151
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Piper ME, Baker TB, Mermelstein R, Benowitz N, Jorenby DE. Relations among cigarette dependence, e-cigarette dependence, and key dependence criteria among dual users of combustible and e-cigarettes. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:100-108. [PMID: 32955271 PMCID: PMC7981280 DOI: 10.1037/adb0000644] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: The aim of this study was to examine dependence on combustible and e-cigarettes among users of both products (dual users), which may provide important insights into long-term use patterns. Method: Dual users (smoking daily for 3 months, using e-cigarettes at least once/week for the past month; N = 256; 45% women, 71% White, M age 39.0 years) not interested in quitting either product participated in a longitudinal, 2-year, observational study. At baseline, participants completed measures of combustible and e-cigarette dependence (Fagerström Test of Cigarette Dependence [FTCD], e-FTCD, Wisconsin Inventory of Smoking Dependence Motives [WISDM], e-WISDM, Penn State Cigarette Dependence Index, and Penn State E-Cigarette Dependence Index) and carried a study smartphone for 2 weeks to record cigarette and e-cigarette use events. Results: Most measures of dependence were product specific (e.g., FTCD and e-FTCD were not correlated, r = -0.003) and predicted product-specific outcomes (e.g., long-term use of that product). However, individuals used the two products for some of the same secondary dependence motives (e.g., weight control, cognitive and affective enhancement). These secondary, or instrumental, motives predicted use of both products at 1 year. Which product was used first in the morning was strongly related to product dependence scores and likelihood of continued product use at 1 year. Conclusions: Among dual users of combustible and e-cigarettes, measures of e-cigarette and cigarette dependence tended to be unrelated to one another, but dual users tended to use both products for the same instrumental motives. Which product is used first in the morning may serve as a valuable measure of relative dependence on the two products. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Megan E. Piper
- University of Wisconsin, School of Medicine and Public Health, Center for Tobacco Research and Intervention
| | - Timothy B. Baker
- University of Wisconsin, School of Medicine and Public Health, Center for Tobacco Research and Intervention
| | - Robin Mermelstein
- University of Illinois at Chicago, Institute for Health Research and Policy
| | - Neal Benowitz
- University of California San Francisco Department of Medicine and Center for Tobacco Control Research and Education
| | - Douglas E. Jorenby
- University of Wisconsin, School of Medicine and Public Health, Center for Tobacco Research and Intervention
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152
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Weinberger AH, Pang RD, Ferrer M, Kashan RS, Estey DR, Segal KS, Esan H. A novel smoking-specific self-control task: An initial study of feasibility, acceptability, and changes in self-control and cigarette smoking behaviors among adults using cigarettes. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:28-38. [PMID: 34081484 PMCID: PMC8639834 DOI: 10.1037/adb0000672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: Self-control is a key factor in quitting cigarettes and practicing general self-control tasks may strengthen self-control. This study examined the feasibility and acceptability of a novel smoking-related self-control task. Method: Seventy-five adults with current cigarette smoking (Mage = 44.8, 74.7% male, 63.5% Black, 74.3% non-Latinx) were randomly assigned to practice a smoking-specific self-control task (Delay Smoking Task, n = 39) or a general self-control task (Posture Task, n = 36) for 1 week. Assessments included cigarettes per day (CPD), motivation to quit smoking, self-control, and task acceptability. Results: Most participants completed both appointments with no difference between task groups (p = .69). The Delay Smoking Task group rated the task as more difficult (p = .04) and more helpful for quitting smoking (p = .005) than did the Posture Task group. Self-control task groups did not differ in task effort (p = .66), task success (p = .14), or self-control used to practice the task (p = .13). Both task groups reported increased quit desire, expected quit success, quit confidence, and quit motivation (p < .05; partial η²s = 0.108-0.333). The time by task group interaction approached significance for expected quit success (p = .06; partial η² = .053), with the Delay Smoking Task group showing greater increases than the Posture Task group. Over the week, smoking decreased an average of 1.0 CPD with no difference between groups (p = .72; partial η² = 0.165). Conclusions: Practicing self-control was associated with increases in motivation to quit, confidence in quitting, and expected success at quitting smoking with similar changes for those practicing a smoking-specific versus a general self-control task. Self-control tasks may be useful for increasing motivation to quit cigarettes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Andrea H. Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York USA
| | - Raina D. Pang
- Keck School of Medicine at University of Southern California, Department of Preventive Medicine, Los Angeles, California, USA
| | - Michelle Ferrer
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York USA
- Hackensack Meridian Health, Hackensack, New Jersey USA
| | - Rachel S. Kashan
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York USA
| | - David R. Estey
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York USA
| | - Kate S. Segal
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York USA
- James J. Peters VA Medical Center, Bronx, New York USA
| | - Hannah Esan
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York USA
- Addiction Institute of Mount Sinai, Mount Sinai Hospital, New York, New York USA
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153
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Pang RD, Tucker CJ, D’Orazio LM, Weinberger AH, Guillot CR. Affect and subjective cognitive functioning by depression symptom levels during naturalistic cigarette smoking in premenopausal females who smoke daily. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2022; 36:90-99. [PMID: 33844567 PMCID: PMC8505572 DOI: 10.1037/adb0000741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: High negative affect, low positive affect, and low cognitive functioning are depression-related states that may be particularly relevant to females who smoke cigarettes and may be more prominent following overnight tobacco abstinence. This study aimed to assess relations between depression symptom levels and negative affect, positive affect, and subjective cognitive functioning in premenopausal females who smoke. Methods: Premenopausal females who smoke daily with low (n = 66) or elevated (n = 33) baseline depression symptoms completed subjective ratings of negative affect, positive affect, and cognitive functioning pre-first cigarette (i.e., after overnight tobacco abstinence) and at random prompts throughout the day via ecological momentary assessment (EMA) for 35 days. Results: Participants with elevated depression symptoms reported overall higher negative affect (p = .01). Positive affect was significantly lower prior to the first cigarette of the day (p < .001), but did not significantly differ between depression symptom groups. Subjective cognitive functioning was significantly lower pre-first cigarette of the day (p < .001). There was a significant Depression Symptom × Prompt Type interaction for subjective cognitive functioning (p = .01). Subjective cognitive functioning did not significantly differ by depression symptom group pre-first cigarette of the day but was significantly different at random prompts throughout the day. Conclusions: As participants smoked as usual, findings identify naturalistic factors which may influence smoking behavior among premenopausal females who smoke with elevated depression symptoms. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Raina D. Pang
- Department of Preventive Medicine and Department of Psychology, University of Southern California
| | - Chyna J. Tucker
- Department of Preventive Medicine, University of Southern California
| | | | - Andrea H. Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University and Department of Epidemiology, and Population Health, Albert Einstein College of Medicine
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154
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Bannai D, Adhan I, Katz R, Kim LA, Keshavan M, Miller JB, Lizano P. Quantifying Retinal Microvascular Morphology in Schizophrenia Using Swept-Source Optical Coherence Tomography Angiography. Schizophr Bull 2022; 48:80-89. [PMID: 34554256 PMCID: PMC8781445 DOI: 10.1093/schbul/sbab111] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Retinovascular changes are reported on fundus imaging in schizophrenia (SZ). This is the first study to use swept-source optical coherence tomography angiography (OCT-A) to comprehensively examine retinal microvascular changes in SZ. METHODS This study included 30 patients with SZ/schizoaffective disorder (8 early and 15 chronic) and 22 healthy controls (HCs). All assessments were performed at Beth Israel Deaconess Medical Center and Massachusetts Eye and Ear. All participants underwent swept-source OCT-A of right (oculus dextrus [OD]) and left (oculus sinister [OS]) eye, clinical, and cognitive assessments. Macular OCT-A images (6 × 6 mm) were collected with the DRI Topcon Triton for superficial, deep, and choriocapillaris vascular regions. Microvasculature was quantified using vessel density (VD), skeletonized vessel density (SVD), fractal dimension (FD), and vessel diameter index (VDI). RESULTS Twenty-one HCs and 26 SZ subjects were included. Compared to HCs, SZ patients demonstrated higher overall OD superficial SVD, OD choriocapillaris VD, and OD choriocapillaris SVD, which were primarily observed in the central, central and outer superior, and central and outer inferior/superior, respectively. Early-course SZ subjects had significantly higher OD superficial VD, OD choriocapillaris SVD, and OD choriocapillaris FD compared to matched HCs. Higher bilateral (OU) superficial VD correlated with lower Positive and Negative Syndrome Scale (PANSS) positive scores, and higher OU deep VDI was associated with higher PANSS negative scores. CONCLUSIONS AND RELEVANCE These results suggest the presence of microvascular dysfunction associated with early-stage SZ. Clinical associations with microvascular alterations further implicate this hypothesis, with higher measures being associated with worse symptom severity and functioning in early stages and with lower symptom severity and better functioning in later stages.
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Affiliation(s)
- Deepthi Bannai
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Iniya Adhan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Raviv Katz
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Leo A Kim
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - John B Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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155
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Myers Smith K, Phillips-Waller A, Pesola F, McRobbie H, Przulj D, Orzol M, Hajek P. E-cigarettes versus nicotine replacement treatment as harm reduction interventions for smokers who find quitting difficult: randomized controlled trial. Addiction 2022; 117:224-233. [PMID: 34187081 DOI: 10.1111/add.15628] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/11/2021] [Accepted: 06/16/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS The majority of smokers accessing the current best treatments continue to smoke. We aimed to test if e-cigarettes (EC) compared with nicotine replacement treatment (NRT) can help such smokers to reduce smoking. DESIGN Randomized controlled trial of EC (n = 68) versus NRT (n = 67) with 6-month follow-up. SETTING Stop smoking service in London, UK. PARTICIPANTS A total of 135 smokers (median age = 40 years, 51% male) previously unable to stop smoking with conventional treatments. INTERVENTIONS Participants received either NRT of their choice (8-week supply) or an EC starter pack and instructions to purchase further e-liquids of strength and flavours of their choice themselves. Products were accompanied by minimal behavioural support. MEASUREMENTS Participants who reported that they stopped smoking or reduced their daily cigarette consumption by at least 50% at 6-month follow-up were invited to provide a carbon monoxide (CO) reading. The primary outcome was biochemically validated reduction in smoke intake of at least 50% at 6 months and the main secondary outcome was sustained validated abstinence at 6 months. Drop-outs were included as 'non-reducers'. FINDINGS Validated smoking reduction (including cessation) was achieved by 26.5 versus 6.0% of participants in the EC and NRT study arms, respectively [relative risk (RR) = 4.4, P = 0.005, 95% confidence interval (CI) = 1.6-12.4]. Sustained validated abstinence rates at 6 months were 19.1 versus 3.0% (RR = 6.4, P = 0.01, 95% CI = 1.5-27.3). Product use was high and equal in both study arms initially, but at 6 months allocated product use was 47% in the EC arm versus 10% in the NRT arm (χ2(1) = 22.0, P < 0.001), respectively. Adverse events were minor and infrequent. CONCLUSIONS In smokers unable to quit using conventional methods, e-cigarettes were more effective than nicotine replacement therapy in facilitating validated long-term smoking reduction and smoking cessation when limited other support was provided.
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Affiliation(s)
- Katie Myers Smith
- Health and Lifestyle Research Unit, Queen Mary University of London, London, UK
| | | | - Francesca Pesola
- Health and Lifestyle Research Unit, Queen Mary University of London, London, UK
| | - Hayden McRobbie
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Dunja Przulj
- Health and Lifestyle Research Unit, Queen Mary University of London, London, UK
| | - Marzena Orzol
- Health and Lifestyle Research Unit, Queen Mary University of London, London, UK
| | - Peter Hajek
- Health and Lifestyle Research Unit, Queen Mary University of London, London, UK
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156
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Ribeiro TCS, Barros MBDA, Lima MG. Smoking and loneliness in older adults: a population-based study in Campinas, São Paulo State, Brazil. CAD SAUDE PUBLICA 2022; 38:e00093621. [DOI: 10.1590/0102-311x00093621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 10/15/2021] [Indexed: 11/21/2022] Open
Abstract
This study aims to analyze the relationship between social isolation and loneliness with smoking in older adults. This is a cross-sectional, population-based study performed with 986 individuals aged 60 years or older. Data were collected from the Health Survey of the Municipality of Campinas (ISACamp 2014/2015), state of São Paulo, Brazil. We estimated the prevalence of smoking and smoking cessation according to independent variables and tested the associations using the chi-square test, considering a 5% significance level. Adjusted prevalence ratios were calculated using simple and multiple Poisson regression. Smoking and smoking cessation were not associated with most variables that indicate objective social isolation. “Often or always” loneliness was related to a higher prevalence of smoking (PR = 2.25; 95%CI: 1.38-3.66) whereas loneliness accompanied of self-reported emotional problems or common mental disorders was strongly associated with smoking and with lower smoking cessation (PR = 6.24; 95%CI: 1.37-28.47 and PR = 0.46; 95%CI: 0.28-0.77, respectively). These findings indicate that loneliness is a psychosocial aspect related to tobacco use which hinders smoking cessation in older adults, emphasizing the importance of emotional problems in this association.
