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Cai L, Cui W, You D, He J, Zhao K. Socioeconomic variations in nicotine dependence in rural southwest China. BMC Public Health 2015; 15:1158. [PMID: 26597724 PMCID: PMC4657195 DOI: 10.1186/s12889-015-2492-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 11/16/2015] [Indexed: 11/16/2022] Open
Abstract
Background This study examines how nicotine dependence is distributed across socioeconomic gradients in rural Yunnan province, which has the most ethnic minorities in one province in southwest China. Methods A cross-sectional survey was conducted in four rural areas of Yunnan province among 17,158 consenting individuals aged ≥18 years in 2011. Information on demographic characteristics and smoking habits was obtained using a standard questionnaire. The Fagerstrom Test for Nicotine Dependence (FTND) was applied to assess nicotine dependence. Multilevel logistic regression was used to model the variation in prevalence of nicotine dependence. Results In the study population, the overall prevalence of current smokers and nicotine dependence was 32.4 % and 31.6 %, respectively. Females were much less likely to have nicotine addiction than males: odds ratio (OR) of 0.01 (95 % CI: 0.008 – 0.012). Higher annual household income was associated with a greater risk of nicotine dependence (OR 1.09, 95 % CI: 1.01 – 1.17). Adults who grew tobacco were more likely to have nicotine addiction (OR 1.22, 95 % CI 1.07 – 1.41). Individual educational level was inversely associated with the probability of nicotine dependence (OR 0.63, 95 % CI 0.55 – 0.72), lower community educational level was also associated with an increased risk of nicotine dependence (OR 0.94, 95 % CI 0.92 – 0.98). Conclusions Nicotine dependence showed significant variations across different indicators of both contextual and individual socioeconomic status in rural southwest China. Future interventions on tobacco cessation should give increased attention to men, tobacco farmers, less educated or poorer persons, and lower educational level communities.
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Affiliation(s)
- Le Cai
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China.
| | - Wenlong Cui
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
| | - Dingyun You
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
| | - Jianhui He
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
| | - Keying Zhao
- Cheng Gong New City, School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Kunming, 650500, China
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Hasin DS, Grant BF. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1609-40. [PMID: 26210739 PMCID: PMC4618096 DOI: 10.1007/s00127-015-1088-0] [Citation(s) in RCA: 270] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/28/2015] [Indexed: 01/12/2023]
Abstract
PURPOSE The NESARC, a "third-generation" psychiatric epidemiologic survey that integrated detailed measures of alcohol and drug use and problems has been the data source for over >850 publications. A comprehensive review of NESARC findings and their implications is lacking. METHOD NESARC was a survey of 43,093 participants that covered alcohol, drug and psychiatric disorders, risk factors, and consequences. Wave 1 of the NESARC was conducted in 2001-2002. Three years later, Wave 2 follow-up re-interviews were conducted with 34,653 of the original participants. Scopus and Pubmed were used to search for NESARC papers, which were sorted into topic areas and summarized. RESULT The most common disorders were alcohol and posttraumatic stress disorders, and major depression. Females had more internalizing disorders and males had more externalizing disorders, although the preponderance of males with alcohol disorders (the "gender gap") was less pronounced than it was in previous decades. A race/ethnic "paradox" (lower risk among disadvantaged minorities than whites) remains unexplained. Younger participants had higher risk for substance and personality disorders, but not unipolar depressive or anxiety disorders. Psychiatric comorbidity was extensive and often formed latent trans-diagnostic domains. Since 1991-1992, risk for marijuana and prescription drug disorders increased, while smoking decreased, although smoking decreases were less pronounced among those with comorbidity. A nexus of comorbidity, social support, and stress predicted transitions in diagnostic status between Waves 1 and 2. Childhood maltreatment predicted psychopathology. Alcohol and drug use disorders were seldom treated; attitudinal barriers (little perceived need, perceived alcoholism stigma, pessimism about efficacy) were more important in predicting non-treatment than financial barriers. CONCLUSIONS Understanding comorbidity and the effects of early stressors will require research incorporating biologic components, e.g., genetic variants and brain imaging. The lack of treatment for alcohol and drug disorders, predicted by attitudinal rather than financial variables, suggests an urgent need for public and professional education to reduce the stigma associated with these disorders and increase knowledge of treatment options.
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Affiliation(s)
- Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, New York, NY, 10032, USA
- Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Bridget F Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3077, Rockville, MD, 20852, USA.
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Lanza ST, Vasilenko SA. New methods shed light on age of onset as a risk factor for nicotine dependence. Addict Behav 2015; 50:161-4. [PMID: 26151579 DOI: 10.1016/j.addbeh.2015.06.024] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 06/04/2015] [Accepted: 06/05/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Early onset of substance use is a risk factor for later drug use, abuse, and dependence. This study examines how the rate of nicotine dependence differs as a function of age of onset of regular smoking in continuous time, in order to identify critical age periods that are most predictive of later dependence for males and females. METHODS Time-varying effect modeling (TVEM) can reveal specific ages of onset that confer greatest risk for adult nicotine dependence. The rate of dependence in adulthood is modeled as a flexible function of age of onset using a subset of adults (N = 15,748) from the National Epidemiologic Survey on Alcohol and Related Conditions who ever smoked regularly. RESULTS The peak risk of adult nicotine dependence coincides with onset of regular use at approximately 10 years old, with an elevated risk persisting to 20 years. The risk of dependence is significantly higher for females compared to males for onset of regular use between ages 9 and 18. CONCLUSIONS Results suggest that the risk of adult nicotine dependence is highest when onset of regular smoking occurs at around 10 years, though the associated risk is high for ages of onset into young adulthood. Early onset of regular use is a relatively stronger risk factor for adolescent females than males. Smoking prevention programs should focus on late childhood through early adolescence, particularly among females. TVEM provides a more nuanced understanding of the risk associated with different ages of onset of health risk behaviors.
