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Mahyoub MA, Al-Qurmoti S, Rai AA, Abbas M, Jebril M, Alnaggar M, He S. Adverse physiological effects of smoking cessation on the gastrointestinal tract: A review. Medicine (Baltimore) 2023; 102:e35124. [PMID: 37747027 PMCID: PMC10519547 DOI: 10.1097/md.0000000000035124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/26/2023] Open
Abstract
Smoking cessation is known to have numerous health benefits, but it can also induce adverse physiological effects, including those affecting the gastrointestinal tract (GIT). Understanding the adverse physiological effects of smoking cessation on the GIT is critical for healthcare professionals and smokers attempting to quit, as it enables them to anticipate and manage potential challenges during the smoking cessation process. Although the detrimental effects of smoking on the GIT have been well established, there is a gap in the literature regarding the specific physiological reactions that may occur upon smoking cessation. This mini-review summarizes the current literature on the predisposing factors, pathophysiology, clinical presentation, and treatment options for adverse physiological effects of smoking cessation on the GIT. We aimed to raise awareness among busy clinical professionals about these adverse effects, empowering them to effectively support individuals striving to quit smoking and maintain their cessation. By consolidating the existing knowledge in this field, this review offers practical implications for smokers, healthcare providers, and policymakers to optimize smoking cessation interventions and support strategies to improve health outcomes.
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Affiliation(s)
- Mueataz A. Mahyoub
- Department of Gastroenterology, Faculty of Medicine and Health Sciences, Thamar University, Dhamar, Yemen
- Department of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Clinical Medical Research Center for Digestive Diseases (Oncology) of Shaanxi Province, Xi’an, China
| | - Sarah Al-Qurmoti
- Department of Cleft Palate-Craniofacial Surgery, College of Stomatology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | | | - Mustafa Abbas
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Thamar University, Dhamar, Yemen
| | - Majed Jebril
- College of Health Sciences, Department of Laboratory Medical Sciences, The Islamic University of Gaza, Gaza, Palestine
| | - Mohammed Alnaggar
- Department of Internal Medicine, Clinic Medical College, Hubei University of Science and Technology, Xianning, Hubei, China
- Department of Oncology, South Hubei Cancer Hospital, Xianning, Hubei, China
| | - Shuixiang He
- Department of Gastroenterology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Clinical Medical Research Center for Digestive Diseases (Oncology) of Shaanxi Province, Xi’an, China
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Strong DR, Glasser AM, Leas EC, Pierce JP, Abrams DB, Hrywna M, Hyland A, Cummings KM, Hatsukami DK, Fong GT, Elton-Marshall T, Sharma E, Edwards KC, Stanton CA, Sawdey MD, Ramôa CP, Silveira ML, Kimmel HL, Niaura RS. Indicators of Tobacco Dependence Among Youth: Findings From Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2023; 25:1565-1574. [PMID: 37156636 PMCID: PMC10439486 DOI: 10.1093/ntr/ntad072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 05/01/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Prior work established a measure of tobacco dependence (TD) among adults that can be used to compare TD across different tobacco products. We extend this approach to develop a common, cross-product metric for TD among youth. METHODS One thousand one hundred and forty-eight youth aged 12-17 who used a tobacco product in the past 30 days were identified from 13 651 youth respondents in Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. FINDINGS Analyses confirmed a single primary latent construct underlying responses to TD indicators for all mutually exclusive tobacco product user groups. Differential Item Functioning analyses supported the use of 8 of 10 TD indicators for comparisons across groups. With TD levels anchored at 0.0 (standard deviation [SD] = 1.0) among cigarette only (n = 265) use group, mean TD scores were more than a full SD lower for e-cigarette only (n = 150) use group (mean = -1.09; SD = 0.64). Other single product use group (cigar, hookah, pipe, or smokeless; n = 262) on average had lower TD (mean = -0.60; SD = 0.84), and the group with the use of multiple tobacco products (n = 471) experienced similar levels of TD (mean = 0.14; SD = 0.78) as the cigarette only use group. Concurrent validity was established with product use frequency among all user groups. A subset of five TD items comprised a common metric permitting comparisons between youth and adults. CONCLUSION The PATH Study Youth Wave 1 Interview provided psychometrically valid measures of TD that enable future regulatory investigations of TD across tobacco products and comparisons between youth and adult tobacco product use group. IMPLICATIONS A measure of tobacco dependence (TD) has been established previously among adults to compare TD across tobacco products. This study established the validity of a similar, cross-product measure of TD among youth. Findings suggest a single latent TD construct underlying this measure, concurrent validity of the scale with product use frequency across different types of tobacco users, and a subset of common items that can be used to compare TD between youth and adults who use tobacco.
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Affiliation(s)
- David R Strong
- Cancer Prevention and Control Program, Moores Cancer Center University of California, San Diego, CA, USA
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - Allison M Glasser
- School of Global Public Health, New York University, New York, NY, USA
| | - Eric C Leas
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - John P Pierce
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - David B Abrams
- School of Global Public Health, New York University, New York, NY, USA
| | - Mary Hrywna
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, New Brunswick, NJ, USA
| | | | | | - Dorothy K Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Geoffrey T Fong
- School of Public Health Sciences, University of Waterloo, Waterloo, ON,Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Tara Elton-Marshall
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | | | | | - Michael D Sawdey
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Carolina P Ramôa
- Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA
| | - Marushka L Silveira
- Kelly Government Solutions, Rockville, MD, USA
- National Institute of Dental and Craniofacial Research (NIDCR/NIH), Bethesda, MD, USA
| | | | - Raymond S Niaura
- School of Global Public Health, New York University, New York, NY, USA
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Chellian R, Behnood-Rod A, Bruijnzeel AW. Development of Dependence in Smokers and Rodents With Voluntary Nicotine Intake: Similarities and Differences. Nicotine Tob Res 2023; 25:1229-1240. [PMID: 36482774 PMCID: PMC10256892 DOI: 10.1093/ntr/ntac280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 11/23/2022] [Accepted: 12/05/2022] [Indexed: 07/29/2023]
Abstract
INTRODUCTION Smoking and vaping throughout adolescence and early adulthood lead to nicotine dependence. Nicotine withdrawal is associated with somatic and affective withdrawal symptoms that contribute to smoking and relapse. Affective nicotine withdrawal symptoms in humans include craving for cigarettes, depression, anxiety, trouble sleeping, and cognitive deficits. METHODS Herein, we review clinical studies that investigated nicotine dependence in people who smoke or vape. We also discuss studies that investigated the development of dependence in animals with oral nicotine intake, nicotine aerosol self-administration, and intravenous nicotine self-administration. RESULTS Clinical studies report that adolescents who smoke daily develop nicotine dependence before those who smoke infrequently, but ultimately all smokers become dependent in adulthood. Preclinical studies indicate that rats that self-administer nicotine also become dependent. Rats that self-administer nicotine display somatic withdrawal signs and affective withdrawal signs, including increased anxiety and depressive-like behavior, cognitive deficits, and allodynia. Most nicotine withdrawal signs were observed in rodents with daily (7 days/week) or intermittent long access (23-hour) to nicotine. Clinical smoking studies report symptoms of nicotine dependence in adolescents of both sexes, but virtually all preclinical nicotine self-administration studies have been done with adult male rats. CONCLUSIONS The role of sex and age in the development of dependence in nicotine self-administration studies remains under-investigated. However, the role of sex and age in nicotine withdrawal has been thoroughly evaluated in studies in which nicotine was administered noncontingently. We discuss the need for volitional nicotine self-administration studies that explore the gradual development of dependence during adolescence and adulthood in rodents of both sexes. IMPLICATIONS The reviewed clinical studies investigated the development of nicotine dependence in male and female adolescent and young adult smokers and vapers. These studies indicate that most adolescent smokers and vapers gradually become nicotine dependent. Preclinical studies with rodents show that nicotine intake in widely used self-administration models also leads to dependence. However, almost all animal studies that investigated the development of nicotine dependence have been conducted with adult male rats. To better model smoking and vaping, it is important that nicotine intake in rats or mice starts during adolescence and that both sexes are included.
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Affiliation(s)
| | - Azin Behnood-Rod
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
| | - Adriaan W Bruijnzeel
- Corresponding Author: Adriaan Bruijnzeel, PhD, University of Florida, Department of Psychiatry, 1149 Newell Dr., Gainesville, Florida 32611, USA. Telephone: 352-294-4931; Fax: 352-392-9887; E-mail:
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Smethells JR, Burroughs D, Saykao A, LeSage MG. The relative reinforcing efficacy of nicotine in an adolescent rat model of attention-deficit hyperactivity disorder. Front Psychiatry 2023; 14:1154773. [PMID: 37255676 PMCID: PMC10225533 DOI: 10.3389/fpsyt.2023.1154773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/14/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Attention-deficit/hyperactivity disorder (ADHD) is an independent risk factor for tobacco use disorder. Individuals with ADHD are more likely to begin smoking at a younger age, become a daily smoker sooner, smoke more cigarettes per day, and exhibit greater nicotine dependence than individuals without ADHD. It is unclear whether these findings are due to the reinforcing efficacy of nicotine per se being greater among individuals with ADHD. The purpose of the present study was to examine this issue using an animal model of ADHD, the spontaneously hypertensive rat (SHR) strain. Methods Adolescent SHR and Wistar (control) rats were given access to a typically reinforcing nicotine unit dose (30 μg/kg), a threshold reinforcing nicotine dose (4 μg/kg), or saline under an FR 1 (week 1) and FR 2 (week 2) schedule during 23 h sessions to examine acquisition of self-administration. Behavioral economic demand elasticity was then evaluated at the 30 μg/kg dose through an FR escalation procedure. Results At the 30 μg/kg dose, SHR rats exhibited a lower average response rate, lower mean active to inactive lever discrimination ratio, and lower proportion of rats acquiring self-administration compared to control rats. During demand assessment, SHR rats showed no significant difference from Wistars in demand intensity (Q0) or elasticity (α; i.e., reinforcing efficacy). In addition, no strain difference in acquisition measures were observed at the 4 μg/kg dose. Discussion These findings suggest that the increased risk of tobacco use disorder in adolescents with ADHD may not be attributable to a greater reinforcing efficacy of nicotine, and that other aspects of tobacco smoking (e.g., non-nicotine constituents, sensory factors) may play a more important role. A policy implication of these findings is that a nicotine standard to reduce initiation of tobacco use among adolescents in the general population may also be effective among those with ADHD.
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Affiliation(s)
- John R. Smethells
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
| | | | - Amy Saykao
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States
| | - Mark G. LeSage
- Hennepin Healthcare Research Institute, Minneapolis, MN, United States
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States
- Department of Pharmacology, University of Minnesota, Minneapolis, MN, United States
- Department of Psychology, University of Minnesota, Minneapolis, MN, United States
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Towers EB, Williams IL, Qillawala EI, Rissman EF, Lynch WJ. Sex/Gender Differences in the Time-Course for the Development of Substance Use Disorder: A Focus on the Telescoping Effect. Pharmacol Rev 2023; 75:217-249. [PMID: 36781217 PMCID: PMC9969523 DOI: 10.1124/pharmrev.121.000361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/05/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
Sex/gender effects have been demonstrated for multiple aspects of addiction, with one of the most commonly cited examples being the "telescoping effect" where women meet criteria and/or seek treatment of substance use disorder (SUD) after fewer years of drug use as compared with men. This phenomenon has been reported for multiple drug classes including opioids, psychostimulants, alcohol, and cannabis, as well as nonpharmacological addictions, such as gambling. However, there are some inconsistent reports that show either no difference between men and women or opposite effects and a faster course to addiction in men than women. Thus, the goals of this review are to evaluate evidence for and against the telescoping effect in women and to determine the conditions/populations for which the telescoping effect is most relevant. We also discuss evidence from preclinical studies, which strongly support the validity of the telescoping effect and show that female animals develop addiction-like features (e.g., compulsive drug use, an enhanced motivation for the drug, and enhanced drug-craving/vulnerability to relapse) more readily than male animals. We also discuss biologic factors that may contribute to the telescoping effect, such as ovarian hormones, and its neurobiological basis focusing on the mesolimbic dopamine reward pathway and the corticomesolimbic glutamatergic pathway considering the critical roles these pathways play in the rewarding/reinforcing effects of addictive drugs and SUD. We conclude with future research directions, including intervention strategies to prevent the development of SUD in women. SIGNIFICANCE STATEMENT: One of the most widely cited gender/sex differences in substance use disorder (SUD) is the "telescoping effect," which reflects an accelerated course in women versus men for the development and/or seeking treatment for SUD. This review evaluates evidence for and against a telescoping effect drawing upon data from both clinical and preclinical studies. We also discuss the contribution of biological factors and underlying neurobiological mechanisms and highlight potential targets to prevent the development of SUD in women.