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157
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Streck JM, Regan S, Bearnot B, Gupta PS, Kalkhoran S, Kalagher KM, Wakeman S, Rigotti NA. Prevalence of Cannabis Use and Cannabis Route of Administration among Massachusetts Adults in Buprenorphine Treatment for Opioid Use Disorder. Subst Use Misuse 2022; 57:1104-1110. [PMID: 35410577 PMCID: PMC10091221 DOI: 10.1080/10826084.2022.2063899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Recent prevalence estimates of cannabis use among individuals receiving medication treatment for OUD (MOUD) are lacking, and no study has characterized cannabis route of administration (cROA) in this population. These knowledge gaps are relevant because cannabis' effects and health outcomes vary by cROA and the availability and perceptions of cROA (e.g., vaping devices) are changing. METHODS The Vaping In Buprenorphine-treated patients Evaluation (VIBE) cross-sectional survey assessed the prevalence and correlates of cannabis use and cROA among adults receiving buprenorphine MOUD from 02/20 to 07/20 at five community health centers in Massachusetts, a state with legal recreational and medical cannabis use. RESULTS Among the 92/222 (41%) respondents reporting past 30-day cannabis use, smoking was the most common cROA (75%), followed by vaping (38%), and eating (26%). Smoking was more often used as a single cROA vs. in combination others (p = 0.01), whereas vaping, eating, and dabbing were more often used in combination with another cROA (all p < 0.05). Of the 39% of participants reporting multiple cROA, smoking and vaping (61%), and smoking and eating (50%), were the most prevalent combinations. Nonwhite race (vs. white) and current cigarette smoking (vs. no nicotine use) were associated with past 30-day cannabis use in multiple logistic regression. CONCLUSIONS Prevalence of past 30-day cannabis use among individuals receiving buprenorphine MOUD in Massachusetts in 2020 was nearly double the prevalence of cannabis use in Massachusetts' adult general population in 2019 (21%). Our data are consistent with state and national data showing smoking as the most common cROA.
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Affiliation(s)
- Joanna M Streck
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Susan Regan
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin Bearnot
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Priya S Gupta
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Sara Kalkhoran
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Kelly M Kalagher
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah Wakeman
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center, Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
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158
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Niezabitowska A, Rokosz M, Poprawa R. Distress Tolerance is Indirectly Related to Nicotine Use through the Smoking Motives. Subst Use Misuse 2022; 57:751-758. [PMID: 35170398 DOI: 10.1080/10826084.2022.2034875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Previous research has shown that low ability to tolerate distress is indirectly related to problematic substance use through the substance use motives. This topic has been previously researched in alcohol and cannabis use; however, it has not yet been explored in tobacco use. We studied whether distress tolerance is indirectly associated with nicotine dependence through motives of tension reduction and habitual smoking. DESIGN AND METHODS A total sample of 451 (230 of which were women) daily and occasional Polish smokers (aged from 18 to 60 years) reported distress tolerance, motives for smoking, and nicotine dependence. We then conducted a mediation analysis with bootstrapping using PROCESS macro. RESULTS Distress tolerance was indirectly related to nicotine dependence through both motives independently. In terms of the sequential model, there was a significant indirect effect of distress tolerance on nicotine dependence through smoking motives: tension reduction and habit. The total effect of distress tolerance on nicotine dependence was insignificant. CONCLUSIONS Our findings suggest that individuals with low distress tolerance are especially prone to nicotine dependence if they use smoking as a coping mechanism and it becomes habitual. The current study highlights the importance of a multidimensional approach in dealing with nicotine dependence.
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Affiliation(s)
| | - Marta Rokosz
- Department of Psychology, University of Wroclaw, Wroclaw, Poland
| | - Ryszard Poprawa
- Department of Psychology, University of Wroclaw, Wroclaw, Poland
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159
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Quinn MH, Olonoff M, Bauer AM, Fox E, Jao N, Lubitz SF, Leone F, Gollan JK, Schnoll R, Hitsman B. History and Correlates of Smoking Cessation Behaviors Among Individuals With Current or Past Major Depressive Disorder Enrolled in a Smoking Cessation Trial. Nicotine Tob Res 2022; 24:37-43. [PMID: 34259871 PMCID: PMC8666119 DOI: 10.1093/ntr/ntab147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Smoking among adults with major depressive disorder (MDD) is at least double that of the general US population. More effective smoking cessation interventions for depressed smokers may be facilitated through a better understanding of the smoking and depression-related characteristics of this population. METHODS We used baseline data from 300 participants enrolled in randomized clinical trial for smokers with current or past MDD. We described history of smoking cessation behaviors (ie, quit attempts, quit motivation, and cessation treatment utilization) and used multivariate regression to identify demographic and depression-related correlates of these behaviors. RESULTS Sixty-eight percent of participants reported at least one quit attempt in the past year, nearly 51% reported motivation to quit in the subsequent 30 days, and 83% reported prior use of a nicotine replacement therapy. A greater readiness to quit smoking was associated with increased age (p = .04) and lower cigarettes per day (p = .01). Greater use of smoking cessation medication was associated with greater education and nicotine dependence, minority race, and greater use of complementary reinforcers (eg, activities associated with increased reinforcing value of smoking; p's < .05). CONCLUSIONS These data indicate that smokers with current or past MDD are highly motivated to quit smoking and have a history of engaging in efforts to quit. Interventions to promote smoking cessation behaviors should address younger and lighter smokers, who may perceive less risk from tobacco use, and efforts to promote smoking cessation medications and counseling should address minority smokers who are engaging in complementary reinforcers. IMPLICATIONS These data are inconsistent with the assumption that smokers with serious mental illness are not willing to quit smoking and suggest the need for studies that test behavioral interventions that address complementary reinforcers to treat tobacco use in this community.
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Affiliation(s)
- Mackenzie Hosie Quinn
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Matthew Olonoff
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Anna-Marika Bauer
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erica Fox
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Nancy Jao
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Su Fen Lubitz
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Frank Leone
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania, Philadelphia, PA, USA
| | - Jacqueline K Gollan
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robert Schnoll
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Brian Hitsman
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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160
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Kassem M, Rahme C, Hallit S, Obeid S. Is the presence of a psychiatric patient at home associated with higher addictions (alcohol, cigarette, and waterpipe dependence) in caregivers? The role of work fatigue, mental illness, spirituality, and religiosity. Perspect Psychiatr Care 2022; 58:383-394. [PMID: 33908628 DOI: 10.1111/ppc.12804] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 03/07/2021] [Accepted: 04/03/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To assess if living with a psychiatric patient, depression, anxiety, stress, fatigue, insomnia, spirituality, and religiosity would be associated with more problematic alcohol use, cigarette, and waterpipe dependence in Lebanese caregivers. METHODS A case-control study was performed in Lebanon that recruited 587 caregivers (July-September 2019). RESULTS Higher religiosity was associated with lower problematic alcohol use. Having low versus no income was significantly associated with more cigarette dependence. Being Christian and high anxiety were significantly associated with more waterpipe dependence, whereas higher insomnia was significantly associated with lower waterpipe dependence. PRACTICAL IMPLICATIONS: Family caregivers go through a lot of stress and burden and need help coping with it in a healthy way for better outcomes for them and the care recipient.
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Affiliation(s)
- Maha Kassem
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Clara Rahme
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon
| | - Sahar Obeid
- Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,INSPECT-LB, Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie-Liban, Beirut, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
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161
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Donny EC, White CM. A review of the evidence on cigarettes with reduced addictiveness potential. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 99:103436. [PMID: 34535366 PMCID: PMC8785120 DOI: 10.1016/j.drugpo.2021.103436] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND In May 2018, the Secretariat for the World Health Organization Framework Convention on Tobacco Control convened a meeting to discuss the potential for reducing the addictiveness of tobacco products. A central focus was to review research findings on the behavioral effects of reducing the addictiveness of cigarettes. METHODS This manuscript reports the results of a review of the behavioral science literature, updated through April 2021, with special attention to both the potential benefits and unintended consequences of reducing nicotine in cigarettes. RESULTS Available evidence suggests that reducing nicotine content in cigarettes to very low levels could benefit public health in three primary ways, by 1) decreasing uptake of regular smoking, 2) decreasing the amount people smoke, and 3) increasing the likelihood of smoking cessation. Current evidence also suggests that reducing nicotine in cigarettes may produce similar benefits across many important subpopulations of people who smoke, including those with psychiatric comorbidities, those who use other substances, those with low socioeconomic status, young people, people who smoke infrequently and people who prefer menthol cigarettes. Cigarette nicotine reduction could also lead to some undesirable outcomes, such as experiencing withdrawal, product manipulation, an illicit market, and harm misperceptions; strategies that may mitigate each are discussed. CONCLUSION Overall, behavioral research suggests product standards that limit the nicotine content of combusted tobacco products could render cigarettes and similar products less addictive. The availability of legal, non-combusted products that effectively substitute for cigarettes and the dissemination of public health campaigns that clarify misperceptions about the relationship between nicotine, tobacco and disease may facilitate the extent to which a nicotine reduction policy reduces smoking.
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Affiliation(s)
- Eric C Donny
- Wake Forest University School of Medicine, Department of Physiology and Pharmacology, Winston-Salem, NC, USA.
| | - Cassidy M White
- Wake Forest University School of Medicine, Department of Physiology and Pharmacology, Winston-Salem, NC, USA
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Reed GL, Colby SM, Sokolovsky AW, Snell LM, DeAtley T, Tidey JW. Predicting Non-Adherence With Very Low Nicotine Content Cigarettes Among Adults With Serious Mental Illness Who Smoke. Nicotine Tob Res 2021; 24:914-918. [PMID: 34958368 PMCID: PMC9048920 DOI: 10.1093/ntr/ntab271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Reducing the nicotine content of cigarettes is a promising policy intervention to decrease cigarette dependence among people who smoke. Randomized trials support the potential efficacy of a reduced nicotine product standard for cigarettes. However, interpretation of such trials is challenged by incomplete adherence to the randomized treatment assignment, as some participants may continue to use commercial cigarettes not provided by the trial. The current study examined prevalence and predictors of non-adherence among trial participants with serious mental illness (SMI). AIMS AND METHODS Adults with SMI who smoke daily and were not trying to quit (N = 58) were randomized to receive very low nicotine content (VLNC) or normal nicotine content cigarettes over 6 weeks. We investigated predictors of biologically assessed non-adherence in participants assigned to VLNC cigarettes (n = 30). Predictors included subjective responses to VLNC cigarettes, baseline nicotine dependence and dependence motives, and psychiatric symptom severity. We fit a series of linear models regressing non-adherence metrics onto covariates (gender; menthol preference) and focal predictors. RESULTS Nearly all participants (96%) were estimated to be less than completely adherent to VLNC cigarettes. Lower enjoyment ratings of respiratory tract sensations of VLNC cigarettes predicted a greater degree of non-adherence (b = -.40, SE = .14, 95% CI: -0.71, -0.10). CONCLUSIONS Less positive subjective response to smoking VLNC cigarettes was the only significant predictor of incomplete adherence among individuals with SMI, consistent with prior research in a general population sample. This suggests the potential for shared strategies to help different smoking populations adjust to a reduced nicotine product standard. IMPLICATIONS Results offer preliminary insight into potential barriers to adherence in SMI populations. Adherence might be enhanced by supplementing VLNC cigarettes with alternative sources of non-combusted nicotine, paired with educational campaigns to encourage quitting or switching to less harmful products. Future studies should replicate these analyses in a larger sample of individuals with SMI who smoke.