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Taha F, Galea S, Hien D, Goodwin RD. Childhood maltreatment and the persistence of smoking: a longitudinal study among adults in the US. CHILD ABUSE & NEGLECT 2014; 38:1995-2006. [PMID: 25466425 PMCID: PMC4448710 DOI: 10.1016/j.chiabu.2014.10.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 10/15/2014] [Accepted: 10/23/2014] [Indexed: 06/04/2023]
Abstract
The current study examined the relationship between childhood maltreatment-emotional, physical, and severe physical maltreatment-and the initiation and persistence of smoking. Data were drawn from the Midlife Development in the United States (MIDUS) Survey Waves 1 and 2. Frequency of childhood emotional, physical, and severe physical maltreatment (never, rare, intermittent, frequent) reported at Wave 1 was examined in relation to ever smoking, smoking daily, and persistent daily smoking at Waves 1 and 2. Logistic regression analyses were used to calculate odds ratios (with 95% confidence intervals), which were then adjusted for potential confounders. Childhood emotional, physical, and severe physical maltreatment were associated with increased odds of ever smoking, smoking daily, and persistent smoking at Waves 1 and 2. The majority of these associations remained significant after adjusting for confounding variables. These results suggest a history of trauma may play a prominent role in recalcitrant cigarette smoking and suggest that the success rates of treatments for smoking cessation may be improved by integrating trauma treatment where appropriate.
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Affiliation(s)
- Farah Taha
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), 65-30 Kissena Boulevard, New York, NY 11367, USA
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Denise Hien
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA; City University of New York, City College, New York, NY 10031, USA
| | - Renee D Goodwin
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY), 65-30 Kissena Boulevard, New York, NY 11367, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
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Vergés A, Jackson KM, Bucholz KK, Trull TJ, Lane SP, Sher KJ. Personality disorders and the persistence of substance use disorders: A reanalysis of published NESARC findings. JOURNAL OF ABNORMAL PSYCHOLOGY 2014; 123:809-20. [PMID: 25314264 PMCID: PMC4229360 DOI: 10.1037/abn0000011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The purpose of this study was to examine whether published findings regarding the association of personality disorders (PDs) with the persistence of substance use disorders (SUDs) are attributable to an artifact due to time of assessment of the PD. Two previous studies analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and found that Antisocial PD, Schizotypal PD, and Borderline PD are unique predictors of SUDs. However, a design limitation in NESARC (assessment of PDs at different waves) can potentially compromise these findings. To assess the influence of time of assessment of PDs and to identify associations that might be robust to time of assessment, we compared the association of PDs with 2 estimates of SUD persistence that were based on different populations at risk: (a) among those who were diagnosed with SUD at baseline, the proportion who continued to meet full criteria at follow-up ("prediction"); and (b) among those who were diagnosed with SUD at follow-up, the proportion who met full criteria at baseline ("postdiction"). Differences between prediction and postdiction revealed a robust pattern of higher odds ratios for postdiction among PDs assessed at baseline, and lower odds ratios for postdiction among PDs assessed at follow-up. All published significant associations between PDs and persistence of SUDs became nonsignificant in the postdiction analyses, with the exception of obsessive-compulsive PD predicting nicotine dependence persistence. The present results raise serious doubts about the validity of published findings on PDs and SUD persistence from the NESARC. Design limitations in NESARC preclude a direct comparison among PDs measured at different waves.
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García-Rodríguez O, Blanco C, Wall MM, Wang S, Jin CJ, Kendler KS. Toward a comprehensive developmental model of smoking initiation and nicotine dependence. Drug Alcohol Depend 2014; 144:160-9. [PMID: 25262528 PMCID: PMC4253146 DOI: 10.1016/j.drugalcdep.2014.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 09/04/2014] [Accepted: 09/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND This study aims to identify predictors of smoking initiation and nicotine dependence (ND) to develop a comprehensive risk-factor model based on Kendler's development model for major depression. METHODS Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), Wave 2 (n=34,653). Risk factors were divided into five developmental tiers according to Kendler's model (childhood, early adolescence, late adolescence, adulthood, past-year). Hierarchical logistic regression models were built to predict the risk of smoking initiation and the risk of ND, given initiation. The continuation ratio (CR) was tested by ordinal logistic regression to examine whether the impact of the predictors was the same on smoking initiation or ND. RESULTS The final models highlighted the importance of different tiers for each outcome. The CR identified substantial differences in the predictors of smoking initiation versus ND. Childhood tier appears to be more determinant for smoking initiation while the effect of more distal tiers (i.e. childhood and early adolescence) was tempered by more proximal ones (i.e. late adolescence, adulthood and past-year) in ND, with few sex differences. CONCLUSIONS The differential effect of some predictors on each outcome shows the complexity of pathways from smoking initiation to ND. While some risk factors may be shared, others impact only at one stage or have even an inverse effect. An adaptation of Kendler's developmental model for major depression showed high predictive power for smoking initiation and ND.
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Affiliation(s)
- Olaya García-Rodríguez
- Department of Psychology, University of Oviedo, 33003 Oviedo, Spain; New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
| | - Carlos Blanco
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Melanie M. Wall
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Shuai Wang
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Chelsea J. Jin
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23298-0126, USA
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Wellman RJ, DiFranza JR, O'Loughlin J. Recalled first reactions to inhaling nicotine predict the level of physical dependence. Drug Alcohol Depend 2014; 143:167-72. [PMID: 25108583 DOI: 10.1016/j.drugalcdep.2014.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/15/2014] [Accepted: 07/16/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The level of physical dependence is a measure of addiction that correlates highly with addiction-associated changes in brain structure. We sought to determine whether age at first inhalation and initial reactions to inhaling nicotine are related to level of physical dependence in early adulthood. METHODS Young adults (n=312; mean age=24 years; 51% female) from the Nicotine Dependence in Teens study who had smoked at least once in the preceding three months completed self-report questionnaires in 2011-12. We assessed level of physical dependence with three validated self-report items assessing 'wanting,' 'craving' and 'needing' triggered by nicotine deprivation. Survey items assessed smoking behavior, including age at first inhalation, and recalled first reactions to inhaling nicotine. RESULTS After adjusting for covariates, experiencing relaxation, heart racing/pounding, rush or "buzz" (OR=1.45; 95% CI: 1.08, 1.94) and dizziness (OR=1.58; 95% CI: 1.15, 2.18) at first nicotine inhalation were associated with an increased odds of being at a higher level of physical dependence in young adulthood; the association for experiencing relaxation (OR=1.78; 95% CI: 1.20, 2.64) and heart racing/pounding (OR=1.51; 95% CI: 1.00, 2.28) persisted after additionally controlling for all other first reactions. Neither age at first inhalation nor unpleasant first reactions predicted level of physical dependence. CONCLUSIONS In accordance with prior research, our findings suggest that smokers who are particularly sensitive to the pleasant, "buzz-related" and generally arousing effects of nicotine may be more likely to attain higher levels of physical dependence.
