Health Psychology Lecture 7 Notes PDF

Health Psychology Lecture 7 Notes **What are the health hazards of smoking?** - Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. - Smoking is directly related for a...

Health Psychology Lecture 7 Notes **What are the health hazards of smoking?** - Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. - Smoking is directly related for approximately 90% of lung deaths and approximately 80-90% of Chronic Obstructive Pulmonary Disease- COPD (emphysema and bronchitis) deaths. - Smoking chemicals mix together to form a sticky tar that lines the inside of your lungs. - The cilia (tiny hair) that line the inside of your lungs help to clean out dirt and germs from your lungs - If the cilia are covered in tar, they can't do their job properly, and germs, chemicals and dirt can stay in your lungs and cause disease-cancer - Smoking permanently damages the alveoli (air sacks) in the lungs, making it harder to breathe. - The alveoli are built like tiny, stretchy ballons. As you breathe in, your alveoli help you absorb oxygens into your body, and as you breath out, alveoli help you get rid of the waste gas-carbon dioxide. - Smoking damages the structure of the alveoli by making it less stretchy-harder for lungs to take in oxygen and get rid of carbon dioxide - Leads to shortness of breath and feeling tired - Heart must work harder to give your body the oxygen it needs - Over time this damage leads to COPD - Smoking sits at the highest percentage of all the health risk factors leading to death, at 19% of all deaths a result of smoking. - Tobacco kills about 37,000 Canadians a year - Tobacco kills about 480,000 Americans a year - Smoking has declined greatly from 1965-2013 in Canada. Smoking prevalence has decreased in Canada in males from 60% to 15%, in females from 37% to 13%, and overall, from 50% to 15% - Results of the Canadian Tobacco and Nicotine Survey (CTNS) in 2020 showed that 8% of people smoked daily, whereas 2% reported smoking occasionally. - In terms of income levels, smoking levels can be more prevalent in certain groups than others. People with higher income are less likely to smoke vs. people with lower income who are more likely to smoke (15% compared to 45% of people). - Smoking cessation results in many positive health consequences; most immediately and substantially cessation reduces the risk for coronary heart disease and other cardiovascular diseases (CVD). - The best thing you can do after being treated for CHD is smoking cessation - Failure rates amongst self-quitters have consistently been shown to be as high as 95-98%. - Relapse after quitting is fast and common (nearly half of relapses within 2 weeks) - Up to 70% of current smokers wish to quit or have made at least 1 quit attempt. - Nicotine is a relaxation drug. - It can be one's response to stress and can be used as a temporary coping mechanism for stress, like alcohol. - Quitting smoking for some can almost be less healthy because quitting can cause weight gain because of oral senses coming back and metabolism increasing. - Psychological: Helps control mood and stress - Habit and sensory (reinforcing cues): Risky situations that trigger the urge to smoke - Risk factors: Depression, history of alcohol or drug abuse, low SES, co-morbidity - Within several seconds, about a quarter of the nicotine has gone through the bloodstream straight to the brain (breaks the blood-brain barrier). - It goes and stimulates nicotine acetylcholine receptors located in the ventral tegmental area (VTA). - This causes the release of dopamine in the nucleus accumbens (This plays an important role in processing rewarding and reinforcing stimuli (addictive drugs, sex, and exercise)). - How nicotine influences increased activity within the brain stem, influencing cognitive functions. - Nicotine is metabolized to cotinine; cotinine is metabolized to 3-hydroxycotinine by the liver enzyme cytochrome P450 2A6. - Rates of this influence smoking behaviour - Nicotine is highly addictive - Quitting smoking is hard and requires much more than individual will power - Exercise has positive effects on mood - It increases self-efficacy and coping - Considered a competitive behaviour to smoking - May reduce weight gain concerns in smokers trying to quit - Reduces the risk of CVD - Strength of desire to smoke decreased by 2 points in the exercise group from before the intervention to 10 minutes after the exercise intervention compared to the control who had a very small increase. - The strength of desire to smoke increased in the exercise group 20-30 minutes after the intervention. - Indicates that desire to smoke can be reduced during exercise, but when complete, desire to smoke begins to increase again - Looks at exercise and control conditions and the relationship between strength of desire to smoke and outcome measured between 0- and 5-minutes post-intervention - The intervention (exercise) group is heavily favoured in this case (34% strength of desire reduction in exercise group vs. control group) - Exercise makes people crave less cigarettes - Lab scenarios deal with single instead of multiple stressors. **Being in a controlled lab makes a big difference.** - A more realistic situation for a smoker attempting to quit: Stressors are presented concurrently: Temporary abstinence, demanding cognitive tasks and/or cue-elicited smoking stimuli - It's unknown how exercise will affect cravings and time to first cigarette in this situation **What is the Fong et al. study?** - Talks about concurrent stressors. - Stressor 1: Abstaining from smoking - Stressor 2: Adding another stressor - Stress symptoms that they score progressively increase over time, according to the graph. - There is very strong evidence that exercise provides relief of the concurrent stressor during the experimental (exercise) trial. Beneficial effects were stronger in the exercise vs. control group. - Weak evidence for time of first cigarette use after the trial (Exercise: 13 minutes), (Sitting: 14 minutes). - Relief: Significant effects, abstinence: Non-significant effects **Which of the following statements summarize or supports the Fogg study?