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Affiliation(s)
- Grace L Reed
- Corresponding Author: Grace L. Reed, Center for Alcohol and Addiction Studies, Brown University School of Public Health, 69 Brown St, #4867, Providence, RI 02912, USA. Telephone: 401-595-2666; E-mail:
| | - Suzanne M Colby
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Alexander W Sokolovsky
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - L Morgan Snell
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Teresa DeAtley
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, RI, USA
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163
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Kotz D, van Rossem C, Viechtbauer W, Spigt M, van Schayck OCP. Validity of urges to smoke measures in predicting smoking relapse during treatment in primary care. NPJ Prim Care Respir Med 2021; 31:48. [PMID: 34887425 PMCID: PMC8660873 DOI: 10.1038/s41533-021-00259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022] Open
Abstract
In the context of smoking cessation treatment in primary care, identifying patients at the highest risk of relapse is relevant. We explored data from a primary care trial to assess the validity of two simple urges to smoke questions in predicting long-term relapse and their diagnostic value. Of 295 patients who received behavioural support and varenicline, 180 were abstinent at week 9. In this subgroup, we measured time spent with urges to smoke (TSU) and strength of urges to smoke (SUT; both scales 1 to 6 = highest). We used separate regression models with TSU or SUT as predictor and relapse from week 9-26 or week 9-52 as an outcome. We also calculated the sensitivity (SP), specificity and positive predictive values (PPV) of TSU and SUT in correctly identifying patients who relapsed at follow-up. The adjusted odds ratios (aOR) for predicting relapse from week 9-26 were 1.74 per point increase (95% CI = 1.05-2.89) for TSU and 1.59 (95% CI = 1.11-2.28) for SUT. The aORs for predicting relapse from week 9-52 were 2.41 (95% CI = 1.33-4.37) and 1.71 (95% CI = 1.14-2.56), respectively. Applying a cut-point of ≥3 on TSU resulted in SP = 97.1 and PPV = 70.0 in week 9-26, and SP = 98.8 and PPV = 90.0 in week 9-52. Applying a cut-point of ≥4 on SUT resulted in SP = 99.0 and PPV = 85.7 in week 9-26, and SP = 98.8 and PPV = 85.7 in week 9-52. Both TSU and SUT were valid predictors of long-term relapse in patients under smoking cessation treatment in primary care. These simple questions may be useful to implement in primary care.Trial registration: Dutch Trial Register (NTR3067).
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Affiliation(s)
- Daniel Kotz
- Institute of General Practice, Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
| | - Carolien van Rossem
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- General Practice Research Unit, Department of Community Medicine, The Arctic University of Tromsø, Tromsø, Norway
| | - Mark Spigt
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- General Practice Research Unit, Department of Community Medicine, The Arctic University of Tromsø, Tromsø, Norway
| | - Onno C P van Schayck
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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164
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Naudé GP, Reed DD, Jarmolowicz DP, Martin LE, Fox AT, Strickland JC, Johnson MW. Single- and cross-commodity discounting among adults who use alcohol and cannabis: Associations with tobacco use and clinical indicators. Drug Alcohol Depend 2021; 229:109082. [PMID: 34634563 DOI: 10.1016/j.drugalcdep.2021.109082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/28/2021] [Accepted: 08/12/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Delay discounting assessments typically involve choices between an immediate outcome and a larger amount of the same outcome after a delay. Real-world choices, however, more often involve qualitatively different alternatives. The primary aim of this study was to examine single- and cross-commodity discounting of money, alcohol, and cannabis, along with clinical measures of alcohol and cannabis use among people who use both alcohol and cannabis, yet differ in tobacco cigarette smoking status (i.e., dual- versus tri-use). METHODS An online crowdsourced sample (N = 318) of people who reported using alcohol and cannabis in the past week completed single- and cross-commodity discounting assessments across each combination of money, alcohol, and cannabis. We recruited a balanced number of people who did and did not also use tobacco cigarettes and examined associations between discounting, tobacco use, and clinical indicators. RESULTS People who reported using tobacco cigarettes in addition to alcohol and cannabis tended to engage in significantly higher rates of harmful alcohol and cannabis use than those who reported using only alcohol and cannabis. Cross-commodity discounting was significantly associated with patterns of harmful alcohol and cannabis use while no associations emerged for single-commodity discounting. CONCLUSIONS Cross-commodity discounting provides a nuanced account of intertemporal choice by incorporating relative commodity valuation and appears to characterize harmful alcohol and cannabis use more clearly than single-commodity arrangements. Further cross-commodity research is needed to better understand the interplay between temporal location and relative commodity value among people who use multiple substances.
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Affiliation(s)
- Gideon P Naudé
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA.
| | - Derek D Reed
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - David P Jarmolowicz
- Department of Applied Behavioral Science, University of Kansas, Lawrence, KS, USA; Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA
| | - Laura E Martin
- Cofrin Logan Center for Addiction Research and Treatment, University of Kansas, Lawrence, KS, USA; Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA
| | - Andrew T Fox
- Hoglund Biomedical Imaging Center, University of Kansas Medical Center, Kansas City, KS, USA; Division of Health Services and Outcomes Research, Children's Mercy Kansas City, Kansas City, KS, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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165
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Ely AV, Keyser H, Spilka N, Franklin TR, Wetherill RR, Audrain-McGovern J. An exploration of associations between smoking motives and behavior as a function of body mass index. DRUG AND ALCOHOL DEPENDENCE REPORTS 2021; 1:100008. [PMID: 36843906 PMCID: PMC9948816 DOI: 10.1016/j.dadr.2021.100008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/05/2021] [Accepted: 11/18/2021] [Indexed: 11/19/2022]
Abstract
Objective Cigarette smoking and obesity are the leading causes of premature morbidity and mortality and increase the risk of all-cause mortality four-fold when comorbid. Although research suggests that smoking motives may differ based on body mass index (BMI), it is unclear how these differences translate to smoking behavior. Method Three groups of adults who smoke cigarettes (N = 79; obese n = 25, overweight n = 30, and lean n = 24) completed measures of smoking and the Smoking Motivations Questionnaire. Groups did not differ on age, education, cigarettes per day (CPD), pack-years, or nicotine dependence, as measured by the Fagerström Test for Cigarette Dependence (FTCD). Results Analyses revealed different associations between reasons for smoking and smoking behavior depending on lean, overweight, or obesity status. Participants (N = 37 female, average age 39.8 years) self-reported smoking was positively associated with Addictive, and Automatic subscale scores among lean participants, with only the Addictive subscale score among those with overweight, and only the Automatic subscale score among those with obesity. Post hoc MANCOVA analysis revealed a significant interaction effect of Group x Automatic Smoking on Pack-years (F(2, 79)=3.34, p = 0.04). Conclusion Findings suggest smoking motives are differentially associated with smoking behavior in adults who smoke depending on weight status. The daily smoking rate of participants with obesity may be less related to the addictive quality of smoking, and automaticity may be less associated with smoking history in those with overweight. Additional research on the influence of BMI on cigarette smoking is necessary to fully elucidate how obesity may impact treatment outcomes to optimize smoking cessation treatment among those with excess body weight.
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Affiliation(s)
- Alice V. Ely
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Heather Keyser
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Nathaniel Spilka
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Teresa R. Franklin
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Reagan R. Wetherill
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
| | - Janet Audrain-McGovern
- University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States
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166
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Berlin I, Berlin N, Malecot M, Breton M, Jusot F, Goldzahl L. Financial incentives for smoking cessation in pregnancy: multicentre randomised controlled trial. BMJ 2021; 375:e065217. [PMID: 34853024 PMCID: PMC8634365 DOI: 10.1136/bmj-2021-065217] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the efficacy of financial incentives dependent on continuous smoking abstinence on smoking cessation and birth outcomes among pregnant smokers. DESIGN Single blind, randomised controlled trial. SETTING Financial Incentive for Smoking Cessation in Pregnancy (FISCP) trial in 18 maternity wards in France. PARTICIPANTS 460 pregnant smokers aged at least 18 years who smoked ≤5 cigarettes/day or ≤3 roll-your-own cigarettes/day and had a pregnancy gestation of <18 weeks were randomised to a financial incentives group (n=231) or a control group (n=229). INTERVENTIONS Participants in the financial incentives group received a voucher equivalent to €20 (£17; $23), and further progressively increasing vouchers at each study visit if they remained abstinent. Participants in the control group received no financial incentive for abstinence. All participants received a €20 show-up fee at each of six visits. MAIN OUTCOME MEASURES The main outcome measure was continuous smoking abstinence from the first post-quit date visit to visit 6, before delivery. Secondary outcomes in the mothers were point prevalence abstinence, time to smoking relapse, withdrawal symptoms, blood pressure, and alcohol and cannabis use in past 30 days. Secondary outcomes in the babies were gestational age at birth, birth characteristics (birth weight, length, head circumference, Apgar score), and a poor neonatal outcome-a composite measure of transfer to the neonatal unit, congenital malformation, convulsions, or perinatal death. RESULTS Mean age was 29 years. In the financial incentives and control groups, respectively, 137 (59%) and 148 (65%) were employed, 163 (71%) and 171 (75%) were in a relationship, and 41 (18%) and 31 (13%) were married. The participants had smoked a median of 60 cigarettes in the past seven days. The continuous abstinence rate was significantly higher in the financial incentives group (16%, 38/231) than control group (7%, 17/229): odds ratio 2.45 (95% confidence interval 1.34 to 4.49), P=0.004). The point prevalence abstinence rate was higher (4.61, 1.41 to 15.01, P=0.011), the median time to relapse was longer (visit 5 (interquartile range 3-6) and visit 4 (3-6), P<0.001)), and craving for tobacco was lower (β=-1.81, 95% confidence interval -3.55 to -0.08, P=0.04) in the financial incentives group than control group. Financial incentives were associated with a 7% reduction in the risk of a poor neonatal outcome: 4 babies (2%) in the financial incentives group and 18 babies (9%) in the control group: mean difference 14 (95% confidence interval 5 to 23), P=0.003. Post hoc analyses suggested that more babies in the financial incentives group had birth weights ≥2500 g than in the control group: unadjusted odds ratio 1.95 (95% confidence interval 0.99 to 3.85), P=0.055; sex adjusted odds ratio 2.05 (1.03 to 4.10), P=0.041; and sex and prematurity adjusted odds ratio 2.06 (0.90 to 4.71), P=0.086. As these are post hoc analyses, the results should be interpreted with caution. CONCLUSIONS Financial incentives to reward smoking abstinence compared with no financial incentives were associated with an increased abstinence rate in pregnant smokers. Financial incentives dependent on smoking abstinence could be implemented as a safe and effective intervention to help pregnant smokers quit smoking. TRIAL REGISTRATION ClinicalTrials.gov NCT02606227.
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Affiliation(s)
- Ivan Berlin
- Département de pharmacologie, Hôpital Pitié-Salpêtrière-Sorbonne Université, 75013 Paris, France
| | - Noémi Berlin
- CNRS, EconomiX, Université Paris Nanterre, Nanterre, France
| | - Marie Malecot
- Unité d'addictologie, Centre Hospitalier St Joseph St Luc, Lyon, France
| | | | - Florence Jusot
- Université Paris-Dauphine, PSL-Research University, LEDa, Paris, France
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The Influence of Episodic Future Thinking and Graphic Warning Labels on Delay Discounting and Cigarette Demand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312637. [PMID: 34886370 PMCID: PMC8656814 DOI: 10.3390/ijerph182312637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 01/23/2023]
Abstract
Delay discounting and operant demand are two behavioral economic constructs that tend to covary, by degree, with cigarette smoking status. Given historically robust associations between adverse health outcomes of smoking, a strong preference for immediate reinforcement (measured with delay discounting), and excessive motivation to smoke cigarettes (measured with operant demand), researchers have made numerous attempts to attenuate the extent to which behaviors corresponding to these constructs acutely appear in smokers. One approach is episodic future thinking, which can reportedly increase the impact of future events on present decision making as well as reduce the reinforcing value of cigarettes. Graphic cigarette pack warning labels may also reduce smoking by increased future orientation. Experiment 1 evaluated the combined effects of episodic future thinking and graphic warning labels on delay discounting; Experiment 2 evaluated solely the effects of episodic future thinking on delay discounting and operant demand. We observed no statistically significant effects of episodic future thinking when combined with graphic warning labels or when assessed on its own. These results serve as a call for further research on the boundary conditions of experimental techniques reported to alter behaviors associated with cigarette smoking.