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Affiliation(s)
- Robert J Wellman
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, USA
| | - Joseph R DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts, 01655, USA.
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, University of Montréal, 3875 St. Urbain, 1st Floor, Montreal, Quebec, H2W 1V1, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal, Tour St-Antoine, 850 St-Denis, Montreal, Quebec, H2X 0A9, Canada; Institut national de santé publique du Québec, 945 Wolfe Avenue, Quebec (QC) G1V 5B3, Canada
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Erez G, Pilver CE, Potenza MN. Gender-related differences in the associations between sexual impulsivity and psychiatric disorders. J Psychiatr Res 2014; 55:117-25. [PMID: 24793538 PMCID: PMC4165523 DOI: 10.1016/j.jpsychires.2014.04.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Revised: 03/12/2014] [Accepted: 04/10/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Sexual impulsivity (SI) has been associated with conditions that have substantial public health costs, such as sexually transmitted infections and unintended pregnancies. However, SI has not been examined systematically with respect to its relationships to psychopathology. We aimed to investigate associations between SI and psychopathology, including gender-related differences. METHOD We performed a secondary data analysis of Wave-2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national sample of 34,653 adults in the United States. DSM-IV-based diagnoses of mood, anxiety, drug and personality disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Scheduled DSM-IV Version. RESULTS The prevalence of SI was considerable (14.7%), with greater acknowledgment by men than women (18.9% versus 10.9%; p < 0.0001). For both women and men, SI was positively associated with most Axis-I and Axis-II psychiatric disorders (OR range: Women, Axis-I:1.89-6.14, Axis-II:2.10-10.02; Men, Axis-I:1.92-6.21, Axis-II:1.63-6.05). Significant gender-related differences were observed. Among women as compared to men, SI was more strongly associated with social phobia, alcohol abuse/dependence, and paranoid, schizotypal, antisocial, borderline, narcissistic, avoidant and obsessive-compulsive personality disorders. CONCLUSION The robust associations between SI and psychopathology across genders suggest the need for screening and interventions related to SI for individuals with psychiatric concerns. The stronger associations between SI and psychopathology among women as compared to men emphasize the importance of a gender-oriented perspective in targeting SI. Longitudinal studies are needed to determine the extent to SI predates, postdates or co-occurs with specific psychiatric conditions.
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Affiliation(s)
- Galit Erez
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Shalvata Mental Health Center, Hod Hasharon, Israel, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Corey E. Pilver
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut,Department of Neurobiology, Yale University School of Medicine, New Haven, Connecticut,Child Study Center, Yale University School of Medicine, New Haven, Connecticut
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Hrywna M, Bover Manderski MT, Delnevo CD. Sex differences in the association of psychological distress and tobacco use. Am J Health Behav 2014; 38:570-6. [PMID: 24636119 DOI: 10.5993/ajhb.38.4.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To examine sex differences in the relationship between serious psychological distress (SPD) and tobacco use. METHODS The 2010 National Health Interview Survey data (N = 26,907) were examined to assess tobacco use among adults with and without SPD. Prevalence and odds ratios (OR) were calculated. The possible moderating effect of sex was examined. RESULTS Lifetime and current use of cigarettes, cigars and smokeless tobacco (SLT) was more prevalent among those with SPD. Sex interaction terms were significant when modeling lifetime and current cigar and SLT use. The adjusted OR for all tobacco outcomes was greater for women than for men. CONCLUSIONS Findings suggest a stronger association of SPD and tobacco use for women.
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Affiliation(s)
- Mary Hrywna
- Rutgers School of Public Health, Center for Tobacco Surveillance and Evaluation Research, New Brunswick, NJ, USA.
| | - Michelle T Bover Manderski
- Rutgers School of Public Health, Center for Tobacco Surveillance and Evaluation Research, New Brunswick, NJ, USA
| | - Cristine D Delnevo
- Rutgers School of Public Health, Center for Tobacco Surveillance and Evaluation Research, New Brunswick, NJ, USA
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Pennanen M, Broms U, Korhonen T, Haukkala A, Partonen T, Tuulio-Henriksson A, Laatikainen T, Patja K, Kaprio J. Smoking, nicotine dependence and nicotine intake by socio-economic status and marital status. Addict Behav 2014; 39:1145-51. [PMID: 24727110 DOI: 10.1016/j.addbeh.2014.03.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 02/27/2014] [Accepted: 03/04/2014] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Low socio-economic status (SES) is strongly related to smoking, but studies examining the association of SES with nicotine dependence (ND) are scarce. The aim of this study was to examine the associations of SES and marital status with smoking, multiple measures of ND, and cotinine as a nicotine intake biomarker. METHODS The sample comprised 1746 ever smokers, sampled from the National FINRISK 2007 Study, who had completed a tobacco specific questionnaire in addition to the standard clinical examination. The Fagerström Test for Nicotine Dependence (FTND), the Heaviness of Smoking Index (HSI), the Nicotine Dependence Syndrome Scale (NDSS), and the Hooked On Nicotine Checklist (HONC) were assessed, while plasma cotinine was measured as a biomarker of nicotine exposure in daily smokers. Univariate and multivariate associations were assessed by linear regression and multinomial logistic regression. RESULTS In multivariate models, lower education was associated with higher FTND and HSI, income with HSI, and occupation with HSI (men only), FTND, HONC and NDSS scores. Lower education was related to higher cotinine levels among daily smokers, although the association diminished slightly after adjusting for daily smoking amount. Living without a spouse was associated with daily smoking and higher ND. CONCLUSION In this cross-sectional study low SES was linked with higher ND among current smokers, while low SES was associated with higher cotinine levels among daily smokers. Living alone was linked with higher ND. Longitudinal studies are warranted to further explore these associations. As lower SES smokers are more addicted they may need more targeted cessation services to succeed in quitting smoking.
