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Zvolska K, Tichopad A, Stepankova L, Pankova A, Adamcekova Z, Donin G, Rafl J, Kralikova E. Increasing prevalence of mental disorders in smokers seeking treatment of tobacco dependence: a retrospective observational study. BMC Psychiatry 2023; 23:621. [PMID: 37620772 PMCID: PMC10464239 DOI: 10.1186/s12888-023-05115-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND There has been a noticeable relative increase in psychiatric comorbidities among smokers as opposed to the general population. This is likely due to comparatively slower decrease in smoking prevalence among individuals with mental health conditions. This study aims to assess the prevalence trend of past or current mental health disorders in individuals seeking specialized smoking cessation assistance. METHODS We conducted a retrospective single-centre observational study to assess the presence of mental disorders such as anxiety, depression, bipolar affective disorder, or schizophrenia in personal history of 6,546 smokers who sought treatment at the Centre for Treatment of Tobacco Dependence in Prague, Czech Republic between 2006 and 2019. The study examined the impact of gender, age, and the effect of successive years on the prevalence of the mental disorders using Poisson distribution regression. RESULTS In the studied cohort, 1,743 patients (26.6%) reported having one or more mental disorders. Compared to patients without a psychiatric disorder, they exhibited similar levels of carbon monoxide in expired air (mean 17 ppm, SD 11 ppm) and scored one point higher on the Fagerström Test of Cigarette Dependence. Among smokers with a mental disorder, women were more prevalent (62%) than men (38%). The prevalence of mental disorders increased on average by 4% every year, rising from 23% in 2006 to 35% in 2019. CONCLUSIONS Consistent with the observation that the prevalence of smoking among people with any mental disorder is higher and declining at a slower rate than in the general population, there is a steadily increasing percentage of these patients seeking specialized treatment over time. Professionals who offer tobacco dependence treatment should be aware of the upward trend in psychiatric disorders among smokers, as more intensive treatment may be needed. Similarly, psychiatric care should pay attention to smoking of their patients.
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Affiliation(s)
- Kamila Zvolska
- Centre for Treatment of Tobacco Dependence, the 3rdMedical Department - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic.
| | - Ales Tichopad
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University, Prague, Czech Republic
| | - Lenka Stepankova
- Centre for Treatment of Tobacco Dependence, the 3rdMedical Department - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Alexandra Pankova
- Centre for Treatment of Tobacco Dependence, the 3rdMedical Department - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Zuzana Adamcekova
- Centre for Treatment of Tobacco Dependence, the 3rdMedical Department - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Gleb Donin
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University, Prague, Czech Republic
| | - Jakub Rafl
- Department of Biomedical Technology, Faculty of Biomedical Engineering, Czech Technical University, Prague, Czech Republic
| | - Eva Kralikova
- Centre for Treatment of Tobacco Dependence, the 3rdMedical Department - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
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Pankova A, Kralikova E, Zvolska K, Stepankova L, Roche AI, Clark MM, Schroder DR, Croghan IT. Relationship of Weight Concerns to Body Mass Index in a Tobacco Treatment Program. Am J Health Behav 2023; 47:420-427. [PMID: 37226354 DOI: 10.5993/ajhb.47.2.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Objectives: Our aim was to examine the relationship between weight concerns (WC) and smoking cessation. Methods: WC was assessed before smoking cessation treatment in 671 adult patients who completed a 12-month follow-up visit at the Centre for Tobacco-Dependent, Prague, Czech Republic, from 2013 through 2019. We evaluated the abstinence rate at 12-month follow-up. Results: Among 669 patients with baseline WC (mean age, 43.4 years), 47% were women (145/306) and 21% were men (78/363). No association existed between WC and abstinence at 12 months. Smokers with obesity had increased fear of gaining weight (34% versus 24% of overweight and 23% of healthy-weight smokers) (p=.034) and were less confident in their ability to maintain their current weight (36% versus 55% of overweight smokers and 59% of healthy- weight smokers) (p<.001). Conclusions: Many smokers are concerned about gaining weight after stopping smoking, but in this cohort of patients, having WC was not associated with 12-month abstinence, but obesity or overweight was related to being afraid of postcessation weight-gain and low confidence for maintaining weight. Practitioners should be aware of the prevalence of WC in those stopping smoking and should address concerns, such as poor motivation and low confidence about managing their weight.
