Smoking (tobacco addiction) is the most significant of the modifiable cardiovascular risk factors. Mistakenly described as a "habit" or "behavioral choice," the onset of tobacco addiction quickly follows the acquisition of an ability to inhale cigarette smoke and is reflected in a transformation of neurophysiologic function and nicotine-receptor density. Thereafter, comfort and a degree of neurophysiologic "equanimity" require the regular administration of nicotine. Smokers inhale thousands of other chemicals, many of which play critical roles in the initiation and accentuation of atherosclerosis by influencing vasomotor activity, vascular dysfunction, oxidation of lipids, atheroma development, and thrombosis. Smoking cessation is a priority in the management of any patient with cardiovascular disease. The benefits of cessation accrue rapidly in such patients and have a pronounced effect on the likelihood of disease progression, hospital readmission, and mortality. All physicians must be familiar with the principles of cessation practice and be able to initiate smoking cessation attempts.

Pipe AL, Papadakis S, Reid RD. Minto Prevention & Rehabilitation Centre, University of Ottawa Heart Institute, ON, Canada. apipe@ottawaheart.ca

Full Title: Impact of self-hypnosis in women on select physiologic and psychological parameters

OBJECTIVE: To examine physiologic and psychologic effects of hypnosis in healthy women. DESIGN: Quasi-experimental, within-subject, repeated measures. SETTING: Private laboratory setting in an urban Midwestern College of Nursing. PARTICIPANTS: Convenience sample of 30 healthy, female volunteers who were nonpregnant, predominantly White, college students. METHOD: Participants listened to a 30-minute recording of relaxing, affirming hypnotic suggestions while sitting comfortably in a recliner. Hypnotizability and trait anxiety were measured at baseline. Tension-anxiety was measured at baseline and following the hypnotic induction. Heart rate, respiratory rate, and heart rate variability were collected before, during, and following the hypnotic experience. RESULTS: Paired t tests revealed significantly reduced heart rate (p<.001), respiratory rate (p<.001), low-to-high frequency heart rate variability ratio (p<.001), and tension-anxiety (p<.001), whereas high frequency heart rate variability was increased (p<.001) after the 30-minute hypnotic session. CONCLUSIONS: Hypnosis is an innovative, low-technology, self-modulated approach that may contribute to stress reduction and health promotion. Parameters demonstrated increased parasympathetic nervous system activity associated with relaxation during and immediately after the hypnosis experience. Findings from this study suggest that nurses can include hypnosis information when advising healthy women about available stress reduction approaches, as well as tailor their nursing care for women who present using this alternative approach.

VandeVusse L, Hanson L, Berner MA, White Winters JM. Marquette University Nurse-Midwifery Program, P. O. Box 1881, Clark Hall, Milwaukee, WI 53201-1881, USA. leona.vandevusse@mu.edu