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Affiliation(s)
- Eleanor Blair Towers
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
| | - Ivy L Williams
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
| | - Emaan I Qillawala
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
| | - Emilie F Rissman
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
| | - Wendy J Lynch
- Psychiatry and Neurobehavioral Sciences (E.B.T., I.L.W., E.I.Q., W.J.L.) and Medical Scientist Training Program (E.B.T.), University of Virginia, Charlottesville, Virginia, and Center for Human Health and the Environment and Program in Genetics, North Carolina State University, Raleigh, North Carolina (E.F.R.)
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Huang S, Furer ML, Smyth JM, Wilson SJ. Momentary associations between affect and craving as a function of perceived smoking opportunity in young adults smoking 1-5 cigarettes per day: An ecological momentary assessment study. Drug Alcohol Depend 2023; 243:109717. [PMID: 36542962 PMCID: PMC10100158 DOI: 10.1016/j.drugalcdep.2022.109717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Very light daily smoking (1-5 cigarettes/day) is associated with adverse consequences and is prevalent among young adults. Evidence suggests that perceived smoking opportunity modulates links between affect and craving in adults with heavier smoking patterns (e.g., > 10 cigarettes per day), but there is a lack of similar data in young adults with very light daily smoking patterns. This study addresses this gap by investigating the associations between affect and craving as a function of perceived smoking opportunity under naturalistic conditions. METHODS Forty-one young adults aged 18-25 (M=21.03, SD=1.75) who reported smoking 1-5 cigarettes per day (M=3.2, SD=1.2) completed intermittent ratings of momentary affective valence and arousal, smoking craving, and perceived smoking opportunity on smartphones five times per day for seven days. RESULTS Multilevel analyses suggested that when participants felt more pleasant or unpleasant, they were likely to report more intense craving. When smoking opportunity was perceived as high, affective arousal was positively associated with craving; this association was not observed when opportunity to smoke was perceived as low. CONCLUSIONS These findings indicate that higher momentary intensity of affective valence (both negative and positive) is linked to stronger momentary craving in young adults who report very light daily smoking. Anticipating an opportunity to satisfy craving by smoking may strengthen the association between reported affective arousal and craving in this population. These results highlight the potential benefits of coping with craving (e.g., by regulating affect) for those who engage in light tobacco use, especially in environments with high cigarette availability.
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Affiliation(s)
- Siyuan Huang
- Department of Psychology, 140 Moore Building, The Pennsylvania State University, University Park, PA 16802, USA
| | - Melinda L Furer
- Department of Psychology, The Pennsylvania State University, 3000 Ivyside Park, Altoona, PA 16601, USA
| | - Joshua M Smyth
- Department of Biobehavioral Health, 231 Biobehavioral Health Building, The Pennsylvania State University, University Park, PA 16802, USA
| | - Stephen J Wilson
- Department of Psychology, 140 Moore Building, The Pennsylvania State University, University Park, PA 16802, USA.
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Stewart RE, Cardamone NC, Schachter A, Becker C, McKay JR, Becker-Haimes EM. A systematic review of brief, freely accessible, and valid self-report measures for substance use disorders and treatment. Drug Alcohol Depend 2023; 243:109729. [PMID: 36535096 PMCID: PMC9872256 DOI: 10.1016/j.drugalcdep.2022.109729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/26/2022] [Accepted: 11/25/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Self-report measures can improve evidence-based assessment practices in substance use disorder treatment, but many measures are burdensome and costly, limiting their utility in community practice and non-specialty healthcare settings. This systematic review identified and evaluated the psychometric properties of brief, free, and readily accessible self-report measures of substance use and related factors. METHODS We searched two electronic databases (PsycINFO and PubMed) in May 2021 for published literature on scales, measures, or instruments related to substance use, substance use treatment, and recovery, and extracted the names of all measures. Measures were included if they were: (1) brief (25 items or fewer), (2) freely accessible in a ready-to-use format, and (3) had published psychometric data. RESULTS An initial search returned 411 measures, of which 73 (18%) met criteria for inclusion. Included measures assessed a variety of substances (e.g., alcohol, nicotine, opioids, cannabinoids, cocaine) and measurement domains (e.g., use, severity, expectancies, withdrawal). Among these measures, 14 (19%) were classified as psychometrically "excellent," 27 (37%) were rated as "good," 32 (44%) were "adequate." CONCLUSIONS Despite the shift toward evidence-based assessment in substance use disorder treatment in the last twenty years, key areas of public health concern are lacking pragmatic, psychometrically valid measures. Among the brief measures we reviewed, less than a fifth met criteria for psychometric "excellence" and most of these instruments fell into one measurement domain: screening for problematic substance use. Future research should focus both on improving the evidence base for existing brief self-report measures and creating new low-burden measures for specific substances and treatment constructs.
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Affiliation(s)
- Rebecca E Stewart
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA 19104, USA.
| | - Nicholas C Cardamone
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA 19104, USA.
| | - Allison Schachter
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA 19104, USA.
| | - Chloe Becker
- George Washington University School of Medicine and Health Sciences, Ross Hall, 2300 Eye Street, NW, Washington, D.C. 20037, USA.
| | - James R McKay
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA 19104, USA; Crescenz Department of Veteran Affairs Medical Center, 3900 Woodland Ave, Philadelphia, PA 19104, USA.
| | - Emily M Becker-Haimes
- University of Pennsylvania, Department of Psychiatry, Philadelphia, PA 19104, USA; Hall Mercer Community Mental Health, University of Pennsylvania, 800 Spruce St, Philadelphia, PA 19107, USA.
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Martins SR, de Araújo AJ, Wehrmeister FC, Freitas BM, Basso RG, Santana ANC, Santos UDP. Prevalence and associated factors of experimentation with and current use of water pipes and electronic cigarettes among medical students: a multicentric study in Brazil. J Bras Pneumol 2023; 49:e20210467. [PMID: 36700569 PMCID: PMC9970372 DOI: 10.36416/1806-3756/e20210467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 11/16/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVE To evaluate the prevalence of and factors associated with experimentation with and current use of water pipes and e-cigarettes among medical students. METHODS This was a cross-sectional multicentric study involving a convenience sample of students from medical schools in most Brazilian geographic regions. Information about experimentation with and current use of conventional cigarettes, water pipes, and e-cigarettes; beliefs and attitudes toward tobacco products; religiosity; and demographics were collected by means of an online structured questionnaire. We used descriptive statistics and logistic regression to analyze the association of those factors. RESULTS Our sample comprised 700 individuals from four Brazilian regions. Prevalence of experimentation with and current use of cigarettes, water pipes, and e-cigarettes were, respectively, 39.1% and 7.9%; 42.6% and 11.4%; and 13.1% and 2.3%. Water pipe experimentation was higher among those who had a sibling (adjusted OR = 2.64; 95% CI, 1.24-5.61) or friends (adjusted OR = 2.33; 95% CI, 1.63-3.31) who smoke. The same occurred regarding e-cigarette experimentation: siblings (adjusted OR = 2.76; 95% CI, 1.17-6.50) and friends (adjusted OR = 2.47; 95% CI, 1:45-4.22). Curiosity and scent/taste were the major reasons for water pipe use and e-cigarette experimentation. Although 93% of the responders learned about health damages of smoking during medical school classes, 51.4% reported having experimented with at least one of these tobacco products. Most responders who reported feeling the presence of God/the Holy Spirit in their lives were never experimenters of water pipes (59.2%) or e-cigarettes (55.3%). CONCLUSIONS There is a high prevalence of experimentation with tobacco products among medical students whose siblings or friends smoke, despite their knowledge about smoking harms.
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Affiliation(s)
- Stella Regina Martins
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | | | - Fernando C Wehrmeister
- . Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas (RS) Brasil
| | - Beatriz Martins Freitas
- . Curso de Medicina, Faculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo (SP) Brasil
| | | | - Alfredo Nicodemos Cruz Santana
- . Hospital Regional da Asa Norte, Escola Superior de Ciências da Saúde, Brasília, Brasília (DF) Brasil.,. Núcleo Avançado de Tórax, Hospital Sírio-Libanês, Brasília (DF) Brasil
| | - Ubiratan de Paula Santos
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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Vitória P, Bento J. Prevalence and predictors of smoking behavior in
Azorean adolescents. POPULATION MEDICINE 2023. [DOI: 10.18332/popmed/159045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Towers EB, Kilgore M, Bakhti-Suroosh A, Pidaparthi L, Williams IL, Abel JM, Lynch WJ. Sex differences in the neuroadaptations associated with incubated cocaine-craving: A focus on the dorsomedial prefrontal cortex. Front Behav Neurosci 2023; 16:1027310. [PMID: 36688133 PMCID: PMC9854116 DOI: 10.3389/fnbeh.2022.1027310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/15/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Women have a shorter course from initial cocaine use to meeting the criteria for cocaine use disorder as compared to men. Preclinical findings similarly indicate that females develop key features of an addiction-like phenotype faster than males, including an enhanced motivation for cocaine and compulsive use, indicating that this phenomenon is biologically based. The goals of this study were to determine whether cocaine-craving, another key feature of addiction, also develops sooner during withdrawal in females than males and to determine whether there are sex differences in the molecular mechanisms associated with its development focusing on markers known to mediate cocaine-craving in males (i.e., dorsomedial prefrontal cortex, dmPFC, expression of brain-derived neurotrophic factor exon-IV, Bdnf-IV, and NMDA receptor subunits, Grin2a, Grin2b, and Grin1). Methods Cocaine-craving was assessed following extended-access cocaine self-administration and 2, 7, or 14 days of withdrawal using an extinction/cue-induced reinstatement procedure. Tissue was obtained from the dmPFC immediately after reinstatement testing and gene expression changes were analyzed using real-time qPCR. Results In males, cocaine-craving (total extinction and cue-induced reinstatement responding) progressively increased from early to later withdrawal time-points whereas in females, cocaine-craving was already elevated during early withdrawal (after 2 days) and did not further increase at later withdrawal time-points. Levels of cocaine-craving, however, were similar between the sexes. Gene expression changes differed markedly between the sexes such that males showed the expected relapse- and withdrawal-associated changes in Bdnf-IV, Grin2a, Grin2b, and Grin1 expression, but females only showed a modest increase Grin1 expression at the intermediate withdrawal timepoint. Discussion These findings indicate that cocaine-craving is similarly expressed in males and females although the time-course for its incubation appears to be accelerated in females; the molecular mechanisms also likely differ in females versus males.
