Paul Wesley McDonald

Paul Wesley McDonald
York University · School of Health Policy and Management

Doctor of Philosophy

About

59
Publications
9,527
Reads
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2,980
Citations
Citations since 2017
0 Research Items
721 Citations
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2017201820192020202120222023050100150
2017201820192020202120222023050100150
2017201820192020202120222023050100150
Introduction
Research focuses on population and public health, particularly the prevention and management of chronic disease/non-communicable disease.

Publications

Publications (59)
Article
Full-text available
Engaging partners for tobacco control within low and middle income countries (LMICs) at early stages of tobacco control presents both challenges and opportunities in the global effort to avert the one billion premature tobacco caused deaths projected for this century. The Dominican Republic (DR) is one such early stage country. The current paper re...
Article
Background: Cervical cancer is the second most common cancer among women worldwide. Failure to prevent cervical cancer is partly due to non-participation in regular screening. It is important to plan and develop screening programs directed towards underscreened women. In order to identify the factors associated with underscreening for cervical can...
Article
Objective: To determine whether telephone-based smoking cessation follow-up counseling (FC), when delivered as part of a multi-component intervention program is associated with increased rates of follow-up support and smoking abstinence. Methods: A cluster randomized controlled-trial was conducted within family medicine practices in Ontario, Can...
Article
Full-text available
Introduction: Few studies have examined the transitions of smokers in the general population through multiple periods of daily, occasional smoking, or abstinence over time. Transitions from daily to occasional smoking are particularly of interest as these may be steps toward cessation. Methods: The Ontario Tobacco Survey panel study followed 4,3...
Article
Access to Nicotine Replacement Therapy (NRT) is a key public health intervention to reduce smoking. We assessed prevalence and correlates of use of NRT in Ontario, where NRT is available without prescription. Participants were a representative sample of 2262 adult smokers in the Ontario Tobacco Survey cohort. Prospectively measured use of NRT over...
Article
To rigorously test the relation between perceived risk (i.e., belief about the likelihood of harm) and quitting smoking. Data from a longitudinal study with a nonrestrictive sample of smokers (N = 4307) from the United States, Canada, the United Kingdom, and Australia were examined to predict quitting behaviors at 8-12 months. Perceived risk predic...
Article
The hardening hypothesis has intuitive and common sense appeal: in jurisdictions that have implemented evidence-based tobacco control policies, the smokers who have a relatively easy time quitting will quit, and as the future unfolds there will be an increasing proportion of remaining smokers who cannot quit and are more resistant to quitting than...
Article
It has been hypothesized that the smoking population is represented by an increasingly 'hardcore' group of smokers who are resistant to quitting. Many definitions of 'hardcore smokers' have been used, but their predictive validity is unknown. To evaluate whether 'hardcore smoker' definition components predict quitting behaviours and which combinati...
Article
To examine the use and role of planned quit attempts by smokers and their impact on abstinence. Retrospective, using longitudinal data from the Ontario Tobacco Survey. Ontario, Canada. A total of 551 adult smokers who reported having made a quit attempt during 2007-08. Reported planning of the most recent quit attempt (i.e. unplanned or planned som...
Article
Full-text available
Previous research has classified smokers and non-smokers on the basis of their attitudes and behaviours towards smoking and smoking restrictions.1–3 Work by Poland et al ,1 using data from 1996, concluded that Ontario smokers clustered into three groups: (1) ‘adamant’ smokers who believe smoking restrictions have gone too far and are unlikely to ac...
Article
Occasional smokers represent an important segment of all smokers and have been described to be a heterogeneous group in terms of past experience and likelihood of maintaining nondaily smoking behavior. In the prospective Ontario Tobacco Survey, 408 occasional smokers were followed for a year. Characteristics of subgroups of occasional smokers, as s...
Article
Full-text available
A systematic review and meta-analysis was conducted to evaluate evidence-based strategies for increasing the delivery of smoking cessation treatments in primary care clinics. The review included studies published before January 1, 2009. The pooled odds-ratio (OR) was calculated for intervention group versus control group for practitioner performanc...
Article
Full-text available
As smoking prevalence declines, some suggest that so-called "hardcore" smokers will come to represent a growing and irreducible proportion of current smokers ("hardening hypothesis"). Different definitions of a "hardcore" smoker have been used in the literature. This paper describes population-based definitions of "hardcore" smokers and compares es...
Article
Full-text available
Discrete classification of smokers by intention to quit is desirable in many public health and clinical settings. Two methodological studies examine measurement properties of measures of discrete-time intention to quit smoking used in population-based tobacco surveillance surveys: an ecological comparison of rates of positive intention in relation...
Article
Full-text available
Tobacco use remains the leading cause of death and disability in Canada. Insufficient research capacity can inhibit evidence-informed decision making for tobacco control. This paper outlines a Canadian project to build research capacity, defined as a community's ability to produce research that adequately informs practice, policy, and future resear...
Article
Non-First Nations people purchasing cigarettes on First Nations reserves do not pay applicable taxes. We estimated prevalence and identified correlates of purchasing contraband cigarettes on reserves; we also quantified the share of contraband purchased on reserves relative to reported total cigarette consumption and the associated financial impact...
