medical profession. It seems to me to be a useful endeavour, therefore, to give the medico-historical account of tobacco, since: (1) Tobacco is an American plant, the Indians having presented it to the rest of the world; (2) According to Webster tobacco is America's most famous plant; (3) Tobacco is probably the only plant which was ever used as the panacea of panaceas; (4) Tobacco is now, and has been through- out history, an important product of the State of Maryland; (5) Tobacco was considered to have been one of the God-sent remedies; (6) Tobacco is a subject for controversy at present over the use of the cigarette for pleasure. The hypothesis of medical men that there existed a panacea of panaceas prompted an age-long search for such a remedy. When Western European explorers of America discovered the tobacco plant, this hypothesis was one of the reasons that prompted the European medical men to seize upon the use of tobacco as medicine and subse- quently to persuade themselves that tobacco was the long-sought panacea. Their later experiments with the plant as medicine confirmed the hypothesis ofthe physicians to their own satisfaction over a long period of years.
    [Show full text]
  • Tobacco: Filling the Gap of Silence
    ISSN(Online): 2319-8753 ISSN (Print): 2347-6710 International Journal of Innovative Research in Science, Engineering and Technology (A High Impact Factor & UGC Approved Journal) Website: www.ijirset.com Vol. 6, Issue 8, August 2017 Tobacco: Filling The Gap Of Silence Kulkarni Bhagyashree ˡ, Kaushik Biswas ² Assistant Professor, Department of Forensic Psychology, Government Institute of Forensic Science, Nagpur, India ˡ U.G Student, Department of Forensic Psychology, Government Institute of Forensic Science, Nagpur, India ² ABSTRACT: “Addiction is a primary, chronic, neuro-biological disease with genetic, psycho social and environmental factors influencing its manifestations”. Tobacco chewing is a habit, stress buster and style statement. It’s inclusive of long term and short term effects. Betel quid is a favored form of tobacco chewers that includes betel nut, lime, catechu and tobacco. The current study of researchers was undertaken to enlighten population about grave effects of ‘kharra’ chewing and, also individual ingredients that make up a betel quid of ‘kharra’, and its side effects. The goal was to determine how lethal the combination of all ingredients put together and chewed. Data of around 400 people was collected for ‘kharra’ chewing, a popular form of tobacco chewed by citizens of Nagpur city, Maharashtra state. A questionnaire and an inventory were developed for this purpose, one being, general awareness regarding tobacco, it’s utility in society, disadvantages and awareness in the age group of 18-40 in Nagpur city with a sample of 100 (M) and 100 (F). The second being an inventory about habits related to ‘kharra’ consumption of the tobacco chewers. It was ascertained form the current study that psycho social, demographic, economic, peer and family acquaintance, life style adaptations all led to increased use of ‘kharra’ chewing of tobacco in the population of Nagpur city.
    [Show full text]