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Affiliation(s)
- Eleanor Blair Towers
- Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
- Medical Scientist Training Program, University of Virginia, Charlottesville, VA, United States
| | - Madison Kilgore
- Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - Anousheh Bakhti-Suroosh
- Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - Lasyapriya Pidaparthi
- Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - Ivy L. Williams
- Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - Jean M. Abel
- Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
| | - Wendy J. Lynch
- Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
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Kirshenbaum AP, Hughes JR. Reinforcement enhancement by nicotine: A novel abuse-liability assessment of e-cigarettes in young adults. Exp Clin Psychopharmacol 2022; 30:959-972. [PMID: 34166033 PMCID: PMC8702578 DOI: 10.1037/pha0000496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Nicotine can act as a primary positive reinforcer, and as negative reinforcer to relieve withdrawal; we tested whether it can also enhance the reinforcing efficacy of non-drug reinforcers. Young-adult never-users were delivered nicotine via e-cigarette, and a videogame reinforcer was used to test nicotine enhancement. Three dose groups were tested (placebo-only, 6 or 12-mg nicotine), and participants returned to the lab for several sessions over the course of 1 month. Those in the two nicotine-dose groups received placebo on some occasions and nicotine on others; nicotine enhancement of the videogame reinforcer was assessed in a within-subjects fashion by comparing each of the two nicotine groups' dedicated nicotine dose to placebo. In the placebo-only group, progressive-ratio (PR) schedule breakpoints did not alter as a function of videogame exposure, suggesting that the videogame retained its basic-reinforcing properties throughout the study. For the two groups that received nicotine, both doses of nicotine increased PR-schedule breakpoints for the videogame reinforcer relative to the placebo condition. Although nicotine was associated with greater subjective evaluation of the enjoyment of the videogame, it was unrelated to the enjoyment of the e-cigarette device. No evidence was found that nicotine elevated either anhedonia or withdrawal symptoms in the timeframe of the study. The results provide initial evidence that nicotine enhancement, via electronic cigarettes, occurs in non-frequent users of nicotine products and may be a reason they can develop nicotine dependence in the absence of withdrawal and direct effects of nicotine. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Novick AM, Duffy KA, Johnson RL, Sammel MD, Cao W, Strasser AA, Sofuoglu M, Kuzma A, Loughead J, Epperson CN. Progesterone Increases Nicotine Withdrawal and Anxiety in Male but Not Female Smokers During Brief Abstinence. Nicotine Tob Res 2022; 24:1898-1905. [PMID: 35713950 PMCID: PMC9653080 DOI: 10.1093/ntr/ntac146] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 05/08/2022] [Accepted: 06/14/2022] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Although exogenous progesterone may hold promise as a treatment for nicotine use disorders, it is unclear whether it is similarly effective in males and females. This study examined the effects of progesterone on nicotine use disorder comprehensively using behavioral, psychological, and neural measures in male and female smokers exposed to brief abstinence. AIMS AND METHODS Thirty-three male and 33 female non-treatment-seeking smokers participated in a double-blind, randomized, placebo-controlled crossover study of 200 mg of progesterone or placebo daily over a four-day abstinence period. Smoking behavior and subjective effects of nicotine were assessed at baseline and after final drug administration. Nicotine withdrawal, smoking urges, mood states, and neural response to smoking cues were measured at baseline, after the first drug administration, and after the final drug administration. RESULTS No main effect of drug (progesterone vs. placebo) emerged for any outcome. Significant sex by drug interactions emerged for nicotine withdrawal (p = .020), perceived strength of nicotine (p = .040), and perceived bad effects of nicotine (p = .029). Males receiving progesterone reported worse nicotine withdrawal (p = .046) and a trend towards decreased bad effects of nicotine (p = .070). Males on progesterone also reported greater tension and anxiety relative to placebo (p = .021). Females on progesterone perceived nicotine's effects as being stronger relative to placebo (p = .046). CONCLUSIONS Progesterone causes sex-dependent effects on smoking-related outcomes during brief abstinence. Specifically, progesterone in males may increase rather than decrease nicotine withdrawal and negative affect during abstinence, potentially hindering efforts to quit smoking. IMPLICATIONS In male and female smokers undergoing a brief period of abstinence, we examined the effects of progesterone on smoking outcomes. While progesterone had limited effects in female smokers, in males, it worsened nicotine withdrawal and negative affect. Our findings emphasize the importance of analyzing sex differences in future studies examining progesterone as a potential treatment and suggest that progesterone in males could potentially exacerbate aspects of nicotine dependence. CLINICALTRIALS.GOV REGISTRATION NCT01954966. https://clinicaltrials.gov/ct2/show/NCT01954966.
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Affiliation(s)
- Andrew M Novick
- Corresponding Author: Andrew M. Novick, MD, PhD, Department of Psychiatry, University of Colorado-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO 80045, USA. Telephone: 303-724-5656; Fax: 844-886-1892; E-mail:
| | - Korrina A Duffy
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Mary D Sammel
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Wen Cao
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Alexandra Kuzma
- Larner College of Medicine, University of Vermont, Burlington, VM, USA
| | - James Loughead
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C Neill Epperson
- Department of Psychiatry, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
- Department of Family Medicine, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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Novick AM, Duffy KA, Johnson RL, Sammel MD, Cao W, Strasser AA, Sofuoglu M, Kuzma A, Loughead J, Morrow AL, Epperson CN. Effect of progesterone administration in male and female smokers on nicotine withdrawal and neural response to smoking cues: role of progesterone conversion to allopregnanolone. Biol Sex Differ 2022; 13:60. [PMID: 36274158 PMCID: PMC9590190 DOI: 10.1186/s13293-022-00472-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/15/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Progesterone administration has therapeutic effects in tobacco use disorder (TUD), with females benefiting more than males. Conversion of progesterone to the neurosteroid allopregnanolone is hypothesized to partly underlie the therapeutic effects of progesterone; however, this has not been investigated clinically. METHODS Smokers (n = 18 males, n = 21 females) participated in a randomized, double-blind, placebo-controlled crossover study of 200 mg progesterone daily across 4 days of abstinence. The ratio of allopregnanolone:progesterone was analyzed in relationship to nicotine withdrawal, smoking urges, mood states, subjective nicotine effects, and neural response to smoking cues. RESULTS Allopregnanolone:progesterone ratio interacted with sex to predict withdrawal symptoms (p = 0.047), such that females with higher allopregnanolone:progesterone ratios reported lower withdrawal severity (b = - 0.98 [- 1.95, - 0.01]; p = 0.048). In addition, allopregnanolone:progesterone ratio interacted with sex to predict confusion (p = 0.014) and fatigue (p = 0.034), such that females with higher allopregnanolone:progesterone ratios reported less confusion (b = - 0.45 [- 0.78, - 0.12]; p = 0.008) and marginally lower fatigue (b = - 0.50 [- 1.03, 0.02]; p = 0.062. Irrespective of sex, higher ratios of allopregnanolone:progesterone were associated with stronger "good effects" of nicotine (b = 8.39 [2.58, 14.20]); p = 0.005) and weaker "bad effects" of nicotine (b = - 7.13 [- 13.53, - 0.73]; p = 0.029). CONCLUSIONS Conversion of progesterone to allopregnanolone correlated with smoking-related outcomes in both sex-dependent and sex-independent ways. Sex-dependent effects suggest that conversion of progesterone to allopregnanolone may contribute to greater therapeutic benefits in females but not males with TUD. Trial registration Clinicaltrials.gov registration, retrospectively registered: NCT01954966; https://clinicaltrials.gov/ct2/show/NCT01954966 \.
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Affiliation(s)
- Andrew M Novick
- Department of Psychiatry, School of Medicine, University of CO-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA.
| | - Korrina A Duffy
- Department of Psychiatry, School of Medicine, University of CO-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Rachel L Johnson
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of CO-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Mary D Sammel
- Department of Psychiatry, School of Medicine, University of CO-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of CO-Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Wen Cao
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Andrew A Strasser
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Mehmet Sofuoglu
- Department of Psychiatry, Yale School of Medicine, Yale University, New Haven, CT, 06511, USA
| | - Alexandra Kuzma
- Larner College of Medicine, University of Vermont, Burlington, VM, 05405, USA
| | - James Loughead
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - A Leslie Morrow
- Departments of Psychiatry and Pharmacology and the Bowles Center for Alcohol Studies, University of North Carolina School of Medicine, Chapel Hill, NC, 27514, USA
| | - C Neill Epperson
- Department of Psychiatry, School of Medicine, University of CO-Anschutz Medical Campus, 13001 E 17th Pl, Aurora, CO, 80045, USA
- Department of Family Medicine, School of Medicine, University of CO-Anschutz Medical Campus, Aurora, CO, 80045, USA
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Seemiller LR, Logue SF, Gould TJ. Inbred mouse strain differences in alcohol and nicotine addiction-related phenotypes from adolescence to adulthood. Pharmacol Biochem Behav 2022; 218:173429. [PMID: 35820468 DOI: 10.1016/j.pbb.2022.173429] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 06/18/2022] [Accepted: 07/06/2022] [Indexed: 11/20/2022]
Abstract
Understanding the genetic basis of a predisposition for nicotine and alcohol use across the lifespan is important for public health efforts because genetic contributions may change with age. However, parsing apart subtle genetic contributions to complex human behaviors is a challenge. Animal models provide the opportunity to study the effects of genetic background and age on drug-related phenotypes, while controlling important experimental variables such as amount and timing of drug exposure. Addiction research in inbred, or isogenic, mouse lines has demonstrated genetic contributions to nicotine and alcohol abuse- and addiction-related behaviors. This review summarizes inbred mouse strain differences in alcohol and nicotine addiction-related phenotypes including voluntary consumption/self-administration, initial sensitivity to the drug as measured by sedative, hypothermic, and ataxic effects, locomotor effects, conditioned place preference or place aversion, drug metabolism, and severity of withdrawal symptoms. This review also discusses how these alcohol and nicotine addiction-related phenotypes change from adolescence to adulthood.
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Affiliation(s)
- Laurel R Seemiller
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA
| | - Sheree F Logue
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA
| | - Thomas J Gould
- Department of Biobehavioral Health, Penn State University, University Park, PA, USA.
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Wilhelm J, Mishina E, Viray L, Paredes A, Pickworth WB. The pH of Smokeless Tobacco Determines Nicotine Buccal Absorption: Results of a Randomized Crossover Trial. Clin Pharmacol Ther 2021; 111:1066-1074. [PMID: 34826137 DOI: 10.1002/cpt.2493] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/14/2021] [Indexed: 11/08/2022]
Abstract
Nicotine absorption rate influences tobacco products' addictiveness. For smokeless tobacco, nicotine buccal absorption is associated with its free-base form; the pH of smokeless tobacco defines the proportion of free-base (i.e., unprotonated) vs. protonated nicotine. This was the first study to compare nicotine pharmacokinetics (PK) and pharmacodynamics (PD) after the use of commercial smokeless tobacco products that were experimentally manipulated to differ only in pH and percent free-base nicotine. Moist snuff users (N = 40) completed four crossover visits and used a single 2 g portion of Copenhagen Original Long Cut amended to 4 pH levels: 5.0, 7.7, 8.2, and 8.6 (free-base nicotine 0.1, 32, 60, and 79%) for 30 minutes. Nicotine PK and PD were assessed for 4 hours post-use. Nicotine PK substantially depends on its free-base proportion, with more than 4-fold increases in mean plasma nicotine maximum concentration and area under the curve over 240 minutes (3.9 to 16.7 ng/mL; 385 to 1810 ng min/mL, respectively, both P < 0.001) from pH 5.0 to 8.6. The autonomic cardiovascular effects of smokeless tobacco use reflected percent free-base nicotine, with small (albeit significant) systematic increases in heart rate and blood pressure associated with free-base nicotine. Smokeless tobacco product pH and percent free-base nicotine play a major role in the rate and extent of nicotine absorption, determining product PD effects and abuse potential. Research and regulation of smokeless tobacco products should consider both total nicotine content and product pH. Further research may address the impact of modifying pH on the addictiveness of smokeless tobacco and associated use behaviors.