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Affiliation(s)
- Alexandra Pankova
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and the General University Hospital, Prague, Czech Republic
| | - Eva Kralikova
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and the General University Hospital, Prague, Czech Republic
| | - Kamila Zvolska
- Centre for Tobacco-Dependent of the Third Medical Department, First Faculty of Medicine, Charles University and the General University Hospital, Prague, Czech Republic
| | - Lenka Stepankova
- Centre for Tobacco-Dependent of the Third Medical Department, First Faculty of Medicine, Charles University and the General University Hospital, Prague, Czech Republic
| | - Anne I Roche
- the Department of Psychiatry and Psychology, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Matthew M Clark
- Department of Psychiatry and Psychology and Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA
| | - Darrell R Schroder
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Ivana T Croghan
- Nicotine Dependence Center, Division of General Internal Medicine, and Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA;,
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Stepankova L, Kralikova E, Zvolska K, Pankova A, Adamcekova Z, Kuhn M, Noland D. Comparison between success rates for smokers re-treated by a smokers' clinic and success rates for smokers treated for the first time. Addiction 2021; 116:346-355. [PMID: 32592219 DOI: 10.1111/add.15175] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/19/2020] [Accepted: 06/19/2020] [Indexed: 11/30/2022]
Abstract
AIMS To compare success rates and characteristics of smokers treated a second time by a smokers' clinic with success rates of their first treatment. DESIGN Retrospective cohort study. SETTING Tobacco Dependence Treatment clinic in Prague, Czech Republic, between 2005 and 2017. PARTICIPANTS A total of 5225 smokers treated either once (n = 5006, single treatment sample, SS) or also second time (n = 219, re-treated sample, RS), on average 4.47 years after the first visit. INTERVENTION Smokers received intensive treatment of tobacco dependence with pharmacotherapy options. Outcomes were evaluated after 1 year. In case of failure or relapse, participants could undergo re-treatment in the same setting at least 1 year after the start of the first treatment. MEASUREMENTS Twelve-month self-reported continuous abstinence; CO-validated (≤ 6 parts per million); number of visits; type of pharmacotherapy; mental health history; Fagerström Test for Cigarette Dependence; time between first and second treatment. RESULTS The abstinence rate in the SS was 34.8% [95% confidence interval (CI) = 33.4%, 36.1%] and in the RS was 37% (95% CI = 30.6%, 43.8%) and 39.7% (95% CI = 33.2%, 45.5%) for their first and second treatments, respectively. The samples were comparable on smoking and socio-demographic characteristics and pharmacotherapy used, but the RS in the second treatment had a higher prevalence of diagnosed mental health disorder at 39.3% (95% CI = 32.8%; 46.1%) compared with 23.7% (95% CI = 22.5%; 24.9%) in the SS. Participants who initiated their second quit attempt 1 to 2 years after the first one were less successful than those who initiated their second quit attempt later (25 versus 43%; P < 0.05). The results of the first treatment cycle were not found to be a reliable predictor for outcomes of the second cycle of treatment in univariate or multivariate logistic regression (odds ratio = 1.35, 95% CI = 0.70-2.63, P = 0.373). CONCLUSION In Prague, Czech Republic, smokers re-attending stop-smoking treatment more than 2 years after their previous quit attempt appear to achieve similar success rates to those being treated for the first time.
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Affiliation(s)
- Lenka Stepankova
- Centre for Tobacco Dependence, 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Eva Kralikova
- Centre for Tobacco Dependence, 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.,Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - Kamila Zvolska
- Centre for Tobacco Dependence, 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Alexandra Pankova
- Centre for Tobacco Dependence, 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.,Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - Zuzana Adamcekova
- Centre for Tobacco Dependence, 3rd Medical Department, Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Matyas Kuhn
- Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Derek Noland
- Behavioral Health and Wellness Program, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
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Hubacek JA, Kurcova I, Maresova V, Pankova A, Stepankova L, Zvolska K, Lanska V, Kralikova E. SNPs within CHRNA5-A3-B4 and CYP2A6/B6, nicotine metabolite concentrations and nicotine dependence treatment success in smokers. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2019; 165:84-89. [PMID: 31796940 DOI: 10.5507/bp.2019.058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/14/2019] [Indexed: 11/23/2022] Open
Abstract
AIM Plasma values of nicotine and its metabolites are highly variable, and this variability has a strong genetic influence. In our study, we analysed the impact of common polymorphisms associated with smoking on the plasma values of nicotine, nicotine metabolites and their ratios and investigated the potential effect of these polymorphisms and nicotine metabolite ratios on the successful treatment of tobacco dependence. METHODS Five variants (rs16969968, rs6474412, rs578776, rs4105144 and rs3733829) were genotyped in a group of highly dependent adult smokers (n=103). All smokers underwent intensive treatment for tobacco dependence; 33 smokers were still abstinent at the 12-month follow-up. RESULTS The rs4105144 (CYP2A6, P<0.005) and rs3733829 (EGLN2, P<0.05) variants were significantly associated with plasma concentrations of 3OH-cotinine and with 3OH-cotinine: cotinine ratios. Similarly, the unweighted gene score was a significant (P<0.05) predictor of both cotinine:nicotine and 3OH-cotinine:cotinine ratios. No associations between the analysed polymorphisms or nicotine metabolite ratios and nicotine abstinence rate were observed. CONCLUSION Although CYP2A6 and EGLN2 polymorphisms were associated with nicotine metabolism ratios, neither these polymorphisms nor the ratios were associated with abstinence rates.