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Affiliation(s)
- Marjaana Pennanen
- Hjelt Institute, Department of Public Health, University of Helsinki, P.O. Box 41, Mannerheimintie 172, 00014 Helsinki, Finland; National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland; Health and Social Services Department, Municipality of Askola, Askolantie 30, FI-07500 Askola, Finland
| | - Ulla Broms
- Hjelt Institute, Department of Public Health, University of Helsinki, P.O. Box 41, Mannerheimintie 172, 00014 Helsinki, Finland; National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland; Health and Social Services Department, Municipality of Askola, Askolantie 30, FI-07500 Askola, Finland
| | - Tellervo Korhonen
- Hjelt Institute, Department of Public Health, University of Helsinki, P.O. Box 41, Mannerheimintie 172, 00014 Helsinki, Finland; National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland
| | - Ari Haukkala
- Department of Social Research, University of Helsinki, P.O. Box 54, Unioninkatu 37, 00014 Helsinki, Finland
| | - Timo Partonen
- National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland
| | - Annamari Tuulio-Henriksson
- National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland; Social Insurance Institution of Finland, P.O. Box 20, Nördenskiöldinkatu 12, 00232 Helsinki, Finland
| | - Tiina Laatikainen
- National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, Yliopistonranta 1, FI-70211 Kuopio, Finland; Hospital District of North Karelia, P.O. Box 111, Tikkamäentie 16, FI-80101 Joensuu, Finland
| | - Kristiina Patja
- National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland; Pro Medico, P.O. Box 49, Mäkelänkatu 2, 00501 Helsinki, Finland
| | - Jaakko Kaprio
- Hjelt Institute, Department of Public Health, University of Helsinki, P.O. Box 41, Mannerheimintie 172, 00014 Helsinki, Finland; National Institute for Health and Welfare, P.O. Box 30, Mannerheimintie 166, FI-00271 Helsinki, Finland; Institute for Molecular Medicine Finland (FIMM), P.O. Box 20, Tukholmankatu 8, 00290 Helsinki, Finland.
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Goodwin RD, Wall MM, Choo T, Galea S, Horowitz J, Nomura Y, Zvolensky MJ, Hasin DS. Changes in the prevalence of mood and anxiety disorders among male and female current smokers in the United States: 1990-2001. Ann Epidemiol 2014; 24:493-7. [PMID: 24935462 PMCID: PMC4393820 DOI: 10.1016/j.annepidem.2014.01.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 12/24/2013] [Accepted: 01/02/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE The present study investigated whether the prevalence of mood and anxiety disorders has increased over time among current smokers and whether these trends differ by gender and in comparison with nonsmokers. METHODS Data were drawn from the National Comorbidity Survey (1990) and the National Comorbidity Survey-Replication (2001), representative samples of the US adult population. Binomial regression analyses were used to determine differences between mood and anxiety disorders among current smokers in 1990 and 2001 and whether these differed by gender and in comparison with those who were former or never current smokers. RESULTS Any anxiety disorder, panic attacks, panic disorder, social anxiety disorder and dysthymia were all significantly more common among current smokers in 2001 compared with 1990 and except for social anxiety disorder these increases were significantly greater than any trend found in non-smokers. Increases in panic attacks, social anxiety disorder, and dysthymia were more pronounced in female than in male smokers. Major depressive disorder and generalized anxiety disorder were not found to increase over time among smokers. CONCLUSIONS The prevalence of several anxiety disorders and dysthymia among current smokers appears to have increased from 1990 to 2001. Future studies are needed to determine whether these trends have continued. If so, interventions aimed at moving the prevalence lower may have limited success if treatment of mental health problems such as anxiety disorders and certain mood disorders are not considered in the development and dissemination of tobacco control programs.
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Affiliation(s)
- Renee D Goodwin
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY); Department of Epidemiology, Mailman School of Public Health, New York, NY.
| | - Melanie M Wall
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY; New York State Psychiatric Institute, New York, NY
| | - Tse Choo
- New York State Psychiatric Institute, New York, NY
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, New York, NY
| | - Jonathan Horowitz
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY)
| | - Yoko Nomura
- Department of Psychology, Queens College and The Graduate Center, City University of New York (CUNY); Department of Psychiatry, Mount Sinai School of Medicine, New York, NY
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX; Department of Psychiatry, MD Anderson Cancer Center, Houston, TX
| | - Deborah S Hasin
- Department of Epidemiology, Mailman School of Public Health, New York, NY; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY; New York State Psychiatric Institute, New York, NY
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Schnoll RA, George TP, Hawk L, Cinciripini P, Wileyto P, Tyndale RF. The relationship between the nicotine metabolite ratio and three self-report measures of nicotine dependence across sex and race. Psychopharmacology (Berl) 2014; 231:2515-23. [PMID: 24402139 PMCID: PMC4040302 DOI: 10.1007/s00213-013-3421-1] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 12/16/2013] [Indexed: 10/25/2022]
Abstract
RATIONALE Variability in the rate of nicotine metabolism, measured by the nicotine metabolite ratio (NMR), is associated with smoking behavior. However, data linking the NMR with nicotine dependence measured by the Fagerström test for nicotine dependence (FTND) are mixed. Few past studies have examined alternative measures of nicotine dependence and how this relationship may vary by sex and race. OBJECTIVE Using data from smokers undergoing eligibility evaluation for a smoking cessation clinical trial (n = 833), this study examined variability in the relationship between NMR and nicotine dependence across sex and race and using three measures of nicotine dependence: FTND, time-to-first-cigarette (TTFC), and the heaviness of smoking index (HSI). RESULTS Controlling for sex and race, nicotine metabolism was associated with nicotine dependence only when using the HSI (p < 0.05). Male normal metabolizers of nicotine were more likely to have high nicotine dependence based on the FTND and HSI (p < 0.05), but NMR was not related to measures of nicotine dependence in women. For African Americans, the NMR was associated with nicotine dependence only for the TTFC (p < 0.05), but NMR was not associated with nicotine dependence among Caucasians. Post hoc analyses indicated that the NMR was associated with cigarettes per day, overall, and among men and Caucasians (p < 0.05). CONCLUSIONS While there was some variation in the relationship between nicotine metabolism and nicotine dependence across measures and sex and race, the results indicate that this relationship may be more attributable to the association between NMR and cigarettes per day.
