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Harutyunyan A, Abrahamyan A, Grigoryan Z, Hayrumyan V, Truzyan N, Petrosyan V. Smoking cessation knowledge, attitude and practices among tuberculosis physicians: A qualitative study. Tob Prev Cessat 2020; 6:70. [PMID: 33409424 PMCID: PMC7762926 DOI: 10.18332/tpc/130475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/11/2020] [Accepted: 11/14/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Smoking cessation interventions within tuberculosis (TB) care are feasible, effective and efficient for increasing smoking cessation rates. We aimed to assess TB physicians’ smoking cessation knowledge, attitude, and practices (KAP). METHODS We conducted a qualitative study with 21 TB physicians and utilized directed deductive content analysis with predefined knowledge, attitude, and practice categories. Physicians’ practice was analyzed using the ABC approach (Ask, Brief advice, and Cessation support). RESULTS Physicians acknowledged the importance of quitting for improved treatment outcomes and decreased risk of TB relapse. Physicians revealed presumed drug interactions, possible side effects of pharmacotherapy, and reluctance to take additional medications as challenges of smoking cessation interventions. Physicians asked about smoking behavior and provided a brief quitting advice to TB patients; however, implementation of cessation support was limited due to poor knowledge of evidence-based cessation methods and the absence of formal tobacco dependence treatment algorithms within TB care. CONCLUSIONS TB physicians’ KAP on smoking cessation was limited. Interventions targeting physicians’ knowledge and skills, and formalization of tobacco dependence treatment within TB care, are core for improving their smoking cessation practices in Armenia.
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Affiliation(s)
- Arusyak Harutyunyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Armine Abrahamyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Zaruhi Grigoryan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Varduhi Hayrumyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Nune Truzyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
| | - Varduhi Petrosyan
- Turpanjian School of Public Health, American University of Armenia, Yerevan, Armenia
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Campesi I, Montella A, Sotgiu G, Dore S, Carru C, Zinellu A, Palermo M, Franconi F. Combined oral contraceptives modify the effect of smoking on inflammatory cellular indexes and endothelial function in healthy subjects. Eur J Pharmacol 2020; 891:173762. [PMID: 33253680 DOI: 10.1016/j.ejphar.2020.173762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/04/2020] [Accepted: 11/06/2020] [Indexed: 12/12/2022]
Abstract
Little information is available on the influence of sex in combination with smoking habits and combined oral contraceptives (COC) use on cellular inflammatory indexes such as neutrophil/lymphocyte ratio (NLR), derived NRL (dNLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), mean platelet volume/platelet count (MPV/PLT), aggregate inflammation systemic index (AISI), and systemic inflammation response index (SIRI), which are cost-effective biomarkers to assessing inflammation. Therefore, the effect of COC was studied alone or in association with smoking and compared with results from healthy COC-free women and men. Furthermore, the association of cellular inflammatory indexes with endothelial function (arginine (Arg), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and lipid peroxidation (malondialdehyde MDA) biomarkers was evaluated. Blood was collected for hematological and biochemical analysis, which were used to calculate PLR, NLR, dNLR, MLR, MPV/PLT, AISI, and SIRI. Serum samples were assayed for Arg, ADMA, SDMA, and MDA. Monocytes, MLR, SIRI, and MPV/PLT were higher in men, while PLT count was higher in women. COC use increased lymphocytes and lowered PLR and MLR. Smoking reduced sexually divergent parameters, especially in COC users: smoking and non-smoking COC-free women displayed six divergent parameters, while COC users displayed only two (monocytes and MPV). In addition, COC affected endothelial function, reducing ADMA and Arg. Moreover, COC-free women had lower Arg levels than men. In conclusion, COC use strongly influence the effects of tobacco smoking, which are sex and parameter specific. Further, these data stress that COC use and smoking attitude select different cohorts indicating that sex and gender studies need intersectionality.
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Affiliation(s)
- Ilaria Campesi
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy; Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100, Sassari, Italy.
| | - Andrea Montella
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy; Unità Operativa di Genetica e Biologia Dello Sviluppo, Azienda Ospedaliero Universitaria di Sassari, 07100, Sassari, Italy
| | - Giovanni Sotgiu
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Simone Dore
- Dipartimento di Scienze Mediche Chirurgiche e Sperimentali, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Ciriaco Carru
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Angelo Zinellu
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100, Sassari, Italy
| | - Mario Palermo
- Unità Operativa di Endocrinologia, Azienda Ospedaliero Universitaria di Sassari, 07100, Sassari, Italy
| | - Flavia Franconi
- Laboratorio Nazionale di Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100, Sassari, Italy
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Li M, Okamoto R. Gender differences and smoking cessation in the Japanese smoking cessation treatment program. Tob Induc Dis 2020; 18:95. [PMID: 33223985 PMCID: PMC7676305 DOI: 10.18332/tid/128497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/14/2020] [Indexed: 11/24/2022] Open
Affiliation(s)
- Meng Li
- Division of Health Sciences, Graduate School of Medicine, Japan
| | - Reiko Okamoto
- Division of Health Sciences, Graduate School of Medicine, Japan
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Khayamzadeh M, Aliakbari F, Zolghadr Z, Emadeddin M, Ahadi M, Akbari M, Abedi AR, Nematollahi S, Hosseini J. Five-Year Survival Rate of Bladder Cancer in Iran during 2001-2007. IRANIAN JOURNAL OF PATHOLOGY 2020; 16:69-74. [PMID: 33391383 PMCID: PMC7691705 DOI: 10.30699/ijp.2020.118375.2287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 09/22/2020] [Indexed: 01/03/2023]
Abstract
Background & Objective: Bladder cancer is the fourth most common cancer in men and the most common cancer in women, comprising 8% of all males and 3% of female tumors. The present study aimed to estimate the five-year survival rates of bladder cancer in Iran. Methods: Information on 3,337 registered cases of bladder cancer was obtained from the Office of National Cancer Registry in the Ministry of Health and Medical Education (MOH & ME). A telephone survey was conducted to gather additional information, such as survival status, demographic, and clinical profile. Kaplan–Meier estimates of five-year survival rates were calculated according to the age of diagnosis, gender, pathological type, and provincial pole. Results and Conclusion: Overall five-year survival rate was 77%. According to the pathologic type, five-year survival rates were 81%, 66%, 81%, 42%, 77%, and 82% in low-grade urothelial carcinoma, high-grade urothelial carcinoma, adenocarcinoma, undifferentiated carcinomas, Squamous Cell Carcinomas (SCCs), and other tumors, respectively. Additionally, those tumors were 93%, 88%, 81%, 64%, and 44% among patients whose average ages at diagnosis were < 50, 50–59, 60–59, 70–79, and > 80 years old, respectively. Our study revealed that age and histological type were the major prognostic factors for survival in patients with bladder cancer. Therefore, given the histologic features of the tumor and patients with advanced age, a continuous screening would be highly warranted.
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Affiliation(s)
- Maryam Khayamzadeh
- Cancer Research Centre, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshte Aliakbari
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Zolghadr
- Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Emadeddin
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Ahadi
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Amir Reza Abedi
- Urology Department, Shohada-ye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Nematollahi
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalil Hosseini
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Allen AM, Yuan NP, Wertheim BC, Krupski L, Bell ML, Nair U. Gender differences in utilization of services and tobacco cessation outcomes at a state quitline. Transl Behav Med 2020; 9:663-668. [PMID: 30099557 DOI: 10.1093/tbm/iby083] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Research suggests that women may have poorer tobacco cessation outcomes than men; however, the literature is somewhat mixed. Less is known about gender differences in cessation within quitline settings. This study examined gender differences in the utilization of services (i.e., coaching sessions, pharmacotherapy) and tobacco cessation among callers to the Arizona Smokers' Helpline (ASHLine). The study sample included callers enrolled in ASHLine between January 2011 and June 2016. We tracked number of completed coaching sessions. At the 7-month follow-up, callers retrospectively reported use of cessation pharmacotherapy (gum, patch, or lozenge), as well as current tobacco use. Associations between gender and tobacco cessation were tested using logistic regression models. At month 7, 36.4% of women (3,277/9,004) and 40.3% of men (2,960/7,341) self-reported 30-day point prevalence abstinence. Compared to men, fewer women reported using pharmacotherapy (women: 71.4% vs. men: 73.6%, p = .01) and completed at least five coaching sessions (women: 35.1% vs. men: 38.5%, p < .01). After adjusting for baseline characteristics, women had significantly lower odds of reporting tobacco cessation than men (OR = 0.91, 95% CI: 0.84 to 0.99). However, after further adjustment for use of pharmacotherapy and coaching, there was no longer a significant relationship between gender and tobacco cessation (OR: 0.96, 95% CI: 0.87 to 1.06). Fewer women than men reported tobacco cessation. Women also had lower utilization of quitline cessation services. Although the magnitude of these differences were small, future research on improving the utilization of quitline services among women may be worth pursuing given the large-scale effects of tobacco.
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Affiliation(s)
- Alicia M Allen
- Department of Family & Community Medicine, College of Medicine, University of Arizona, Tucson, USA
| | - Nicole P Yuan
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | | | - Laurie Krupski
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Melanie L Bell
- Department of Epidemiology & Biostatistics, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Uma Nair
- Department of Health Promotion Sciences, Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
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Abstract
Interest in electronic cigarette (EC) use, or vaping, to help control weight is increasing. Many American Indian (AI) populations have a high prevalence of smoking, obesity, and EC use, but their perceptions of EC use for weight control are unknown. In Oklahoma in 2016, 375 AI adults who smoke completed a survey including perceptions about smoking and EC effects on weight control. Only 24% believed that smoking helps control weight, and 8% believed that vaping helps control weight. Perceptions differed by EC use, with ever users more often than never users perceiving that smoking (30% vs 12%, respectively; p < .01) and vaping (10% vs 5%; p = .04) help to control weight. Sex, age group (18-44 years vs 45 + years), education (high school graduate/equivalent vs less than high school), smoking cessation attempt in past year, and likelihood to quit in 6 months were not associated with weight control perceptions for either smoking or vaping. Uncertainty regarding EC effects on weight control was less common among EC ever users compared to never users (41% vs 53%, respectively; p = .04). Most people who did not believe or were uncertain that smoking controls weight also did not believe or were uncertain that vaping controls weight. However, only a minority (29%) of people who believed smoking controls weight also believed that vaping controls weight. Among adult AI who smoke, both smoking and vaping were infrequently perceived as helping to control weight, but such perceptions were reported more frequently among those who ever used ECs.
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Heberg J, Simonsen MK, Thomsen T, Zoffmann V, Danielsen AK. Smoking cessation prolongs survival in female cancer survivors - the Danish nurse cohort. Eur J Oncol Nurs 2020; 47:101796. [PMID: 32682286 DOI: 10.1016/j.ejon.2020.101796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To explore smoking cessation between cancer survivors and cancer-free women, and the potential survival benefits from smoking cessation in cancer surviving women. METHOD We pooled 46,334 responses from the Danish Nurse Cohort. The cohort consists of female nurses, who were invited for surveys in 1993, 1999 and 2009. Participants were linked to nationwide registries on hospitalization, cause of death and migration through 2016. Odds for smoking cessation by cancer diagnosis were computed in propensity score matched logistic regression models, while survival by postdiagnosis smoking cessation was estimated in cox proportional hazards models. RESULTS Eligible for analysis were 7841 women (mean age = 56.7 years, SD ± 7.2), who were smokers at baseline and survived to the next follow-up survey. Of these, 545 women were diagnosed with cancer and matched by propensity score (1:2) with 1090 cancer-free women. Odds for smoking cessation were significantly higher in cancer-diagnosed women compared to their cancer-free peers (OR = 1.31, 95% CI: 1.06-1.61). Moreover, mortality risk was significantly lower among cancer survivors who stopped smoking (HR = 0.64, 95% CI: 0.46-0.91), compared to persistent smokers. CONCLUSIONS The results suggest considerable survival benefits from smoking cessation in cancer surviving female nurses, and that the time surrounding cancer diagnosis may serve as a teachable moment for smoking cessation. However, due to substantial methodological limitations embedded in the study, careful interpretation of the presented results is warranted. Future studies are needed to demonstrate the effects of diagnosis on smoking cessation as well as the effects of smoking cessation on survival in female cancer populations.