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Affiliation(s)
- Jaroslav A Hubacek
- Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Ivana Kurcova
- Department of Toxicology and Forensic Medicine, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Vera Maresova
- Department of Toxicology and Forensic Medicine, 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Alexandra Pankova
- Centre for Tobacco-Dependent, 3rd Department of Medicine - Department of Endocrinology and Metabolism, 1st Faculty of Medicine, Charles University and the General University Hospital in Prague, Czech Republic.,Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University and the General University Hospital in Prague, Czech Republic
| | - Lenka Stepankova
- Centre for Tobacco-Dependent, 3rd Department of Medicine - Department of Endocrinology and Metabolism, 1st Faculty of Medicine, Charles University and the General University Hospital in Prague, Czech Republic
| | - Kamila Zvolska
- Centre for Tobacco-Dependent, 3rd Department of Medicine - Department of Endocrinology and Metabolism, 1st Faculty of Medicine, Charles University and the General University Hospital in Prague, Czech Republic
| | - Vera Lanska
- Statistical Unit, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Eva Kralikova
- Centre for Tobacco-Dependent, 3rd Department of Medicine - Department of Endocrinology and Metabolism, 1st Faculty of Medicine, Charles University and the General University Hospital in Prague, Czech Republic.,Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University and the General University Hospital in Prague, Czech Republic
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Pankova A, Kralikova E, Zvolska K, Stepankova L, Blaha M, Ovesna P, Aveyard P. Early weight gain after stopping smoking: a predictor of overall large weight gain? A single-site retrospective cohort study. BMJ Open 2018; 8:e023987. [PMID: 30559159 PMCID: PMC6303564 DOI: 10.1136/bmjopen-2018-023987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 11/12/2018] [Accepted: 11/14/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Most people gain weight on stopping smoking but the extent of weight gain varies greatly. Interventions aimed at all quitters to prevent weight gain on cessation have proven unpopular but targeting people who have gained excess weight immediately after quitting may improve uptake and cost-effectiveness. We examined whether early large postcessation weight gain predicts overall large weight gain. DESIGN Retrospective cohort study. SETTING Primary care setting-smoking cessation centre in Prague, Czech Republic. PARTICIPANTS Out of 3537 patients treated between 2005 and 2013, 1050 were continuous abstainers (verified by carbon monoxide measurement) at 1-year follow-up and formed the cohort of the current report. 48.7% were women (n=511) with the mean age of 46 (±14.4) years. METHODS In this retrospective cohort study, all patients underwent usual tobacco dependence treatment using evidence-based methods. Weight was measured prior to smoking cessation and at each visit after quitting. RESULTS The mean weight gain in the first month (n=763) was 0.79% (±2.03%), in the second month (n=646) was 1.49% (±2.58%), for the third month (n=566) 2.33% (±3.44%) and 4.1% (±5.31%) after 1-year follow-up (n=1050). The regression coefficient per 1% rise in the first 3 months was +0.13% (95% CI -0.04% to 0.30%). A receiver operating curve analysis showed that patients gaining more than 0.98% of their baseline weight during first 3 months had a sensitivity of 66% and specificity of 44% for gaining 7% or more weight by 12 months. In addition, lower body mass index and an increase in appetite at 3 months after quitting were associated with greater weight gain, while using nicotine replacement therapy was associated with less weight gain at 1-year follow-up. CONCLUSIONS People who stop smoking and gain a larger amount of weight early after quitting are not more likely to gain excessively at 1 year.