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Affiliation(s)
- Jess Wilhelm
- Battelle Public Health Research Center, Baltimore, Maryland, USA
| | - Elena Mishina
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Lauren Viray
- Battelle Public Health Research Center, Baltimore, Maryland, USA
| | - Antonio Paredes
- Center for Tobacco Products, US Food and Drug Administration, Silver Spring, Maryland, USA
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16
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Wei LC. Smoking by pregnant mothers and risk of future tobacco use by offspring: a meta-analysis. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1967477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Lien-Chung Wei
- Department of Addiction Psychiatry, Taoyuan Psychiatric Center, Ministry of Health and Welfare, Taoyuan, Taiwan
- Department of Counseling and Industrial/Organizational Psychology, Ming Chuan University, Taipei, Taiwan
- Division of Epidemiology, School of Public Health, UC Berkeley, California, USA
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17
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Leyrer-Jackson JM, Overby PF, Bull A, Marusich JA, Gipson CD. Strain and sex matters: Differences in nicotine self-administration between outbred and recombinase-driver transgenic rat lines. Exp Clin Psychopharmacol 2021; 29:375-384. [PMID: 32297781 PMCID: PMC8375641 DOI: 10.1037/pha0000376] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Preclinical studies of nicotine self-administration provide important value for the field as they are highly rigorous, controlled, can be conducted quickly, and are generalizable to humans. Given the translational value of the nicotine self-administration model, and the relatively new guidelines of the National Institutes of Health to include sex as a biological variable, strain and sex differences in nicotine acquisition were examined here in two outbred rat strains. Sprague-Dawley (SD) and Long-Evans (LE; wildtype and cholinergic acetyltransferase cre-recombinase transgenic) rats of each sex were implanted with indwelling intravenous jugular catheters. Rats were trained to self-administer nicotine (0.02 mg/kg per infusion, paired with contingent light + tone stimuli). Acquisition criteria were set at a minimum active:inactive response ratio of 2:1 and a minimum of 10 infusions per session, both of which had to be met for a minimum of 10 sessions. Across 10 sessions, male SD rats self-administered significantly more nicotine than female SD rats (p < .05), indicating a sex difference in this strain. LE females self-administered more nicotine than SD females indicative of a strain difference between females (p < .05). SD males increased nicotine infusions across sessions compared to LE males and SD females (p < .05). No strain or sex differences were observed in the number of sessions to reach criteria. No differences between wildtype and transgenic LE rats were observed. These results demonstrate sex and strain differences in nicotine self-administration between SD and LE rats and may lend insight into development of other nicotine self-administration models, where sex and strain may impact acquisition. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Paula F. Overby
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Amanda Bull
- Department of Psychology, Arizona State University, Tempe, Arizona, USA
| | - Julie A. Marusich
- Center for Drug Discovery, RTI International, Research Triangle Park, North Carolina, USA
| | - Cassandra D. Gipson
- Department of Family and Community Medicine, University of Kentucky, Lexington Kentucky, USA,Correspondence to: Cassandra D. Gipson, Ph.D., Department of Family and Community Medicine, University of Kentucky, 741 S. Limestone, BBSRB Room 363, Lexington, KY, 40536, USA,
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18
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Mahajan SD, Homish GG, Quisenberry A. Multifactorial Etiology of Adolescent Nicotine Addiction: A Review of the Neurobiology of Nicotine Addiction and Its Implications for Smoking Cessation Pharmacotherapy. Front Public Health 2021; 9:664748. [PMID: 34291026 PMCID: PMC8287334 DOI: 10.3389/fpubh.2021.664748] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/24/2021] [Indexed: 12/14/2022] Open
Abstract
Nicotine is the primary pharmacologic component of tobacco, and its highly addictive nature is responsible for its widespread use and significant withdrawal effects that result in challenges to smoking cessation therapeutics. Nicotine addiction often begins in adolescence and this is at least partially attributed to the fact that adolescent brain is most susceptible to the neuro-inflammatory effects of nicotine. There is increasing evidence for the involvement of microglial cells, which are the brain's primary homeostatic sensor, in drug dependence and its associated behavioral manifestations particularly in the adolescent brain. A hallmark of neuro-inflammation is microglial activation and activation of microglia by nicotine during adolescent development, which may result in long-term addiction to nicotine. This non-systematic review examines multifactorial etiology of adolescent nicotine addiction, neurobiology of nicotine addiction and the potential mechanisms that underlie the effects of nicotine on inflammatory signaling in the microglia, understanding how nicotine affects the adolescent brain. We speculate, that modulating homeostatic balance in microglia, could have promising therapeutic potential in withdrawal, tolerance, and abstinence-related neural adaptations in nicotine addiction, in the adolescent brain. Further, we discuss nicotine addiction in the context of the sensitization-homeostasis model which provides a theoretical framework for addressing the potential role of microglial homeostasis in neural adaptations underlying nicotine abuse.
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Affiliation(s)
- Supriya D. Mahajan
- Department of Community Health and Health Behavior, School of Public Health, University at Buffalo, Buffalo, NY, United States
| | - Gregory G. Homish
- Department of Community Health and Health Behavior, School of Public Health, University at Buffalo, Buffalo, NY, United States
| | - Amanda Quisenberry
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
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Sharma MK, Suman LN, Srivastava K, Suma N, Vishwakarma A. Psychometric properties of Fagerstrom Test of Nicotine Dependence: A systematic review. Ind Psychiatry J 2021; 30:207-216. [PMID: 35017802 PMCID: PMC8709504 DOI: 10.4103/ipj.ipj_51_21] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 11/25/2022] Open
Abstract
The Fagerstrom test for nicotine dependence (FTND) is a widely used test for assessing physical nicotine dependence. However, there is a need to assess the psychometric properties of FTND to assess its role in treatment outcome studies. The aim of the present investigation was to review the psychometric properties of the FTND. A broad systematic literature search was performed from Pubmed and PsycINFO from 2000 to 2019. The publication language was limited to English. Two review authors performed the study selection and extracted the data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Rayyan software used to screen relevant studies. A total of 1471 articles retrieved from the search, of which 33 studies fulfilled the inclusion criteria. Eleven studies related to testing the reliability of the FTND were analyzed. Twenty-five studies evaluated the Cronbach alpha of the test. Analysis of the studies revealed the questionable psychometric qualities of the adapted versions of the test across different cultures and ethnicity. It also suggested that it may not tap the appropriate constructs that would predict smoking patterns in light smokers, e-cigarette smokers, and smokeless tobacco users. Thus, further research must focus on improving the psychometric properties of FTND to enhance the measurement of nicotine dependence.
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Affiliation(s)
- Manoj Kumar Sharma
- SHUT Clinic (Service for Healthy Use of Technology), Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - L N Suman
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Kalpana Srivastava
- Department of Psychiatry, Defence Research and Development Service, Armed Forces Medical College, Pune, Maharashtra, India
| | - N Suma
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Akash Vishwakarma
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Ebrahimi Kalan M, Bahelah R, Bursac Z, Ward KD, Ben Taleb Z, Tleis M, Jebai R, Asfar T, Eissenberg T, Maziak W. A Group-based Modeling Approach to Identify Developmental Trajectories of Nicotine Dependence Among Lebanese Adolescents Waterpipe Smokers. Nicotine Tob Res 2021; 23:2056-2064. [PMID: 34125916 DOI: 10.1093/ntr/ntab128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 06/11/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Adolescence represents a critical period in which nicotine dependence(ND) symptoms are developing. Little is known about waterpipe(WP) smoking and developmental trajectories of ND criteria across adolescence. Here, we aimed to identify ND trajectories from early to late adolescence in current(past 30 days) WP smokers and examine baseline correlates of each identified trajectory, using the International Classification of Diseases, 10thVersion(ICD10). METHODS The analytical sample consisted of 278 current WP smokers from 8-waves of an ongoing longitudinal cohort of 8 th-9 th-graders in Lebanon. Group-based trajectory modeling was estimated to identify trajectory classes for ICD-10-ND criteria over ages11-18. RESULTS A group-based modeling approach yielded a four-class solution that best fit the data and reflected differences in the timing of ND onset during adolescence:no-onset of ND(43.9%), early(16.2%), mid(26.6%), and late-onset(13.3%) of ND criteria. Having a less-educated mother (adjusted odds ratio[aOR]=4.08, 95%confidence interval:1.01-16.53) and siblings who smoke WP(aOR=3.95:1.08-14.42), exposure to favorite WP-specific advertisements(aOR=3.33:1.03-10.85), and being a novelty seeker(aOR=1.12:1.02-1.23) were associated with early-onset of ND. Daily(aOR=3.48:1.08-11.23) or weekly(aOR=2.20:1.05-4.62) WP smokers (vs. monthly) and having higher stress level (aOR=1.07:1.00-1.14) were associated with mid-onset trajectory. Believing that WP smoking is not harmful to health (aOR=0.11:0.02-0.82) and spending >60 minutes on a WP smoking session(aOR=5.62:1.20-26.44) were associated with late-onset ND trajectory class. CONCLUSIONS Monitoring the development of ND trajectories among WP smokers may identify an individual as belonging to one of these four groups with distinct individual and socio-environmental factors, and allow the individual and healthcare providers opportunities to inform initiate on-time WP-specific tailored prevention and cessation interventions.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 11200 SW 8th St AHC5, 4th Floor, Miami, FL, 33199, USA
| | - Raed Bahelah
- School of Health Sciences, Baldwin Wallace University, Kamm Hall, 191 E Center St, Berea, OH 44017, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, 11200 SW 8th St AHC5, 4th Floor, Miami, FL, 33199, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, 3720 Alumni Ave, Memphis, TN 38152, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, 411 S. Nedderman Drive Box 19407, Arlington, Texas 76019-0407, USA
| | - Malak Tleis
- Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Bliss Street. P.O. Box 11-0236. Beirut, Lebanon. Miami, FL 3313, USA
| | - Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 11200 SW 8th St AHC5, 4th Floor, Miami, FL, 33199, USA
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 11200 SW 8th St AHC5, 4th Floor, Miami, FL, 33199, USA
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21
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Chellappa LR, Balasubramaniam A, Indiran MA, Rathinavelu PK. A qualitative study on attitude towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status. J Family Med Prim Care 2021; 10:1282-1287. [PMID: 34041166 PMCID: PMC8140283 DOI: 10.4103/jfmpc.jfmpc_1628_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/06/2020] [Accepted: 11/24/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Tobacco consumed as smoke and smokeless forms is an important preventable public health issue projected to be the single largest cause of mortality worldwide. The aim of the study was to qualitatively assess the attitudes towards smoking, quitting and tobacco control policies among current smokers of different socio-economic status. MATERIALS AND METHODS An in-depth interview for 10 current smokers and a focus group discussion comprising of 10 current smokers was conducted with a guide and moderator which was audio recorded. About 6, 8 and 6 subjects from white collar, blue collar, and black collar employee status participated in the study. Their tobacco consumption and dependence using the Fagerstrom Test for Nicotine Dependence scale (FTNDS) was assessed. RESULTS About 50% of the participants had low; 30% had moderate and 20% had high nicotine dependency. Most of the participants started smoking by peer influence and continued as it made them to socialize. Relapses during their quit attempt was mainly due to work stress. Participants heard about the control of tobacco act but were unsure of the features in it. They perceived that no changes will happen if government bans production and selling of tobacco products. Also anti-tobacco commercials in social media will have no use. Nicotine replacement therapy may help in quitting the habit. CONCLUSION The study concluded that people in low socio-economic status had high nicotine dependency with inadequate knowledge on tobacco control policies. They strongly believe that an individual's self-restrain only can succeed him in quitting the habit.
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Affiliation(s)
- Lalitha Rani Chellappa
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Management and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai, Tamil Nadu, India
| | - Arthi Balasubramaniam
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Management and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai, Tamil Nadu, India
| | - Meignana Arumugham Indiran
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Management and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai, Tamil Nadu, India
| | - Pradeep Kumar Rathinavelu
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Management and Technical Sciences, Saveetha University, No. 162, Poonamallee High Road, Chennai, Tamil Nadu, India
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Smethells JR, Burroughs D, Saykao A, Pentel PR, Rezvani AH, LeSage MG. The reinforcement threshold and elasticity of demand for nicotine in an adolescent rat model of depression. Drug Alcohol Depend 2021; 219:108433. [PMID: 33310485 PMCID: PMC7855441 DOI: 10.1016/j.drugalcdep.2020.108433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND The Food and Drug Administration (FDA) is considering setting a nicotine standard for tobacco products to reduce their addictiveness. Such a standard should account for the apparent greater vulnerability to nicotine addiction in some subpopulations, such as adolescents with depression. The present study examined whether the reinforcement threshold and elasticity of demand (i.e., reinforcing efficacy) for nicotine in a genetic inbred rat model of depression (Flinders Sensitive Line [FSL]) differs from an outbred control strain. METHODS Acquisition of nicotine self-administration (NSA) across a wide range of nicotine doses was measured in both FSL and Sprague-Dawley (SD) control adolescent rats. At the highest dose, elasticity of demand was also measured. Nicotine pharmacokinetics was examined to determine whether it might modulate NSA, as it does smoking in humans. RESULTS FSL rats acquired self-administration quicker and showed more inelastic demand (greater reinforcing efficacy) than SDs at the highest unit dose. However, there was no strain difference in the reinforcement threshold of nicotine. FSL rats exhibited faster nicotine clearance, larger volume of distribution, and lower plasma and brain nicotine concentrations. However, these differences were not consistently related to strain differences in NSA measures. CONCLUSION These findings are consistent with studies showing greater dependence and reinforcing efficacy of cigarettes in smokers with depression and those with relatively fast nicotine metabolism. However, these findings also suggest that a nicotine standard to reduce initiation of tobacco use should be similarly effective in both the general adolescent population and those with depression.