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Affiliation(s)
- Jette Heberg
- Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark; Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark.
| | - Mette Kildevæld Simonsen
- The Parker Institute, Bispebjerg and Frederiksbergs Hospital, Region H, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark; Aarhus University, Health, Department of Public Health, Vennelyst, Boulevard 4, 8000, Aarhus C, Denmark
| | - Thordis Thomsen
- Herlev Acute, Critical and Emergency Care Science Unit, Department of Anaesthesiology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark; University of Copenhagen, Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
| | - Vibeke Zoffmann
- Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark; University of Copenhagen, IFSV, Section of Health Services Research, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Anne Kjaergaard Danielsen
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark; University of Copenhagen, Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
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58
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Pribadi ET, Devy SR. Application of the Health Belief Model on the intention to stop smoking behavior among young adult women. J Public Health Res 2020; 9:1817. [PMID: 32728563 PMCID: PMC7376467 DOI: 10.4081/jphr.2020.1817] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/13/2020] [Indexed: 11/30/2022] Open
Abstract
Background: The smoking behavior among young adult women causes health issues and has effects on ethical norms, especially femininity and gender. A woman smoker usually has an intention to quit and several factors have been perceived to be related to this action according to the Health Belief Model (HBM). Design and Methods: This study was conducted cross-sectionally to analyze the correlation between young adult women’s intention to stop smoking with perceived factors in the construction of HBM. A sample of 58 young adult women smokers and aged between 15-30 years were selected through the use of a purposive sampling technique in 2018. Results: The results showed the intention to stop smoking has a significant correlation with perceived susceptibility (P=0.036), perceived severity (P=0.028), perceived benefits (P=0.011), perceived barriers (P=0.003), and perceived self-efficacy (P=0.005). This means there was a significant correlation between the intention of young adult smokers to quit smoking and the perceived factors of HBM. Conclusions: The intention of stop smoking behavior among women smokers has a significant correlation with the perceived factors of the Health Belief Model construct, which includes perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and perceived self-efficacy. Significance for public health Women smokers have a high tendency of wanting to quit based on self-encouragement as well as the pressure from the surrounding social environment. The encouragement can be in the form of awareness of illnesses and diseases caused by smoking or other reasons relating to gender. This paper describes the correlation of these factors and their influence on the desire of young adult women smokers to quit smoking were analyzed through the construction of the Health Belief Model (HBM).
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Affiliation(s)
| | - Shrimarti Rukmini Devy
- Department of Health Promotion and Behavioral Sciences, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
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Alomari MA, Khabour OF, Alzoubi KH, Eissenberg T. Puffing topography and physiological responses in men and women with low versus high waterpipe dependence during smoking: The WiHi Irbid project. Drug Alcohol Depend 2020; 212:108037. [PMID: 32417361 PMCID: PMC9271691 DOI: 10.1016/j.drugalcdep.2020.108037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/15/2020] [Accepted: 04/18/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Waterpipe smoking is spreading worldwide, and it is associated with many adverse effects. The aim of this study was to investigate the interaction of waterpipe smoking puffing topography, and related physiological measures, with both gender and level of dependence on waterpipe. METHOD Exclusive waterpipe smokers were asked to smoke a single waterpipe session in a specialized laboratory while their smoking topography, and in-breath CO level were recorded pre- and post- smoking. Waterpipe dependence was measured using the LWDS-11 scale. RESULTS In the high dependence group, the total number of puffs, was greater in men than women. In addition, the average flow rate was greater in men with high compared to low dependence. For inter-puffing intervals, greater values were recorded in men and women with low versus high dependence. No other differences were found between the subgroups in total session time, average puff duration, average puff volume, and maximum flow rate. Pre-smoking CO content and CO boost were greater in men versus women in both dependence groups. Post-smoking CO content was greater in women with high versus low dependence, whereas it was lower in women versus men with low dependence. CONCLUSIONS The current results indicate several effects for waterpipe smoking dependence on smoking topography. Many of these differences were gender dependent with men having higher exposure than women in most aspects.
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Affiliation(s)
- Mahmoud A. Alomari
- Department of Physical Education, Qatar University, Doha 2713, Qatar.,Division of Physical Therapy, Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Omar F. Khabour
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Karem H. Alzoubi
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Thomas Eissenberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Trevisan C, Alessi A, Girotti G, Zanforlini BM, Bertocco A, Mazzochin M, Zoccarato F, Piovesan F, Dianin M, Giannini S, Manzato E, Sergi G. The Impact of Smoking on Bone Metabolism, Bone Mineral Density and Vertebral Fractures in Postmenopausal Women. J Clin Densitom 2020; 23:381-389. [PMID: 31350204 DOI: 10.1016/j.jocd.2019.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Smoking is recognized among the risk factors for osteoporosis, but only few studies have comprehensively explored its influence on bone metabolism and strength. We aimed to evaluate smoking effects on calcium-phosphate metabolism, bone mineral density (BMD) and fracture risk in postmenopausal women. METHODS Our sample included 1067 postmenopausal women who arrived to our osteoporosis outpatient clinic. Anamnestic data, smoking habits (categorized as never, former, and current; and by smoking intensity and duration), biochemical parameters, lumbar/femoral BMD, and presence of vertebral fractures were recorded. In a subsample of 357 women, the changes in BMD after a 2-yr follow-up period were also assessed. RESULTS Current smokers had shorter reproductive age, lower body mass index, and higher prevalence of heavy alcohol consumption than former/never smokers. They also had lower PTH values and weaker linear association between serum vitamin D and parathyroid hormone (current β = -0.11[SE = 0.004]; former β = -0.14[SE = 0.01]; never β = -0.20[SE = 0.003]; p < 0.01 for all). Baseline BMD did not reflect differences based on smoking habits, duration or intensity. However, after 2 years, only current smokers significantly worsened in femural BMD. After adjustment for confounders, the chance of having sustained vertebral fractures at the first evaluation increased by 74% (95% confidence interval:1.07-2.83) in current compared with never smokers, especially among heavy smokers. CONCLUSIONS Smoking may negatively affect bone by inhibiting vitamin D-parathyroid hormone axis, reducing estrogen exposure, promoting risky health behaviors, and accelerating bone loss, especially at the femur. No significant differences were observed in these outcomes among former smokers, suggesting that quitting smoking has beneficial effects on bone health.
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Affiliation(s)
- Caterina Trevisan
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy.
| | - Agnese Alessi
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Gaia Girotti
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | | | - Anna Bertocco
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Mattia Mazzochin
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Francesca Zoccarato
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Francesca Piovesan
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Marta Dianin
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
| | - Sandro Giannini
- Department of Medicine, ClinicaMedica 1, University of Padua and Regional Centre for Osteoporosis, Padua, Italy
| | - Enzo Manzato
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy; National Research Council, Neuroscience Institute, Padua, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padua, Padua, Italy
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Desai R, Patel U, Parekh T, Hanna B, Sitammagari K, Fong HK, Lodhi MU, Varma Y, Damarlapally N, Doshi R, Savani S, Kumar G, Sachdeva R. Nationwide Trends in Prevalent Cardiovascular Risk Factors and Diseases in Young Adults: Differences by Sex and Race and In-Hospital Outcomes. South Med J 2020; 113:311-319. [PMID: 32483642 DOI: 10.14423/smj.0000000000001106] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Prevalence and trends in all cardiovascular disease (CVD) risk factors among young adults (18-39 years) have not been evaluated on a large scale stratified by sex and race. The aim of this study was to establish the prevalence and temporal trend of CVD risk factors in US inpatients younger than 40 years of age from 2007 through 2014 with racial and sex-based distinctions. In addition, the impact of these risk factors on inpatient outcomes and healthcare resource utilization was explored. METHODS A cross-sectional nationwide analysis of all hospitalizations, comorbidities, and complications among young adults from 2007 to 2014 was performed. The primary outcomes were frequency, trends, and race- and sex-based differences in coexisting CVD risk factors. Coprimary outcomes were trends in all-cause mortality, acute myocardial infarction, arrhythmia, stroke, and venous thromboembolism in young adults with CVD risk factors. Secondary outcomes were demographics and resource utilization in young adults with versus without CVD risk factors. RESULTS Of 63 million hospitalizations (mean 30.5 [standard deviation 5.9] years), 27% had at least one coexisting CVD risk factor. From 2007 to 2014, admission frequency with CVD risk factors increased from 42.8% to 55.1% in males and from 16.2% to 24.6% in females. Admissions with CVD risk were higher in male (41.4% vs 15.9%) and white (58.4% vs 53.8%) or African American (22.6% vs 15.9%) patients compared with those without CVD risk. Young adults in the Midwest (23.9% vs 21.1%) and South (40.8% vs 37.9%) documented comparatively higher hospitalizations rates with CVD risk. Young adults with CVD risk had higher all-cause in-hospital mortality (0.4% vs. 0.3%) with a higher average length of stay (4.3 vs 3.2 days) and charges per admission ($30,074 vs $20,124). CONCLUSIONS Despite modern advances in screening, management, and interventional measures for CVD, rising trends in CVD risk factors across all sex and race/ethnic groups call for attention by preventive cardiologists.
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Affiliation(s)
- Rupak Desai
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Upenkumar Patel
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Tarang Parekh
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Bishoy Hanna
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Kranthi Sitammagari
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Hee Kong Fong
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Muhammad Uzair Lodhi
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Yash Varma
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Nanush Damarlapally
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Rajkumar Doshi
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Sejal Savani
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Gautam Kumar
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
| | - Rajesh Sachdeva
- From the Division of Cardiology, Atlanta Veterans Affairs Medical Center, Decatur, Georgia, the Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, the Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, the Division of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, the Department of Internal Medicine, Atrium Health Union, Monroe, North Carolina, the Division of Cardiology, University of California, Davis Medical Center, Sacramento, the Department of Internal Medicine, Eastern Idaho Regional Medical Center, Idaho Falls, the Department of Medicine, Bhavnagar Medical College, Gujarat, India, the Department of Health Sciences, Coleman College of Health Sciences, Houston, Texas, the Department of Internal Medicine, University of Nevada, Reno School of Medicine, Reno, and the Department of Public Health, New York University, New York, New York
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Nair US, Miller ES, Bell ML, Allen S, Collins BN, Allen AM. Feasibility and acceptability of testing a menstrual-cycle timed smoking cessation intervention for women of reproductive age ( Project Phase): Protocol of a pilot randomized controlled trial. Contemp Clin Trials Commun 2020; 18:100569. [PMID: 32435718 PMCID: PMC7229486 DOI: 10.1016/j.conctc.2020.100569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/16/2020] [Accepted: 04/19/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Compared to men, women have unique barriers to smoking cessation and are less likely to utilize quitline services. While current clinical recommendations have called for sex/gender-specific smoking cessation protocols, quitlines have not been expanded protocols to address the unique needs of women. Menstrual cycles (and/or ovarian hormones) influence quit outcomes in women. This paper presents the study design and protocol for a randomized control trial (Project Phase) designed to test the feasibility and acceptability of utilizing menstrual cycle timing to improve quit outcomes in women of reproductive age. METHODS/DESIGN Participants include treatment-seeking women (n = 116), between the ages of 18-40 with regular and naturally-occurring menstrual cycles. Eligible participants are randomized to either the mid-Follicular Phase (FP) or Standard Care (SC-control) group. Counseling includes six weekly telephone sessions with four weeks of nicotine replacement therapy. The timing and frequency of sessions is identical to both conditions, with the exception of the quit day (week 3 of counseling). In addition to providing education on menstrual cycle and quitting, quit day for FP participants is set within 6-8 days post onset of menses; the SC group quit day is set for Week 3 of counseling regardless of their menstrual cycle phase. Dried blood spots will be used to bioverify menstrual cycle phase and smoking status. DISCUSSION If feasible and acceptable, our behavioral counseling intervention that times the quit day to the mid-follicular phase of the menstrual may increase quit outcomes among women of reproductive age and has potential for dissemination across quitlines nationally.
