Lifestyle and Long-Term Smoking Cessation.

BACKGROUND: Since smoking is the leading cause of preventable death, discouraging smoking initiation, encouraging smoking cessation, and exploring factors that help individuals to stay smoke free are immensely important. One such relevant factor may be the impact of lifestyle for long-term smoking cessation. METHOD: A representative sample of successful quitters was recruited for a study about smoking cessation. These respondents are now part of a 7-year follow-up with the overall aim of revealing factors affecting long-term smoking cessation. Descriptive analyses were carried out at baseline and at follow-up, as well as a further two-step cluster analysis to explore profiles of long-term smoke-free individuals. RESULTS: A majority did not make any particular lifestyle changes, but among those who did, most adopted a healthier lifestyle and/or increased their quota of physical training, where permanent changes in this direction seem to promote a more enduring smoke-free life. CONCLUSIONS: Individuals who want to quit smoking should be encouraged to increase their level of physical activity. Swedish health care institutions should be able to provide support for this both initially and over time to promote the long-term maintenance of a smoke-free lifestyle.

Problematic internet use: A scoping review - longitudinal research on a contemporary social problem, 2006-2017.

Background and aims: Problematic internet use (PIU), and kindred concepts such as internet addiction (IA), make up a growing research field, partly due to the suggested inclusion of internet gaming disorder in a future DSM-6 as well as the fact that gaming disorder is on its way to being included in the ICD-11. Conclusions from research are far from unified. This study aims to synthesise the research field of problematic internet use/internet addiction/gaming disorder, with a focus on the reporting of prevalence and change. Methods: Longitudinal studies of PIU/IA formed the basis for a scoping review. Systematic searches of Web of Science, Scopus and Proquest, for peer-reviewed and published articles based on empirical data collected at a minimum of two time points for studies, and with an end point set at 2017, led to the inclusion of 97 studies. Endnote X7 was used to organise the results and NVivo 11 was used for synthesising the results. Results: Analyses focused on prevalence and change. Findings show variation among measures and prevalence as well as in reported outcomes relating to social life and other problems. Most studies reported relations between PIU/IA and other problems in life, but no specific time order could be established. Furthermore, many studies did not present data on prevalence or change even though using a longitudinal survey design. Discussion and conclusions: In summary, the research field is plagued by a lack of consensus and common understanding, regarding both measures, perceptions of the problem, and findings.

Persistence in Problematic Internet Use-A Systematic Review and Meta-Analysis.

Background and Aims: Problematic internet use, internet addiction, and internet gaming disorder all describe a global phenomenon where individuals have trouble limiting their use of internet to such an extent that their use has negative consequences. Past systematic reviews and meta-analyses have focused on estimating prevalence, but there has been no comprehensive research synthesis of the trajectory of the problem. The research objective was to create a pooled estimate of the persistence of problematic internet use. This review included studies using a longitudinal panel data design with a follow-up of at least a year. Studies had to be published before the end of the year 2017, in peer-reviewed academic journals, using English language. Samples from populations in any country were accepted, given they were of acceptable quality. Methods: A literature search was conducted in Web of Science, Pro Quest, and Scopus. Several definitions of problematic internet use were included. Inverse-variance, random-effect meta-analysis was used to estimate weighted summary means of persistence. Attrition and selection bias was investigated using pre-specified tools, and heterogeneity was assessed in subgroup analysis. Results: Nine studies fit the criteria, all using samples from Asian or Western countries. The aggregate estimate for 1-year persistence it was 50% (CI: 40-61%), but results were heterogeneous. Prevalence and persistence estimates were correlated and generally higher in Asian countries. Methodological differences only explain part of the heterogeneity. Conclusion: All included studies found individuals with persistent problems, but the between-studies variation is substantial.

A weak scientific basis for gaming disorder: Let us err on the side of caution.

We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people whose play of video games is related to life problems. We believe that understanding this population and the nature and severity of the problems they experience should be a focus area for future research. However, moving from research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side of caution for now and postpone the formalization.

Extensive internet involvement--addiction or emerging lifestyle?