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Affiliation(s)
- John R. Smethells
- Hennepin Healthcare Research Institute, Minneapolis, MN,Departments of Medicine and Pharmacology, University of Minnesota Medical School, Minneapolis, MN
| | | | - Amy Saykao
- Hennepin Healthcare Research Institute, Minneapolis, MN
| | - Paul R. Pentel
- Hennepin Healthcare Research Institute, Minneapolis, MN,Departments of Medicine and Pharmacology, University of Minnesota Medical School, Minneapolis, MN
| | - Amir H. Rezvani
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
| | - Mark G. LeSage
- Hennepin Healthcare Research Institute, Minneapolis, MN,Departments of Medicine and Pharmacology, University of Minnesota Medical School, Minneapolis, MN,Department of Psychology, University of Minnesota, Minneapolis, MN
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23
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Kalan ME, Behaleh R, DiFranza JR, Bursac Z, Taleb ZB, Tleis M, Asfar T, Nakkash R, Ward KD, Eissenberg T, Maziak W. Natural Course of Nicotine Dependence Among Adolescent Waterpipe and Cigarette Smokers. J Adolesc Health 2020; 67:859-867. [PMID: 32622925 PMCID: PMC7683372 DOI: 10.1016/j.jadohealth.2020.04.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 04/01/2020] [Accepted: 04/27/2020] [Indexed: 12/31/2022]
Abstract
PURPOSE Waterpipe (WP) smoking patterns and setting can result in a unique trajectory of nicotine dependence (ND) compared with cigarette smoking. This longitudinal study compared the development of ND symptoms among adolescent WP and cigarette smokers. METHODS A cohort of 647 eighth and ninth graders in Lebanon were followed over 5 years. This study was based on 283 current exclusive WP and 146 current exclusive cigarette smokers. Kaplan-Meier survival analyses were conducted to evaluate 50% cumulative probability for the development of initial Hooked on Nicotine Checklist symptoms and the International Classification of Diseases, 10th revision (ICD-10) ND. RESULTS An initial Hooked on Nicotine Checklist symptom was endorsed by 59% of WP and 50% of cigarette smokers after smoking onset. Among those, 50% of both WP and cigarette smokers did so within 9.7 and 18.5 months, respectively. Approximately 28% of WP smokers and 22% of cigarette smokers developed ICD-10 ND. Among those, 50% of both WP and cigarette smokers did so within 15 and 22 months, respectively. The most common first to fourth ICD-10 criteria reported by WP smokers were "a strong desire to use tobacco," "difficulties in controlling tobacco taking behavior," "neglect of alternative pleasure," and "use despite harm." The most common first to fourth ICD-10 criteria reported by cigarette smokers were "a strong desire to use tobacco," "difficulties in controlling tobacco taking behavior," "withdrawal," and "tolerance". CONCLUSIONS Compared with adolescent cigarette smokers, initial ND symptoms and ICD-10 ND can develop sooner after starting to smoke and progress more rapidly among adolescent WP smokers. Developing, implementing, and evaluating intervention programs with adolescent WP smokers should be guided by the WP-specific trajectory of ND.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Raed Behaleh
- School of Health Sciences, Baldwin Wallace University, Berea, OH, USA
| | - Joseph R. DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Malak Tleis
- Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA,Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Rima Nakkash
- Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Aleppo, Syria,School of Public Health, University of Memphis, Memphis, TN, USA
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria,Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida; Syrian Center for Tobacco Studies, Aleppo, Syria.
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24
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Ebrahimi Kalan M, Bahelah R, Bursac Z, Ben Taleb Z, DiFranza JR, Tleis M, Nakkash R, Jebai R, Alam MM, Cano MÁ, Sutherland MT, Fenni K, Asfar T, Eissenberg T, Ward KD, Maziak W. Predictors of nicotine dependence among adolescent waterpipe and cigarette smokers: A 6-year longitudinal analysis. Drug Alcohol Depend 2020; 217:108346. [PMID: 33075692 PMCID: PMC7861130 DOI: 10.1016/j.drugalcdep.2020.108346] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/25/2020] [Accepted: 09/29/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Identifying the factors associated with nicotine dependence (ND) is essential to prevent initiation and continued use, and to promote cessation among youth. This study aims to document the predictors of the appearance of initial ND symptoms and full ND syndrome among adolescent waterpipe (WP) and cigarette smokers. METHODS A 6-year longitudinal study was conducted among 8th and 9th graders from 38 schools in Lebanon. The analysis sample included exclusive-WP (n = 228) and exclusive-cigarette smokers (n = 139). Weighted Cox proportional hazards models were used to characterizing predictors of initial ND symptoms and full ND syndrome. RESULTS Predictors of experiencing initial ND symptoms among WP smokers included low maternal educational level, having a sibling who smoked WP, low physical activity, high body mass index (BMI), smoking initiation at a younger age. For cigarette smokers these were being male, younger, having lower BMI, having a sibling who smoked cigarettes, living in a crowded household, and smoking daily. Among WP smokers, predictors of developing full ND syndrome include being younger, believing that WP smokers have more friends, depression, high levels of impulsivity, and initiating smoking at a younger age. For cigarette smokers, predictors of full ND syndrome were being younger and initiating smoking at a younger age. CONCLUSION Smoking cessation and prevention interventions targeting youth should address modifiable, and tobacco use-specific factors that influence the development of ND among young WP and cigarette smokers. They also need to start at a younger age to target those most vulnerable to developing life-long addiction to tobacco products.
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Affiliation(s)
- Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL, 33199, USA.
| | - Raed Bahelah
- School of Health Sciences, Baldwin Wallace University, Kamm Hall, 191 E Center St, Berea, OH 44017, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health, Florida International University, 11200 SW 8th St AHC5, 4th Floor, Miami, FL, 33199, USA
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, 411 S. Nedderman Drive Box 19407, Arlington, Texas 76019-0407, USA
| | - Joseph R DiFranza
- Reliant Medical Group, 225 New Lancaster Rd, Leominster, MA 01453, USA
| | - Malak Tleis
- Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Bliss Street. P.O. Box 11-0236. Beirut, Lebanon
| | - Rima Nakkash
- Health Promotion and Community Health Department, Faculty of Health Sciences, American University of Beirut, Bliss Street. P.O. Box 11-0236. Beirut, Lebanon
| | - Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL, 33199, USA
| | - Mohammad Masudul Alam
- Center for the Study of Tobacco, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W Markham St, Little Rock, AR 72205, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL, 33199, USA
| | - Matthew T Sutherland
- Department of Psychology, Florida International University, 11101 S.W. 13 ST., Miami, FL 33199, USA
| | - Kristopher Fenni
- Division of Natural Sciences, New College of Florida, 5800 Bay Shore Road Sarasota, FL 34243, FL, USA
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 120 NW 14th Street, CRB 919, Miami, FL 3313, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1475 NW 12th Ave, Miami, FL 33136, USA; Syrian Center for Tobacco Studies, Tishreen Street, SheehanAleppo, P.O.Box: 16542, Syria
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Tishreen Street, SheehanAleppo, P.O.Box: 16542, Syria; Center for the Study of Tobacco Products, Department of Psychology, Virginia Commonwealth University, 100 W. Franklin St. Suite 200, Richmond, VA 23220, USA
| | - Kenneth D Ward
- Syrian Center for Tobacco Studies, Tishreen Street, SheehanAleppo, P.O.Box: 16542, Syria; School of Public Health, University of Memphis, 3720 Alumni Ave, Memphis, TN 38152, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, 11200 SW 8thSt AHC5, 4thFloor, Miami, FL, 33199, USA; Syrian Center for Tobacco Studies, Tishreen Street, SheehanAleppo, P.O.Box: 16542, Syria
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25
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Xue W, Lopez-Quintero C, Anthony JC. 'Time to first tobacco cigarette soon after waking' occurs more often among underage newly incident smokers in the United States, 2004-2017. Addict Behav 2020; 111:106535. [PMID: 32712495 DOI: 10.1016/j.addbeh.2020.106535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 11/28/2022]
Abstract
AIMS Time to first cigarette (TTFC) after waking is a highly regarded and readily measured manifestation of a tobacco dependence process. We aim to estimate short TTFC as it occurs very soon after the onset of cigarette smoking (CS) in a community sample of newly incident smokers, all 12-21 years of age, and to study risk variation with the age of CS onset. METHODS United States National Surveys on Drug Use and Health, 2004-2017, drew large nationally representative samples of 12-to-21-year-old community residents, and used computerized self-interviews to measure tobacco cigarette smoking, the Fagerstrom TTFC construct, and related variables. A 'short' TTFC was defined as smoking the first cigarette after waking up within 30 min vs. 'long' TTFC or smoking more than 30 min. We studied 8188 newly incident smokers, all assessed within six months after the first puff. Estimated age-specific cumulative incidence proportions (CIP) and odds ratios (OR) are estimated and compared, with due attention to complex survey design and weights. RESULTS Among underage newly incident smokers (12-17 years old), an estimated 5.2% experienced short TTFC within 6 months after CS onset (95% CI = 4.4%, 6.2%), versus 3.7% for older new smokers (18-21 years; 95% CI = 2.8%, 4.6%). Underage smokers are 1.5 times more likely to develop short TTFC compared to older initiates (95% CI = 1.1, 2.1). No male-female variations are seen, but exploratory analysis disclosed findings that involve Census-defined race-ethnicity subgroups. Non-Hispanic African-American initiates are twice as likely to develop short TTFC, and Hispanic initiates are less likely to develop short TTFC, as compared with non-Hispanic White smokers. CONCLUSIONS Based on US community samples our study offers new evidence about TTFC formation observed within six months after the first puff when cigarette smoking starts before age 18 years.
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Affiliation(s)
- Wei Xue
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA; Department of Biostatistics, University of Florida, Gainesville, FL, USA.
| | | | - James C Anthony
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
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26
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Nicotine Dependence and Loss of Autonomy among Greek Adolescent Smokers: A Countrywide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218191. [PMID: 33167606 PMCID: PMC7664176 DOI: 10.3390/ijerph17218191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 11/26/2022]
Abstract
Nicotine dependence is one of the main reasons for the continuation of smoking among adolescents. Loss of autonomy (LOA) is a measure of dependence. This study is the first to investigate LOA and its determinants among Greek adolescents. In 2013, 13-to-15-year-old middle-school students were selected by multi-stage clustered sampling. LOA was evaluated with the Hooked-on-Nicotine Checklist (HONC). Multiple univariate analysis was used to assess the association between adolescent demographics, smoking habits, and loss of autonomy. Three-hundred thirty-nine current smokers responded to the questionnaire (response rate: 82.3%). Of these respondents, 51.2% were male and 88.8% reported at least one LOA symptom. The mean HONC score was 4.13/10 (95% CI: 3.82–4.45). Higher scores were negatively associated with lower smoking frequency (cumulative odds ratio (cOR): 0.240, 95% CI: 0.144–0.400) and positively associated with lower age at first cigarette (cOR: 2.29, 95% CI: 1.38–3.82). Female gender was significantly associated with the prevalence but not the degree of LOA. Overall, the prevalence and the degree of nicotine dependence among adolescent smokers in Greece is similar to other countries. Frequent smoking and initiation of smoking at a younger age are linked to nicotine dependence, although it was not possible to make causal inferences. The relationship between nicotine dependence and gender remains unclear.
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27
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Alam MM, Ward KD, Bahelah R, Kalan ME, Asfar T, Eissenberg T, Maziak W. The Syrian Center for Tobacco Studies-13 (SCTS-13): Psychometric evaluation of a waterpipe-specific nicotine dependence instrument. Drug Alcohol Depend 2020; 215:108192. [PMID: 32738447 PMCID: PMC7860966 DOI: 10.1016/j.drugalcdep.2020.108192] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/14/2020] [Accepted: 07/09/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Waterpipe tobacco smoking (WTS) has surged globally among young people and causes nicotine dependence (ND). No existing ND instruments are sensitive to waterpipe-specific features of ND and early stages of use. METHODS We conducted a psychometric scale evaluation among 192 current waterpipe smokers, initially averaging 15 years of age, recruited from schools in Beirut, Lebanon, and assessed 4 times, 6 months apart. Twenty eight self-report items tapping multiple features of ND were submitted to exploratory and confirmatory factor analyses (EFA and CFA) to reduce items and verify factor structure. Convergent validity was assessed with the Lebanese Waterpipe Dependence Scale and the Hooked on Nicotine Checklist, and discriminant validity with the Depressive Symptom Scale and Adolescent Life Events Stress Scale. Concurrent and predictive validity measures included smoking status and intensity (amount, frequency, session duration, and change in frequency), quitting interest and success, perceived addiction, and smoking alone. RESULTS The EFA yielded a single factor, 13 item solution (named the Syrian Center for Tobacco Studies [SCTS]-13) that explained 91% of variance in responses, was internally consistent (Cronbach's alpha and McDonald's omega = 0.87), and captured several positive reinforcement, negative reinforcement, and social/sensory-related features of ND. The CFA indicated good model fit. The SCTS-13 showed acceptable convergent and discriminant validity. Higher SCTS-13 scores predicted current waterpipe and dual (waterpipe and cigarette) smoking, greater intensity of use, less interest in quitting, shorter duration of abstinence, greater perceived addiction, and smoking alone (vs. socially). CONCLUSION The SCTS-13 is a promising brief, waterpipe-specific ND instrument.