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Affiliation(s)
- Uma S. Nair
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Elizabeth S. Miller
- Department of health Promotion Sciences, Mel and Enid Zuckerman College of Public Heath, University of Arizona, Tucson, AZ, USA
| | - Melanie L. Bell
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sharon Allen
- Department of Family Medicine and Community Health, University of Minnesota Medical School, MN, USA
| | - Bradley N. Collins
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Alicia M. Allen
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
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63
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Arinze JT, de Roos EW, Karimi L, Verhamme KMC, Stricker BH, Brusselle GG. Prevalence and incidence of, and risk factors for chronic cough in the adult population: the Rotterdam Study. ERJ Open Res 2020; 6:00300-2019. [PMID: 32337212 PMCID: PMC7167208 DOI: 10.1183/23120541.00300-2019] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 02/06/2020] [Indexed: 12/22/2022] Open
Abstract
Chronic cough is a common complaint in the general population but there are no precise data on the incidence of, and prospectively examined risk factors for chronic cough in a population-based setting. Therefore, we investigated the period prevalence, incidence and risk factors for chronic cough in adult subjects. In a prospective population-based cohort study among subjects aged ≥45 years, data on chronic cough were collected on two separate occasions using a standardised questionnaire. Chronic cough was defined as daily coughing for at least 3 months duration during the preceding 2 years. Potential risk factors were gathered by interview, physical examination and several investigations. Of the 9824 participants in this study, 1073 (10.9%) subjects had chronic cough at baseline. The prevalence of chronic cough increased with age and peaked in the eighth decade. In subjects aged <70 years, chronic cough was more common in women. During an average follow-up of 6 years, 439 incident cases of chronic cough occurred with an overall incidence rate of 11.6 per 1000 person-years (95% CI 10.6-12.8). In current smokers, the incidence of chronic cough was higher in men. In the multivariable analysis, current smoking, gastro-oesophageal reflux disease (GORD), asthma and COPD were identified as risk factors for chronic cough. Chronic cough is common among adults and highly prevalent in the older population. Current smoking, GORD, asthma and COPD are independent risk factors for chronic cough. Individuals at risk of developing chronic cough may benefit from smoking cessation and control of the underlying disease.
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Affiliation(s)
- Johnmary T Arinze
- Dept of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Emmely W de Roos
- Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Leila Karimi
- Dept of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Katia M C Verhamme
- Dept of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Guy G Brusselle
- Dept of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.,Dept of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium.,Dept of Respiratory Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
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64
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Jayakumar N, Chaiton M, Zhang B, Selby P, Schwartz R. Sex Differences in Use of Smoking Cessation Services and Resources: A Real-World Study. Tob Use Insights 2020; 13:1179173X20901500. [PMID: 32030067 PMCID: PMC6977215 DOI: 10.1177/1179173x20901500] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 12/20/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives: Smoking cessation interventions with sex considerations have been found to effectively increase cessation rates. However, evidence is limited and weak. This study examined sex differences in the use of smoking cessation services or resources among Ontario adults. Methods: Data are from the Smokers’ Panel, an ongoing online survey of Ontario adult smokers and recent quitters. The analysis included 1009 male and 1765 female participants. Bivariate analysis was used to examine differences in sociodemographic characteristics and smoking-related variables by use of cessation services/resources. Logistic regression was then used to identify sociodemographic characteristics and smoking-related variables associated with the use of cessation services/resources. Results: The analysis shows that there were significant sex differences in the use of individual interventions. Female participants were more likely to use nicotine patch (63% vs 58%; adjusted odds ratio, AOR: 1.39, 95% confidence interval [CI]: 1.16-1.67), varenicline (29% vs 24%; AOR: 1.37, 95% CI: 1.13-1.66), Smokers’ Helpline phone (14% vs 10%; AOR: 1.39, 95% CI: 1.07-1.79), Smokers’ Helpline online (27% vs 21%; AOR 1.43, 95% CI: 1.18-1.74), self-help materials (23% vs 16%; AOR: 1.81 95% CI: 1.46-2.26), and alternative methods (23% vs 19%; AOR: 1.40, 95% CI: 1.14-1.73) compared with male participants, after adjusting for covariates. Conclusion: Consistent with other findings, the study shows sex differences in the use of smoking cessation services or resources among adult smokers. Women are more likely to use recommended cessation resources such as nicotine patch, varenicline, and Smokers’ Helpline than men. Health professionals should use this increased willingness to help female smokers quit. However, men may be underserved and more men-specific interventions need to be developed and evaluated.
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Affiliation(s)
- Navitha Jayakumar
- Ontario Tobacco Research Unit, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Michael Chaiton
- Ontario Tobacco Research Unit, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Michael Chaiton, Ontario Tobacco Research Unit, 155 College Street, Toronto, ON M5T 3M7, Canada.
| | - Bo Zhang
- Ontario Tobacco Research Unit, Toronto, ON, Canada
| | - Peter Selby
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Robert Schwartz
- Ontario Tobacco Research Unit, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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65
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Montgomery L, Webb Hooper M. Gender Differences in the Association between Marijuana and Menthol Cigarette Use among African American Adult Cigarette Smokers. Subst Use Misuse 2020; 55:1335-1342. [PMID: 32253967 PMCID: PMC7281863 DOI: 10.1080/10826084.2020.1741633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction: Despite the strong relationship between marijuana and tobacco use, especially among African American individuals and males, very few studies have examined the association between marijuana and menthol cigarette use. This study was designed to identify the prevalence of past month, past year and lifetime marijuana use and marijuana dependence among menthol and non-menthol cigarette smokers, as well as the association between marijuana and menthol cigarette use among African American female and male cigarette smokers. Methods: Data were drawn from 1,173 African American adult cigarette smokers in the 2017 National Survey on Drug Use and Health. Results: Overall, 8.8%, 13.9% and 44.7% of African American menthol and non-menthol cigarette smokers reported past month, past year and lifetime marijuana use, respectively. Weighted multivariable logistic regression models revealed a significant interaction between gender and past month marijuana use on menthol cigarette use (AOR = 1.49, 95% CI: 1.21-2.42, p < .05). Past month marijuana use was associated with an increased odds of past month menthol cigarette use (relative to non-menthol cigarette use) among females, but a decreased odds of past of past month menthol cigarette use among males. Conclusions: When stratified by gender, marijuana use is differentially related to menthol cigarette use among African American adults. Given the prevalence of menthol cigarette use among this population, it is important to examine factors such as marijuana use that could be targeted in prevention and treatment interventions for African Americans, especially females, who are at risk for smoking or are currently smoking menthol cigarettes. Implications: This study found that marijuana use was associated with an increased odds of menthol cigarette use among African American females, while marijuana use was associated with a decreased odds of menthol cigarette use among their male counterparts. The impact of marijuana use on menthol cigarette smoking differs among females and males, highlighting the need for gender-tailored interventions that target marijuana use among African American individuals, especially females, who are at risk for smoking or are currently smoking menthol cigarettes.
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Affiliation(s)
- LaTrice Montgomery
- Department of Psychiatry and Behavioral Neuroscience, Addiction Sciences Division, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Monica Webb Hooper
- Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Torres OV, Estep JC, Gwin M, Villalta I. Gender Differences in Negative Mood, Emotional Intelligence and Tobacco Use among Young Adults. Subst Use Misuse 2020; 55:1881-1891. [PMID: 32532170 DOI: 10.1080/10826084.2020.1775649] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background: Tobacco use is recognized as a form of addiction and remains a significant health concern. Despite this well accepted problem, the various components associated with tobacco use across gender remain relatively unknown. Objectives: The purpose of this study was to investigate the relationship between tobacco use and negative moods (anxiety, depression, stress) between men and women. The relationship between emotional intelligence (EI) and attitudes about smoking was also investigated. Methods: A questionnaire was used to determine sociodemographic characteristics, negative moods, EI, smoking behavior, and tobacco-related attitudes (N = 350). Results: Amongst individuals who used tobacco products, women reported greater disturbances in stress and anxiety compared to men. In addition, both men and women who used tobacco products reported higher depression scores compared to nonsmokers, however, no gender differences were observed. Hierarchical regression analyses revealed that higher EI scores explained negative attitudes about smoking in relation to health concerns. Lastly, women reported stronger attitudes for the restriction of cigarette sales and marketing of tobacco products. Conclusion: These findings support the literature by showing that mood dysregulation is an important factor associated with tobacco use among women. Additionally, we report that specific aspects of EI are psychological constructs closely linked with attitudes about smoking. Future studies elucidating the various components of tobacco use across gender might lead to more effective treatments for smoking.
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Affiliation(s)
- Oscar V Torres
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
| | - Justin C Estep
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
| | - Mary Gwin
- Department of Social Sciences, San Diego Mesa College, San Diego, California, USA
| | - Ian Villalta
- Department of Behavioral Sciences, San Diego Mesa College, San Diego, California, USA
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Reyes-Caballero H, Park B, Loube J, Sanchez I, Vinayachandran V, Choi Y, Woo J, Edwards J, Brinkman MC, Sussan T, Mitzner W, Biswal S. Immune modulation by chronic exposure to waterpipe smoke and immediate-early gene regulation in murine lungs. Tob Control 2019; 29:s80-s89. [PMID: 31852817 DOI: 10.1136/tobaccocontrol-2019-054965] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 08/22/2019] [Accepted: 08/24/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE We investigated the effects of chronic waterpipe (WP) smoke on pulmonary function and immune response in a murine model using a research-grade WP and the effects of acute exposure on the regulation of immediate-early genes (IEGs). METHODS WP smoke was generated using three WP smoke puffing regimens based on the Beirut regimen. WP smoke samples generated under these puffing regimens were quantified for nicotine concentration. Mice were chronically exposed for 6 months followed by assessment of pulmonary function and airway inflammation. Transcriptomic analysis using RNAseq was conducted after acute exposure to characterise the IEG response. These biomarkers were then compared with those generated after exposure to dry smoke (without water added to the WP bowl). RESULTS We determined that nicotine composition in WP smoke ranged from 0.4 to 2.5 mg per puffing session. The lung immune response was sensitive to the incremental severity of chronic exposure, with modest decreases in airway inflammatory cells and chemokine levels compared with air-exposed controls. Pulmonary function was unmodified by chronic WP exposure. Acute WP exposure was found to activate the immune response and identified known and novel IEG as potential biomarkers of WP exposure. CONCLUSION Chronic exposure to WP smoke leads to immune suppression without significant changes to pulmonary function. Transcriptomic analysis of the lung after acute exposure to WP smoke showed activation of the immune response and revealed IEGs that are common to WP and dry smoke, as well as pools of IEGs unique to each exposure, identifying potential biomarkers specific to WP exposure.