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168
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Weinberger AH, Dierker L, Zhu J, Levin J, Goodwin RD. Cigarette dependence is more prevalent and increasing among US adolescents and adults who use cannabis, 2002-2019. Tob Control 2021:tobaccocontrol-2021-056723. [PMID: 34815363 DOI: 10.1136/tobaccocontrol-2021-056723] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 10/27/2021] [Indexed: 01/16/2023]
Abstract
SIGNIFICANCE Cannabis use is increasing among cigarette smokers. If cannabis use is associated with cigarette dependence, a barrier to smoking cessation, this could have public health implications for tobacco control. The current study estimated the prevalence of cigarette dependence among US individuals who smoke cigarettes by cannabis use status, and investigated trends in cigarette dependence from 2002 to 2019 among cigarette smokers by cannabis use status and cigarette consumption (ie, cigarettes per day, CPD). METHODS Data were drawn from the 2002-2019 annual National Survey on Drug Use and Health and included US individuals aged 12+ years who used cigarettes at least once in the past month (n=231 572). Logistic regression was used to estimate the prevalence of cigarette dependence, measured as time to first cigarette <30 min, by past-month cannabis use (no use, non-daily use, daily use), and to estimate trends in cigarette dependence from 2002 to 2019 overall and stratified by cannabis use and smoking level (light, 1-5 CPD; moderate, 6-15 CPD; heavy, 16+ CPD). RESULTS Across all levels of cigarette use, cigarette dependence was significantly more common among individuals with daily cannabis use compared with those with non-daily or no cannabis use. From 2002 to 2019, cigarette dependence increased among cigarette smokers with non-daily cannabis use, and among light and moderate cigarette smokers with no cannabis use. CONCLUSIONS US individuals who use both cigarettes and cannabis report a higher prevalence of cigarette dependence relative to individuals who use cigarettes and do not use cannabis at virtually all levels of cigarette consumption. Further, cigarette dependence is increasing in the USA both among those who use and do not use cannabis. Given the increase in cannabis use among those using cigarettes, efforts to elucidate the nature of the association between cannabis and cigarette dependence are needed.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.,Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Lisa Dierker
- Psychology, Wesleyan University, Middletown, Connecticut, USA
| | - Jiaqi Zhu
- Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, New York, USA
| | - Jacob Levin
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Renee D Goodwin
- Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, New York, USA .,Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
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169
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Tobacco Profile and Evaluation of the DS14 Scale in Patients with Coronary Syndrome. PSYCH 2021. [DOI: 10.3390/psych3040044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: the prevalence of current smokers in patients with coronary syndrome is high. This risk behaviour significantly increases the risk of cardiovascular complications. In the recommendations for the management of cardiovascular diseases, psychosocial and psychological factors are still neglected in practice. The aim of study was to verify the prevalence of tobacco use in hospitalized patients with coronary syndrome, notably to verify the type-D personality and tobacco use in the groups obtained from the evaluation of the DS14 scale. Methods: in this cross-sectional study, we addressed 100 hospitalized patients with coronary syndrome. Results: in the cohort, 48% patient were current smokers, 21% were never smokers, 24% were former smokers, 4% were occasional smokers, and 3% were quitters. Based on the evaluation of DS14, 21% of patients were classified as type-D personality and 38% as non-type-D; we identified two subtypes: the NA group at 23% and the SI group at 18%. In the group of the current smokers, 81% declared that they wanted to quit smoking, 15% of the patients were undecided, and 4% of current smokers did not want to quit. Conclusions: cardiac patients are aware that their disease is related to smoking; despite the severity of their disease, patients’ motivation to change their risky behaviour is low.
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170
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Ghahremani DG, Pochon JB, Perez Diaz M, Tyndale RF, Dean AC, London ED. Functional connectivity of the anterior insula during withdrawal from cigarette smoking. Neuropsychopharmacology 2021; 46:2083-2089. [PMID: 34035468 PMCID: PMC8505622 DOI: 10.1038/s41386-021-01036-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 12/18/2022]
Abstract
Currently available therapies for smoking cessation have limited efficacy, and potential treatments that target specific brain regions are under evaluation, with a focus on the insula. The ventral and dorsal anterior subregions of the insula serve distinct functional networks, yet our understanding of how these subregions contribute to smoking behavior is unclear. Resting-state functional connectivity (RSFC) provides a window into network-level function associated with smoking-related internal states. The goal of this study was to determine potentially distinct relationships of ventral and dorsal anterior insula RSFC with cigarette withdrawal after brief abstinence from smoking. Forty-seven participants (24 women; 18-45 years old), who smoked cigarettes daily and were abstinent from smoking overnight (~12 h), provided self-reports of withdrawal and underwent resting-state fMRI before and after smoking the first cigarette of the day. Correlations between withdrawal and RSFC were computed separately for ventral and dorsal anterior insula seed regions in whole-brain voxel-wise analyses. Withdrawal was positively correlated with RSFC of the right ventral anterior insula and dorsal anterior cingulate cortex (dACC) before but not after smoking. The correlation was mainly due to a composite effect of craving and physical symptoms of withdrawal. These results suggest a role of right ventral anterior insula-dACC connectivity in the internal states that maintain smoking behavior (e.g., withdrawal) and present a specific neural target for brain-based therapies seeking to attenuate withdrawal symptoms in the critical early stages of smoking cessation.
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Affiliation(s)
- Dara G. Ghahremani
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA
| | - Jean-Baptiste Pochon
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA
| | - Maylen Perez Diaz
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA
| | - Rachel F. Tyndale
- grid.17063.330000 0001 2157 2938Department of Pharmacology & Toxicology, University of Toronto, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Department of Psychiatry, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON Canada
| | - Andy C. Dean
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Brain Research Institute, University of California, Los Angeles, CA USA
| | - Edythe D. London
- grid.19006.3e0000 0000 9632 6718Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Brain Research Institute, University of California, Los Angeles, CA USA ,grid.19006.3e0000 0000 9632 6718Department of Molecular and Medical Pharmacology, University of California, Los Angeles, CA USA
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171
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Selamoglu A, Langley C, Crean R, Savulich G, Cormack F, Sahakian BJ, Mason B. Neuropsychological performance in young adults with cannabis use disorder. J Psychopharmacol 2021; 35:1349-1355. [PMID: 34694178 PMCID: PMC8600580 DOI: 10.1177/02698811211050548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Cannabis is a commonly used recreational drug in young adults. The worldwide prevalence in 18- to 25-year-olds is approximately 35%. Significant differences in cognitive performance have been reported previously for groups of cannabis users. However, the groups are often heterogeneous in terms of cannabis use. Here, we study daily cannabis users with a confirmed diagnosis of cannabis use disorder (CUD) to examine cognitive performance on measures of memory, executive function and risky decision-making. METHODS Forty young adult daily cannabis users with diagnosed CUD and 20 healthy controls matched for sex and premorbid intelligence quotient (IQ) were included. The neuropsychological battery implemented was designed to measure multiple modes of memory (visual, episodic and working memory), risky decision-making and other domains of executive function using subtests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). RESULTS Our results showed that young adult daily cannabis users with CUD perform significantly poorer on tasks of visual and episodic memory compared with healthy controls. In addition, executive functioning was associated with the age of onset. CONCLUSIONS Further research is required to determine whether worse performance in cognition results in cannabis use or is a consequence of cannabis use. Chronic heavy cannabis use during a critical period of brain development may have a particularly negative impact on cognition. Research into the persistence of cognitive differences and how they relate to functional outcomes such as academic/career performance is required.
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Affiliation(s)
- Ayla Selamoglu
- Department of Psychiatry, University of
Cambridge, Cambridge, UK
| | - Christelle Langley
- Department of Psychiatry, University of
Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience
Institute, University of Cambridge, Cambridge, UK,Christelle Langley, Department of
Psychiatry, University of Cambridge, The Herchel Smith Building for Brain and
Mind Sciences, Forvie Site Robinsons Way, Cambridge CB2 0SZ, UK.
| | - Rebecca Crean
- The Pearson Center for Alcoholism and
Addiction Research, Department of Molecular Medicine, The Scripps Research
Institute, La Jolla, CA, USA
| | - George Savulich
- Department of Psychiatry, University of
Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience
Institute, University of Cambridge, Cambridge, UK
| | | | - Barbara J Sahakian
- Department of Psychiatry, University of
Cambridge, Cambridge, UK,Behavioural and Clinical Neuroscience
Institute, University of Cambridge, Cambridge, UK
| | - Barbara Mason
- The Pearson Center for Alcoholism and
Addiction Research, Department of Molecular Medicine, The Scripps Research
Institute, La Jolla, CA, USA
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Smits JAJ, Zvolensky MJ, Rosenfield D, Brown RA, Otto MW, Dutcher CD, Papini S, Freeman SZ, DiVita A, Perrone A, Garey L. Community-based smoking cessation treatment for adults with high anxiety sensitivity: a randomized clinical trial. Addiction 2021; 116:3188-3197. [PMID: 34033178 PMCID: PMC10091508 DOI: 10.1111/add.15586] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 05/12/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIMS People with anxiety disorders are more likely to smoke and less likely to succeed when they try to quit. Anxiety sensitivity may underlie both phenomena, such that people with high anxiety sensitivity react to interoceptive distress by avoidance. This study aimed to test the efficacy of an exercise program that induced interoceptive distress and thereby created tolerance to this distress in a safe environment. DESIGN, SETTING AND PARTICIPANTS Randomized clinical trial at four YMCA branches in Austin, Texas, USA. Participants [n = 150; 130 (86.7%) white; 101 (67.3%) female; meanage = 38.6, standard deviation (SD)age = 10.4] were adult, daily smokers with high anxiety sensitivity motivated to quit smoking, who reported no regular moderate-intensity exercise. INTERVENTIONS Participants were assigned a YMCA personal trainer who guided them through a 15-week intervention aerobic exercise program. Participants assigned to the personalized intervention trained at 60-85% of their heart rate reserve (HRR), whereas participants assigned to the control intervention trained at 20-40% of their HRR. Participants in both groups received standard behavioral support and nicotine replacement therapy. MEASUREMENTS The primary outcome was biologically verified 7-day point prevalence abstinence (PPA) at 6-month follow-up. FINDINGS Sixty-one per cent of participants were available at the 6-month follow-up. PPA at 6 months was higher in the personalized intervention than the control intervention [27.6 versus 14.8%; odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.28, 3.80, P = 0.005], assuming missing at random. Anxiety sensitivity declined in both groups with no evidence that this differed between groups. CONCLUSIONS An exercise program of high intensity increased abstinence from smoking in people with high anxiety sensitivity, but may not have done so by reducing anxiety sensitivity.
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Affiliation(s)
- Jasper A J Smits
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | | | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
| | - Richard A Brown
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Michael W Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Christina D Dutcher
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Santiago Papini
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Slaton Z Freeman
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Annabelle DiVita
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Alex Perrone
- Institute for Mental Health Research and Department of Psychology, The University of Texas at Austin, Austin, USA
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, TX, USA
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173
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Gale N, McEwan M, Camacho OM, Hardie G, Proctor CJ, Murphy J. Changes in biomarkers after 180 days of tobacco heating product use: a randomised trial. Intern Emerg Med 2021; 16:2201-2212. [PMID: 34196886 PMCID: PMC8563516 DOI: 10.1007/s11739-021-02798-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/15/2021] [Indexed: 01/14/2023]
Abstract
The aim of this study was to investigate whether biomarkers of exposure (BoE) and potential harm (BoPH) are modified when smokers switch from smoking cigarettes to exclusive use of a tobacco heating product (THP) in an ambulatory setting. Participants in this randomised, controlled study were healthy volunteer smokers assigned either to continue smoking or switch to a THP, and a control group of smokers who abstained from cigarette smoking. Various BoE and BoPH related to oxidative stress, cardiovascular and respiratory diseases, and cancer were assessed at baseline and up to 180 days. In continuing smokers, BoE and BoPH remained stable between baseline and day 180, while THP users' levels of most BoE reduced significantly, becoming similar to those in controls abstaining from cigarette smoking. Also at 180 days, significant changes in numerous BoPH, including total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol, 8-epi-prostaglandin F2α type III, fractional concentration of exhaled nitric oxide and white blood cell count, were directionally consistent with lessened health impact. Our findings support the notion that the deleterious health impacts of cigarette smoking may be reduced in smokers who completely switch to using THPs.