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Affiliation(s)
- Mohammad Masudul Alam
- Center for the Study of Tobacco, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kenneth D Ward
- School of Public Health, University of Memphis, Memphis, TN, United States; Syrian Center for Tobacco Studies, Aleppo, Syria.
| | - Raed Bahelah
- Department of Public Health & Prevention Science, School of Health Sciences, Baldwin Wallace University, Berea, OH, United States
| | - Mohammad Ebrahmi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Public Health Sciences, University of Miami Miller School of Medicine, and Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Thomas Eissenberg
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Psychology and Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA, United States
| | - Wasim Maziak
- Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
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Hamidullah S, Thorpe HHA, Frie JA, Mccurdy RD, Khokhar JY. Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates. Front Hum Neurosci 2020; 14:298. [PMID: 32848673 PMCID: PMC7418456 DOI: 10.3389/fnhum.2020.00298] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 07/03/2020] [Indexed: 12/11/2022] Open
Abstract
Adolescence is an important ontogenetic period that is characterized by behaviors such as enhanced novelty-seeking, impulsivity, and reward preference, which can give rise to an increased risk for substance use. While substance use rates in adolescence are generally on a decline, the current rates combined with emerging trends, such as increases in e-cigarette use, remain a significant public health concern. In this review, we focus on the neurobiological divergences associated with adolescent substance use, derived from a cross-sectional, retrospective, and longitudinal studies, and highlight how the use of these substances during adolescence may relate to behavioral and neuroimaging-based outcomes. Identifying and understanding the associations between adolescent substance use and changes in cognition, mental health, and future substance use risk may assist our understanding of the consequences of drug exposure during this critical window.
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Affiliation(s)
| | - Hayley H A Thorpe
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jude A Frie
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Richard D Mccurdy
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
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Osibogun O, Bursac Z, Mckee M, Li T, Maziak W. Cessation outcomes in adult dual users of e-cigarettes and cigarettes: the Population Assessment of Tobacco and Health cohort study, USA, 2013-2016. Int J Public Health 2020; 65:923-936. [PMID: 32710136 PMCID: PMC7429273 DOI: 10.1007/s00038-020-01436-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/03/2020] [Accepted: 07/13/2020] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVES We examined the transitions of adult dual e-cigarette/cigarette users in the USA in relation to nicotine dependence (ND) symptoms, interest in quitting, and history of cardiovascular disease (CVD). METHODS We used the Population Assessment of Tobacco and Health study Waves 1 and 3 (2013-2016) in a longitudinal analysis of adults (≥ 18 years). Dual past-month users of e-cigarettes/cigarettes were identified from Wave 1 and followed for tobacco use transitions 2 years later (Wave 3). RESULTS Among 1870 adult dual users at Wave 1, 25.7% (95% CI 23.5-28.2) were dual users 2 years later, 12.1% (95% CI 10.6-13.7) reported no past-month tobacco use, 7.0% (95% CI 5.6-8.9) e-cigarette mono-use, and 55.2% (95% CI 52.4-58.0) cigarette mono-use. In the regression analysis, greater ND severity was associated with decreased relative risk of no past-month tobacco use (RRR 0.29; 95% CI 0.12-0.71). Interest in quitting and CVD factors were not associated with no past-month tobacco or e-cigarette mono-use. CONCLUSIONS Dual users who are nicotine dependent are less likely to transition to cessation. To quit cigarette use, other cessation resources may be necessary to support the needs of cigarette smokers who use e-cigarettes, particularly those at risk of continuing cigarette smoking or those with smoking-related illnesses.
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Affiliation(s)
- Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA.
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Martin Mckee
- London School of Hygiene and Tropical Medicine, London, UK
| | - Tan Li
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, 33199, USA.
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Tobacco Retailers Near Schools and the Violations of Tobacco Retailing Laws in Thailand. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:537-542. [PMID: 30148748 PMCID: PMC7329131 DOI: 10.1097/phh.0000000000000880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A growing body of evidence indicates that the location of tobacco retailers may influence tobacco access among youths.
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31
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Thermal and chemical burns caused by e-cigarette battery explosions. ANN CHIR PLAST ESTH 2020; 65:24-30. [DOI: 10.1016/j.anplas.2019.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/05/2019] [Indexed: 12/23/2022]
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32
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Khan Z, Suliankatchi RA, Heise TL, Dreger S. Naswar (Smokeless Tobacco) Use and the Risk of Oral Cancer in Pakistan: A Systematic Review With Meta-Analysis. Nicotine Tob Res 2020; 21:32-40. [PMID: 29294113 DOI: 10.1093/ntr/ntx281] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 12/23/2017] [Indexed: 11/12/2022]
Abstract
Introduction With an annual increase of 16000 new cases each year, oral cancer is the second most common cancer in Pakistan. There is conflicting evidence regarding the carcinogenicity of different forms of smokeless tobacco (SLT) from different countries. This difference in evidence may be attributed to the varied composition of SLT products used around the world, necessitating the establishment of individual risks related to each SLT product. Methods An electronic search in relevant databases yielded 119 publications, out of which six were included in this review. Effect estimates (odds ratios (ORs)) were abstracted or calculated from the given data. A fixed effects meta-analysis was performed to assess the risk of oral cancer with the use of Naswar. Population attributable fractions (PAF) were also calculated. Results The Meta Odds Ratio (mOR) for oral cancer associated with the "ever use" of Naswar compared to "never use" was 11.8 (95% CI = 8.4-16.4), I2 = 67%. The pooled estimate for oral cancer in "Ever-users" of Naswar compared to "Never-users," in the Khyber Pakhtunkhwa province was 18.3 (95% CI = 8.7-38.5), I2 = 0%. The PAF for oral cancer associated with the use of Naswar in Pakistan was 44% (95% CI = 35-53). Discussion This review highlights a strong relationship between oral cancer incidence and the use of Naswar in Pakistan and adds to the evidence base on the carcinogenicity of SLT products in humans. Although the synthesized evidence may not be of a high quality, it represents the "best available evidence" which can be used to inform policy. Implications The carcinogenicity of Naswar, a form of smokeless tobacco used extensively in Pakistan, Afghanistan, and Central Asia, has yet to be recognized by the International Agency for Research on Cancer (IARC), partly due to the lack of evidence on the association of Naswar use and cancer. Additionally, Naswar is yet un-regulated in Pakistan and evades the tax net, resulting in it being freely available to both adults and children at very cheap prices compared to cigarettes, which has been the main focus of tobacco control in Pakistan. This review provides ample evidence for the IARC to declare Naswar as carcinogenic, as well as the Government of Pakistan to regulate the production and sale of Naswar.
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Affiliation(s)
| | | | - Thomas L Heise
- Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany.,Faculty of Human and Health Sciences, Universitaet Bremen, Germany
| | - Steffen Dreger
- Leibniz Institute for Prevention Research and Epidemiology (BIPS), Bremen, Germany
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Mirtavoos-Mahyari H, Ghadami M, Khosravi A, Esfahani-Monfared Z, Seifi S, Motevaseli E, Pourabdollah M, Modarressi M. Cell Free Tumoral DNA Versus Paraffin Block Epidermal Growth Factor Receptor Mutation Detection in Patients with Non-Small Cell Lung Cancer. Asian Pac J Cancer Prev 2019; 20:3591-3596. [PMID: 31870098 PMCID: PMC7173361 DOI: 10.31557/apjcp.2019.20.12.3591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 11/09/2019] [Indexed: 01/03/2023] Open
Abstract
Increasing knowledge about the molecular profile of tumors has led to personalized treatment for achieving better outcomes in patients with nonsmall cell lung cancer (NSCLC). Currently, finding exact somatic genomic changes of tumor has gained great importance. On the other hand, crescendoing needs to actual tumor tissue at different time points during cancer treatment may produce major discomfort for NSCLC patients. Tumor genomes can be reconstructed by information obtained from circulating cell-free deoxyribonucleic acid (cfDNA) of peripheral blood. cfDNA may be represented as a suitable alternative test for epidermal growth factor receptor (EGFR) mutation detection in these patients. This study aimed to assess validity of cfDNA in somatic EGFR mutation identification in Iranian NSCLC cases. METHODS Somatic mutation of EGFR gene was studied in both tissue specimens and plasma. Then, mutations were detected by polymerase chain reaction(PCR) and sequencing. RESULTS We observed a high concordance (90%) between tissue samples and cfDNA for EGFR gene mutation. The sensitivity, accuracy, and positive precision value were 90%, 90% and 100%, respectively. A false negative rate of 10% was also demonstrated in this study. CONCLUSION We established sensitive methods for detecting EGFR gene mutation which may be very useful in clinical practice. .
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Affiliation(s)
| | - Mohsen Ghadami
- Department of Medical Genetics, Faculty of Medicine, Tehran University of Medical Sciences,
| | | | - Zahra Esfahani-Monfared
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences,
| | - Sharareh Seifi
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences,
| | - Elaheh Motevaseli
- Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran. Iran.
| | - Mihan Pourabdollah
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences,
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Evans DS, O'Farrell A, Sheridan A, Kavanagh P. Comparison of the health and well-being of smoking and non-smoking school-aged children in Ireland. Child Care Health Dev 2019; 45:694-701. [PMID: 31039602 DOI: 10.1111/cch.12681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although most young people are aware of the long-term consequences of smoking, it has been shown that young smokers expect to give up before any health damage occurs. Little is known in an Irish context about the association between smoking and young people's current health. This could be helpful to help reduce smoking initiation and encouraging quitting. The study aimed to determine the association between smoking and health and well-being indicators among Irish school-aged children. METHODS The 2014 Irish Health Behaviour in School-aged Children study was analysed, which comprised a random stratified sample of 9,623 schoolchildren (aged 10-18). The prevalence of eight self-reported health complaints and two subjective well-being measures were compared across strata classified by self-reported smoking status using Pearson's chi square and independent t tests. Logistic regression and ordinal regression were used to control for age, gender, and social class. RESULTS A significantly larger proportion of smokers (p < .001) reported fair to poor health (32% versus 11% for non-smokers), lower mean life satisfaction scores (6.2 compared with 7.5), and each of eight health complaints at least once a week (range = 25-50% compared with 15-21%). These patterns remained significant after adjusting for differences in age, gender, and social class profile (p < .001). CONCLUSIONS The study demonstrates the potential of developing initiatives, which target smoking in adolescence as opposed to the longer term health effects of smoking which are well known. The findings can be utilized to counteract positive perceptions of smoking among schoolchildren. This, combined with providing supports to help children quit, may help achieve government targets to reduce smoking prevalence.