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Affiliation(s)
- Alexandra Pankova
- Centre for Tobacco-Dependent, 3rd Medical Department, First Faculty of Medicine, Charles University and the General University Hospital, Charles University, Prague, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and the General University Hospital, Charles University, Prague, Czech Republic
| | - Eva Kralikova
- Centre for Tobacco-Dependent, 3rd Medical Department, First Faculty of Medicine, Charles University and the General University Hospital, Charles University, Prague, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and the General University Hospital, Charles University, Prague, Czech Republic
| | - Kamila Zvolska
- Centre for Tobacco-Dependent, 3rd Medical Department, First Faculty of Medicine, Charles University and the General University Hospital, Charles University, Prague, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and the General University Hospital, Charles University, Prague, Czech Republic
| | - Lenka Stepankova
- Centre for Tobacco-Dependent, 3rd Medical Department, First Faculty of Medicine, Charles University and the General University Hospital, Charles University, Prague, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and the General University Hospital, Charles University, Prague, Czech Republic
| | - Milan Blaha
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petra Ovesna
- Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Stepankova L, Kralikova E, Zvolska K, Pankova A, Ovesna P, Blaha M, Brose LS. Depression and Smoking Cessation: Evidence from a Smoking Cessation Clinic with 1-Year Follow-Up. Ann Behav Med 2017; 51:454-463. [PMID: 28035641 PMCID: PMC5440483 DOI: 10.1007/s12160-016-9869-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Smoking is more prevalent among people with depression. Depression may make cessation more difficult and cessation may affect depression symptoms. PURPOSE The aims of this study were to assess the associations between (1) baseline depression and 1-year smoking abstinence and (2) abstinence and change in depression. METHODS Observational study using data collected routinely in a smoking cessation clinic in the Czech Republic from 2008 to 2014. Aim 1: N = 3775 patients; 14.3% reported mild and 15.4% moderate/severe baseline depression levels measured using Beck's Depression Inventory (BDI-II). Logistic regressions assessed if depression level predicted 1-year biochemically verified abstinence while adjusting for patient and treatment characteristics. Aim 2: N = 835 patients abstinent at 1 year; change in depression was analysed using Chi-square statistics, t test and mixed method analyses of variance. RESULTS Rate of abstinence was lower for patients with mild (32.5%, OR = 0.68; 95% CI: 0.54 to 0.87, p = 0.002) and moderate/severe depression (25.8%; OR = 0.57, 95% CI: 0.45 to 0.74, p < 0.001) compared with patients without depression (40.5%). Across abstinent patients, the majority with baseline depression reported lower depression levels at follow-up. Overall mean (SD) BDI-II scores improved from 9.2 (8.6) to 5.3 (6.1); t(834) = 14.6, p < 0.001. There were significant main effects of time (F(1832) = 880.8, p < 0.001, partial η2 = 0.51) and baseline depression level (F(2832) = 666.4, p < 0.001, partial η2 = 0.62) on follow-up depression and a significant depression * time interaction (F(2832) = 296.5, p < 0.001, partial η2 = 0.42). CONCLUSIONS In this effective smoking cessation clinic, depression at the start of treatment predicted reduced smoking abstinence 1 year later. Patients abstinent from smoking experienced considerable improvement in depression.