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Affiliation(s)
- Nathan Gale
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK.
| | - Michael McEwan
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - Oscar M Camacho
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | - George Hardie
- British American Tobacco (Investments) Limited, Research and Development, Regents Park Road, Southampton, SO15 8TL, UK
| | | | - James Murphy
- R. J. Reynolds Tobacco Company, 401 N Main Street, Winston-Salem, NC27101, USA
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174
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Liautaud MM, Kechter A, Bello MS, Guillot CR, Oliver JA, Banks DE, D’Orazio LM, Leventhal AM. Anhedonia in tobacco withdrawal among African-American smokers. Exp Clin Psychopharmacol 2021; 29:511-523. [PMID: 34110886 PMCID: PMC8511043 DOI: 10.1037/pha0000474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anhedonia-diminished interest and pleasure in response to rewards-may be a symptom of tobacco withdrawal that is understudied in priority populations. This experiment investigated the magnitude and correlates of various dimensions of anhedonia during tobacco withdrawal among African-American (AA) smokers-a population subject to health disparities. AA smokers (N = 607; ≥ 10 cigarettes/day, 37.8% female, M[SD] age = 50.0[10.6] years) completed self-report measures assessing expected pleasure from (i.e., consummatory anhedonia) and desire to engage in (i.e., anticipatory anhedonia) various types of hypothetically experienced rewards at counterbalanced 16-hr tobacco deprived and nondeprived lab visits. Other tobacco withdrawal symptom measures (e.g., craving, negative affect, hunger) were also assessed. Tobacco deprivation most robustly increased scores on a composite measure of consummatory anhedonia directed toward various reward domains (i.e., hobbies, sensory experiences, social activities; d = .32, p < .001). Deprivation modestly increased consummatory and anticipatory anhedonia directed toward sexual rewards (ds = .09-.12, ps < .02), did not significantly change anhedonia toward food rewards, and decreased anhedonia directed toward psychoactive drug rewards (i.e., increased desire for and pleasure from drugs; ds = -.21 to -.19, ps < .001). Deprivation-induced changes in anhedonia were modestly correlated with other withdrawal symptoms (average |r|s = .04-.23) and were amplified among participants with higher nicotine dependence and lower positive affect-related traits (|β|s = .10-.12, ps < .01). Some dimensions of anhedonia may be genuine expressions of acute tobacco withdrawal in AA smokers. Applying multi-dimensional anhedonia conceptualizations might advance basic knowledge and treatment of tobacco use disorder, improve smoking cessation outcomes, and address tobacco-related health disparities facing AA smokers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Afton Kechter
- University of Southern California, Department of Preventive Medicine
| | | | | | - Jason A. Oliver
- Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences
| | - Devin E. Banks
- University of Missouri Saint Louis, Department of Psychological Sciences
| | | | - Adam M. Leventhal
- University of Southern California, Department of Preventive Medicine
- University of Southern California, Department of Psychology
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175
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Ely AV, Jagannathan K, Spilka N, Keyser H, Rao H, Franklin TR, Wetherill RR. Exploration of the influence of body mass index on intra-network resting-state connectivity in chronic cigarette smokers. Drug Alcohol Depend 2021; 227:108911. [PMID: 34364193 PMCID: PMC8464487 DOI: 10.1016/j.drugalcdep.2021.108911] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Obesity and cigarette smoking are two leading preventable causes of death. Previous research suggests that comorbid smoking and obesity likely share neurobehavioral underpinnings; however, the influence of body mass index (BMI) on resting-state functional connectivity (rsFC) in smokers remains unknown. In this study, we explore how BMI affects rsFC and associations between rsFC and smoking-related behavior. METHODS Treatment-seeking cigarette smokers (N = 87; 54 % men) completed a BOLD resting-state fMRI scan session. We grouped smokers into BMI groups (N = 23 with obesity, N = 33 with overweight, N = 31 lean) and used independent components analysis (ICA) to identify the resting state networks commonly associated with cigarette smoking: salience network (SN), right and left executive control networks (ECN) and default mode network (DMN). Average rsFC values were extracted (p < 0.001, k = 100) to determine group differences in rsFC and relationship to self-reported smoking and dependence. RESULTS Analyses revealed a significant relationship between BMI and connectivity in the SN and a significant quadratic effect of BMI on DMN connectivity. Heavier smoking was related to greater rsFC in the SN among lean and obese groups but reduced rsFC in the overweight group. CONCLUSIONS Findings build on research suggesting an influence of BMI on the neurobiology of smokers. In particular, dysfunction of SN-DMN-ECN circuitry in smokers with overweight may lead to a failure to modulate attention and behavior and subsequent difficulty quitting smoking. Future research is needed to elucidate the mechanism underlying the interaction of BMI and smoking and its impact on treatment.
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Affiliation(s)
- Alice V. Ely
- Corresponding authors: University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia PA 19104, ,
| | | | | | | | | | | | - Reagan R. Wetherill
- Corresponding authors: University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia PA 19104, ,
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176
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Brown CR. The relationship between COVID-19-specific health risk beliefs and the motivation to quit smoking: A UK-based survey. Drug Alcohol Depend 2021; 227:108981. [PMID: 34488076 PMCID: PMC8397491 DOI: 10.1016/j.drugalcdep.2021.108981] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/08/2021] [Accepted: 07/16/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND In some individuals who smoke, the COVID-19 pandemic has triggered an increase in the motivation to quit smoking due to the potential higher risk of severe COVID-19 infection. However, this change is not universal, and the motivation to quit appears dependent upon factors such as fear of COVID-19 and perceived risk from COVID-19. In the current investigation both COVID-19 severity and infection probability beliefs were measured to isolate which beliefs correlated with the motivation to quit smoking. METHODS UK-based smokers (N = 243) completed an online survey between September and October 2020, in which they reported their current motivation to quit smoking, fear of COVID-19, and their beliefs about how severe COVID-19 infection would be and how probable COVID-19 infection was. RESULTS The only significant predictor of the motivation to quit smoking was the perceived probability of COVID-19 infection, β = .22, p < .001, 95CI[.10, .34]. This relationship remained when controlling for the general perceived probability and severity of other smoking-related health risks, β = .20, p = .002, 95CI[.08,.32], suggesting a COVID-19-specific effect. Further, perceived probability of COVID-19 infection mediated the positive impact of fear of COVID-19 on motivation, β = .07, p = .006, 95CI[.03,.13]. CONCLUSIONS The result places the perceived probability of COVID-19 infection as a central predictor of the motivation to quit during the pandemic. Based on this evidence, messaging aiming to facilitate smoking cessation during the pandemic should focus on the highly contagious nature of the virus to increase the motivation to quit.
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177
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Russo C, Caponnetto P, Cibella F, Maglia M, Alamo A, Campagna D, Frittitta L, Di Mauro M, Leotta C, Mondati E, Krysiński A, Franek E, Polosa R. A double blind randomized controlled trial investigating efficacy and safety of varenicline for smoking cessation in patients with type 2 diabetes: study protocol. Intern Emerg Med 2021; 16:1823-1839. [PMID: 33735416 PMCID: PMC8502165 DOI: 10.1007/s11739-021-02684-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 02/22/2021] [Indexed: 12/23/2022]
Abstract
Reducing exposure to cigarette smoke is an imperative for public health and for diabetic patients. Patients with diabetes who continue to smoke face challenges at quitting and the delivery of effective smoking cessation interventions is a major unmet need. The high-affinity α4β2 nicotinic acetylcholine receptor partial agonist varenicline in combination with counseling is effective for smoking cessation, but evidence in patients with diabetes is limited. A clinical trial of varenicline targeted specifically at smokers with T2DM is warranted. This randomized, double blind, placebo-controlled trial will be the first study to test efficacy and safety of varenicline in smokers with type 2 diabetes mellitus (T2DM) over the course of 52 weeks. We hypothesize that varenicline treatment (1 mg BID, administered for 12 weeks) would increase quit rates, maintain smoking abstinence up to 1 year after treatment, and be well-tolerated in T2DM smokers intending to quit. Efficacy end points will include carbon monoxide-confirmed continuous abstinence rate (CAR) and 7-day point prevalence of abstinence. The results of this RCT will help inform medical/health authorities and physicians worldwide whether an optimally varenicline-treated cohort of T2DM patients who smoke will experience significant success rates, without significant side effects.Trial registration NCT01387425 ( https://clinicaltrials.gov/ct2/show/NCT01387425 ).
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Affiliation(s)
- C Russo
- Ambulatorio Di Diabetologia, UOC Medicina Interna E D'Urgenza, Policlinico Universitario, AOU "Policlinico-V. Emanuele", Catania, Italy
| | - P Caponnetto
- Centro Per La Prevenzione E Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "Policlinico-V.Emanuele" Dell'Università Di Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - F Cibella
- Institute for Biomedical Research and Innovation, National Research Council of Italy, Palermo, Italy
| | - M Maglia
- Centro Per La Prevenzione E Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "Policlinico-V.Emanuele" Dell'Università Di Catania, Via S. Sofia 78, 95123, Catania, Italy
| | - A Alamo
- Centro Diabetologico - UOC Andrologia Ed Endocrinologia, Policlinico Universitario, AOU "Policlinico-V. Emanuele", Catania, Italy
| | - D Campagna
- Ambulatorio Di Diabetologia, UOC Medicina Interna E D'Urgenza, Policlinico Universitario, AOU "Policlinico-V. Emanuele", Catania, Italy
- UOC MCAU, University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - L Frittitta
- Centro Per Il Diabete E L'Obesità - UOC Endocrinologia, Ospedale Garibaldi Nesima, ARNAS Garibaldi, Catania, Italy
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), Dipartimento Di Medicina Clinica E Sperimentale, Università Di Catania, Catania, Italy
| | - M Di Mauro
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), Dipartimento Di Medicina Clinica E Sperimentale, Università Di Catania, Catania, Italy
- Ambulatorio Di Diabetologia, Ospedale V. Emanuele, AOU "Policlinico-V. Emanuele", Catania, Italy
| | - C Leotta
- Ambulatorio Di Diabetologia - UOC Geriatria, Ospedale Cannizzaro, Catania, Italy
| | - E Mondati
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), Dipartimento Di Medicina Clinica E Sperimentale, Università Di Catania, Catania, Italy
- UOS Sorveglianza Delle Complicanze Delle Malattie Metaboliche, Ospedale S. Marta, AOU "Policlinico-V. Emanuele", Catania, Italy
| | - A Krysiński
- Mossakowski Clinical Research Centre, Polish Academy of Sciences, Warsaw, Poland
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Warsaw, Poland
| | - E Franek
- Mossakowski Clinical Research Centre, Polish Academy of Sciences, Warsaw, Poland
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Warsaw, Poland
| | - R Polosa
- Ambulatorio Di Diabetologia, UOC Medicina Interna E D'Urgenza, Policlinico Universitario, AOU "Policlinico-V. Emanuele", Catania, Italy.
- Centro Per La Prevenzione E Cura del Tabagismo (CPCT), Azienda Ospedaliero-Universitaria "Policlinico-V.Emanuele" Dell'Università Di Catania, Via S. Sofia 78, 95123, Catania, Italy.
- Center of Excellence for the Acceleration of HArm Reduction (CoEHAR), Dipartimento Di Medicina Clinica E Sperimentale, Università Di Catania, Catania, Italy.
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178
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Walker N, Smith B, Barnes J, Verbiest M, Parag V, Pokhrel S, Wharakura M, Lees T, Cubillos Gutierrez H, Jones B, Bullen C. Cytisine versus varenicline for smoking cessation in New Zealand indigenous Māori: a randomized controlled trial. Addiction 2021; 116:2847-2858. [PMID: 33761149 PMCID: PMC8519028 DOI: 10.1111/add.15489] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/13/2020] [Accepted: 03/10/2021] [Indexed: 01/06/2023]
Abstract
AIM To determine whether cytisine was at least as effective as varenicline in supporting smoking abstinence for ≥ 6 months in New Zealand indigenous Māori or whānau (extended-family) of Māori, given the high smoking prevalence in this population. DESIGN Pragmatic, open-label, randomized, community-based non-inferiority trial. SETTING Bay of Plenty, Tokoroa and Lakes District Health Board regions of New Zealand. PARTICIPANTS Adult daily smokers who identified as Māori or whānau of Māori, were motivated to quit in the next 2 weeks, were aged ≥ 18 years and were eligible for subsidized varenicline. Recruitment used multi-media advertising. INTERVENTIONS A total of 679 people were randomly assigned (1 : 1) to receive a prescription for 12 weeks of cytisine or varenicline, plus low-intensity cessation behavioural support from the prescribing doctor and community stop-smoking services or a research assistant. Day 5 of treatment was the designated quit date. MEASUREMENTS The primary outcome was carbon monoxide-verified continuous abstinence at 6 months, analysed as intention-to-treat (with multiple imputation for missing data). Secondary outcomes measured at 1, 3, 6 and 12 months post-quit date included: self-reported continuous abstinence, 7-day point prevalence abstinence, cigarettes per day, time to (re)lapse, adverse events, treatment adherence/compliance and acceptability, nicotine withdrawal/urge to smoke and health-care utilization/health-related quality of life. FINDINGS Verified continuous abstinence rates at 6 months post-quit date were 12.1% (41 of 337) for cytisine versus 7.9% (27 of 342) for varenicline [risk difference 4.29%, 95% confidence interval (CI) = -0.22 to 8.79; relative risk 1.55; 95% CI = 0.97-2.46]. Sensitivity analyses confirmed that the findings were robust. Self-reported adverse events over 6 months occurred significantly more frequently in the varenicline group (cytisine: 313 events in 111 participants; varenicline: 509 events in 138 participants, incidence rate ratio 0.56, 95% CI = 0.49-0.65, P < 0.001) compared with the cytisine group. Common adverse events were headache, nausea and difficulty sleeping. CONCLUSION A randomized controlled trial found that cytisine was at least as effective as varenicline at supporting smoking abstinence in New Zealand indigenous Māori or whānau (extended-family) of Māori, with significantly fewer adverse events.