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Affiliation(s)
- Hermes Reyes-Caballero
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bongsoo Park
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jeffrey Loube
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ian Sanchez
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Vinesh Vinayachandran
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Youngshim Choi
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Juhyung Woo
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Justin Edwards
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Thomas Sussan
- Toxicology Directorate, US Army Public Health Command, Aberdeen Proving Ground, Maryland, USA
| | - Wayne Mitzner
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
| | - Shyam Biswal
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, Maryland, USA
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68
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Heberg J, Simonsen MK, Danielsen AK, Klausen TW, Zoffmann V, Thomsen T. Joint tobacco smoking and alcohol intake exacerbates cancer risk in women- the Danish nurse cohort. Eur J Oncol Nurs 2019; 43:101675. [PMID: 31644965 DOI: 10.1016/j.ejon.2019.101675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 10/04/2019] [Accepted: 10/08/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To explore separate and combined tobacco and alcohol use and risk of overall, smoking-related, alcohol-related, breast and gynecological cancers in women. METHOD Questionnaires from 19,898 women in The Danish Nurse Cohort in 1993 were linked to registries on hospitalizations, death causes and migration until Dec 2016. Cancer risk by tobacco and alcohol was estimated using Cox proportional hazards models. RESULTS 16,106 nurses, aged >44 years (mean = 56), were eligible for analysis. Throughout 23 years (mean follow-up = 18.8 years) overall cancers counted 4,968. Of these, 1,897, 2,231, 1,407 and 579 events were smoking-related, alcohol-related, breast cancers and gynecological cancers. Increased risks of overall, smoking-related, and breast cancer were observed for current smoking and excess alcohol intake (>14 units/week), separately, compared to never smoking and light drinking (1-7 units/week) respectively. Moderate drinking (8-14 units/week) increased the risk of alcohol-related and breast cancer. Additional risk increases were observed among smokers drinking alcohol above light levels for overall, smoking-related, alcohol-related and breast cancer (HR = 1.40, 95% CI:1.30-1.51, HR = 1.72, 95% CI:1.52-1.94, HR = 1.33, 95% CI:1.26-1.40, HR = 1.32, 95% CI:1.15-1.53, respectively), compared to non-smokers drinking lightly. These risks increased further for smokers drinking above moderate levels (HR = 1.49, 95% CI:1.36-1.63, HR = 1.97, 95% CI:171.-2.26, HR = 1.40, 95% CI:1.22-1.60, HR = 1.33, 95% CI:1.12-1.57, respectively). No significant associations were found for gynecological cancer. CONCLUSIONS Smoking and alcohol, both separately and combined, increased risks of overall, smoking-related, alcohol-related and breast cancer; combined use resulted in incremental risk increases. Co-use of smoking and alcohol represent an extensive threat to public health; thus, prevention could benefit from combined targeting.
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Affiliation(s)
- Jette Heberg
- Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark; Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark.
| | - Mette Kildevæld Simonsen
- The Parker Institute and Diakonissestiftelsen, Bispebjerg and Frederiksberg Hospital, Region H, Denmark
| | - Anne Kjaergaard Danielsen
- Department of Gastroenterology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark
| | - Tobias Wirenfeldt Klausen
- Department of Hematology, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, University of Copenhagen, Denmark
| | - Vibeke Zoffmann
- Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Tagensvej 22, 2200, Copenhagen N, Denmark; University of Copenhagen, IFSV, Section of Health Services Research, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen K, Denmark
| | - Thordis Thomsen
- Herlev Acute, Critical and Emergency Care Science Unit, Herlev and Gentofte Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark; University of Copenhagen, Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen N, Denmark
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Ekenga CC, Wang X, Pérez M, Schootman M, Jeffe DB. A Prospective Study of Weight Gain in Women Diagnosed with Early-Stage Invasive Breast Cancer, Ductal Carcinoma In Situ, and Women Without Breast Cancer. J Womens Health (Larchmt) 2019; 29:524-533. [PMID: 31460829 DOI: 10.1089/jwh.2018.7638] [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] [Indexed: 12/16/2022] Open
Abstract
Background: Weight gain after breast cancer has been associated with recurrence and mortality. We therefore examined factors associated with ≥5% weight gain over 2-year follow-up of a cohort of newly diagnosed early-stage invasive breast cancer (EIBC) and ductal carcinoma in situ (DCIS) patients and age-matched controls without a breast cancer history. Materials and Methods: We interviewed participants 4-6 weeks after definitive surgical treatment (patients) or a negative/benign screening mammogram (controls). Multivariable logistic regression models were used to identify socioeconomic, psychosocial, and treatment factors associated with ≥5% weight gain over 2-year follow-up. Results: Overall, 88 (24%) of 362 EIBC patients, 31 (17%) of 178 DCIS patients, and 82 (15%) of 541 controls had ≥5% weight gain during follow-up. EIBC patients were more likely to experience ≥5% weight gain than DCIS patients (Odds ratio [OR] = 2.16; 95% confidence interval [95% CI] = 1.19-3.95) and controls (OR = 1.76; 95% CI = 1.23-2.51). Among EIBC patients, older patients (OR = 0.96; 95% CI = 0.93-0.99), patients who underwent endocrine therapy (OR = 0.43; 95% CI = 0.19-0.95), smokers (OR = 0.35; 95% CI = 0.14-0.86), and African Americans (OR = 0.23; 95% CI = 0.09-0.58) were less likely to have ≥5% weight gain than their respective counterparts. Among DCIS patients, older patients (OR = 0.94; 95% CI = 0.89-0.99) were less likely to have ≥5% weight gain. Among controls, smokers were more likely to have ≥5% weight gain (OR = 3.03; 95% CI = 1.49-6.17). Conclusions: EIBC patients were more likely than DCIS patients and controls to experience ≥5% weight gain over follow-up. Studies are necessary to elucidate mechanisms of weight gain in early-stage breast cancer survivors.
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Affiliation(s)
| | - Xiaoyan Wang
- Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Maria Pérez
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Mario Schootman
- Department of Clinical Analytics and Insight, Center for Clinical Excellence, SSM Health, St. Louis, Missouri
| | - Donna B Jeffe
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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St-Pierre M, Sinclair I, Elgbeili G, Bernard P, Dancause KN. Relationships between psychological distress and health behaviors among Canadian adults: Differences based on gender, income, education, immigrant status, and ethnicity. SSM Popul Health 2019; 7:100385. [PMID: 31193063 PMCID: PMC6514727 DOI: 10.1016/j.ssmph.2019.100385] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 01/09/2019] [Accepted: 03/12/2019] [Indexed: 12/23/2022] Open
Abstract
Objective Psychosocial health predicts physical health outcomes in both clinical samples and the general population. One mechanism is through relationships with health behaviors. Results might differ based on sociodemographic characteristics such as education, income, ethnicity, and immigrant status. Our objective was to analyze sociodemographic differences in relationships between psychosocial health measures and health behaviors in the general population of Canadian adults. Methods We analyzed relationships between non-specific psychological distress, assessed using the Kessler-10 scale, and five key health behaviors: fruit and vegetable intake, screen sedentary behavior, physical activity, alcohol consumption, and cigarette use. Data were collected by Statistics Canada for the Canadian Community Health Survey in 2011–2014. Our sample included 54,789 participants representative of 14,555,346 Canadian adults. We used univariate general linear models on the weighted sample to analyze relationships between distress (predictor) and each health behavior, controlling for age. We entered sex and one of four sociodemographic variable of interest (education, income, ethnicity, immigrant status) into each model to analyze gender and sociodemographic differences in relationships. Results Greater distress predicted less fruit and vegetable intake and physical activity, and greater screen sedentary behavior and cigarette use, in the full sample, with small effect sizes (partial η2 up to 0.013). Differences by gender and sociodemographic characteristics were evident for all health behaviors. Conclusions Psychosocial health might contribute to persistent socioeconomic disparities in health in part through relationships with health behaviors, although relationships in the general population are modest. Health behavior interventions incorporating psychosocial health might need to be tailored based on socioeconomic characteristics, and future research on intersections between multiple sociodemographic risk factors remains necessary. Past studies show relationships between psychosocial health and health behaviors. Relationships might differ based on sociodemographic characteristics. We analyzed distress and five health behaviors in a nationally representative sample. Relationships differed based on gender, education, income, immigration status, and ethnicity. Modest relationships observed might be important given persistent health disparities.
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Affiliation(s)
- Myriane St-Pierre
- Université du Québec à Montréal (UQAM), Département des Sciences de l'activité Physique, Montreal, QC, Canada
| | - Isabelle Sinclair
- Université du Québec à Montréal (UQAM), Département des Sciences de l'activité Physique, Montreal, QC, Canada
| | - Guillaume Elgbeili
- Douglas Hospital Research Center, Psychosocial Research Division, Montreal, QC, Canada
| | - Paquito Bernard
- Université du Québec à Montréal (UQAM), Département des Sciences de l'activité Physique, Montreal, QC, Canada
- Institut universitaire en santé mentale de Montréal, Montreal, QC, Canada
| | - Kelsey Needham Dancause
- Université du Québec à Montréal (UQAM), Département des Sciences de l'activité Physique, Montreal, QC, Canada
- Corresponding author. Département des Sciences de l'activité Physique, Faculté des sciences, Université du Québec à Montréal (UQAM), 141, avenue du Président-Kennedy, Montréal, QC H2X 1Y4, Canada.
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Allen AM, Weinberger AH, Wetherill RR, Howe CL, McKee SA. Oral Contraceptives and Cigarette Smoking: A Review of the Literature and Future Directions. Nicotine Tob Res 2019; 21:592-601. [PMID: 29165663 PMCID: PMC6468133 DOI: 10.1093/ntr/ntx258] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 11/16/2017] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Evidence continues to mount indicating that endogenous sex hormones (eg, progesterone and estradiol) play a significant role in smoking-related outcomes. Although approximately one out of four premenopausal smokers use oral contraceptives (OCs), which significantly alter progesterone and estradiol levels, relatively little is known about how OCs may influence smoking-related outcomes. Thus, the goal of this review article is to describe the state of the literature and offer recommendations for future directions. METHODS In March 2017, we searched seven databases, with a restriction to articles written in English, using the following keywords: nicotine, smoker(s), smoking, tobacco, cigarettes, abstinence, withdrawal, and craving(s). We did not restrict on the publication date, type, or study design. RESULTS A total of 13 studies were identified. Three studies indicated faster nicotine metabolism in OC users compared to nonusers. Five of six laboratory studies that examined physiological stress response noted heightened response in OC users compared to nonusers. Three studies examined cessation-related symptomatology (eg, craving) with mixed results. One cross-sectional study observed greater odds of current smoking among OC users, and no studies have explored the relationship between OC use and cessation outcomes. CONCLUSIONS Relatively few studies were identified on the role of OCs in smoking-related outcomes. Future work could explore the relationship between OC use and mood, stress, weight gain, and brain function/connectivity, as well as cessation outcomes. Understanding the role of OC use in these areas may lead to the development of novel smoking cessation interventions for premenopausal women. IMPLICATIONS This is the first review of the relationship between oral contraceptives (OCs) and smoking-related outcomes. The existing literature suggests that the use of OCs is related to increased nicotine metabolism and physiological stress response. However, the relationship between OC use and smoking-related symptoms (eg, craving) is mixed. Further, no published data were available on OC use and smoking cessation outcomes. Therefore, we recommend additional research be conducted to characterize the relationship between OC use and smoking cessation outcomes, perhaps as a function of the effect of OC use on mood, stress, weight gain, and brain function/connectivity.