** - First study to examine the effects of acute exercise following concurrent stressors - Reflects a more ecologically valid scenario when a smoker is attempting to quit - Exercise significantly decreased cravings following concurrent stressors - Exercise had no effect on ad lib smoking - **All support the Fogg study** - Studies include temporarily abstinent smokers rather than quitters - Severity of desire (cravings) symptoms may not correspond entirely with those felt when an individual is fully invested in a quit attempt - Maybe we could add a craving product alongside exercise to prevent people from going back and smoking, but these effects are unknown - Would craving reduction be improved with the use of exercise alongside a nicotine lozenge? - From times 4-7, we have post-treatment data, 2-3 is during treatment, 1 is pre-treatment/baseline - The lozenge group is seeing a 3-point reduction in desire to smoke - The exercise and lozenge group sees a greater 4-point reduction in desire to smoke, meaning the use of lozenge along with exercise was very significant in reducing nicotine cravings - Conclusion: Engaging in an acute bout of moderate-intensity exercise while consuming a nicotine lozenge yields additive cigarette craving relief for recently quit smokers. - It begs the question: How do you get the information to be released to the public? - Exercise: Expectancy effect - Expectancy beliefs towards exercise are unrelated to reductions in cravings - Serves as a distraction: - Idea that if a smoker redirects their attention toward something else, the urge will pass - Possible that it may play a small role early on in the exercise bout, but it is unlikely to have any effects once the exercise stops - Alleviates affect/mood/feeling disturbances: - Some evidence that exercise can reduce negative affect (depressed mood, irritability), which in turn can reduce cravings - Some evidence that exercise can reduce negative mood and enhance positive mood which in turn can reduce cravings - Group 1 given clear evidence of craving relief due to exercise - Group 2 given mixed evidence of craving relief due to exercise - Group 3 given no evidence of craving relief due to exercise - Results: Group 1 had better craving than group 2 at time 2, group 2 better than group 3 at time 2 - No significant group main effects were found for desire to smoke, all groups showed a similar reduction in desire to smoke during and following exercise - Expectancy effects do not impact exercise with respect to nicotine cravings - Exercise influences positive affect (improves it) which influences (reduces) cravings, exercise influences negative affect (reduces it) which influences (reduces) cravings. - This is a psychological mechanism pathway as to why exercise might work for reduction in nicotine cravings - Psychological pathway: Evidence, Biological pathway: no evidence - Higher levels of cortisol are in smokers vs. nonsmokers - Cortisol has been shown to drop during the first 2 weeks of abstinence. This may be associate with increased tobacco cravings - To get it back to a normal level, this could be done through exercise - Only people in the vigorous exercise group are showing a significant drop in cravings as a result of a spike in cortisol. - It suggests that to see the effects of cortisol on cravings with exercise, we need to complete more strenuous exercise. **What are the overall summary and conclusions of mechanisms?** - Acute exercise produces craving reductions in temporary abstinent smokers - Why is exercise works not well understood? **Cut-off for temporary abstinent smoking and long-term smoking** **What is the study done by Marcus et al. in terms of long-term abstinence of smoking in individuals?** - 12-week program. - Exercise group outperforming control group at all time points (8 weeks, 3 months, 12 months). - When you add exercise to a traditional CBT cessation program, you are adding value to abstinence rates. - Exercise performance: Higher in exercise than control. - Weight gain: Higher in quitters compared to non-quitters. Seen to be effective in exercise group vs. control group during the study, but not during the follow-up (People seeing significant weight gain because of not exercising and only using CBT cessation) - Adding Cognitive Behaviour Therapy to exercise gave better cessation rates not only at the end of the program but also at 3 to 12 months. - During the program, exercise was able to prevent weight gain, but after the exercise session, the weight gain in the exercise group became noticeable - Cessation rates start to drop off as the treatment finishes - Exercise is the only thing manipulated in both the Marcus and De Jesus studies, there is no pressure on cessation - People naturally reduce smoking when doing a certain behaviour, exercise - Does someone smoke their cigarettes harder after exercise because they are smoking less cigarettes in general? - Do these people still enjoy smoking? - Smoking Topography: Tracked - A thorough representation of the physical characteristics of smoking behaviour (number of puffs, puff volume, flow rate, puff duration, time between puffs) - Left graph: Baseline, Week 1, Week 2 - Right graph: Baseline, Week 1, Week 2 - We see a 4 point reduction in number of cigarettes and carbon monoxide intake - Only smoking topography graph going up is average flow - Puff Duration is very stable as well as interpuff interval - We're showing very steady topography - All 4 types of psychological data are suggesting a natural decline, the smokers are not receiving the same kind of rewards from cigarettes as before. - Summary: The pre-quit period of the exercise-based quit smoking program had a beneficial impact: - Number of cigarettes smoked goes down - Smoking topography remains steady - Smoking sensations goes down - No evidence for compensation: As number of cigarettes goes down smoking topography remains steady instead of going up - Exercise before quitting sets up one's quitting profile very nicely.