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Affiliation(s)
- David S Evans
- Merlin Park Hospital, Department of Public Health, Health Service Executive West, Galway, Republic of Ireland
| | - Anne O'Farrell
- Health Intelligence Unit, Strategic Planning and Transformation, Research and Development, Health Service Executive, Dublin, Republic of Ireland
| | - Aishling Sheridan
- Tobacco Free Ireland Programme, Health Service Executive, Navan, Republic of Ireland
| | - Paul Kavanagh
- Tobacco Free Ireland Programme, Health Service Executive, Dublin, Republic of Ireland
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Selya AS, Ivanov O, Bachman A, Wheat D. Youth smoking and anti-smoking policies in North Dakota: a system dynamics simulation study. Subst Abuse Treat Prev Policy 2019; 14:34. [PMID: 31429769 PMCID: PMC6701071 DOI: 10.1186/s13011-019-0219-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 08/06/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current study utilizes system dynamics to model the determinants of youth smoking and simulate effects of anti-smoking policies in the context of North Dakota, a state with one of the lowest cigarette tax rates in the USA. METHODS An explanatory model was built to replicate historical trends in the youth smoking rate. Three different policies were simulated: 1) an increase in cigarette excise taxes; 2) increased funding for CDC-recommended comprehensive tobacco control programs; and 3) enforcement of increased retailer compliance with age restrictions on cigarette sales. RESULTS The explanatory model successfully replicated historical trends in adolescent smoking behavior in North Dakota from 1992 to 2014. The policy model showed that increasing taxes to $2.20 per pack starting in 2015 was the most effective of the three policies, producing a 32.6% reduction in youth smoking rate by 2032. Other policies reduced smoking by a much lesser degree (7.0 and 3.2% for comprehensive tobacco control program funding and retailer compliance, respectively). The effects of each policy were additive. CONCLUSIONS System dynamics modeling suggests that increasing cigarette excise taxes are particularly effective at reducing adolescent smoking rates. More generally, system dynamics offers an important complement to conventional analysis of observational data.
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Affiliation(s)
- Arielle S Selya
- Department of Population Health, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA.
- Behavioral Sciences Group, Sanford Research, Sioux Falls, SD, USA.
- Department of Pediatrics, University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA.
| | - Oleksandr Ivanov
- System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway
| | - Abigail Bachman
- Department of Population Health, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA
- Research Department, Altru Health System, Grand Forks, ND, USA
| | - David Wheat
- System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway
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Hinds JT, Li X, Loukas A, Pasch KE, Perry CL. Flavored Cigars Appeal to Younger, Female, and Racial/Ethnic Minority College Students. Nicotine Tob Res 2019; 20:347-354. [PMID: 28199700 DOI: 10.1093/ntr/ntx041] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 02/06/2017] [Indexed: 11/12/2022]
Abstract
Introduction This study examined the association of sociodemographic characteristics, tobacco and substance use behaviors, and reasons to use cigars in young adults' flavored and non-flavored cigar use. Methods Participants were 523, 18- to 29- year-old young adult college students (60.4% male; 40.9% non-Hispanic white) who reported current (past 30-day) cigar use. Results Almost 75% of the sample regularly chose flavored cigar products. Multilevel logistic regression analyses indicated that younger, female, and racial/ethnic minority cigar users had significantly greater odds of using flavored cigars than their counterparts. Current marijuana smokers, ever-blunt smokers, and students who reported using cigars because they were affordable and/or available in flavors they liked had a greater odds of flavored cigar use compared to their counterparts. Moreover, among dual users of cigars and cigarettes, those who cited using cigars because they were cheaper than cigarettes and because cigars felt like smoking regular cigarettes had greater odds of using flavored cigars compared to their peers. Number of days cigars were smoked and current use of other tobacco products were not associated with flavored cigar use. Conclusions Appealing attributes of flavored cigars have the potential to contribute to the tobacco use and subsequent nicotine addiction of younger, female, and racial/ethnic minority young adults. The wide variety of cigar flavors, their attractive price, and similarity to cigarette smoking underscore the need for additional research that links these unique traits to sustained tobacco use, and underscore the need for regulation of flavored products. Implications This study extends the current literature by finding that younger, female, and racial/ethnic minorities have greater odds of flavored cigar use than their peers. Flavored cigars have characteristics that appeal to members of these populations, which can contribute to their long-term use and potential for addiction.
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Affiliation(s)
- Josephine T Hinds
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX
| | - Xiaoyin Li
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX
| | - Alexandra Loukas
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX
| | - Keryn E Pasch
- Department of Kinesiology and Health Education, University of Texas at Austin, Austin, TX
| | - Cheryl L Perry
- The Michael and Susan Dell Center for Healthy Living, UTHealth School of Public Health, Austin, TX
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Creamer M, Case K, Loukas A, Cooper M, Perry CL. Patterns of sustained e-cigarette use in a sample of young adults. Addict Behav 2019; 92:28-31. [PMID: 30579114 DOI: 10.1016/j.addbeh.2018.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/06/2018] [Accepted: 12/07/2018] [Indexed: 01/23/2023]
Abstract
INTRODUCTION E-cigarette use and devices are rapidly changing, yet there is not much scientific evidence examining these changes over time. The purpose of this study is to describe patterns of e-cigarette use in a sample of sustained (i.e., reporting past 30-day e-cigarette use at every wave) e-cigarette users over a two-year period. METHODS Data are drawn from five waves of the Project M-PACT cohort. Analyses are limited to those reporting past 30-day e-cigarette use at each wave (n = 75). Mixed effects regressions were conducted for the following dependent variables: device type, number of days used, combustible tobacco product use, and symptoms of nicotine dependence. Each model used survey wave as the time variable, and controlled for sociodemographic variables. RESULTS Among sustained users, the majority reported using a rechargeable device. The average number of days used was about 2 for disposable devices and 14 for rechargeable devices (p < .0001). The odds of combustible tobacco product use decreased over time (AOR = 0.71; 95% CI 0.57-0.89), while symptoms of e-cigarette nicotine dependence increased over time (β = 0.07 SE = 0.03, p-value = .02). For both e-cigarette device types, there were no changes in device type or number of days used over time. CONCLUSION This is one of the first studies to look at changes in e-cigarette use, including symptoms of dependence and number of days used over a two-year period. This brief report extends the current literature by examining more than the prevalence and frequency of e-cigarette use.
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Chapman S, Bareham D, Maziak W. The Gateway Effect of E-cigarettes: Reflections on Main Criticisms. Nicotine Tob Res 2019; 21:695-698. [PMID: 29660054 PMCID: PMC6468127 DOI: 10.1093/ntr/nty067] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 04/04/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Simon Chapman
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - David Bareham
- Lincolnshire Community Health Services NHS Trust, Louth County Hospital, Louth, United Kingdom
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL
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Elharrar X, Fortin M, Beguinot E, Dols AM, Greillier L, Martinet Y. [Prohibition of tobacco sales to minors in France and Quebec. Comparison of legislative frameworks, their enforcement, and underage smoking]. Rev Epidemiol Sante Publique 2019; 67:181-187. [PMID: 30954324 DOI: 10.1016/j.respe.2019.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/31/2019] [Accepted: 02/13/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Prohibition of tobacco sales to minors is a provision of the World Health Organization Framework Convention on tobacco control. This measure is effective to reduce youth tobacco use, if the legislation adopted is properly implemented and enforced. Through the examples of France and Quebec, the objective of this study is to compare legislative frameworks prohibiting tobacco sales to minors, their enforcement, and possible impact on underage smoking. METHODS Identification of legislative instruments, reports from public health authorities, and articles addressing the focused question was performed trough Medline and Google. RESULTS Selling tobacco products to minors under 18 years of age has been banned by the law since 1998 in Quebec and 2009 in France. In 2011, in France for individuals aged 17, compliance with the law was 15%. In 2017 in France, 94% of 17-year-old daily smokers regularly bought their cigarettes in a tobacco store. Law enforcement controls and sanctions are non-existent. In 2013 in Quebec, 23% of underage smoking students usually bought their own cigarettes in a business. The compliance rate with the prohibition law rose from 37% in 2003 to 92.6% in 2017. An approach of underage "mystery shoppers" attempting to purchase tobacco products and dedicated inspectors has been implemented, and progressive sanctions are applied in case of non-compliance. In 2013, 12.2% of Quebec high school students and, in 2017, 34.1% of French 17 year olds reported using tobacco products in the last 30 days. CONCLUSION Only an improved law enforcement, through the training of tobacco retailer's, inspections and effective deterrent penalties for non-compliance, leads to an effective legislative measure in terms of public health.
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Affiliation(s)
- X Elharrar
- Service des maladies respiratoires, centre hospitalier d'Aix-en-Provence, avenue des Tamaris, 13616 Aix-en-Provence, France; Comité national contre le tabagisme, 75002 Paris, France.
| | - M Fortin
- Institut universitaire de cardiologie et de pneumologie de Québec, G1V 4G5 Québec, Canada
| | - E Beguinot
- Comité national contre le tabagisme, 75002 Paris, France
| | - A M Dols
- Pôle santé publique, CHU Grenoble-Alpes, 38043 Grenoble, France
| | - L Greillier
- Oncologie multidisciplinaire et innovations thérapeutiques, université Aix-Marseille, AP-HM, 13015 Marseille, France
| | - Y Martinet
- Comité national contre le tabagisme, 75002 Paris, France; Unité de coordination de tabacologie du CHRU de Nancy et université de Lorraine, 54500 Vandoeuvre Lès Nancy, France
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Hong H, McConnell R, Liu F, Urman R, Barrington-Trimis JL. The impact of local regulation on reasons for electronic cigarette use among Southern California young adults. Addict Behav 2019; 91:253-258. [PMID: 30503511 DOI: 10.1016/j.addbeh.2018.11.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 11/14/2018] [Accepted: 11/15/2018] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Tobacco control policies have decreased tobacco use among youth and young adults. We aimed to identify whether specific local tobacco retail licensing ordinances were associated with reasons for e-cigarette use, in order to examine whether strong local policies may reduce e-cigarette initiation rates by influencing the appeal of these products. METHODS Online questionnaires were completed by Southern California Children's Health Study participants in 2015-2016 (mean age = 18.9 years). Those who had ever used an e-cigarette (N = 614) were asked about reasons for use; additional data were collected on local jurisdiction tobacco sales policy, friends' attitudes toward e-cigarette use, e-cigarette characteristics (level of nicotine, flavorings), and history of tobacco use. Multivariate logistic regression models evaluated associations of each factor with reasons for e-cigarette use, adjusting for gender, ethnicity, highest parental education, tobacco use history and with a random effect of jurisdiction. RESULTS The top reason for e-cigarette use was "They come in flavors I like" (56.6%). Using e-cigarettes to quit smoking was uncommon (12.8%). Participants in jurisdictions with weaker tobacco retail licensing ordinances were more likely to report use of e-cigarettes because they are less harmful than cigarettes (50.1% vs. 36.2%), more acceptable to non-tobacco users (38% vs. 25%), and because they can use e-cigarettes in places where smoking is prohibited (30.7% vs. 18.3%; all p < .05). CONCLUSION Targeted policy to enforce a strong regulatory environment that denormalizes e-cigarette use, conveys the adverse impact of e-cigarettes, and restricts use in public places may reduce e-cigarette use among adolescents and young adults.
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INTARUT N, SANGTHONG R, CHONGSUVIVATWONG V. Smoking Trends among Thailand's Youths from 1996-2015: An Age-Period-Cohort Analysis of National Health Surveys. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:429-434. [PMID: 31223569 PMCID: PMC6570795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to investigate secular trends of smoking among Thailand's youths. METHODS We combined 8 datasets from national representative surveys between 1996 and 2015. Multi-stage cluster sampling was applied in all studies. Overall, 231459 participants aged 11-26 yr were included and analyzed. Participants were classified as current smokers if they responded "yes" to the question "Do you currently smoke?", and former smoker if they reported no current smoking but had smoked previously. Age-period-cohort (APC) models were used to estimate age, period, and cohort effects on smoking for investigating secular trend of smoking. RESULTS The prevalence of smoking tended to decrease over time. Among those aged 11-14, the prevalence of current and former smoking was low but not negligible. Rates of underage smoking remained quite steady, around 3.8% in 1996 and 3.6% in 2015. The results of the APC model show that the prevalence of smoking among young male cohorts was lower than in older cohorts. CONCLUSION Thailand's tobacco control program has been effective in deterring youths from smoking. The prevalence of smoking in this population needs to be reduced further though, something achieved by reorienting tobacco consumption prevention campaigns towards this age group.
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Affiliation(s)
- Nirun INTARUT
- Faculty of Medicine, Mahasarakham University, Muang, Mahasarakham, Thailand, Clinical Epidemiology Unit, Faculty of Medicine, Mahasarakham University, Muang, Mahasrakham, Thailand,Corresponding Author:
| | - Rassamee SANGTHONG
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
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Komiyama M, Takahashi Y, Tateno H, Mori M, Nagayoshi N, Yonehara H, Nakasa N, Haruki Y, Hasegawa K. Support for Patients Who Have Difficulty Quitting Smoking: A Review. Intern Med 2019; 58:317-320. [PMID: 30210111 PMCID: PMC6395133 DOI: 10.2169/internalmedicine.1111-18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Smoking cessation plays a crucial role in reducing preventable morbidity and mortality. However, some smokers find smoking cessation difficult, despite receiving treatment. This includes heavy smokers with chronic obstructive pulmonary disease, smokers with a psychiatric disorder, and female and underage smokers. This review article describes smoking cessation approaches for patients who find it difficult to quit smoking.