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Affiliation(s)
- Alicia M Allen
- Family & Community Medicine Department, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, USA
| | - Reagan R Wetherill
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Carol L Howe
- University of Arizona Health Sciences Library, University of Arizona, Tucson, AZ
| | - Sherry A McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
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Oncken C, Dornelas EA, Kuo CL, Sankey HZ, Kranzler HR, Mead EL, Thurlow MSD. Randomized Trial of Nicotine Inhaler for Pregnant Smokers. Am J Obstet Gynecol MFM 2019; 1:10-18. [PMID: 31380506 DOI: 10.1016/j.ajogmf.2019.03.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Background Smoking during pregnancy is a serious public health problem in need of better treatments. Nicotine replacement treatment (NRT) (patch or gum) has not been shown in randomized placebo-controlled trials to be efficacious for smoking cessation during pregnancy. However, the nicotine inhaler may have advantages over other NRTs as it replicates some of the sensory effects of smoking. Objective The purpose of the study was examine the efficacy and safety of the nicotine inhaler for smoking cessation during pregnancy. We hypothesized that the nicotine inhaler compared to placebo would increase quit rates and reduce smoking during treatment and at the end of pregnancy, result in a higher birth weight and gestational age in the offspring, and reduce the incidence of preterm birth and low birth weight infants. Study Design We conducted a randomized, double-blind, placebo-controlled trial of the nicotine inhaler for smoking cessation during pregnancy. Pregnant women who smoked ≥5 cigarettes daily received behavioral counseling and random assignment to a 6-week treatment with nicotine or placebo inhaler, followed by a 6-week taper period. Throughout treatment, we assessed tobacco exposure biomarkers, cessation rates, and adverse events. We also obtained information on birth outcomes. The primary outcome was smoking cessation at 32-34 weeks gestation; secondary outcomes were smoking reduction, birth weight and gestational age, and the incidence of preterm birth or low birth weight infants. We compared treatment groups on these measures using t-tests, Fisher's exact tests, and multivariate linear and logistic regression. Results Participants in the placebo (n=67) and nicotine (n=70) groups were comparable on baseline characteristics, though women in the placebo group reported a higher motivation to quit (p=0.016). Biochemically-validated smoking cessation rates were similar with nicotine and placebo (after 6 weeks of treatment: 4% (3/70) vs. 3% (2/67), respectively, p< 0.99, and at 32-34 weeks gestation: 10% (7/70) vs. 18% (12/67), respectively, p=0.220). Cigarettes per day (CPD) decreased over time in both groups (p< 0.001), with the nicotine inhaler group having a greater decrease than the placebo group two (p=0.022) and six weeks after the quit date (p=0.042), but not at 32-34 weeks gestation (p=0.108). Serum cotinine levels, birth weight, gestational age and reductions in carbon monoxide did not differ by group. However, the incidence of preterm delivery was higher in the placebo than the nicotine group: 15% (10/67) vs. 4% (3/67), respectively, p=0.030). The incidence of delivering a low birth weight infant was also higher in the placebo than the nicotine group: 15% (10/67) vs. 6% (4/67), respectively, p=0.035, but not after adjusting for preterm delivery p=0.268. Conclusions Although the nicotine inhaler group did not have a higher quit rate during pregnancy than the placebo group, the outcome of preterm delivery occurred less frequently in the nicotine group.
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Affiliation(s)
- Cheryl Oncken
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT.,Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, CT
| | - Ellen A Dornelas
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT.,Division of Oncology, Hartford Hospital, Hartford, CT
| | - Chia-Ling Kuo
- Connecticut Institute for Clinical and Translational Science, University of Connecticut School of Medicine, Farmington, CT
| | - Heather Z Sankey
- Department of Obstetrics and Gynecology, Baystate Medical Center, Springfield, MA
| | - Henry R Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Erin L Mead
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT
| | - Ms Sheila D Thurlow
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT
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Population risk and burden of health behavioral-related all-cause, premature, and amenable deaths in Ontario, Canada: Canadian Community Health Survey-linked mortality files. Ann Epidemiol 2019; 32:49-57.e3. [PMID: 30803751 DOI: 10.1016/j.annepidem.2019.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/10/2019] [Accepted: 01/22/2019] [Indexed: 11/22/2022]
Abstract
PURPOSE To examine the association of all-cause and premature mortality with four modifiable lifestyle behaviors and quantify the burden of behavioral-related premature death in Ontario, Canada. METHODS We analyzed a cohort of 149,262 adults in the 2000-2010 Canadian Community Health Surveys, linked to vital statistics data to ascertain deaths until December 31, 2015. The strength of the association between behaviors (smoking, body mass index, physical inactivity, and alcohol consumption) and all-cause and premature mortality was estimated using sex-specific Cox proportional hazards models. We estimated the proportion of deaths from causes amenable to the health system by behavior. RESULTS After full adjustment, hazard ratios (95% confidence interval) for premature mortality were significantly increased for heavy smokers versus nonsmokers [males: 5.48 (4.55-6.60); females 4.45 (3.49-5.66)]; obese class III versus normal weight [males: 2.47 (1.76-3.48); females: 1.73 (1.29-2.31)]; and physically inactive versus active [males: 1.25 (1.07-1.45); females: 1.70 (1.41-2.04)]. In both sexes, a disproportionate burden of amenable deaths were experienced by heavy smokers, severely obese, physically inactive, and heavy drinkers. CONCLUSIONS The findings emphasize the importance of prevention to reduce the prevalence of risk behaviors that contribute to a large burden of premature deaths that are amenable to the health system.
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Sheffer CE, Prashad N, Lunden S, Malhotra R, O'Connor RJ. To smoke or not to smoke: Does delay discounting affect the proximal choice to smoke? Subst Use Misuse 2019; 54:1237-1246. [PMID: 30982388 PMCID: PMC6629040 DOI: 10.1080/10826084.2018.1528463] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Delay discounting rate shows robust predictive validity for tobacco use behaviors and is a new therapeutic target in the treatment of tobacco use. Identifying factors that influence relations between delay discounting and the choice to smoke cigarettes is key to the development of effective interventions that target delay discounting to reduce cigarette consumption. OBJECTIVE To examine relations between delay discounting, motivational factors, self-efficacy, nicotine dependence level, and the proximal choice to smoke in the context of other commonly rewarding activity choices. METHODS In this cross-sectional design, daily smokers (n = 480) from Amazon Mechanical Turk completed a questionnaire that assessed delay discounting rate; motivation, intention, and self-efficacy to quit smoking; nicotine dependence level, and the preference for immediately engaging in multiple commonly rewarding activities. We hypothesized that 1) greater motivation to quit would be associated with lower priority given to smoking; 2) the relation between delay discounting and the priority given to smoking would be mediated by motivation, self-efficacy, and nicotine dependence level. RESULTS Greater motivation to quit was significantly associated with a lower priority given to smoking. The relation between delay discounting and the priority given to smoking was marginally mediated by nicotine dependence level (p > .057). CONCLUSIONS Motivation to quit influences decision-making by impacting the prioritization of choices. Nicotine dependence is likely to mediate the relation between delay discounting and the choice to smoke. Interventions that target delay discounting to reduce cigarette consumption or prevent relapse need to account for motivation to quit and nicotine dependence level.
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Affiliation(s)
- Christine E Sheffer
- a Roswell Park Comprehensive Cancer Center, Elm & Carlton , Buffalo , New York , USA
| | - Neelam Prashad
- b The City University of New York Medical School , 160 Convent Ave, City College of New York , New York , New York , USA
| | - Sara Lunden
- b The City University of New York Medical School , 160 Convent Ave, City College of New York , New York , New York , USA
| | - Ria Malhotra
- b The City University of New York Medical School , 160 Convent Ave, City College of New York , New York , New York , USA
| | - Richard J O'Connor
- a Roswell Park Comprehensive Cancer Center, Elm & Carlton , Buffalo , New York , USA
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Ngaruiya C, Abubakar H, Kiptui D, Kendagor A, Ntakuka MW, Nyakundi P, Gathecha G. Tobacco use and its determinants in the 2015 Kenya WHO STEPS survey. BMC Public Health 2018; 18:1223. [PMID: 30400915 PMCID: PMC6219013 DOI: 10.1186/s12889-018-6058-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND According to the World Health Organization (WHO), in 2015, over 1.1 billion people smoked tobacco, which represents around 15% of the global population. In Africa, around one in five adults smoke tobacco. The 2014 Kenya Global Adult Tobacco Survey reported that 2.5 million adults use tobacco products. The objective of our study was to describe patterns and determinants of tobacco use from the 2015 Kenya STEPS survey, including use of "smokeless" tobacco products and the more novel e-cigarettes. METHODS The WHO STEPwise approach to surveillance (STEPS) was completed in Kenya between April and June 2015. Logistic regression analyses was used to assess factors affecting prevalence and frequency of tobacco use. Sociodemographic variables associated with tobacco use were considered: age, sex, level of education, wealth quintile, and residence. The relationship with alcohol as an intervening risk factor was also assessed. Our main outcomes of interest were current tobacco use, daily tobacco use and use of smokeless tobacco products. RESULTS Of 4484 respondents, 605 (13.5%) reported being current tobacco users. Most active tobacco users were male (n = 507/605, 83.8%). Three out of four tobacco users (n = 468/605, 77.4%) reported being less than 50 years old, with the average start age being 21 (20.6, 95% CI 19.3-21.8) and the average quit age 27 (27.2, 95% CI 25.8-28.6). Most tobacco users had only ever attended up to primary school (n = 434/605, 71.7%). Men had nearly seven times higher odds of being tobacco users as compared to women (OR 7.63, 95% CI 5.63-10.33). Alcohol use had a positive effect on tobacco use. Finally, less than ten respondents reported having used e-cigarettes. CONCLUSION The 2015 Kenya WHO STEPS provided primary data on the status of tobacco use in the country and other leading NCD risk factors, such as alcohol, and associated diseases. Our findings highlight key target populations for tobacco cessation efforts: young people, men, those with lower levels of education, and alcohol consumers. Further data is needed on the use of smokeless tobacco, and its impact on smoked tobacco products, as well as on the novel use of e-cigarettes.
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Affiliation(s)
| | - Hussein Abubakar
- Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya
- Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya
| | - Dorcas Kiptui
- Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya
- Alcohol Control Focal Point, Ministry of Health, Nairobi, Kenya
| | - Ann Kendagor
- Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya
- Alcohol Control Focal Point, Ministry of Health, Nairobi, Kenya
| | - Melau W Ntakuka
- Alcohol Control Focal Point, Ministry of Health, Nairobi, Kenya
| | - Philip Nyakundi
- Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya
| | - Gladwell Gathecha
- Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya
- Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya
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Comiford AL, Rhoades DA, Spicer P, Ding K, Dvorak JD, Driskill L, Wagener TL, Doescher MP. E-cigarettes and Tobacco Exposure Biomarkers among American Indian Smokers. Am J Health Behav 2018; 42:101-109. [PMID: 30158005 DOI: 10.5993/ajhb.42.6.10] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective We assessed associations between electronic cigarette (e-cigarette) use and smoking-related measures among American Indians (AIs) who smoke. MethodsWe collected baseline survey and smoking biomarker data in a cohort of 375 adult AI smokers at a Cherokee Nation healthcare facility in Oklahoma. We used multivariate logistic and linear regression analyses to determine associations between e-cigarette use and smoking-related characteristics, including biomarkers. ResultsCurrent e-cigarette users were more likely than never users to report a quit attempt in the past 12 months (current vs never adjusted odds ratio (AOR) = 2.24 [95% CI 1.20-4.16]). Current and past e-cigarette users were more likely than never users to report a likelihood to quit smoking (current vs never AOR = 2.97 [95% CI 1.34-6.56]; past vs never AOR = 1.77 [95% CI 1.08-2.91]). E-cigarette use was not significantly associated with confidence to quit smoking, cigarette packs smoked per day, or cotinine levels. ConclusionsE-cigarette use was associated with previous and future quit attempts, but not with reductions in cigarette smoking or confidence in quitting. This suggests that many dual users might benefit from the addition of evidence-based smoking cessation treatments.
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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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Weaver KE, Snively BM, Hogan P, Josephs K, Johnson KC, Coday M, Progovac AM, Cirillo DJ, Ockene JK, Tindle HA. Predictors of Continued Smoking and Interest in Cessation Among Older Female Smokers. J Aging Health 2018; 30:624-640. [PMID: 28553800 DOI: 10.1177/0898264316687622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Older female smokers are highly vulnerable, yet little is known about their attitudes, beliefs, and behaviors regarding smoking cessation. METHODS Southeast region Women's Health Initiative participants identified as smokers on at least one prior assessment were surveyed in 2012 regarding current tobacco use. RESULTS Most of these current and former smokers ( N = 409, 63% response) were non-Hispanic White (81.7%) and had some college (80%), with mean age of 75.1 years. Current smoking was confirmed by 56%, and while 61% of these reported a past-year quit attempt, less than half used quit aids. Of current smokers, 57.5% intended to quit within 6 months (26.6% within 30 days), and 68% were interested in joining a cessation study. CONCLUSIONS Older female smokers were highly motivated to quit, yet profoundly underutilized proven quit aids. Results support high acceptability of cessation interventions for this undertreated population.