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Affiliation(s)
- Robert A Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, 3535 Market Street, 4th Floor, Philadelphia, PA, 19104, USA,
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Haller CS, Etter JF, Courvoisier DS. Trajectories in cigarette dependence as a function of anxiety: a multilevel analysis. Drug Alcohol Depend 2014; 139:115-20. [PMID: 24703608 DOI: 10.1016/j.drugalcdep.2014.03.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 03/09/2014] [Accepted: 03/10/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND We assessed the association of anxiety with cigarette dependence over time, depending on smoking status (daily, occasional or ex-smoker); and the association of anxiety with (a) smoking cessation, (b) reduction, and (c) relapse. METHODS A prospective Internet survey of 1967 ever smokers was assessed three times at 2 weeks interval, in 2007-2010. Cigarette dependence was assessed using the cigarette dependence scale. Predictors included time, smoking status (daily, occasional or ex-smoker) and anxiety. All measures were assessed at each time point. RESULTS Dependence decreased over time (slope=-0.21, p<0.001), as did feeling prisoner of cigarettes (slope=-0.25, p<0.001). Both decreased faster between week 0 and week 2 then between week 2 and week 4 (slopes=0.25, and 0.13; p<0.01). Differences in anxiety across individuals were associated with dependence (slope=0.28, p=0.001), feeling prisoner of cigarettes (slope=0.38, p<0.001), cessation (OR=0.42, p<0.001), relapse (OR=1.81, p<0.01), but not with smoking reduction (OR=0.85, p=0.35). Change over time in anxiety (within individuals) was associated with dependence (slope=-0.11, p=0.04), nor feeling prisoner of cigarettes (slope=-0.21, p=0.02), predicted smoking cessation (OR=0.51, p<0.001), smoking reduction (OR=0.67, p=0.047), and relapse (OR=1.52, p=0.03). CONCLUSIONS Cross-sectionally, cigarette dependence, feeling prisoner of cigarettes, and smoking cessation were associated with anxiety; whereas prospectively, smoking cessation, reduction, and relapse were predicted by state anxiety. Thus, anxiety is an important factor that is associated with smoking behavior. Implications for treatment are discussed.
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Affiliation(s)
- Chiara S Haller
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA; Harvard Medical School, Boston, MA 02115, USA; Division of Public Psychiatry, Massachusetts Mental Health Center, 75 Fenwood Road, Boston, MA 02115, USA; Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
| | - Jean-François Etter
- Faculty of Medicine, University of Geneva, IMSP-CMU, 1 rue Michel-Servet, CH-1211 Geneva 4, Switzerland
| | - Delphine Sophie Courvoisier
- Division of Clinical Epidemiology, University of Geneva and Geneva University Hospitals, 4 rue Perret-Gentil, 1205 Geneva, Switzerland
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Mines D, Tennis P, Curkendall SM, Li DK, Peterson C, Andrews EB, Calingaert B, Chen H, Deshpande G, Esposito DB, Everage N, Holick CN, Meyer NM, Nkhoma ET, Quinn S, Rothman KJ, Chan KA. Topiramate use in pregnancy and the birth prevalence of oral clefts. Pharmacoepidemiol Drug Saf 2014; 23:1017-25. [DOI: 10.1002/pds.3612] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 01/23/2014] [Accepted: 02/17/2014] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | - De-Kun Li
- Division of Research, Kaiser Foundation Research Institute; Kaiser Permanente; Oakland CA USA
| | | | | | | | - Hong Chen
- Division of Research, Kaiser Foundation Research Institute; Kaiser Permanente; Oakland CA USA
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Shahab L, Andrew S, West R. Changes in prevalence of depression and anxiety following smoking cessation: results from an international cohort study (ATTEMPT). Psychol Med 2014; 44:127-141. [PMID: 23507203 DOI: 10.1017/s0033291713000391] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Smoking cessation improves physical health but it has been suggested that in vulnerable individuals it may worsen mental health. This study aimed to identify the short- and longer-term effects of stopping smoking on depression and anxiety in the general population and in those with a history of these disorders. METHOD Sociodemographic and smoking characteristics, and mental and physical health were assessed using established measures in the ATTEMPT cohort, an international longitudinal study of smokers (n = 3645). Smokers who had stopped for at least 3 months or less than 3 months at the 12-month follow-up were compared with current smokers (n = 1640). RESULTS At follow-up, 9.7% [95% confidence interval (CI) 8.3-11.2] of smokers had stopped for less than 3 months and 7.5% (95% CI 6.3-8.9) for at least 3 months. Compared with current smokers, prevalence of depression prescriptions obtained in the last 2 weeks was lower for those who had stopped for less than 3 months [odds ratio (OR) 0.37, 95% CI 0.14-0.96] or at least 3 months (OR 0.25, 95% CI 0.06-0.94) after adjusting for baseline prescription levels and confounding variables. Adjusted prevalence of recent depression symptoms was also lower for ex-smokers who had stopped for less than 3 months (OR 0.34, 95% CI 0.15-0.78) or at least 3 months (OR 0.24, 95% CI 0.09-0.67) than among continuing smokers. There was no change in anxiety measures in the general population or any increase in anxiety or depression symptoms in ex-smokers with a past history of these conditions. CONCLUSIONS Smoking cessation does not appear to be associated with an increase in anxiety or depression and may lead to a reduced incidence of depression.