In the discussions for the future DSM-5, the Substance-Related Disorders Work Group has been addressing "addiction-like" behavioral disorders such as "Internet addiction" to possibly be considered as potential additions for the diagnostic system. Most research aiming to specify and define the concept of Internet addiction (or: Excessive/Compulsive/Problematic Internet Use--PIU), takes its point of departure in conventional terminology for addiction, based in established DSM indicators. Still, it is obvious that the divide between characteristics of addiction and dimensions of new lifestyles built on technological progress is problematic and far from unambiguous. Some of these research areas are developing from the neurobiological doctrine of addiction as not being tied to specific substances. The concept of "behavioral addictions", based on biological mechanisms such as the reward systems of the brain, has been launched. The problems connected to this development are in this study discussed and reflected with data from a Swedish survey on Internet use (n = 1,147). Most Swedes (85%) do use the Internet to some degree. The prevalence of excessive use parallels other similar countries. Respondents in our study spend (mean value) 9.8 hours per week online at home, only 5 percent spend more than 30 hours per week. There are both positive and negative social effects at hand. Many respondents have more social contacts due to the use of Internet, but there is a decline in face-to-face contacts. About 40% of the respondents indicate some experience of at least one problem related to Internet use, but only 1.8% marked the presence of all problems addressed. Most significant predictors for problem indicators, except for age, relate to "time" and time consuming activities such as gaming, other activities online or computer skills.

Pleasures of drinking: a cross-cultural perspective.

The purpose of this study was to evaluate how drinking is related to positive expectations of the effects of drinking. Data emanates from Gender, Alcohol and Culture - An International Study (GENACIS), a collaborative project in which surveys from all included countries utilized the same core questionnaire. Three indicators for positive expectations were used, representing a social, relational, and intimate dimension. Cross-country comparisons of positive expectancy reports were conducted, as well as exploratory multiple regression analyses of the relationships between expectations and drinking. Volume and binge drinking were used as two indicators for drinking pattern. The share of current drinkers varied between countries and genders. In all countries, men reported on expectancies more often than women. Regression model results are variable and not directly interpretable into cultural patterns, across countries and continents.

Beyond drinking: differential effects of demographic and socioeconomic factors on alcohol-related adverse consequences across European countries.

BACKGROUND/AIMS: Evidence underlines the importance of drinking patterns and individual characteristics in experiencing adverse alcohol-related consequences; however, little research has been conducted to explore who does and who does not experience consequences with similar drinking patterns. Using data from seven European countries, this study assesses the association between demographic and socioeconomic characteristics and six adverse consequences. METHODS: Conditional logistic regression models were estimated, cases (experiencing a consequence) being matched to controls (not experiencing the consequence) by drinking patterns. RESULTS: In general, protective effects with increasing age and being in a partnership were consistent. Gender effects were mixed, but mainly protective for women. Educational achievement and economic status showed consistent effects across countries, but different directions of effect across consequences. Consequences mostly associated with individual drinking pattern (injury, blackout, and loss of control over drinking) exhibited similar patterns of associations, but varying ones arose for consequences additionally influenced by societal reaction to drinking (guilt, role failure, and pressure to cut down drinking). CONCLUSION: Differences in strengths and directions of effects across consequences pointed to the possibility that the reporting of adverse consequences is not only influenced by alcohol consumption, but also by attributional processes related to demographic and socioeconomic statuses.

Gender roles, family, and drinking: women at the crossroad of drinking cultures.

During the postwar era, extensive changes in family structure and gender roles have occurred in Western countries. The aim of this study was to see if processes of change and convergence in gender roles have led to new drinking patterns among Swedish women. Data were collected from a survey conducted in 1979 and replicated in 2003. For this study, data on aspects of drinking patterns and problems were combined with demographics and indicators of social situation. For one of the drinking pattern indicators, the assumption of convergence between the sexes was confirmed. Generally, though, differences in drinking patterns are at hand among both women and men in the same direction. Also, social background factors and demographics have weaker explanatory power today compared to the late 1970s.