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Affiliation(s)
| | | | - Patricia Hogan
- 1 Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Karen C Johnson
- 3 University of Tennessee Health Science Center, Memphis, USA
| | - Mace Coday
- 3 University of Tennessee Health Science Center, Memphis, USA
| | - Ana M Progovac
- 4 Harvard Medical School, Boston, MA, USA
- 5 Cambridge Health Alliance, Cambridge, MA, USA
| | - Dominic J Cirillo
- 6 University of Rochester School of Medicine and Dentistry and Department of Epidemiology, NY, USA
- 7 University of Iowa College of Public Health, Rochester, NY, USA
| | - Judith K Ockene
- 8 University of Massachusetts Medical School, Worcester, USA
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Eisenbaum E, DiNitto DM, Bishop-Fitzpatrick L. Gender differences in tobacco use among U.S. Special Olympics athletes. Disabil Health J 2018; 11:466-470. [PMID: 29428208 DOI: 10.1016/j.dhjo.2018.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 01/11/2018] [Accepted: 01/20/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The rise in women's tobacco use and subsequent health complications has generated an increase in gender-related tobacco use research. However, no research has examined gender's influence on tobacco use among people with intellectual and developmental disabilities (IDD). OBJECTIVE To examine 1) tobacco use prevalence rates among men and women with IDD, and 2) correlates of tobacco use among men and women with IDD. METHODS This study examined gender differences in tobacco use among a sample of 3587 adult U.S. Special Olympics athletes who participated in health screenings from 2007 to 2014. The athletes were aged 18-89 (M = 32.86); 55.8% were male. Prevalence rates were calculated for men and women, and logistic regression analyses were conducted to examine tobacco use's association with age, blood pressure, body mass index, family member tobacco use, and daily fruit and vegetable consumption for each gender. RESULTS Women's tobacco use prevalence was 4.1%, and men's was 9.4%. The only variable significantly associated with women's tobacco use was family member use, while men's tobacco use was associated with age, systolic blood pressure, family member tobacco use, and fruit and vegetable consumption. CONCLUSION Results shed light on possible courses of action for reducing tobacco use among women and men with IDD. Further research is needed to develop effective prevention and intervention approaches appropriate for people with IDD.
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Affiliation(s)
- Elaine Eisenbaum
- University of Kentucky, Human Development Institute, 120 Graham Avenue, Lexington, KY 40508, USA.
| | - Diana M DiNitto
- The University of Texas at Austin, School of Social Work, 1925 San Jacinto Blvd, Stop D3500, Austin, TX 78712-1405, USA.
| | - Lauren Bishop-Fitzpatrick
- University of Wisconsin-Madison, School of Social Work, 1350 University Ave., Madison, WI 53706, USA.
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81
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Allen AM, Abdelwahab NM, Carlson S, Bosch TA, Eberly LE, Okuyemi K. Effect of brief exercise on urges to smoke in men and women smokers. Addict Behav 2018; 77:34-37. [PMID: 28950116 DOI: 10.1016/j.addbeh.2017.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 09/01/2017] [Accepted: 09/17/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Although smoking urges have been demonstrated to vary by gender and also be influenced by exercise, it is unknown if exercise has a differential effect on smoking urges by gender. This study aimed to explore gender-specific effects of an acute bout of exercise on cessation-related symptoms in men and women smokers during acute abstinence. METHODS We enrolled smokers (≥5 cigarettes/day) who were 18-40years old for a study on exercise and smoking behavior. Participants abstained from smoking for at least 3h, prior to measurement of their maximal oxygen consumption tested, which was the acute bout of exercise. Prior to and after the exercise, participants completed the Questionnaire of Smoking Urges - Brief and the Minnesota Nicotine Withdrawal Scale. RESULTS Participants (n=38; 61% women) were, on average, 30.0±0.9years old and smoked 13.0±0.8 cigarettes/day. All measured aspects of cessation-related symptoms significantly improved after the exercise in both men and women. In women there was a significant decline in anticipated relief from negative affect after the exercise (women: -0.45±0.20, p=0.0322; men: -0.41±0.26, p=0.1312). In men there was a significant decline in the intention to smoke after the exercise (men: -0.77±0.23, p=0.0053; women: -0.66±0.37, p=0.0909). CONCLUSIONS An acute bout of exercise reduced smoking urges in both men and women smokers during an acute state of abstinence. Additional research is needed to replicate these observations in a larger, more diverse sample, and to explore the implication of these observations on cessation.
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82
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Triandafilidis Z, Ussher JM, Perz J, Huppatz K. Young Australian women's accounts of smoking and quitting: a qualitative study using visual methods. BMC WOMENS HEALTH 2018; 18:5. [PMID: 29301518 PMCID: PMC5755039 DOI: 10.1186/s12905-017-0500-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/19/2017] [Indexed: 11/21/2022]
Abstract
Background Although the overall rate of smoking in Australia continues to decline, the rate of decline has begun to slow. Rates of smoking among young women in Australia have been a particular concern, which has led to the development of targeted public health campaigns. Poststructuralist theory has successfully been used in research to explore the way in which young women experience smoking. However, there is an absence of poststructuralist analysis of young women’s experiences of quitting. This study aims to address this gap. Methods We carried out 27 interviews with young Australian women smokers and ex-smokers. Eighteen of those women then participated in a photography activity and follow-up interviews. A Foucauldian discourse analysis of the data was conducted. Results Through our analysis, we identified three discourses: ‘The irresponsibility of smoking: Quitting as responsible’, ‘The difficulties of quitting: Smoking as addictive’, and ‘Making a decision to quit: Smoking as a choice’. In relation to these discourses, participants took up contradictory positions of responsibility and resistance, addiction and agency. Taking up these positions had implications for young women’s subjectivity, and the way they engaged with tobacco controls and cessation support. Conclusions The analysis highlights the complex and contradictory nature of young women’s experiences with smoking and quitting. The study’s findings are considered in relation to the improvement of tobacco control policies and cessation support programmes targeted at young women.
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Affiliation(s)
- Zoi Triandafilidis
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia.
| | - Jane M Ussher
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
| | - Kate Huppatz
- School of Social Sciences and Psychology, Western Sydney University, Locked Bag 1797, Penrith South, NSW, 2751, Australia
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83
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Oliveira RMD, Santos JLF, Furegato ARF. Tobacco addiction in the psychiatric population and in the general population. Rev Lat Am Enfermagem 2017; 25:e2945. [PMID: 29211192 PMCID: PMC5738870 DOI: 10.1590/1518-8345.2202.2945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/02/2017] [Indexed: 11/21/2022] Open
Abstract
Objective: To estimate the degree of tobacco addiction and identify independently associated
factors by comparing the psychiatric population of secondary and tertiary care
with the general population of the primary healthcare network. Method: This is a cross-sectional epidemiological study, conducted in a municipality of
São Paulo, with 134 smokers of a Mental Health Outpatient Unit (MHOU), a
Psychiatric Hospital (PH), and a Primary Healthcare Unit (PHU). Data were
collected by means of individual interviews, recorded on a mobile device. Data
were statistically processed using Stata/12 Results: Of the 134 participants, 54.5% were women. While 49.1% of the psychiatric
population (MHOU/PH) had medium/high nicotine addiction, 58.3% of smokers of the
general population had very low/low dependency. The Poisson regression model
indicated a higher prevalence of smokers with high dependence among men (PR =
1.41), people aged 49 years or less (15 - 29 years, PR = 4.06, 30 - 39 PR = 2.96
years, 40 - 49 years PR = 1.84), with severe mental disorders (PR = 3.05), with
anxiety disorders/other (PR = 3.98), and with high suicide risk (PR = 1.55). Conclusion: Nicotine dependence was greater in the psychiatric population than in the general
population. The independent factors associated with severe dependence were sex,
age group, diagnosis, and current risk of suicide. These results trigger
reflection among nurses on the need to focus more attention on a neglected subject
in mental health services.
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Affiliation(s)
| | - Jair Lício Ferreira Santos
- PhD, Full Professor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonia Regina Ferreira Furegato
- PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
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84
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Cross SJ, Linker KE, Leslie FM. Sex-dependent effects of nicotine on the developing brain. J Neurosci Res 2017; 95:422-436. [PMID: 27870426 DOI: 10.1002/jnr.23878] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/08/2016] [Accepted: 07/14/2016] [Indexed: 02/06/2023]
Abstract
The use of tobacco products represents a major public health concern, especially among women. Epidemiological data have consistently demonstrated that women have less success quitting tobacco use and a higher risk for developing tobacco-related diseases. The deleterious effects of nicotine are not restricted to adulthood, as nicotinic acetylcholine receptors regulate critical aspects of neural development. However, the exact mechanisms underlying the particular sensitivity of women to develop tobacco dependence have not been well elucidated. In this mini-review, we show that gonadal hormone-mediated sexual differentiation of the brain may be an important determinant of sex differences in the effects of nicotine. We highlight direct interactions between sex steroid hormones and ligand-gated ion channels critical for brain maturation, and discuss the extended and profound sexual differentiation of the brain. We emphasize that nicotine exposure during the perinatal and adolescent periods interferes with normal sexual differentiation and can induce long-lasting, sex-dependent alterations in neuronal structure, cognitive and executive function, learning and memory, and reward processing. We stress important age and sex differences in nicotine's effects and emphasize the importance of including these factors in preclinical research that models tobacco dependence. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Sarah J Cross
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California
| | - Kay E Linker
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California
| | - Frances M Leslie
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, California.,Department of Pharmacology, School of Medicine, University of California, Irvine, California
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85
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Abbate KJ, Hingle MD, Armin J, Giacobbi P, Gordon JS. Recruiting Women to a Mobile Health Smoking Cessation Trial: Low- and No-Cost Strategies. JMIR Res Protoc 2017; 6:e219. [PMID: 29101091 PMCID: PMC5695655 DOI: 10.2196/resprot.7356] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 05/26/2017] [Accepted: 09/04/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Successful recruitment of participants to mobile health (mHealth) studies presents unique challenges over in-person studies. It is important to identify recruitment strategies that maximize the limited recruitment resources available to researchers. OBJECTIVE The objective of this study was to describe a case study of a unique recruitment process used in a recent mHealth software app designed to increase smoking cessation among weight-concerned women smokers. The See Me Smoke-Free app was deployed to the Google Play Store (Alphabet, Inc., Google, LLC), where potential participants could download the app and enroll in the study. Users were invited in-app to participate in the study, with no in-person contact. The recruitment activities relied primarily on earned (free) and social media. METHODS To determine the relationship between recruitment activities and participant enrollment, the researchers explored trends in earned and social media activity in relation to app installations, examined social media messaging in relation to reach or impressions, and described app users' self-reported referral source. The researchers collected and descriptively analyzed data regarding recruitment activities, social media audience, and app use during the 18-week recruitment period (March 30, 2015-July 31, 2015). Data were collected and aggregated from internal staff activity tracking documents and from Web-based data analytics software such as SumAll, Facebook Insights (Facebook, Inc.), and Google Analytics (Alphabet, Inc., Google, LLC). RESULTS Media coverage was documented across 75 publications and radio or television broadcasts, 35 of which were local, 39 national, and 1 international. The research team made 30 Facebook posts and 49 tweets, yielding 1821 reaches and 6336 impressions, respectively. From March 30, 2015 to July 31, 2015, 289 unique users downloaded the app, and 151 participants enrolled in the study. CONCLUSIONS Research identifying effective online recruitment methods for mHealth studies remains minimal, and findings are inconsistent. We demonstrated how earned media can be leveraged to recruit women to an mHealth smoking cessation trial at low cost. Using earned media and leveraging social media allowed us to enroll 3 times the number of participants that we anticipated enrolling. The cost of earned media resides in the staff time required to manage it, particularly the regular interaction with social media. We recommend communication and cooperation with university public affairs and social media offices, as well as affiliate programs in journalism and communications, so that earned media can be used as a recruitment strategy for mHealth behavior change interventions. However, press releases are not always picked up by the media and should not be considered as a stand-alone method of recruitment. Careful consideration of an intervention's broad appeal and how that translates into potential media interest is needed when including earned media as part of a comprehensive recruitment plan for mHealth research.
