Browsing by Subject "abstinence"

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    Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact
    (Elsevier, 2017-09) Santelli, John S.; Kantor, Leslie M.; Grilo, Stephanie A.; Speizer, Ilene S.; Lindberg, Laura D.; Heitel, Jennifer; Schalet, Amy T.; Lyon, Maureen E.; Mason-Jones, Amanda J.; McGovern, Terry; Heck, Craig J.; Rogers, Jennifer; Ott, Mary A.; Pediatrics, School of Medicine
    Adolescence is marked by the emergence of human sexuality, sexual identity, and the initiation of intimate relations; within this context, abstinence from sexual intercourse can be a healthy choice. However, programs that promote abstinence-only-until-marriage (AOUM) or sexual risk avoidance are scientifically and ethically problematic and—as such—have been widely rejected by medical and public health professionals. Although abstinence is theoretically effective, in actual practice, intentions to abstain from sexual activity often fail. Given a rising age at first marriage around the world, a rapidly declining percentage of young people remain abstinent until marriage. Promotion of AOUM policies by the U.S. government has undermined sexuality education in the United States and in U.S. foreign aid programs; funding for AOUM continues in the United States. The weight of scientific evidence finds that AOUM programs are not effective in delaying initiation of sexual intercourse or changing other sexual risk behaviors. AOUM programs, as defined by U.S. federal funding requirements, inherently withhold information about human sexuality and may provide medically inaccurate and stigmatizing information. Thus, AOUM programs threaten fundamental human rights to health, information, and life. Young people need access to accurate and comprehensive sexual health information to protect their health and lives.
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    Automated Telephone Monitoring for Relapse Risk among Recent Quitters Enrolled in Quitline Services
    (Office of the Vice Chancellor for Research, 2011-04-08) McDaniel, Anna M.; Carlini, Beatriz H.; Stratton, Renée M.; Cerutti, Barbara; Monahan, Patrick O.; Stump, Timothy E.; Kauffman, Ross M.; Zbikowski, Susan M.
    This study is part of a randomized controlled trial to test the efficacy of interactive voice response (IVR) technology for enhancing existing quitline services (Free & Clear’s Quit for Life® program) to prevent smoking relapse and achieve abstinence. The IVR system screens for six indicators of risk for relapse including smoking lapse, physical withdrawal symptoms, depressive symptoms, perceived stress, decreased self-efficacy for quitting, and decreased motivation to quit. Participants can screen positive on any one or more risks, resulting in a rollover call to a telephone counselor. There are two intervention arms that differ in timing and frequency of IVR screening. In the Technology Enhanced Quitline arm (TEQ-10), 10 automated calls are placed at decreasing frequency for 8 weeks post-quit (twice a week for the first two weeks, then weekly). The High Intensity Technology-Enhanced Quitline arm (TEQ-20) includes 20 IVR calls (daily for the first 2 weeks, then weekly). This preliminary analysis includes IVR data collected on calls from 4/12/2010 to 10/31/2010. 2620 calls were made to 98 participants in the two intervention arms, TEQ-10 (n=44) and TEQ-20 (n=54). The two arms did not differ significantly on demographics or comorbid conditions. Three outcomes were analyzed: completed screening assessments, positive screen for relapse risk, and smoking lapse (i.e., smoking even a puff since the last call). 136 of the 736 (18.5%) completed assessments were positive for relapse risk: 66 for smoking lapse (49%), 42 craving (31%), 32 depressive symptoms (24%), 27 lack of confidence (20%), 8 stress (6%), and 8 lack of motivation (6%). Logistic regression models (adjusted for age and gender), with GEE estimation to account for withinperson correlation, showed that compared to the TEQ-10 study group, participants in the TEQ-20 study group were more likely to complete assessments (OR=1.7; 95% CI=1.2-2.4), less likely to screen positive for relapse risk (OR=.3; 95% CI=.2-.6), and less likely to have smoked (OR=.2; 95% CI=.09-.4). These results indicate that frequent IVR monitoring during the immediate postquit period may have a positive effect on relapse risk.
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    WHEN A FIRE LEADS TO A DRINK: ENHANCEMENT OF ALCOHOL-SEEKING BY MICROINJECTIONS OF NICOTINE DIRECTLY INTO THE REWARD NEUROCIRCUITRY
    (Office of the Vice Chancellor for Research, 2012-04-13) Popoola, Daniel O.; Hauser, Sheketha R.; Rodd, Zachary A.
    Alcohol addiction is a cyclical disorder that is characterized by periods of alcohol consumption and abstinence. The periods of abstinence are frequently brief, and the rate of relapse to alcohol consumption is typically higher than 95% within a year. Most alcoholics are not just alcoholics. The vast majority (80-95%) of alcoholics also concurrently use, or are dependent on, nicotine. During periods of alcohol abstinence, nicotine use dramatically increases. The use of nicotine can potentiate self-reported craving for alcohol and the amount of alcohol used following a relapse episode. The goal of the present project was to determine the biological basis of nicotine’s ability to stimulate alcohol (EtOH)-seeking in a rodent model of alcoholism (alcohol-preferring [P] rat). Specifically, the current project examined the effect of nicotine on EtOH-seeking when administered directly into the brain reward neurocircuit (posterior Ventral Tegmental Area – pVTA). In order to determine the neurotransmitter systems regulating nicotine’s ability to enhance EtOH-seeking when administered into the pVTA, two subsequent studies examined the effect of co-administration of nicotine with a acetylcholine nicotine receptor (AchN) antagonist (mecamylamine (MEC)) or with a serotonin-3 (5HT3) receptor antagonist (zacopride (Zac)). Nicotine binds with high affinity to both the AchN and 5HT3 receptors. The data collected indicated that at very low concentrations nicotine microinjected into the pVTA increased EtOH-seeking in P rats. Co-administration of mecamylamine or zacopride blocked nicotine’s ability to potentiate EtOH-seeking. Overall, the results show that nicotine can enhance alcohol-seeking behaviors through activation of the AchN and 5-HT3 receptors in pVTA. The clinical implication of the data set would be that to reduce the amount of alcohol-craving, which could lead to relapse, nicotine use should also be terminated.