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Affiliation(s)
- Lenka Stepankova
- Center for Tobacco-Dependent of the 3rd Medical Department—Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Karlovo namesti 32, 128 00 Praha 2, Czech Republic
| | - Eva Kralikova
- Center for Tobacco-Dependent of the 3rd Medical Department—Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Karlovo namesti 32, 128 00 Praha 2, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital Prague, Studničkova 7, 128 00 Praha 2, Czech Republic
| | - Kamila Zvolska
- Center for Tobacco-Dependent of the 3rd Medical Department—Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Karlovo namesti 32, 128 00 Praha 2, Czech Republic
| | - Alexandra Pankova
- Center for Tobacco-Dependent of the 3rd Medical Department—Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Karlovo namesti 32, 128 00 Praha 2, Czech Republic
- Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University and General University Hospital Prague, Studničkova 7, 128 00 Praha 2, Czech Republic
| | - Petra Ovesna
- Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science, Masaryk University, Kamenice 126/3, 625 00 Brno, Czech Republic
| | - Milan Blaha
- Institute of Biostatistics and Analyses at the Faculty of Medicine and the Faculty of Science, Masaryk University, Kamenice 126/3, 625 00 Brno, Czech Republic
| | - Leonie S Brose
- Psychology and Neuroscience, King’s College London, UK and UK Centre for Tobacco and Alcohol Studies, Institute of Psychiatry, Addictions Sciences Building, 4 Windsor Walk, Denmark Hill, SE5 8BB London, UK
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Hubacek J, Pankova A, Stepankova L, Zvolska K, Adamkova V, Lanska V, Kralikova E. SNPs within CHRNA5-A3-B4 and CYP2A6/B6 are associated with smoking dependence but not with tobacco dependence treatment outcomes in the Czech population. Gene 2017; 606:35-38. [DOI: 10.1016/j.gene.2017.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/18/2016] [Accepted: 01/05/2017] [Indexed: 11/30/2022]
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Stepankova L, Kralikova E, Zvolska K, Kmetova A, Blaha M, Bortlicek Z, Sticha M, Anders M, Schroeder DR, Croghan IT. Tobacco treatment outcomes in patients with and without a history of depression, Czech Republic, 2005-2010. Prev Chronic Dis 2013; 10:E158. [PMID: 24050528 PMCID: PMC3780712 DOI: 10.5888/pcd10.130051] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Higher prevalence of smoking among depressed patients, as well as the risk of depression in smokers, is well documented. The proportion of patients with a history of depression among those seeking intensive treatment of tobacco dependence is also high. In contrast, evidence of treatment success in this subgroup of patients is controversial. The aim of this study was to compare smoking abstinence rates after tobacco treatment in smokers with and without a history of depression. Methods We reviewed retrospective data from 1,730 smokers seeking treatment in Prague, Czech Republic. History of depression was defined as past diagnosis of depression or current treatment of depression. After a 1-year, self-reported smoking status was validated by expired-air carbon monoxide. We used logistic regression to analyze associations between abstinence rates, history of depression, and other factors (eg, age, sex, tobacco dependence). Results Of 1,730 smokers treated, 289 (16.7%) had a history of depression. The smoking abstinence rate at 1 year was 32.5% for smokers with a history of depression and 38.7% for those with no history (P = .048). Among women, abstinence did not differ between groups (35.0% vs 35.7%; P = .86). However, among men, those with a history of depression had lower rates of abstinence (27.4% vs 41.3%; P = .009). After adjustment for baseline covariates, history of depression was not significantly associated with smoking abstinence in men or women. Conclusion Intensive outpatient tobacco treatment programs can achieve abstinence rates among smokers with a history of depression similar to rates among the general population.
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Affiliation(s)
- Lenka Stepankova
- The 3rd Medical Department, and Institute of Hygiene and Epidemiology, First Faculty of Medicine and General University Hospital, Charles University in Prague, Czech Republic
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Kralikova E, Kmetova A, Stepankova L, Zvolska K, Davis R, West R. Fifty-two-week continuous abstinence rates of smokers being treated with varenicline versus nicotine replacement therapy. Addiction 2013; 108:1497-502. [PMID: 23668486 DOI: 10.1111/add.12219] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 11/05/2012] [Accepted: 04/08/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Cross-study comparisons of effect sizes suggest that varenicline is more effective than nicotine replacement therapy (NRT) in aiding smoking cessation, but evidence from direct comparisons is limited. This study compared biochemically verified 52-week sustained abstinence rates in smokers attending the same clinical service according to whether they used varenicline or NRT in their quit attempt. METHODS This was a prospective cohort study of 855 smokers attending a large smoking cessation clinic who used their choice of NRT product or varenicline in their quit attempt. All received the same behavioural support programme and chose their medication option (n = 519 varenicline; n = 336 NRT). The primary outcome measure was self-report of 52 weeks' abstinence following the target quit date confirmed by expired air carbon monoxide concentration. Baseline measures included socio-demographic variables, mental health diagnoses, measures of smoking, cigarette dependence and past use of NRT or varenicline. RESULTS The 52-week abstinence rates were 42.8% versus 31.0% in those using varenicline versus NRT, respectively (P < 0.001). After adjusting for all baseline variables, the odds of remaining abstinent for 52 weeks were 2.03 (95% CI 1.46-2.82), P < 0.001 times higher in those using varenicline than those using NRT. CONCLUSIONS Smokers in the same behavioural support programme who use varenicline appear to have a greater probability of achieving long-term abstinence than those using their choice of nicotine replacement therapy options, even after adjusting for potentially confounding smoker characteristics.
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Affiliation(s)
- Eva Kralikova
- Centre for Tobacco-Dependence of the 3rd Medical Department-Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague, Praha 2, Czech Republic
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