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Affiliation(s)
- L Shahab
- Department of Epidemiology and Public Health, University College London, London, UK
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66
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Dearing RL, Hequembourg AL. Culturally (in)competent? Dismantling health care barriers for sexual minority women. SOCIAL WORK IN HEALTH CARE 2014; 53:739-761. [PMID: 25255338 DOI: 10.1080/00981389.2014.944250] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Lesbian and bisexual (LB) women exhibit elevated rates of a variety of behaviors (i.e., smoking, excessive caloric intake, physical inactivity, heavy alcohol consumption) that put them at risk for adverse health consequences. Furthermore, LB women experience numerous barriers to obtaining culturally competent health care. In this article we review risk behaviors and health care barriers and we discuss the role of stress as an important contributing factor in LB women's health outcomes. We suggest future research, health care delivery changes, and training improvements that will prepare social workers to effectively address the needs of their LB clients.
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Affiliation(s)
- Ronda L Dearing
- a Research Institute on Addictions, University at Buffalo, The State University of New York , Buffalo , New York , USA
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67
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McClure LA, Arheart KL, Lee DJ, Sly DF, Dietz NA. Young adult former ever smokers: the role of type of smoker, quit attempts, quit aids, attitudes/beliefs, and demographics. Prev Med 2013; 57:690-5. [PMID: 24021991 PMCID: PMC3855223 DOI: 10.1016/j.ypmed.2013.08.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 08/16/2013] [Accepted: 08/31/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Young adults who smoke are often nondaily users who either quit or transition into dependent smokers. Further, this age group often has been considered an extension of the adult population. This study aims to examine young adult former ever smokers to understand factors associated with their stopping smoking. METHOD Telephone interviews were conducted in 2010 with 4401 young adults in Florida. We examined the association between former ever smokers and sociodemographics, smoking behavior, quit attempts, quit aids, and attitudes/beliefs about smoking. RESULTS Thirty-seven percent of young adults were former smokers, 20% were current smokers, and 43% were never smokers. Former smokers were more likely to be female, situational smokers (compared to occasional or established), more likely to have stopped smoking without acknowledging making a quit attempt, less likely to have used a quit aid, and less likely to display pro-tobacco attitudes/beliefs. CONCLUSION Young adult former and current smokers have unique patterns of smoking and stopping smoking. Young adults may require novel intervention techniques to promote prevention and cessation based on these unique smoking patterns. Future research is needed to understand motivations to quit smoking among young adults.
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Affiliation(s)
- Laura A. McClure
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14 Street, 15 Floor C202, Miami, Florida 33136, USA
| | - Kristopher L. Arheart
- Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, 1120 NW 14 St, 10 Floor, Miami, FL 33136, USA
| | - David J. Lee
- Sylvester Comprehensive Cancer Center, Department of Epidemiology and Public Health, University of Miami Miller School of Medicine, 1120 NW 14 Street, Room 911, Miami, Florida 33136, USA
| | - David F. Sly
- College of Social Sciences, Florida State University, 543 Old Cove Rd N, Jasper, GA 30143, USA
| | - Noella A. Dietz
- Department of Epidemiology and Public Health, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14 Street, 15 Floor C202, Miami, Florida 33136, USA
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68
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Schnoll RA, Goren A, Annunziata K, Suaya JA. The prevalence, predictors and associated health outcomes of high nicotine dependence using three measures among US smokers. Addiction 2013; 108:1989-2000. [PMID: 23795712 DOI: 10.1111/add.12285] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 05/03/2013] [Accepted: 06/11/2013] [Indexed: 02/06/2023]
Abstract
AIMS Using the Fagerström Test of Nicotine Dependence (FTND), the Heaviness of Smoking Index (HSI) and the time-to-first-cigarette (TTFC), this study estimated prevalence, evaluated optimal scale cut-offs, identified predictors and assessed potential impact on health, productivity and health-care use of high nicotine dependence among US smokers. DESIGN, SETTING AND PARTICIPANTS This cross-sectional study used 2011 National Health and Wellness Survey data (n = 50 000). MEASUREMENTS Nicotine dependence, demographic data, measures of health, productivity and health-care use and health attitudes were assessed. FINDINGS The prevalence of high nicotine dependence ranged from 23% (TTFC < 5 minutes) to 63.6% (TTFC < 30 minutes). Based on diagnostic accuracy, the cut-offs for high nicotine dependence using HSI and TTFC varied according to FTND cut-off: if FTND > 4, then HSI > 3 and TTFC < 30 minutes represented optimal cut-offs; if FTND > 5, HSI > 4 and TTFC < 5 minutes represented optimal cut-offs. Across all measures, high nicotine dependence was related significantly to being male, single, age 45-64 years and Caucasian; lower education; lack of health insurance; under/unemployment; comorbid respiratory or cardiovascular disease, diabetes or psychiatric illness; and lower rates of exercise and concern for weight control. Controlling for demographic variables and comorbid physical and psychiatric illness, high nicotine dependence, measured by FTND, HSI or TTFC, was associated significantly with reduced mental and physical quality of life, reduced work-place productivity and more health-care use. CONCLUSIONS High nicotine dependence is associated with lower quality of life, lower work productivity and higher health-care use. The Heaviness of Smoking Index and the time-to-first-cigarette can provide useful screening measures of nicotine dependence in clinical and research settings.