Article
Full-text available
Population-based samples of smokers are necessary for tobacco behavior monitoring and surveillance and for evaluating tobacco control programs and policies. We evaluated the sensitivity and specificity of a simple, onequestion screener as a tool to maximize efficiency of obtaining a population representative sample of current smokers. This analysis...
Article
To obtain information about the prevalence of cigarette smoking among a selected sample of university students in Karachi and build our understanding of the determinants of smoking with respect to family smoking, smoking in the home, smoke-free public places, and quit smoking cessation programmes. Data were collected as a part of a pilot project in...
Article
Full-text available
Evidence-based smoking cessation guidelines recommend nicotine replacement therapy (NRT), bupropion SR and varenicline as first-line therapy in combination with behavioural interventions. However, there are limited data to guide clinicians in recommending one form over another, using combinations, or matching individual smokers to particular forms....
Conference Paper
While tobacco prevalence rates in Ontario (Canada's most populous province) have dropped substantially over the last four decades, approximately 16% of Ontarians (15 and older) still smoke. The net tobacco related burden includes 44 deaths per day, about a third of all cancers (excluding non-melanoma skin cancer), and excess health care costs of 1....
Article
Most youth smokers intend to quit, but the majority is neither aware nor interested in most conventional cessation approaches. As such, a critical first step in understanding youth cessation is to better understand the beliefs youth have about different cessation options. This cross-sectional study used self-reported data collected from 26,379 grad...
Article
The authors undertook this qualitative study as part of a larger evaluation of the effect of eight clinical practice guidelines issued by an arm's-length government agency in a Canadian province. Using Orlandi and colleagues' version of the Rogers diffusion of innovation model as a framework, the authors mapped doctors' views on implementation of c...
Article
Nicotine addiction is believed to be a major impediment for many people in quitting smoking, but measures of nicotine dependence such as the Heaviness of Smoking Index (HSI) have had mixed success in predicting cessation. Using the National Population Health Survey, the relationship between HSI at baseline in cycle 2 (1996-1997) and successful smok...
Article
Models of research translation frequently emphasize independent roles for research producers and intended users. This article describes a novel approach for enhancing exchange between researchers and practitioners. The framework is based on Wenger's notion of Communities of Practice (CoP) where knowledge is regarded as a social enterprise at the ce...
Article
The population impact of programs designed to develop healthy eating behaviors is limited by the number of people who use them. Most public health providers and researchers rely on purchased mass media, which can be expensive, on public service announcements, or clinic-based recruitment, which can have limited reach. Few studies offer assistance fo...
Article
The purpose of this study was to examine how social models for smoking are related to smoking susceptibility among a sample of non-smoking elementary school students. The Tobacco Module of the School Health Action, Planning and Evaluation System (SHAPES) was administered to 6,431 students (grades 6 to 8) in 57 elementary schools in the province of...
Article
Little is known about physical activity levels in patients with coronary artery disease (CAD) who are not engaged in cardiac rehabilitation. We explored the trajectory of physical activity after hospitalization for CAD, and examined the effects of demographic, medical, and activity-related factors on the trajectory. A prospective cohort study. A to...
Article
To examine if the recommended taxonomies for the stages of youth smoking onset are aligned with the beliefs of smoking youth. The SHAPES Tobacco Module was administered to 23,047 students (grades 9 to 13) in a convenience sample of 29 secondary schools during the 2000-2001 school year in the province of Ontario, Canada. Cross-tabs were used to comp...
Article
Sir Ruiter and Kok1 criticize a study we published in the American Journal of Public Health , which found that smokers who experienced greater emotional reactions in response to graphic cigarette warning labels in Canada were more likely to engage in cessation behaviour at follow-up.2 Ruiter and Kok conclude that: ‘Policy makers should…be reluctan...
Article
To examine how older smoking peers at school and the smoking behavior of friends and family members are related to youth smoking. The School Smoking Profile was used to collect data on tobacco use and determinants of tobacco use from 22,091 students from 29 secondary schools in Ontario, Canada. Correlates of occasional and regular smoking were exam...
Article
To examine how social models in the school environment and individual student characteristics are related to smoking susceptibility. Using data from the School Smoking Profile Project, multi-level logistic regression analysis was used to identify school and student characteristics related to smoking susceptibility among 6679 never smokers from 29 s...
Article
The purpose of this study was to examine the attitudes of youth smokers toward nine common smoking cessation approaches. Attitudes were examined among 3660 youth smokers who intended to quit smoking. The majority of youth smokers report that they would never use the smoking cessation approaches that are commonly recommended for youth populations. T...
Article
Physician office settings play an important role in tobacco cessation intervention. However, few tobacco cessation trials are conducted at these sites, in part because of the many challenges associated with recruiting community physician offices into research. The present study identified and implemented strategies for recruiting physician offices...
Article