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Affiliation(s)
- Natalie Walker
- National Institute for Health InnovationSchool of Population Health, The University of AucklandAucklandNew Zealand
| | - Barry Smith
- Lakes District Health BoardRotoruaNew Zealand
| | - Joanne Barnes
- School of Pharmacy, The University of AucklandAucklandNew Zealand
| | - Marjolein Verbiest
- Tranzo Scientific Centre for Care and Wellbeing, School of Social and Behavioral SciencesTilburg UniversityTilburgthe Netherlands
| | - Varsha Parag
- National Institute for Health InnovationSchool of Population Health, The University of AucklandAucklandNew Zealand
| | - Subhash Pokhrel
- Health Economics Research GroupBrunel University LondonUxbridgeUK
| | - Mary‐Kaye Wharakura
- National Institute for Health InnovationSchool of Population Health, The University of AucklandAucklandNew Zealand
| | - Tina Lees
- National Institute for Health InnovationSchool of Population Health, The University of AucklandAucklandNew Zealand
| | - Huber Cubillos Gutierrez
- National Institute for Health InnovationSchool of Population Health, The University of AucklandAucklandNew Zealand
| | - Brian Jones
- National Institute for Health InnovationSchool of Population Health, The University of AucklandAucklandNew Zealand
| | - Christopher Bullen
- National Institute for Health InnovationSchool of Population Health, The University of AucklandAucklandNew Zealand
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Kimber C, Cox S, Frings D, Albery IP, Dawkins L. Development and testing of relative risk-based health messages for electronic cigarette products. Harm Reduct J 2021; 18:96. [PMID: 34496865 PMCID: PMC8424813 DOI: 10.1186/s12954-021-00540-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to (1) develop and test a selection of relative risk messages for e-cigarette products; (2) compare these to the two current EU Tobacco Products Directive (TPD) nicotine addiction messages; and (3) explore differences between smokers, non-smokers and dual users. METHOD Twenty-six messages focusing on either harm-reduction or cessation were developed and rated by multidisciplinary experts for accuracy, persuasiveness and clarity. The eight highest ranking messages were compared alongside the TPD messages in a sample of 983 European residents (316 smokers, 327 non-smokers, 340 dual users) on understandability, believability and convincingness. RESULTS On all three constructs combined, the two TPD messages rated the highest, closely followed by four relative risk messages "Completely switching to e-cigarettes lowers your risk of smoking related diseases", "Use of this product is much less harmful than smoking", "Completely switching to e-cigarettes is a healthier alternative to smoking", and "This product presents substantially lower risks to health than cigarettes" which did not differ statistically from the TPD messages. Non-smokers rated TPD1 significantly higher overall than dual users. Dual users rated "This product is a safer alternative to smoking" significantly higher than non-smokers. Messages did not differ on understandability. CONCLUSIONS These alternative messages provide a useful resource for future research and for policy makers considering updating e-cigarette product labelling.
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Affiliation(s)
- Catherine Kimber
- Centre for Addictive Behaviour Research, Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA UK
| | - Sharon Cox
- Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT UK
| | - Daniel Frings
- Centre for Addictive Behaviour Research, Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA UK
| | - Ian P. Albery
- Centre for Addictive Behaviour Research, Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA UK
| | - Lynne Dawkins
- Centre for Addictive Behaviour Research, Division of Psychology, School of Applied Sciences, London South Bank University, 103 Borough Road, London, SE1 0AA UK
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180
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McRobbie H, Kwan B. Tobacco use disorder and the lungs. Addiction 2021; 116:2559-2571. [PMID: 33140508 DOI: 10.1111/add.15309] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/17/2020] [Accepted: 10/23/2020] [Indexed: 12/22/2022]
Abstract
This narrative review provides a summary of the impact of tobacco smoking on the respiratory system and the benefits of smoking cessation. Tobacco smoking is one of the leading preventable causes of death world-wide and a major risk factor for lung cancer and chronic obstructive pulmonary disease. Smoking is also associated with an increased risk of respiratory infections and appears to be related to poorer outcomes among those with COVID-19. Non-smokers with second-hand smoke exposure also experience significant adverse respiratory effects. Smoking imposes enormous health- and non-health-related costs to societies. The benefits of smoking cessation, in both prevention and management of respiratory disease, have been known for decades and, to this day, cessation support remains one of the most important cost-effective interventions that health professionals can provide to people who smoke. Cessation at any age confers substantial health benefits, even in smokers with established morbidities. As other treatments for chronic respiratory disease advance and survival rates increase, smoking cessation treatment will become even more relevant. While smoking cessation interventions are available, the offer of these by clinicians and uptake by patients remain limited.
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Affiliation(s)
- Hayden McRobbie
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia.,Lakes District Health Board, Rotorua, New Zealand
| | - Benjamin Kwan
- Department of Respiratory and Sleep Medicine, Sutherland Hospital, Sydney, Australia.,St George and Sutherland Clinical School, University of New South Wales, Sydney, Australia
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181
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Freitas-Lemos R, Stein JS, Tegge AN, Kaplan BA, Heckman BW, Cummings KM, Bickel WK. The Illegal Experimental Tobacco Marketplace I: Effects of Vaping Product Bans. Nicotine Tob Res 2021; 23:1744-1753. [PMID: 33955478 PMCID: PMC8403238 DOI: 10.1093/ntr/ntab088] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/29/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Banning vaping products may have unintended outcomes, such as increased demand for illegal products. This study experimentally examined the effects of a vaping ban and a flavored vaping ban on the probability of purchasing illicit vaping products, and factors affecting purchasing from a hypothetical illegal marketplace. METHODS A crowdsourced sample of exclusive cigarette smokers, exclusive e-cigarette users, and frequent dual users (n = 150) completed hypothetical purchasing trials in an Experimental Tobacco Marketplace under three conditions (no ban, vaping ban, and flavored vaping ban). Participants chose to purchase in a hypothetical legal experimental tobacco marketplace (LETM) or illegal experimental tobacco marketplace (IETM). Vaping products were available in each marketplace depending on the condition. Other tobacco products were always available in the LETM. A hypothetical illicit purchase task with five fine amounts assessed the effect of monetary penalties. RESULTS Participants from all groups were more likely to purchase from the IETM when product availability in the LETM was more restricted, with e-cigarette users being most affected. The likelihood of purchasing illegal products was systematically decreased as monetary penalties associated with the IETM increased, with e-cigarette users showing greater persistence in defending their illicit purchases. CONCLUSIONS Restricting vaping products from the marketplace may shift preference towards purchasing vaping products in the illegal marketplace. Nevertheless, penalties imposed on consumer's behavior might be effective in preventing illicit trade. The IETM is a methodological extension that supports the utility and flexibility of the ETM as a framework for understanding the impact of different tobacco regulatory policies. IMPLICATIONS This study suggests that limiting or banning vaping products as a possible strategy to reduce the adverse effects of vaping products could result in some tobacco-users seeking banned products from illegal sources. Monetary fines were shown to reduce illegal purchases. Therefore, policymakers should consider implementing strategies that may mitigate illegal purchases.
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Affiliation(s)
| | - Jeffrey S Stein
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA
| | - Allison N Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA
- Department of Statistics, Virginia Tech, Blacksburg, VA
| | - Brent A Kaplan
- Department of Family and Community Medicine, University of Kentucky, Lexington, KY
| | - Bryan W Heckman
- Center for the Study of Social Determinants on Health, Meharry Medical College, Nashville, TN
| | - K Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Warren K Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA
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182
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Perez Diaz M, Pochon JB, Ghahremani DG, Dean AC, Faulkner P, Petersen N, Tyndale RF, Donis A, Paez D, Cahuantzi C, Hellemann GS, London ED. Sex Differences in the Association of Cigarette Craving With Insula Structure. Int J Neuropsychopharmacol 2021; 24:624-633. [PMID: 33830218 PMCID: PMC8378076 DOI: 10.1093/ijnp/pyab015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/01/2021] [Accepted: 04/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cigarette craving, which can negatively impact smoking cessation, is reportedly stronger in women than in men when they initiate abstinence from smoking. Identifying approaches to counteract craving in people of different sexes may facilitate the development of personalized treatments for Tobacco Use Disorder, which disproportionately affects women. Because cigarette craving is associated with nicotine dependence and structure of the insula, this study addressed whether a person's sex influences these associations. METHODS The research participants (n = 99, 48 women) reported daily cigarette smoking and provided self-reports of nicotine dependence. After overnight abstinence from smoking, they underwent structural magnetic resonance imaging scanning to determine cortical thickness of the left and right anterior circular insular sulcus, and self-rated their cigarette craving before and after their first cigarette of the day. RESULTS Women reported stronger craving than men irrespective of smoking condition (i.e., pre- and post-smoking) (P = .048), and smoking reduced craving irrespective of sex (P < .001). A 3-way interaction of sex, smoking condition, and right anterior circular insular sulcus thickness on craving (P = .033) reflected a negative association of cortical thickness with pre-smoking craving in women only (P = .012). No effects of cortical thickness in the left anterior circular insular sulcus were detected. Nicotine dependence was positively associated with craving (P < .001) across groups and sessions, with no sex differences in this association. CONCLUSIONS A negative association of right anterior insula thickness with craving in women only suggests that this region may be a relevant therapeutic target for brain-based smoking cessation interventions in women.
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Affiliation(s)
- Maylen Perez Diaz
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Jean-Baptiste Pochon
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Paul Faulkner
- Department of Psychology, University of Roehampton, London, UK
| | - Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Rachel F Tyndale
- Department of Pharmacology and Toxicology and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - Andrea Donis
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Diana Paez
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Citlaly Cahuantzi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Gerhard S Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
- Department of Molecular and Medical Pharmacology
- Brain Research Institute, University of California, Los Angeles, California, USA
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183
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Buu A, Cai Z, Li R, Wong SW, Lin HC, Su WC, Jorenby DE, Piper ME. Validating E-Cigarette Dependence Scales Based on Dynamic Patterns of Vaping Behaviors. Nicotine Tob Res 2021; 23:1484-1489. [PMID: 33758949 DOI: 10.1093/ntr/ntab050] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Existing e-cigarette dependence scales are mainly validated based on retrospective overall consumption or perception. Further, given that the majority of adult e-cigarette users also use combustible cigarettes, it is important to determine whether e-cigarette dependence scales capture the product-specific dependence. This study fills in the current knowledge gaps by validating e-cigarette dependence scales using novel indices of dynamic patterns of e-cigarette use behaviors and examining the association between dynamic patterns of smoking and e-cigarette dependence among dual users. METHODS Secondary analysis was conducted on the 2-week ecological momentary assessment data from 116 dual users. The Smoothly Clipped Absolute Deviation penalty (SCAD) was adopted to select important indices for dynamic patterns of consumption or craving and estimate their associations with e-cigarette dependence scales. RESULTS The fitted linear regression models support the hypothesis that higher e-cigarette dependence is associated with higher levels of e-cigarette consumption and craving as well as lower instability of e-cigarette consumption. Controlling for dynamic patterns of vaping, dual users with lower e-cigarette dependence tend to report higher day-to-day dramatic changes in combustible cigarette consumption but not higher average levels of smoking. CONCLUSIONS We found that more stable use patterns are related to higher levels of dependence, which has been demonstrated in combustible cigarettes and we have now illustrated in e-cigarettes. Furthermore, the e-cigarette dependence scales may capture the product-specific average consumption but not product-specific instability of consumption. IMPLICATIONS This study provides empirical support for three e-cigarette dependence measures: PS-ECDI, e-FTCD, and e-WISDM, based on dynamic patterns of e-cigarette consumption and craving revealed by EMA data that have great ecological validity. This is the first study that introduces novel indices of dynamic patterns and demonstrates their potential applications in vaping research.
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Affiliation(s)
- Anne Buu
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Zhanrui Cai
- Department of Statistics, Pennsylvania State University, University Park, PA, USA
| | - Runze Li
- Department of Statistics, Pennsylvania State University, University Park, PA, USA
| | - Su-Wei Wong
- Department of Health Promotion and Behavioral Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Wei-Chung Su
- Department of Epidemiology, Human Genetics & Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Douglas E Jorenby
- Center for Tobacco Research & Intervention, University of Wisconsin, Madison, WI, USA
| | - Megan E Piper
- Center for Tobacco Research & Intervention, University of Wisconsin, Madison, WI, USA
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184
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Lee MJ, Lee KS. Maintenance of smoking cessation in Korean single mothers. BMC Womens Health 2021; 21:292. [PMID: 34372838 PMCID: PMC8351155 DOI: 10.1186/s12905-021-01426-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Single mothers in South Korea are vulnerable to developing smoking habits, due to many difficulties and limitations; however, they have often been overlooked by smoking cessation support services. Therefore, this study aimed to investigate the general and smoking-related characteristics of single mothers registered with the Visiting a Smoking Cessation Service in Seoul, South Korea, to identify factors associated with smoking cessation maintenance at 4 weeks and 24 weeks after they initially quit smoking. METHODS The participants were 77 single mothers registered in the Smoking Cessation Service Program. Data were included from a three-year span (January 2017-December 2019). Smoking cessation counseling, motivational enhancement, and self-exploration counseling were provided for six months. The participants were evaluated on their smoking cessation status at 4 weeks and 24 weeks. RESULTS Most participants were aged 22 years or younger. The rates of smoking cessation maintenance were 58.4 and 18% at 4 weeks and 24 weeks, respectively. The higher the number of counseling sessions, the higher the participants' chances of maintaining smoking in all non-smoking periods, and whether pregnancy, CO level, and drinking were significant only in a short-term non-smoking period (4 weeks). CONCLUSIONS Our results suggest that the number of smoking cessation counseling sessions is important for long-term smoking cessation beyond short-term cessation in single mothers. To increase the smoking cessation rate of single mothers, it is important to conduct customized smoking cessation counseling at the time of smoking cessation and continue such counseling in the long term.