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Affiliation(s)
- Maki Komiyama
- Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
| | - Yuko Takahashi
- Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
| | - Hiroki Tateno
- Department of Internal Medicine, Saitama City Hospital, Japan
| | - Masahiro Mori
- Department of Surgery, National Hospital Organization Chiba Medical Center, Japan
| | | | | | - Naoko Nakasa
- Health Support Center, Matsue Memorial Hospital, Japan
| | - Yuko Haruki
- Health Support Center, Matsue Memorial Hospital, Japan
| | - Koji Hasegawa
- Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
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Longitudinal association between tobacco use and the onset of depressive symptoms among Swedish adolescents: the Kupol cohort study. Eur Child Adolesc Psychiatry 2019; 28:695-704. [PMID: 30315361 PMCID: PMC6514114 DOI: 10.1007/s00787-018-1237-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 10/08/2018] [Indexed: 11/08/2022]
Abstract
Tobacco use in adolescence has been linked to the onset of depressive symptoms, but results of previous studies are inconsistent. The aim of this study was to clarify if tobacco use during early adolescence may affect the short-term onset of depressive symptoms. The study is based on Swedish Kupol study (3959 students). Current cigarette smoking, snus use, and tobacco dependence were assessed using questionnaires at baseline and 1-year follow-up. Outcome was the onset of depressive symptoms measured with the CES-DC scale, using a cut-off ≥ 30 as threshold. Adjusted linear and logistic regression models were employed to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI). CES-DC mean score at baseline was 14.3, higher in females than males (17.5 vs 10.9). The incidence of depressive symptoms at follow-up was 8.3%, greater in current than never smokers at baseline (13.7% vs 3.1%). Current cigarette smoking at the age of 13 years was strongly associated with the onset of depressive symptoms 1 year later, particularly in males (OR 12.7, 95% CI: 2.5-63.9), with a significant interaction between tobacco use and sex; feeling dependent on tobacco was also associated with depressive symptoms in males but not in females. Snus and overall tobacco use were not associated with the onset of depressive symptoms. Tobacco use during adolescence appears to influence the onset of depressive symptoms, with a stronger association in males than females. Pubertal maturation and sex-specific response patterns to the scale instrument may explain the moderating effect of sex.
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Kalkhoran S, Benowitz NL, Rigotti NA. Reprint of: Prevention and Treatment of Tobacco Use. J Am Coll Cardiol 2018; 72:2964-2979. [DOI: 10.1016/j.jacc.2018.10.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 02/06/2023]
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Khosravi A, Salimi B, Esfahani-Monfared Z, Seifi S, Mirtavoos-Mahyari H. A Phase IV Efficacy Study of Formeta Plus Carboplatin as First-Line Treatment of Advanced Non-Squamous, Non-Small
Cell Lung Cancer in Iran: An Affordable Price with Clinical Benefit. Asian Pac J Cancer Prev 2018; 19:2973-2978. [PMID: 30362335 PMCID: PMC6291026 DOI: 10.22034/apjcp.2018.19.10.2973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: This study performed to assess the efficacy and safety of Formeta (generic form of Pemetrexed) plus Carboplatin as first-line chemotherapy in advanced stage, non- squamous, non small cell lung cancer (NSCLC) in Iran. Methods: This was a post marketing single-arm phase IV efficacy study of Formeta (manufactured by Oncomed., Czech Republic) and Carboplatin in chemo-naive advanced non-squamous NSCLC Iranian patients. Patients received up to six cycles of Formeta (500 mg/m2) combined with Carboplatin (area under the curve: AUC 5) every 3 weeks. The primary endpoint was the progression free survival (PFS) and secondary endpoints were safety and overall survival (OS). Results: Fifty-two patients were enrolled between June 2014 to January 2016, and 44 patients were evaluable for both safety and efficacy. Partial and complete responses were achieved in 19 (36.5 %) and 2 (3.8%) patients, respectively as well as stable disease in 8 patients (15.3 %). Median of PFS and OS were 7.9 ± 1.1 months and 12.43±0.6 months, respectively. Anemia was the most prevalent adverse events of this regimen. Grades 3 or 4 of adverse events were not observed in any patients. Non-hematologic and other grades of hematologic toxicities were generally mild, and there were no treatment-related deaths. Conclusion: The combination of Formeta and Carboplatin was effective in advanced non-squamous NSCLC and can be a suitable candidate as first-line treatment in these patient’s population.
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Affiliation(s)
- Adnan Khosravi
- Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Kalkhoran S, Benowitz NL, Rigotti NA. Prevention and Treatment of Tobacco Use: JACC Health Promotion Series. J Am Coll Cardiol 2018; 72:1030-1045. [PMID: 30139432 PMCID: PMC6261256 DOI: 10.1016/j.jacc.2018.06.036] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/22/2018] [Accepted: 06/24/2018] [Indexed: 01/07/2023]
Abstract
Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among youth and smoking cessation among established smokers are key for reducing smoking prevalence and the associated negative health consequences. Proven tobacco cessation treatment includes pharmacotherapy and behavioral support, which are most effective when provided together. First-line medications (varenicline, bupropion, and nicotine replacement) are effective and safe for patients with CVD. Clinicians who care for patients with CVD should give as high a priority to treating tobacco use as to managing other CVD risk factors. Broader tobacco control efforts to raise tobacco taxes, adopt smoke-free laws, conduct mass media campaigns, and restrict tobacco marketing enhance clinicians' actions working with individual smokers.
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Affiliation(s)
- Sara Kalkhoran
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts.
| | - Neal L Benowitz
- Division of Clinical Pharmacology and Experimental Therapeutics, Departments of Medicine and Bioengineering & Therapeutic Sciences, University of California, San Francisco, California
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts.
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Ashare RL, Wetherill RR. The Intersection of Sex Differences, Tobacco Use, and Inflammation: Implications for Psychiatric Disorders. Curr Psychiatry Rep 2018; 20:75. [PMID: 30094593 PMCID: PMC7018440 DOI: 10.1007/s11920-018-0946-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Tobacco use, sex differences, and psychiatric disorders are associated with altered immune function. There are also sex differences in tobacco use and psychiatric disorders. This review summarizes findings from the small, but growing literature examining sex differences in the effects of tobacco use on inflammation and the implications for psychiatric disorders. RECENT FINDINGS We identified four studies that tested the interaction between sex and tobacco/nicotine on inflammation. Although males and females generally exhibited differential tobacco-induced immune responses, the pattern varied depending on the sample (rodents vs. humans) and the method to evaluate inflammation. Evidence suggests that sex modulates the effects of tobacco smoke on inflammation. Many inflammation markers associated with sex differences and tobacco use are related to psychiatric disorders. We propose a model in which sex, tobacco use, and inflammation interact to increase risk for psychiatric disorders. Future studies are needed to examine the mechanisms that explain this relationship.
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Affiliation(s)
- Rebecca L. Ashare
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA
| | - Reagan R. Wetherill
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA
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Sylvestre MP, Chagnon M, Wellman RJ, Dugas EN, O’Loughlin J. Sex Differences in Attaining Cigarette Smoking and Nicotine Dependence Milestones Among Novice Smokers. Am J Epidemiol 2018. [PMID: 29522067 DOI: 10.1093/aje/kwy045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
There may be sex differences in the response to nicotine, according to findings of studies in animals; however, sex differences in the natural course of cigarette smoking and nicotine dependence are documented in few studies. Prevalent (n = 240 girls; n = 184 boys) and incident (n = 231 girls; n = 184 boys) cigarette smokers from the Nicotine Dependence in Teens Study were followed up to 5 years after first puff, from age 12 to 18 years (1999-2005). We used Cox proportional hazards models to compare time to development of 3 cigarette-use (i.e., whole cigarette; 100 cigarettes lifetime; regular smoking), and 3 nicotine-dependence symptom (i.e., "really need a cigarette"; mentally addicted; physically addicted) milestones across sex. Girls were at higher risk than boys of attaining all milestones; hazard ratios (95% confidence intervals) ranged from 1.35 (1.06, 1.72) for 100 cigarettes lifetime to 1.74 (1.44, 2.10) for "really need a cigarette." Among nonregular smokers, 26% (8%; 43%) and 25% (6%; 44%) more girls than boys reported "really need a cigarette" 1 and 2 years, respectively, after first puff. Preventive interventions may need adjustment to incorporate these findings. Additional research should clarify the relative contribution of biological and social underpinnings of these sex differences.
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Affiliation(s)
- Marie-Pierre Sylvestre
- Centre de recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada
| | - Miguel Chagnon
- Centre de recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada
| | - Robert J Wellman
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Erika N Dugas
- Centre de recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Jennifer O’Loughlin
- Centre de recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montréal, Montréal, Quebec, Canada
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Põld M, Pärna K. Factors associated with desire to quit smoking among Estonian physicians: Cross-sectional data of 2002 and 2014. Tob Prev Cessat 2018; 4:29. [PMID: 32411855 PMCID: PMC7205111 DOI: 10.18332/tpc/93009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 06/29/2018] [Accepted: 07/04/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Smoking is a major health threat and quitting smoking would be a notable benefit. The aim of the present study was to explore factors associated with desire to quit smoking among Estonian physicians in 2002 and 2014. METHODS Self-reported data of current smokers were drawn from Estonian physicians' cross-sectional postal surveys in 2002 (n=322) and 2014 (n=189). A logistic regression model was used to analyse the association between desire to quit smoking and factors related to smoking behaviour among 'current smokers'. RESULTS The prevalence of desire to quit smoking among physicians was 55.3% in 2002 and 52.9% in 2014. Physicians who were concerned about harms of smoking, had higher odds for desire to quit compared with those who were not concerned (OR=9.06; 95% CI: 4.15-19.74). Compared to physicians with no quit attempts, odds for desire to give up smoking were significantly higher among physicians with quit attempts. Wish to set a good example was significantly associated with desire to quit (OR=2.38; 95% CI: 1.12-5.09). Compared to specialist doctors, dentists had higher odds for desire to quit smoking (OR=2.42; 95% CI: 1.25-4.69). CONCLUSIONS More than half of Estonian smoking physicians expressed the desire to quit. Desire to quit was associated with concern about harms of smoking, number of previous quit attempts, setting a good example, and medical specialty. The findings suggest that there is a need for smoking cessation counselling services that are addressed, especially for physicians in Estonia.
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LeSage MG, Smethells JR, Harris AC. Status and Future Directions of Preclinical Behavioral Pharmacology in Tobacco Regulatory Science. ACTA ACUST UNITED AC 2018; 18:252-274. [PMID: 30214916 DOI: 10.1037/bar0000113] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Behavioral pharmacology is a branch of the experimental analysis of behavior that has had great influence in drug addiction research and policy. This paper provides an overview of recent behavioral pharmacology research in the field of tobacco regulatory science, which provides the scientific foundation for the Food and Drug Administration Center for Tobacco Products (FDA CTP) to set tobacco control policies. The rationale and aims of tobacco regulatory science are provided, including the types of preclinical operant behavioral models it deems important for assessing the abuse liability of tobacco products and their constituents. We then review literature relevant to key regulatory actions being considered by the FDA CTP, including regulations over nicotine and menthol content of cigarettes, and conclude with suggesting some directions for future research. The current era of tobacco regulatory science provides great opportunities for behavioral pharmacologists to address the leading cause of preventable death and disease worldwide.
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Affiliation(s)
- Mark G LeSage
- Department of Medicine, Minneapolis Medical Research Foundation
- Departments of Medicine, University of Minnesota
- Department of Psychology, University of Minnesota
| | - John R Smethells
- Department of Medicine, Minneapolis Medical Research Foundation
- Departments of Medicine, University of Minnesota
| | - Andrew C Harris
- Department of Medicine, Minneapolis Medical Research Foundation
- Departments of Medicine, University of Minnesota
- Department of Psychology, University of Minnesota
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