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Affiliation(s)
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture & Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Julie Armin
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, United States
| | - Peter Giacobbi
- Department of Social and Behavioral Sciences, West Virginia University, Morgantown, WV, United States
| | - Judith S Gordon
- College of Nursing, University of Arizona, Tucson, AZ, United States
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86
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Lynch WJ, Tan L, Narmeen S, Beiter R, Brunzell DH. Exercise or saccharin during abstinence block estrus-induced increases in nicotine-seeking. Physiol Behav 2017; 203:33-41. [PMID: 29080668 DOI: 10.1016/j.physbeh.2017.10.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/29/2017] [Accepted: 10/23/2017] [Indexed: 12/11/2022]
Abstract
Recent evidence suggests that adolescent and young adult females may be particularly responsive to nicotine use interventions that include exercise or environmental enrichment. This possibility was addressed in the current study by comparing the efficacy of exercise versus non-exercise environmental enrichment (saccharin) during abstinence at reducing subsequent nicotine-seeking/relapse vulnerability in an adolescent-onset rat model. The efficacy of each intervention was examined as a function of estrous cycle phase given findings indicating that hormonal status influences relapse vulnerability and treatment outcome in females. Once adolescent female rats acquired nicotine self-administration, they were given 23-h/day access to nicotine (0.01mg/kg/infusion) for 10days. Following the last self-administration session, rats began a 10-day forced abstinence period with 2-h/day access to an unlocked wheel (exercise, n=15), a bottle containing a saccharin-sweetened solution (0.25%; saccharin, n=19), or without access to a wheel or saccharin (control, n=20). Nicotine-seeking, as assessed under an extinction/cued-induced reinstatement procedure, was examined on day 11 of abstinence. Levels of nicotine-seeking were highest in females tested during estrus as compared to females tested during non-estrus phases. Exercise or saccharin during abstinence reduced nicotine-seeking in females tested during estrus, but neither affected the low levels of nicotine-seeking observed in females tested during non-estrus phases, presumably due to a floor effect. These results demonstrate that exercise or saccharin during abstinence decrease nicotine-seeking, and suggest that either would be effective as an early intervention for nicotine use and addiction in females.
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Affiliation(s)
- Wendy J Lynch
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA.
| | - Lillian Tan
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Syeda Narmeen
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Rebecca Beiter
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA 22902, USA
| | - Darlene H Brunzell
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA 23298, USA
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87
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Dumais KM, Franklin TR, Jagannathan K, Hager N, Gawrysiak M, Betts J, Farmer S, Guthier E, Pater H, Janes AC, Wetherill RR. Multi-site exploration of sex differences in brain reactivity to smoking cues: Consensus across sites and methodologies. Drug Alcohol Depend 2017; 178:469-476. [PMID: 28711813 PMCID: PMC5567981 DOI: 10.1016/j.drugalcdep.2017.05.044] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/04/2017] [Accepted: 05/25/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Biological sex influences cigarette smoking behavior. More men than women smoke, but women have a harder time quitting. Sex differences in smoking cue (SC) reactivity may underlie such behavioral differences. However, the influence of sex on brain reactivity to SCs has yielded inconsistent findings suggesting the need for continued study. Here, we investigated the effect of sex on SC reactivity across two sites using different imaging modalities and SC stimulus types. METHODS Pseudo-continuous arterial spin-labeled (pCASL) perfusion functional magnetic resonance imaging (fMRI) was used to assess brain responses to SC versus non-SC videos in 40 smokers (23 females) at the University of Pennsylvania. BOLD fMRI was used to assess brain responses to SC versus non-SC still images in 32 smokers (18 females) at McLean Hospital. Brain reactivity to SCs was compared between men and women and was correlated with SC-induced craving. RESULTS In both cohorts, males showed higher SC versus non-SC reactivity compared to females in reward-related brain regions (i.e., ventral striatum/ventral pallidum, ventral medial prefrontal cortex). Brain activation during SC versus non-SC exposure correlated positively with SC-induced subjective craving in males, but not females. CONCLUSIONS The current work provides much needed replication and validation of sex differences in SC-reactivity. These findings also add to a body of literature showing that men have greater reward-related brain activation to drug cues across drug classes. Such sex differences confirm the need to consider sex not only when evaluating SC-reactivity but when examining nicotine dependence etiology and treatment.
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Affiliation(s)
- Kelly M Dumais
- McLean Imaging Center, McLean Hospital, Harvard Medical School,115 Mill Street, Belmont, MA, 02478, USA.
| | - Teresa R Franklin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Kanchana Jagannathan
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Nathan Hager
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Michael Gawrysiak
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Jennifer Betts
- McLean Imaging Center, McLean Hospital, Harvard Medical School,115 Mill Street, Belmont, MA, 02478, USA
| | - Stacey Farmer
- McLean Imaging Center, McLean Hospital, Harvard Medical School,115 Mill Street, Belmont, MA, 02478, USA
| | - Emily Guthier
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Heather Pater
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
| | - Amy C Janes
- McLean Imaging Center, McLean Hospital, Harvard Medical School,115 Mill Street, Belmont, MA, 02478, USA
| | - Reagan R Wetherill
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania,3900 Chestnut Street, Philadelphia, PA, 19104, USA
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88
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Humphries KH, Izadnegahdar M, Sedlak T, Saw J, Johnston N, Schenck-Gustafsson K, Shah RU, Regitz-Zagrosek V, Grewal J, Vaccarino V, Wei J, Bairey Merz CN. Sex differences in cardiovascular disease - Impact on care and outcomes. Front Neuroendocrinol 2017; 46:46-70. [PMID: 28428055 PMCID: PMC5506856 DOI: 10.1016/j.yfrne.2017.04.001] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/31/2017] [Accepted: 04/13/2017] [Indexed: 02/07/2023]
Affiliation(s)
- K H Humphries
- Division of Cardiology, University of British Columbia, Vancouver, Canada; BC Centre for Improved Cardiovascular Health, Vancouver, Canada.
| | - M Izadnegahdar
- BC Centre for Improved Cardiovascular Health, Vancouver, Canada
| | - T Sedlak
- Division of Cardiology, University of British Columbia, Vancouver, Canada
| | - J Saw
- Division of Cardiology, University of British Columbia, Vancouver, Canada
| | - N Johnston
- Department of Medical Sciences, Cardiology, Uppsala University Hospital, Uppsala, Sweden
| | - K Schenck-Gustafsson
- Department of Medicine, Cardiac Unit and Centre for Gender Medicine, Karolinska University Hospital and Karolinska Institutet, Sweden
| | - R U Shah
- Division of Cardiovascular Medicine, University of Utah School of Medicine, USA
| | - V Regitz-Zagrosek
- Institute of Gender in Medicine (GIM) and Center for Cardiovascular Research (CCR) Charité, University Medicine Berlin and DZHK, Partner Site Berlin, Germany
| | - J Grewal
- Division of Cardiology, University of British Columbia, Vancouver, Canada
| | - V Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - J Wei
- Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA
| | - C N Bairey Merz
- Barbra Streisand Women's Heart Center, Cedars-Sinai Heart Institute, Los Angeles, CA, USA
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89
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Gordon JS, Armin J, D Hingle M, Giacobbi P, Cunningham JK, Johnson T, Abbate K, Howe CL, Roe DJ. Development and evaluation of the See Me Smoke-Free multi-behavioral mHealth app for women smokers. Transl Behav Med 2017; 7:172-184. [PMID: 28155107 PMCID: PMC5526811 DOI: 10.1007/s13142-017-0463-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Women face particular challenges when quitting smoking, especially those with weight concerns. A multi-behavioral smoking cessation intervention addressing these concerns and incorporating guided imagery may assist women to engage in healthy lifestyle behaviors. An mHealth app can easily disseminate such an intervention. The goals of this pilot study were to develop and test the feasibility and potential of the See Me Smoke-Free™ mHealth app to address smoking, diet, and physical activity among women smokers. We used pragmatic, direct-to-consumer methods to develop and test program content, functionality, and the user interface and conduct a pre-/post-test, 90-day pilot study. We enrolled 151 participants. Attrition was 52%, leaving 73 participants. At 90 days, 47% of participants reported 7-day abstinence and significant increases in physical activity and fruit consumption. Recruitment methods worked well, but similar to other mHealth studies, we experienced high attrition. This study suggests that a guided imagery mHealth app has the potential to address multiple behaviors. Future research should consider different methods to improve retention and assess efficacy.
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Affiliation(s)
- Judith S Gordon
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA.
| | - Julie Armin
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Melanie D Hingle
- Department of Nutritional Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, USA
| | - Peter Giacobbi
- College of Physical Activity and Sports Sciences, University of West Virginia, Morgantown, WV, USA
| | - James K Cunningham
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Thienne Johnson
- Departments of Computer Science and Electrical and Computer Engineering, University of Arizona, Tucson, AZ, USA
| | | | - Carol L Howe
- Department of Family and Community Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Denise J Roe
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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90
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Mowls DS, Boeckman L, Gillaspy SR, Beebe LA. Long-term Quit Rates in Fax-Referred as Compared to Self-Referred Tobacco Quitline Registrants. Am J Prev Med 2017; 52:e115-e121. [PMID: 27989452 DOI: 10.1016/j.amepre.2016.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 10/21/2016] [Accepted: 11/03/2016] [Indexed: 11/29/2022]
Abstract
INTRODUCTION To increase the use of quitlines for treating tobacco use and dependence, quitline referral interventions are recommended for healthcare systems and providers. Research is limited as to whether fax-referred smokers have quit outcomes similar to those of traditional self-callers to quitlines. METHODS Oklahoma Tobacco Helpline registration data from March 2013 to October 2014 and 7-month follow-up data were used to compare hospital- and clinic-based fax-referred registrants (n=537) to self-callers (n=2,577). Contingency table chi-square tests and relative risks were used to identify differences in 30-day point prevalence abstinence at 7-month follow-up. Two-sided p-values <0.05 were considered statistically significant. Analyses were conducted in 2015. RESULTS Fax-referred registrants versus self-callers were significantly more likely to be older (49.4 vs 47.6 years), white (70.6% vs 59.1%), non-Hispanic (96.8% vs 94.2%), and to have smoked fewer than one pack of cigarettes per day (54.0% vs 44.9%). Self-callers versus fax-referred registrants were significantly more likely to be uninsured (36.5% vs 29.4%) and have received nicotine-replacement therapy from the Helpline (92.3% vs 79.9%). At 7-month follow-up, a similar proportion of fax-referred registrants reported not using tobacco in the past 30 days as compared to self-callers (29.3% vs 31.8%, p=0.2945). CONCLUSIONS Although differences in sociodemographics, tobacco use behavior, and Helpline services were observed between fax-referred registrants and self-callers, quit outcomes at follow-up did not differ. This observational study has important implications for tobacco control initiatives as it shows patients fax-referred by hospitals and clinics to quitlines may be as successful as self-callers in quitting smoking.