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Affiliation(s)
- Robert A Schnoll
- Department of Psychiatry and Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
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69
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Cosh S, Maksimovic L, Ettridge K, Copley D, Bowden JA. Aboriginal and Torres Strait Islander utilisation of the Quitline service for smoking cessation in South Australia. Aust J Prim Health 2013; 19:113-8. [PMID: 22950938 DOI: 10.1071/py11152] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2011] [Accepted: 04/26/2012] [Indexed: 11/23/2022]
Abstract
Smoking prevalence among Indigenous Australians far exceeds that of non-Indigenous Australians and is considered the greatest contributor to burden of disease for Indigenous Australians. The Quitline is a primary intervention for facilitating smoking cessation and, given the health implications of tobacco use, maximising its effectiveness for Indigenous Australians is imperative. However, the utilisation and effectiveness of this service within the Indigenous Australian population has not been examined. This study explores the utilisation of the South Australian Quitline by smokers identifying as Indigenous Australian. Quitline counsellors collected data regarding demographic characteristics, and smoking and quitting behaviour from Quitline callers in 2010. Results indicated that the proportion of Indigenous and non-Indigenous smokers who registered for the service was comparable. Demographic variables and smoking addiction at time of registration with the Quitline were similar for Indigenous and non-Indigenous callers. However, results indicated that Indigenous callers received significantly fewer callbacks than non-Indigenous callers and were significantly less likely to set a quit date. Significantly fewer Indigenous callers reported that they were still successfully quit at 3 months. Thus, Indigenous Australian callers may be less engaged with the Quitline and further research is required exploring whether the service could be tailored to make it more engaging for Indigenous Australians who smoke.
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Affiliation(s)
- Suzanne Cosh
- Tobacco Control Research and Evaluation Program, Cancer Council South Australia, Adelaide, SA 5063, Australia.
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70
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Piñeiro B, Fernández del Río E, López-Durán A, Martínez Ú, Becoña E. The association between probable personality disorders and smoking cessation and maintenance. Addict Behav 2013; 38:2369-73. [PMID: 23628430 DOI: 10.1016/j.addbeh.2013.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 01/18/2013] [Accepted: 03/27/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Although it has been suggested that persons with psychopathological disorders experience greater difficulty in quitting smoking, the few studies that have analyzed personality disorders in smokers have failed to produce conclusive results. The aim of this study was to examine whether the presence of probable personality disorders was associated with the achievement of abstinence at the end of a smoking cessation treatment, as well as the maintenance of abstinence at 6 and 12 months of follow-up. METHODS The sample comprised 290 smokers (41% men and 59% women) who participated in a psychological smoking cessation treatment and who were followed for a year. Abstinence was tested by measuring carbon monoxide in exhaled air. RESULTS Participants with a probable borderline, antisocial or avoidant personality disorder were less likely to quit smoking at the end of the treatment, whereas probable schizoid personality disorder predicted better maintenance of abstinence at 6 and 12 months. In addition, smoking 25 or more cigarettes before starting the treatment decreased the likelihood of maintaining abstinence at 6 and 12 months of follow-up. CONCLUSIONS This study revealed differential (and opposing) relationships between specific personality disorders and smoking cessation outcomes, illustrating the need to consider Axis II disorders separately when predicting treatment outcomes.
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71
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Correlates of smoking among young adults: the role of lifestyle, attitudes/beliefs, demographics, and exposure to anti-tobacco media messaging. Drug Alcohol Depend 2013. [PMID: 23182411 DOI: 10.1016/j.drugalcdep.2012.10.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Young adults (18-24 years) have the highest smoking rate of any age group. Unlike youth/adult populations where there is one primary message targeting behavior, anti-tobacco campaigns targeting young adults should contain messages of prevention and cessation. The objective was to identify factors influencing young adult cigarette use, employing the Centers for Disease Control and Prevention logic model, with an emphasis on the role of lifestyle, tobacco use tolerance, and attitudes/beliefs. METHODS Cross-sectional data were collected from 4401 young adults using telephone interviews in 2010 as part of the evaluation for the Tobacco Free Florida Campaign. Multivariate logistic regression was used to examine the relationship between current smoking status and lifestyles, tolerance of tobacco use, and attitude/belief variables. RESULTS The young adult cigarette prevalence rate is 20.3%, with males more likely to be smokers (25.1%) than females (15.6%) and non-Hispanic Whites more likely to be smokers than other racial/ethnic groups (23.8%). Significant associations were found between lifestyle variables (frequent bar/club, drinks per month, and number of friends who smoke), tolerance of tobacco use (allow smoke in house/car and moderate tobacco use), and four attitude/belief indices and current smoking behavior. CONCLUSIONS Results suggest lifestyles and attitudes/beliefs should be key behavioral targets of prevention programs aimed at young adults. Data strongly suggest that as young adults reject negative labels attached to smokers, they are more likely to smoke. Prevention (and cessation) programs may need to reduce barriers that result in segregating nonsmokers/smokers so smokers can have an increased chance of adopting attitudes/beliefs of nonsmokers.
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72
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Hatsukami DK, Benowitz NL, Donny E, Henningfield J, Zeller M. Nicotine reduction: strategic research plan. Nicotine Tob Res 2013; 15:1003-13. [PMID: 23100460 PMCID: PMC3646645 DOI: 10.1093/ntr/nts214] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 08/20/2012] [Indexed: 01/19/2023]
Abstract
BACKGROUND Reducing nicotine content in cigarettes and other combustible products to levels that are not reinforcing or addictive has the potential to substantially reduce tobacco-related morbidity and mortality. The authority to reduce nicotine levels as a regulatory measure is provided in the U.S. Family Smoking Prevention and Tobacco Control Act and is consistent with the general regulatory powers envisioned under the relevant articles of the World Health Organization's Framework Convention on Tobacco Control. Many experts have considered reducing nicotine in cigarettes to be a feasible national policy approach, but more research is necessary. PURPOSE This article describes proceedings from a conference that had the goals of identifying specific research gaps, describing methods and measures to consider for addressing these gaps, and considering ways to foster collaboration. RESULTS AND CONCLUSION Identified research gaps included determining the dose of nicotine that would be optimal for reducing and extinguishing cigarette use, examining approaches for reducing nicotine levels in the general and special populations of smokers, understanding how constituents other than nicotine may contribute to the reinforcing effects of tobacco, and identifying unintended consequences to determine ways to mitigate them. Methods that can be used ranged from brain imaging to large human clinical trials. The development and availability of valid biomarkers of exposure and effect are important. Infrastructures to facilitate collaboration need to be established.