Current research on the etiology of tobacco use has largely focused on identifying the influential psychosocial characteristics of individual students; the influences of characteristics in the school environment are generally ignored. The purpose of this study was to simultaneously examine how school and individual student characteristics were rela...
Article
The purpose of this study was to examine the relationship between municipal no-smoking bylaw strength and the odds of being a former smoker. Data from Statistics Canada's Canadian Community Health Survey (Cycle 1.1, 2001) and a validated bylaw scoring scheme (2001) were linked and analyzed to determine whether the odds of being a former smoker were...
Article
Full-text available
We assessed the impact of graphic Canadian cigarette warning labels. We used a longitudinal telephone survey of 616 adult smokers. Approximately one fifth of participants reported smoking less as a result of the labels; only 1% reported smoking more. Although participants reported negative emotional responses to the warnings including fear (44%) an...
Article
Despite the existence of effective cessation methods, the vast majority of smokers attempt to quit on their own. To date, there is little evidence to explain the low adoption rates for effective forms of cessation assistance, including pharmaceutical aids. This study sought to assess smokers' awareness and perceived effectiveness of cessation metho...
Article
To examine the options for use, efficiency, and effectiveness for structuring a population-based telephone smoking-cessation service. Callers (n=632) to a 1-800 number were randomized in a 2 (50-minute counseling with 2/6 calls) x 2 (pamphlet/booklet) design with print only control. Six-month use of the service was 0.6% of adult smokers. Service pr...
Article
Low participation rates reduce the public health impact of smoking cessation programs. Two barriers for improving participation are the cost of media campaigns and the proportion of smokers motivated to quit smoking. The objective of this study was to examine the feasibility of using classified newspaper ads and messages aimed at each stage of chan...
Article
Full-text available
To assess the impact of graphic Canadian cigarette warning labels on current adult smokers. A random-digit-dial telephone survey was conducted with 616 adult smokers in south western Ontario, Canada in October/November 2001, with three month follow up. Smoking behaviour (quitting, quit attempts, and reduced smoking), intentions to quit, and salienc...
Article
Full-text available
To effectively address the health burden of tobacco use, tobacco control programs must find ways of motivating smokers to quit. The present study examined the extent to which former smokers' motivation to quit was influenced by two tobacco control policies recently introduced in the Waterloo Region: a local smoke-free bylaw and graphic cigarette wa...
Article
Full-text available
Clinical approaches to smoking cessation are based on a goal of increasing the odds that a given person will quit smoking. Current treatment recommendations are based on meta-analyses of randomized clinical trials conducted over short intervals. An underlying assumption is that nicotine is the primary reason it is so difficult to quit and that phar...
Article
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To offer programmers, policy makers, and researchers a scientific basis for developing and selecting smoking cessation treatments for adolescents. An evidence review panel systematically rated published and unpublished reports of cessation treatments for youth to make recommendations on theoretical foundations, delivery settings, types of intervent...
Article
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To provide recommendations that will build a better foundation for research on youth smoking cessation. The Youth Tobacco Collaborative Cessation panel evaluated youth tobacco cessation literature and convened meetings to reach consensus. Methodological issues include design, recruitment and retention, follow-up, measurement, and youth vernacular....
Article
As the prevalence of adolescent smoking and, notably, regular smoking has increased over the last decade, researchers and practitioners have called for a consideration of treatment programs to promote cessation among adolescents who smoke. The adolescent smoking cessation treatment field is still in its infancy, though. The literature addressing ad...
Article
Over 60 per cent of adults have at least one modifiable cardiovascular disease (CVD) risk factor. Community-based initiatives are a central component of a population-based CVD risk reduction strategy. Describes the development of an information system in which CHHIOP collected quantitative and qualitative information on heart health activities in c...
Article
Full-text available
An Abyss divided common understandings about waiting lists from evidence about their nature and causes and what might work to rationalize them. In a recent comprehensive report for Health Canada we found that the state of waiting-list information and management systems in Canada is Woefully inadequate, particularly for elective procedures. Here, we...
Article
Full-text available
The Canadian debate about access to care, and waiting lists in particular, is characterized by disturbing chasms between widely held views and research evidence. This disjunction apprears to be the product of a number of factors, including lack of standars approaches to measurement and reporting of waiting-list lengths and waiting time and a genera...
Article
Attempts to reduce the prevalence of smoking through quit-smoking programs have been unsuccessful because they have not attracted large numbers of smokers to participate in them. An analytic review of the literature was conducted to identify potential communication variables that might enhance recruitment for community-based quit-smoking programs....
Article
The term alexithymia denotes a cluster of traits including a marked difficulty in finding words to describe emotions. Despite a rapidly growing literature, the construct has not been validated adequately. The present study addressed the validity of the construct. Twenty males assessed as alexithymic or not, on the basis of the Schalling-Sifneos Per...

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