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Affiliation(s)
- Dana S Mowls
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma;.
| | - Lindsay Boeckman
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Stephen R Gillaspy
- Department of Pediatrics Section of General and Community Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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91
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De Genna NM, Goldschmidt L, Day NL, Cornelius MD. Maternal trajectories of cigarette use as a function of maternal age and race. Addict Behav 2017; 65:33-39. [PMID: 27716477 DOI: 10.1016/j.addbeh.2016.09.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/19/2016] [Accepted: 09/28/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patterns of smoking vary as a function of age and race. The goals of this study were to identify trajectories of maternal cigarette use over a 17-year span, and to determine if maternal age at first birth and race were associated with smoking trajectories. METHODS Pregnant women (N=690) were recruited at an urban prenatal clinic. The women (13-42years old; 62% African-American, 38% White) were interviewed about cigarette use during pregnancy and 6, 10, 14, and 16years postpartum. Growth mixture modeling (GMM) was used to identify trajectories. Regressions were used to determine if maternal age at first birth and race predicted trajectory class membership. RESULTS A GMM of maternal cigarette use delineated 5 groups: none/unlikely to use (33%), decreasing likelihood of use (6%), late desistance (5%), increasing likelihood of use (17%), and chronic use (39%). Women who became mothers at a younger age were more likely to be classified as late desisters or increasingly likely to smoke. White mothers were more likely to be chronic smokers. Different smoking trajectories and predictors of trajectories were identified for the African-American and White mothers. Covariates including prenatal substance use, hostility, education, and economic hardship also differentiated smoking trajectories. CONCLUSIONS Both prevention and treatment of smoking should be targeted to specific groups by age of first pregnancy and race. Pregnant smokers should be provided with more information and resources to help them avoid cigarettes during pregnancy and maintain abstinence after pregnancy.
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Affiliation(s)
- Natacha Marie De Genna
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Lidush Goldschmidt
- University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Nancy L Day
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
| | - Marie D Cornelius
- University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA.
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92
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Allen A, Vogel RI, Meier E, Anderson A, Jensen J, Severson HH, Hatsukami D. Gender differences in snus versus nicotine gum for cigarette avoidance among a sample of US smokers. Drug Alcohol Depend 2016; 168:8-12. [PMID: 27610935 PMCID: PMC5215723 DOI: 10.1016/j.drugalcdep.2016.08.624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/12/2016] [Accepted: 08/17/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Women are more susceptible to the harmful effects of cigarette smoking. Thus, identifying effective harm reduction approaches for women is necessary. The goal of this project was to examine gender differences in response to snus versus nicotine gum for cigarette avoidance, as a means of harm reduction. METHODS Participants were randomly assigned to use snus or nicotine gum as a method to avoid cigarette smoking. Participants attended clinic visits to receive study product, as well as provide biological samples to assess smoking avoidance and biomarkers and report on use of study product and cigarettes. A secondary analysis comparing men and women by randomization to study product was conducted. RESULTS Participants (n=391; 47% women) were randomized into the snus group (n=196; 45% women) and the gum group (n=195; 49% women). Men used more snus whereas women used more gum (p=0.02). During treatment, men in the snus group had higher total nicotine equivalent values whereas women did not vary by group (p=0.03). Overall, fewer men in the snus group completely avoided cigarettes compared to men in the gum group (e.g., continuous abstinence at Week 12: odds ratio=0.43, 95% confidence interval=0.20-0.93). Among women, there were no differences by randomization in cigarette avoidance. CONCLUSIONS Despite a number of gender differences in response to snus versus nicotine gum, these data suggest that snus may not be an optimal harm reduction approach for either gender.
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Affiliation(s)
- Alicia Allen
- University of Minnesota, Family Medicine and Community Health, Minneapolis, MN, United States; University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States.
| | - Rachel Isaksson Vogel
- University of Minnesota, Gynecologic Oncology, Minneapolis, MN, United States,University of Minnesota, Masonic Comprehensive Cancer Center – Biostatistics and Bioinformatics Core, Minneapolis, MN, United States
| | - Ellen Meier
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | - Amanda Anderson
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | - Joni Jensen
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | | | - Dorothy Hatsukami
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States,University of Minnesota, Psychiatry, Minneapolis, MN, United States
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93
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Allen AM, Scheuermann TS, Nollen N, Hatsukami D, Ahluwalia JS. Gender Differences in Smoking Behavior and Dependence Motives Among Daily and Nondaily Smokers. Nicotine Tob Res 2015; 18:1408-13. [PMID: 26136526 DOI: 10.1093/ntr/ntv138] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 06/16/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION While the overall prevalence of smoking has declined, nondaily smoking is on the rise. Among daily smokers (DS) men tend to smoke more cigarettes per day and have higher dependence. Unfortunately little is known about gender differences in nondaily smokers (NDS). METHODS This secondary-data analysis utilized data from a cross-sectional online survey. Participants reported on smoking behavior (eg, cigarettes per day, history of quit attempts) and nicotine dependence motives as assessed by the Brief Wisconsin Inventory of Dependence Motives via the primary and secondary subscales (ie, core features of tobacco dependence such as craving and accessory motives such as weight control, respectively). RESULTS Participants were 1175 DS (60% women) and 1201 NDS (56% women). Two interactions between group and gender were noted suggesting that the NDS had greater gender differences in past quit attempts (P < .01) and reported change in smoking behavior over the past year (P < .01). Further, among the NDS group, men scored significantly higher than women on both the primary and secondary dependence motives subscales (3.6±0.1 vs. 2.9±0.1, P < .0001; 3.8±0.1 vs. 3.3±0.1, P < .0001; respectively). There were no significant differences in dependence motives in the DS group (P > .05). CONCLUSIONS Gender differences in smoking behavior and dependence motives varied between NDS and DS. Specifically, gender differences in smoking behavior and smoking dependence motives may be larger among NDS compared to DS. Additional research is needed to explore how these relationships may relate to smoking cessation in NDS.
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Affiliation(s)
- Alicia M Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN;
| | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Nicole Nollen
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN
| | - Jasjit S Ahluwalia
- Department of Epidemiology, School of Public Health, Rutgers, State University of New Jersey, Piscataway, NJ
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94
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KIM HC, LAMICHHANE DK, JUNG DY, KIM HR, CHOI EH, OH SS, KANG HT, RHEE KY, CHANG SJ. Association of active and passive smoking with occupational injury in manual workers: a cross-sectional study of the 2011 Korean working conditions survey. INDUSTRIAL HEALTH 2015; 53:445-453. [PMID: 26051290 PMCID: PMC4591137 DOI: 10.2486/indhealth.2015-0011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 05/21/2015] [Indexed: 06/04/2023]
Abstract
This study was conducted to investigate the relationship of active and passive smoking with occupational injury among manual workers. Data from the 2011 Korean Working Conditions Survey were analyzed for 12,507 manual workers aged ≥15 yr. Overall, 60.4% of men and 5.8% of women were current smokers. The prevalence of injury was higher among never smokers who were exposed to secondhand smoke (SHS) (7.7% in men and 8.1% in women) than current smokers (4.2% in men and 4.1% in women). After controlling for potential confounders, in men, compared to those who never smoked and were not exposed to SHS, people who never smoked and were exposed to SHS (adjusted odds ratio (aOR)=3.7, 2.2-6.4) and current smokers (aOR=2.5, 1.6-3.8) were more likely to experience injury. Among women, the aORs of occupational injury were 8.4 (4.2-16.7) for never smoking women with occasional exposure to SHS and 3.5 (95% CI: 1.4-8.7) for current smokers, in comparison to never smoking women who were never exposed to SHS at work (reference group). The present study suggests that exposure to SHS is a possible risk factor of occupational injury for never smoking men and women.
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Affiliation(s)
- Hwan-Cheol KIM
- Department of Occupational and Environmental Medicine, School
of Medicine, Inha University, Republic of Korea
| | - Dirga Kumar LAMICHHANE
- Department of Social and Preventive Medicine, School of
Medicine, Inha University, Republic of Korea
| | - Dal-Young JUNG
- Department of Social and Preventive Medicine, School of
Medicine, Inha University, Republic of Korea
| | - Hyoung-Ryoul KIM
- Department of Occupational and Environmental Medicine,
College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Eun-Hee CHOI
- Institute of Lifestyle Medicine, Wonju College of Medicine,
Yonsei University, Republic of Korea
| | - Sung-Soo OH
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
| | - Hee-Tae KANG
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
| | - Kyung-Yong RHEE
- Occupational Safety and Health Research Institute, KOSHA,
Republic of Korea
| | - Sei-Jin CHANG
- Department of Preventive Medicine and Institute of
Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University,
Republic of Korea
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95
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Allen AM, Lunos S, Heishman SJ, al'Absi M, Hatsukami D, Allen SS. Subjective response to nicotine by menstrual phase. Addict Behav 2015; 43:50-3. [PMID: 25553511 DOI: 10.1016/j.addbeh.2014.12.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 12/09/2014] [Accepted: 12/10/2014] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The luteal menstrual phase might be a favorable time for smoking cessation when non-nicotine interventions (e.g. counseling, bupropion) are used, whereas the follicular menstrual phase appears favorable when nicotine interventions are used. Thus, there may be an interaction between menstrual phase and response to nicotine. We sought to examine the role of menstrual phase on response to nicotine during acute smoking abstinence. METHODS In this controlled cross-over trial, women completed two identical experimental sessions (follicular [F] vs. luteal [L] phase) after four days of biochemically-verified smoking abstinence. During the sessions, nicotine nasal spray was administered, and participants provided a series of subjective assessments. RESULTS Participants (n=140) were 29.7±6.6years old and smoked 12.6±5.8 cigarettes per day. Compared to the F phase, the L phase was associated with a greater increase in stimulation (7.2±2.2 vs. 14.4±2.3, p=0.01, respectively) and greater decrease in urge to smoke (-13.6±2.3 vs. -21.1±2.5, p=0.02, respectively) after the first dose of nicotine. No other significant differences were observed. CONCLUSIONS Out of 13 total measures examined at two different time points, we observed only two significant menstrual phase differences in the subjective response to nicotine. Therefore, these data do not provide strong evidence for a menstrual phase difference in the subjective response to nicotine. Additional research is needed to confirm this relationship and explore how non-nicotine smoking reinforcements (such as sensory sensations) may vary by menstrual phase.
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Affiliation(s)
- Alicia M Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, 717 Delaware Street SE, Room 422, Minneapolis, MN, USA 55414.
| | - Scott Lunos
- Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, Minneapolis, MN 55414, USA
| | - Stephen J Heishman
- Nicotine Psychopharmacology Section, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mustafa al'Absi
- Department of Behavioral Sciences, Medical School, University of Minnesota, DuluthDuluth, MN 55812, USA
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN 55414, USA
| | - Sharon S Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota, Minneapolis, MN 55414, USA
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96
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Hinderaker K, Allen AM, Tosun N, al'Absi M, Hatsukami D, Allen SS. The effect of combination oral contraceptives on smoking-related symptomatology during short-term smoking abstinence. Addict Behav 2015; 41:148-51. [PMID: 25452059 DOI: 10.1016/j.addbeh.2014.10.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 08/12/2014] [Accepted: 10/19/2014] [Indexed: 12/20/2022]
Abstract
Although an estimated 25% of premenopausal smokers report using oral contraceptives (OC), little is known about how OC use may influence smoking cessation. The purpose of this study was to examine the difference in smoking-related symptomatology during acute smoking abstinence between women on a standardized combination OC (Tri-Sprintec(™)) compared to women not on OCs (no-OC). Participants were women aged 18-40 who smoked ≥5 cigarettes/day and reported regular menstrual cycles. Using a controlled cross-over design, participants completed two six-day testing weeks: Low Progesterone Week (LPW; Follicular (F) phase in no-OC or 1st week of pills in OC) and High Progesterone Week (HPW; Luteal (L) phase in no-OC or 3rd week of pills in OC). Each testing week included daily assessment of symptomatology and biochemical confirmation of smoking status. During smoking abstinence, the OC group (n=14) reported significantly lower levels of positive affect (21.56±7.12 vs. 24.57±6.46; β=3.63, p=0.0323) than the no-OC group (n=28). Further significant interactions between group and testing week were observed as follows: Smoking satisfaction was higher during LPW in the OC group (LPW: 4.29±1.30 vs. HPW: 4.10±1.37) but higher during HPW in the no-OC group (LPW: 3.91±1.30 vs. HPW: 4.23±1.30; β=-0.5499, p<0.0001). Similar interactions were noted in negative affect and psychological reward of smoking. These results suggest that women on OCs may have different patterns of smoking-related symptomatology during short-term smoking abstinence as compared to women not on OCs. Additional work is needed to examine how this may affect smoking cessation efforts.
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