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Affiliation(s)
- Dorothy K Hatsukami
- Department of Psychiatry, University of Minnesota, Minneapolis, MN 55414, USA.
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73
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Goodwin RD, Perkonigg A, Höfler M, Wittchen HU. Mental disorders and smoking trajectories: a 10-year prospective study among adolescents and young adults in the community. Drug Alcohol Depend 2013; 130:201-7. [PMID: 23375557 DOI: 10.1016/j.drugalcdep.2012.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 11/09/2012] [Accepted: 11/10/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Numerous studies have documented an association between mental disorders and onset of cigarette smoking. Yet, there is little understanding of the potential impact of mental disorders on trajectories of smoking over time. The objective of this study was to investigate this relationship among adolescents over a 10-year span. METHODS Data were drawn from the Early Developmental Stages of Psychopathology Study, a 10-year prospective investigation of youth in Germany. Growth mixture modeling was used to identify smoking trajectories and logistic regression analyses were used to examine relationships between mental disorders and subsequent trajectories. RESULTS Four trajectories were identified: non-users; increasing use; decreasing use; persistent use. Alcohol/drug use disorders, stress disorders, anxiety disorders, somatoform disorder and nicotine dependence were associated with nicotine use (as compared to the non-smoker class). However, comparisons between trajectories of nicotine use showed that any stress disorder predicted only decreasing use compared to the other two trajectories; nicotine dependence, alcohol/illicit drug use disorders as well as panic disorder and somatoform disorders were inversely associated with increasing use; nicotine dependence and alcohol/drug use disorders were associated with persistent use. CONCLUSIONS Several mental disorders appear to be non-specific markers of the range of smoking trajectories while others predict specific trajectories. Numerous disorders (e.g., alcohol/drug use disorders) do not appear to occur only prior to and predict increased smoking trajectory as had been previously suggested, but rather they also occur concurrently, with high levels of smoking and in some cases smoking persists at a steady level over time.
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Affiliation(s)
- Renee D Goodwin
- Department of Psychology, Queens College, City University of New York, Flushing, NY 11367, United States.
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74
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Dome P, Gonda X, Rihmer Z. Effects of smoking on health outcomes in bipolar disorder with a special focus on suicidal behavior. ACTA ACUST UNITED AC 2012. [DOI: 10.2217/npy.12.51] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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75
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Comorbidity of psychiatric and substance use disorders in the United States: current issues and findings from the NESARC. Curr Opin Psychiatry 2012; 25:165-71. [PMID: 22449770 PMCID: PMC3767413 DOI: 10.1097/yco.0b013e3283523dcc] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW The comorbidity between psychiatric and substance use disorders remains an important phenomenon to understand, and an active area of investigation. The purpose of this review is to highlight key 2011 issues and novel findings on psychiatric and substance disorders comorbidity from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a large national survey of the US general population. RECENT FINDINGS Topics of active investigation included the internalizing/externalizing meta-structure of common mental disorders; the 10 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) personality disorders; the 3-year incidence and persistence of disorders; treatment of major depression; and many other topics not as easily categorized. SUMMARY Meta-structure may increasingly offer a parsimonious way of addressing comorbidity, although adding new disorders adds complexity and the value of etiologic analyses utilizing broad dimensions of psychopathology rather than individual disorders is not yet fully known. Expanding the range of personality disorders beyond antisocial personality disorder appears essential in understanding the incidence and persistence of substance use disorders. Substance use disorders have low rates of treatment relative to major depression, but increase the likelihood of depression treatment among comorbid cases, a phenomenon that needs to be understood. These comorbidity studies provide much novel information, and indicate many potentially fruitful directions for new research.
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76
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Ouellet K, Bacon SL, Boudreau M, Plourde A, Moullec G, Lavoie KL. Individual and combined impact of cigarette smoking, anxiety, and mood disorders on asthma control. Nicotine Tob Res 2012; 14:961-9. [PMID: 22355077 DOI: 10.1093/ntr/ntr315] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Despite the availability of effective therapies, research indicates that more than 50% of asthmatics are poorly controlled. Poor asthma control has been linked to behavioral (i.e., cigarette smoking) and psychological factors (i.e., anxiety and depression). However, little is known about the individual versus combined impact of cigarette smoking and anxiety or mood disorders in adult asthmatics on asthma control. METHODS A total of 796 confirmed adult asthma patients completed a sociodemographic and medical history interview and underwent a psychiatric interview using the Primary Care Evaluation of Mental Disorders. Asthma control was evaluated using the Asthma Control Questionnaire. RESULTS After adjusting for age, sex, and dose of inhaled corticosteroids, general linear model analyses indicated a significant main effect of current smoking on asthma control (B [SE] = 0.156 [0.059], p = .008) and main effects of anxiety disorders (B [SE] = 0.408 [0.095], p = < .001) and mood disorders (B [SE] = 0.448 [0.098], p = < .001) on asthma control. Pack-years were not associated with asthma control, and there were no interaction effects of current smoking or pack-years with either anxiety or mood disorders on asthma control. CONCLUSIONS Findings suggest that current smoking, having an anxiety disorder, and having a mood disorder are independently associated with poorer asthma control but that cumulative smoking history (i.e., pack-years) was not associated with worse asthma control. These results indicate that smoking cessation may have a positive impact on asthma control levels in spite of past smoking intensity and highlight the importance of interventions that target anxiety and mood disorders in adult asthmatics.
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Affiliation(s)
- Karine Ouellet
- Department of Psychology, Montréal Behavioural Medicine Centre, University of Quebec at Montréal, P.O. Box 8888, Succursale Center-Ville, Montréal, Quebec H3C 3P8, Canada
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