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Affiliation(s)
- Mi-Ji Lee
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Republic of Korea
- Seoul Tobacco Control Center, Seoul, Republic of Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Kang-Sook Lee
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Republic of Korea.
- Seoul Tobacco Control Center, Seoul, Republic of Korea.
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea.
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185
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Hollands GJ, Sutton S, Aveyard P. The effect of nicotine dependence and withdrawal symptoms on use of nicotine replacement therapy: Secondary analysis of a randomized controlled trial in primary care. J Subst Abuse Treat 2021; 132:108591. [PMID: 34391588 DOI: 10.1016/j.jsat.2021.108591] [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: 03/01/2021] [Revised: 07/13/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Nicotine replacement therapy (NRT) is effective for smoking cessation, but the optimal method of using NRT to maximize benefit is unclear. We examined whether nicotine dependence was associated with consumption of NRT, whether this was mediated by withdrawal symptoms, and the impact of these factors on cessation, in a population advised to use as much NRT as needed. METHODS Secondary analysis of data from an open label, parallel group randomized controlled trial. Participants (n = 539) attended a smoking cessation clinic in primary care and remained engaged with treatment for at least one week following a quit attempt. Baseline dependence was measured by the Fagerström Test for Cigarette Dependence (FTCD), with tobacco exposure assessed via an exhaled carbon monoxide test. At one week after quit day, mean daily consumption of NRT was measured for all participants; withdrawal (Mood and Physical Symptoms Scale (MPSS)) was also assessed in the subsample who reported being completely abstinent to that point (n = 279). Abstinence was biochemically assessed at four weeks for all participants as the principal smoking cessation outcome. RESULTS Each point higher on the FTCD was associated with 0.83 mg/day more NRT consumption, controlling for tobacco exposure. This relationship was diminished when withdrawal was controlled for, and withdrawal was associated with NRT consumption, with each point higher on the MPSS associated with a 0.12 mg/day increase. Increased consumption of NRT directly predicted subsequent smoking cessation. CONCLUSIONS Higher dependence appears to lead to greater withdrawal, which appears to drive greater use of NRT. This effect may partly offset lower abstinence rates in people with higher dependence. Advice to use sufficient NRT to suppress withdrawal may increase abstinence rates.
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Affiliation(s)
- Gareth J Hollands
- Behaviour and Health Research Unit, Department of Public Health and Primary Care, University of Cambridge, UK.
| | - Stephen Sutton
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
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186
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González-Roz A, Secades-Villa R, García-Fernández G, Martínez-Loredo V, Alonso-Pérez F. Depression symptom profiles and long-term response to cognitive behavioral therapy plus contingency management for smoking cessation. Drug Alcohol Depend 2021; 225:108808. [PMID: 34198211 DOI: 10.1016/j.drugalcdep.2021.108808] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression is heterogeneous in nature and using diagnostic categories limits insight into understanding psychopathology and its impact on treatment efficacy. This secondary analysis sought to: 1) identify distinct subpopulations of cigarette users with depression, and 2) examine their response to cognitive-behavioral treatment (CBT) + contingency management (CM) for smoking cessation at one year. METHOD The sample comprised 238 (74 % females) adults who smoke receiving CBT only or CBT + CM. A latent class analysis was conducted on baseline depressive symptoms measured using the Beck Depression Inventory-II. Generalized estimating equations assessed the main and interactive effects of class, time, treatment, and sex on smoking abstinence. RESULTS Three distinct classes were identified: C1 (n= 76/238), characterized by mild depression, loss of energy, pessimism, and criticism, C2 (n= 100/238) presenting moderate severity and decreased appetite, and C3 (n= 62/238) showing severe depression, increased appetite, and feelings of punishment. There was a significant cluster × treatment interaction, which indicated additive effects of CM over CBT alone for Class 1 and 2. Persons in Class 1 and 2 were 3.60 [95 % CI: 1.62, 7.97] and 2.65 [95 % CI: 1.19, 5.91] times more likely to be abstinent if CBT + CM was delivered rather than CBT only. No differential sex effects were observed on treatment response according to cluster. CONCLUSIONS Profiling depression symptom subtypes of cigarette users may be more informative to improve CM treatment response than merely focusing on total scores.
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Affiliation(s)
- Alba González-Roz
- Department of Psychology/Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Spain; Department of Psychology, University of Oviedo, Spain.
| | | | | | - Víctor Martínez-Loredo
- Department of Psychology, University of Oviedo, Spain; Department of Psychology and Sociology, University of Zaragoza, Spain
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187
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Impact of nicotine reduction in cigarettes on smoking behavior and exposure: Are there differences by race/ethnicity, educational attainment, or gender? Drug Alcohol Depend 2021; 225:108756. [PMID: 34051544 PMCID: PMC8282676 DOI: 10.1016/j.drugalcdep.2021.108756] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Lowering nicotine in cigarettes may reduce smoking prevalences; however, it is not known whether an immediate or gradual reduction in nicotine is the optimal approach for all population groups. OBJECTIVES We examined whether the optimal approach to nicotine reduction depended on the education, gender, or race of people who smoke and whether the optimal approach differentially benefited people who smoke based on their education, gender, or race. METHODS Secondary analysis was conducted on a randomized clinical trial (N = 1250) comparing (1) immediate reduction from 15.5 to 0.4 mg of nicotine per gram of tobacco(mg/g);(2) gradual reduction to 0.4 mg/g;(3) control group with normal nicotine cigarettes(15.5 mg/g). Outcomes included cigarettes per day(CPD), carbon monoxide(CO), total nicotine equivalents(TNE), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides(NNAL), phenanthrene tetraol(PheT), N-Acetyl-S-(2-cyanoethyl)-l-cysteine(CEMA). Data were analyzed as area under the curve(AUC). RESULTS Results were presented by education (High school[HS] or less n = 505, more than HS n = 745), gender (males n = 701, females n = 549), and race (Black participants n = 373,White participants n = 758). Regardless of education, gender, and race, CPD, CO, TNE, NNAL, PheT, and CEMA were lower in immediate versus gradual nicotine reduction. Comparing immediate versus the control, outcomes were lower for all subgroups; however, the magnitude of the effect for TNE varied by race. Specifically, geometric mean of the AUC of TNE in immediate versus gradual was 49 % lower in Black participants and 61 % lower in White participants (p-value = 0.047). CONCLUSIONS Immediately reducing nicotine in cigarettes has the potential to benefit people who smoke across lower and higher educational attainment, male and female gender, and Black and White race.
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188
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Brown RA, Minami H, Hecht J, Kahler CW, Price LH, Kjome KL, Bloom EL, Levy DE, Carpenter KM, Smith A, Smits JAJ, Rigotti NA. Sustained Care Smoking Cessation Intervention for Individuals Hospitalized for Psychiatric Disorders: The Helping HAND 3 Randomized Clinical Trial. JAMA Psychiatry 2021; 78:839-847. [PMID: 33950156 PMCID: PMC8100915 DOI: 10.1001/jamapsychiatry.2021.0707] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
IMPORTANCE Smoking among individuals with serious mental illness (SMI) represents a major public health problem. Intervening during a psychiatric hospital stay may provide an opportunity to aid engagement in smoking cessation treatment and facilitate success in quitting. OBJECTIVE To examine the effectiveness of a multicomponent, sustained care (SusC) smoking cessation intervention in adults with SMI receiving inpatient psychiatric care. DESIGN, SETTING, AND PARTICIPANTS The Helping HAND 3 randomized clinical trial compared SusC with usual care (UC) among individuals with SMI who smoked daily and were receiving inpatient psychiatric care in Austin, Texas, in a single hospital. The study was conducted from July 2015 through August 2019. INTERVENTIONS The UC intervention involved brief smoking cessation information, self-help materials and advice from the admitting nurse, and an offer to provide nicotine replacement therapy during hospitalization. The SusC intervention included 4 main components designed to facilitate patient engagement with postdischarge smoking cessation resources: (1) inpatient motivational counseling; (2) free transdermal nicotine patches on discharge; (3) an offer of free postdischarge telephone quitline, text-based, and/or web-based smoking cessation counseling, and (4) postdischarge automated interactive voice response calls or text messages. MAIN OUTCOMES AND MEASURES The primary outcome was biochemically verified 7-day point-prevalence abstinence at 6-month follow-up. A secondary outcome was self-reported smoking cessation treatment use at 1, 3, and 6 months after discharge. RESULTS A total of 353 participants were randomized, of whom 342 were included in analyses (mean [SD] age, 35.8 [12.3] years; 268 White individuals [78.4%]; 280 non-Hispanic individuals [81.9%]; 169 women [49.4%]). They reported smoking a mean (SD) of 16.9 (10.4) cigarettes per day. Participants in the SusC group evidenced significantly higher 6-month follow-up point-prevalence abstinence rates than those in the UC group (8.9% vs 3.5%; adjusted odds ratio, 2.95 [95% CI, 1.24-6.99]; P = .01). The number needed to treat was 18.5 (95% CI, 9.6-306.4). A series of sensitivity analyses confirmed effectiveness. Finally, participants in the SusC group were significantly more likely to report using smoking cessation treatment over the 6 months postdischarge compared with participants in the UC group (74.6% vs 40.5%; relative risk, 1.8 [95% CI, 1.51-2.25]; P < .001). CONCLUSIONS AND RELEVANCE The findings of this randomized clinical trial provide evidence for the effectiveness of a scalable, multicomponent intervention in promoting smoking cessation treatment use and smoking abstinence in individuals with SMI following hospital discharge. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02204956.
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Affiliation(s)
| | - Haruka Minami
- Department of Psychology, Fordham University, Bronx, New York
| | - Jacki Hecht
- School of Nursing, University of Texas at Austin, Austin
| | - Christopher W. Kahler
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island,Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Lawrence H. Price
- Butler Hospital, Alpert Medical School of Brown University, Providence, Rhode Island,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Kimberly L. Kjome
- Seton Shoal Creek Hospital, Austin, Texas,Department of Psychiatry, Dell Medical School at the University of Texas at Austin, Austin
| | - Erika Litvin Bloom
- Rhode Island Hospital, Providence, Rhode Island,Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island,Department of Medicine, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Douglas E. Levy
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Harvard Medical School, Boston,Mongan Institute Health Policy Research Center, Department of Medicine, Massachusetts Medical School, Harvard Medical School, Boston
| | | | - Ashleigh Smith
- Department of Psychiatry, Dell Medical School, University of Texas at Austin, Austin,Department of Health Social Work, Steve Hicks School of Social Work, University of Texas at Austin, Austin
| | | | - Nancy A. Rigotti
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Harvard Medical School, Boston
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189
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Piirtola M, Kaprio J, Baker TB, Piasecki TM, Piper ME, Korhonen T. The associations of smoking dependence motives with depression among daily smokers. Addiction 2021; 116:2162-2174. [PMID: 33629475 PMCID: PMC8274496 DOI: 10.1111/add.15390] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/16/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
AIMS To investigate how strongly smoking dependence and smoking dependence motives are associated with depressive symptoms among daily smokers and if these associations are independent of measured confounders and shared familial factors. DESIGN Cross-sectional individual-based and within-pair analyses. SETTING Fourth wave of the population-based Finnish Twin Cohort conducted in 2011. PARTICIPANTS 918 daily smokers born 1945-1957 (48% men), mean age 59.5 years including 38 twin pairs discordant for depression. MEASUREMENTS Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale with a cut off value ≥20 for depression. Smoking dependence was assessed using the Fagerström Test for Cigarette Dependence (FTCD) and smoking dependence motives with three subscales from the multi-dimensional Brief Wisconsin Inventory of Smoking Dependence Motives (WISDM): primary dependence motives (PDM), affective enhancement (AE), and Taste. Logistic regressions, using standardized scores of independent variables and adjusted for multiple confounders with correction for sampling as twin pairs, were used in the individual-based analyses. Conditional logistic regression was used to control for shared familial factors in discordant twin pairs. FINDINGS Prevalence of depression was 18% (n = 163: 61 [14%] in men, n = 102 [22%] in women). Higher smoking dependence measured by the FTCD (OR 1.45; 95% CI 1.20, 1.75), and dependence motives measured by the PDM (1.56; 1.30, 1.87) and the AE (1.54; 1.28, 1.85) were associated with higher odds of depression. The associations remained after adjusting for individual confounders, except for neuroticism, which attenuated all associations. FTCD, PDM, and AE showed associations with depression within depression-discordant monozygotic pairs, suggesting an association independent of familial factors. CONCLUSIONS Depression appears to be associated with smoking dependence and smoking dependence motives related to heavy, automatic use and use to regulate affective states. The associations appear to be confounded or mediated by neuroticism but are independent of shared familial influences.
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Affiliation(s)
- Maarit Piirtola
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Po. Box 20, 20014 University of Helsinki, Helsinki, Finland
| | - Timothy B. Baker
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1930 Monroe Street, Madison, WI 53711 -2059, United States
| | - Thomas M. Piasecki
- Department of Psychological Sciences, University of Missouri, 210 McAlester Hall, Columbia, MO 65211, United States
| | - Megan E. Piper
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 1930 Monroe Street, Madison, WI 53711 -2059, United States
| | - Tellervo Korhonen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, PO. Box 20, 00014 University of Helsinki, Helsinki, Finland
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190
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Causes of smoking relapse in the 12 months after smoking cessation treatment: Affective and cigarette dependence-related factors. Addict Behav 2021; 119:106903. [PMID: 33773201 DOI: 10.1016/j.addbeh.2021.106903] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 01/15/2021] [Accepted: 03/02/2021] [Indexed: 11/22/2022]
Abstract
Despite advances in smoking cessation treatments, smoking relapse remains common. Experiencing positive or negative affect and cigarette dependence are the most common causes of relapse; however, little is known about the characteristics that increase the risk of relapse from these causes among current treatment-seeking smokers. Thus, this study aimed to identify the most frequent causes of relapse and the individual characteristics that increase the risk of relapse from these causes during a 12-month period after smoking cessation. Participants included 121 treatment-seeking smokers who quit smoking at the end of treatment and relapsed during a 12-month follow-up period (60.3% female;Mage = 42.57, SD = 11.07). Results indicated that the most frequent smoking relapse situations occurred when smokers experienced positive (e.g., being relaxed; 43.0%) or negative (e.g., being angry; 37.2%) affect or cigarette dependence-related situations (e.g., craving; 19.8%). At an individual level, males with a higher level of education and without a psychopharmaceutical prescription had a higher risk of relapsing in positive-affect situations. Smoking the first cigarette at an older age increased the risk of relapse in negative-affect situations. Finally, being younger and less motivated to quit at pretreatment increased the likelihood of relapse in cigarette dependence-related situations. These findings provide detailed information about smoking relapse situations and identify a set of characteristics that might help to improve current relapse-prevention interventions.
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191
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Freitas-Lemos R, Keith DR, Tegge AN, Stein JS, Cummings KM, Bickel WK. Estimating the Impact of Tobacco Parity and Harm Reduction Tax Proposals Using the Experimental Tobacco Marketplace. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7835. [PMID: 34360124 PMCID: PMC8345477 DOI: 10.3390/ijerph18157835] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022]
Abstract
Taxes are a demonstrably effective method to suppress tobacco use. This study examined the effects of the tobacco parity (i.e., imposing taxes equally on all tobacco products) and the harm reduction (i.e., applying taxes in proportion to the products' levels of harm) tax proposals on demand and substitution across products. A crowdsourced sample of cigarette smokers (n = 35) completed purchasing trials with increasing tax magnitudes across different tax tiers in the Experimental Tobacco Marketplace in a repeated-measures design. Products were placed in three tax tiers (high, medium, and no tax) according to each proposal's goal. The results indicated that total nicotine (mg) purchased was not significantly different between the proposals, with higher taxes yielding lower demand. However, as taxes increased, the tobacco parity proposal decreased the purchasing of all tobacco products and increased the purchasing of medicinal nicotine (i.e., the no tax tier). Conversely, the harm reduction proposal resulted in greater purchases of electronic nicotine delivery systems and smokeless tobacco (i.e., the medium tax tier). These findings support tobacco taxation as a robust tool for suppressing purchasing and suggest that differential taxation in proportion to product risk would be an effective way to incentivize smokers to switch from smoked to unsmoked products. Further studies should investigate the unintended consequences of their implementation.
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Affiliation(s)
- Roberta Freitas-Lemos
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA; (R.F.-L.); (D.R.K.); (A.N.T.); (J.S.S.)
| | - Diana R. Keith
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA; (R.F.-L.); (D.R.K.); (A.N.T.); (J.S.S.)
| | - Allison N. Tegge
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA; (R.F.-L.); (D.R.K.); (A.N.T.); (J.S.S.)
- Department of Statistics, Virginia Tech, Blacksburg, VA 24060, USA
| | - Jeffrey S. Stein
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA; (R.F.-L.); (D.R.K.); (A.N.T.); (J.S.S.)
| | - K. Michael Cummings
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Warren K. Bickel
- Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA; (R.F.-L.); (D.R.K.); (A.N.T.); (J.S.S.)
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Pearson JL, Watanabe M, Sanchez J, Mann S, Drake C, Mercincavage M. The "organic" descriptor and its association with commercial cigarette health risk expectancies, subjective effects, and smoking topography: a pilot human laboratory study. Nicotine Tob Res 2021; 24:69-76. [PMID: 34286827 DOI: 10.1093/ntr/ntab151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/20/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The purpose of this mixed method pilot study was to (1) examine whether the "organic" descriptor affects smokers' health risk expectancies, subjective ratings of smoking, and topography, and (2) describe how smokers interpret the "organic" descriptor and relate it to their subjective smoking experience. METHODS Twenty-two daily smokers (45.5% men, 81.8% non-Hispanic White, M (SD) age = 47.3 [12.7], M (SD) cigarettes/day = 14.5 [5.1]) completed a within-person laboratory study. Following a baseline session, smokers attended 2 experimental sessions where they smoked a study-provided cigarette (identical across conditions) paired with either an "organic" or conventional (e.g., no "organic") descriptor condition and completed subjective and behavioral measures. Participants completed a semi-structured interview at the last visit. RESULTS Relative to the conventional cigarette, more participants rated the "organic" cigarette as healthier, having fewer chemicals, and having a more favorable burn rate (p's<0.05). There were no differences in total puff volume by condition (p=0.42). Stratifying by gender, men inhaled 225 ml (SE = 82.7) more in the conventional condition (p=0.02); women inhaled 408 ml (SE = 233.3) more in the organic condition (p=0.11). A common understanding of "organic" was that the product was "…less processed... like less chemicals and it's more natural." Some believed that "organic" cigarettes contained fewer chemicals, which in turn produced a "much cleaner and healthier smoking cigarette" and that they could "taste the difference." CONCLUSIONS Findings support that smokers associate the "organic" descriptor with health and reduced harm. This descriptor may differentially impact puffing behavior by gender. IMPLICATIONS This study provides qualitative and quantitative data regarding how the "organic" descriptor influences adult daily smokers' perceptions and use of cigarettes. After smoking two identical cigarettes described as "organic" and conventional (e.g., no "organic"), smokers expressed more problematic health expectancies about the "organic" cigarette condition, providing further empirical support that the "organic" descriptor is associated with expectancies of reduced harm. The source of reduced harm was understood to be fewer chemicals in the organic cigarette. Though preliminary, findings suggest that "organic" may differentially affect puffing behavior by gender.
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Affiliation(s)
- Jennifer L Pearson
- Division of Social and Behavioral Science/Health Administration and Policy, School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Mika Watanabe
- Division of Social and Behavioral Science/Health Administration and Policy, School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Jennifer Sanchez
- Division of Social and Behavioral Science/Health Administration and Policy, School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Suman Mann
- Department of Psychology, School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Cara Drake
- Division of Social and Behavioral Science/Health Administration and Policy, School of Public Health, University of Nevada, Reno, Nevada, USA
| | - Melissa Mercincavage
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia,PA
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193
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Moran JK, Keil J, Masurovsky A, Gutwinski S, Montag C, Senkowski D. Multisensory Processing Can Compensate for Top-Down Attention Deficits in Schizophrenia. Cereb Cortex 2021; 31:5536-5548. [PMID: 34274967 DOI: 10.1093/cercor/bhab177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/20/2021] [Accepted: 05/25/2021] [Indexed: 11/13/2022] Open
Abstract
Studies on schizophrenia (SCZ) and aberrant multisensory integration (MSI) show conflicting results, which are potentially confounded by attention deficits in SCZ. To test this, we examined the interplay between MSI and intersensory attention (IA) in healthy controls (HCs) (N = 27) and in SCZ (N = 27). Evoked brain potentials to unisensory-visual (V), unisensory-tactile (T), or spatiotemporally aligned bisensory VT stimuli were measured with high-density electroencephalography, while participants attended blockwise to either visual or tactile inputs. Behaviorally, IA effects in SCZ, relative to HC, were diminished for unisensory stimuli, but not for bisensory stimuli. At the neural level, we observed reduced IA effects for bisensory stimuli over mediofrontal scalp regions (230-320 ms) in SCZ. The analysis of MSI, using the additive approach, revealed multiple phases of integration over occipital and frontal scalp regions (240-364 ms), which did not differ between HC and SCZ. Furthermore, IA and MSI effects were both positively related to the behavioral performance in SCZ, indicating that IA and MSI mutually facilitate bisensory stimulus processing. Multisensory processing could facilitate stimulus processing and compensate for top-down attention deficits in SCZ. Differences in attentional demands, which may be differentially compensated by multisensory processing, could account for previous conflicting findings on MSI in SCZ.
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Affiliation(s)
- James K Moran
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, St. Hedwig Hospital, 10115 Berlin, Germany
| | - Julian Keil
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, St. Hedwig Hospital, 10115 Berlin, Germany.,Biological Psychology, Christian-Albrechts-University Kiel 24118, Germany
| | - Alexander Masurovsky
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, St. Hedwig Hospital, 10115 Berlin, Germany
| | - Stefan Gutwinski
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, St. Hedwig Hospital, 10115 Berlin, Germany
| | - Christiane Montag
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, St. Hedwig Hospital, 10115 Berlin, Germany
| | - Daniel Senkowski
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, St. Hedwig Hospital, 10115 Berlin, Germany
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194
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Lydon-Staley D, MacLean R, Falk E, Bassett D, Wilson S. The feasibility of an in-scanner smoking lapse paradigm to examine the neural correlates of lapses. Addict Biol 2021; 26:e13001. [PMID: 33508880 PMCID: PMC8225575 DOI: 10.1111/adb.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/13/2020] [Accepted: 01/02/2021] [Indexed: 11/28/2022]
Abstract
Quitting smoking is notoriously difficult. Models of nicotine dependence posit that strength of cognitive control contributes to maintaining smoking abstinence during smoking cessation attempts. We examine the role for large-scale functional brain systems associated with cognitive control in smoking lapse using a novel adaption of a well-validated behavioral paradigm. We use data from 17 daily smokers (five females) after 12 h of smoking abstinence. Participants completed up to 10 sequential 5-min functional magnetic resonance imaging (fMRI) runs, within a single scanning session. After each run, participants decided whether to stay in the scanner in order to earn additional money or to terminate the session in order to smoke a cigarette (i.e., lapse) and forego additional monetary reward. Cox regression results indicate that decreased segregation of the default mode system from the frontoparietal system undermines the ability to resist smoking. This study demonstrates the feasibility of modifying an established behavioral model of smoking lapse behavior for use in the neuro imaging environment, and it provides initial evidence that this approach yields valuable information regarding fine-grained, time-varying changes in patterns of neural activity in the moments leading up to a decision to smoke. Specifically, results lend support to the hypothesis that the time-varying interplay between large-scale functional brain systems associated with cognitive control is implicated in smoking lapse behavior.
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Affiliation(s)
- D.M. Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - R.R. MacLean
- VA Connecticut Healthcare System, West Haven, CT
- Yale University School of Medicine, New Haven, CT
| | - E.B. Falk
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA
- Department of Psychology, University of Pennsylvania, Philadelphia, PA
- Wharton Marketing Department, University of Pennsylvania, Philadelphia, PA
| | - D.S. Bassett
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA
- Department of Electrical & Systems Engineering, School of Engineering & Applied Science, University of Pennsylvania, Philadelphia, PA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Department of Physics & Astronomy, College of Arts & Sciences, University of Pennsylvania, Philadelphia, PA
- The Santa Fe Institute, Sante Fe, NM
| | - S.J. Wilson
- Department of Psychology, The Pennsylvania State University, University Park, PA
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195
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Kimber CF, Soar K, Dawkins LE. Changes in puffing topography and subjective effects over a 2-week period in e-cigarette naïve smokers: Effects of device type and nicotine concentrations. Addict Behav 2021; 118:106909. [PMID: 33756301 DOI: 10.1016/j.addbeh.2021.106909] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/11/2021] [Accepted: 03/07/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION This study aimed to document changes in puffing topography and, the effects of device type and nicotine concentration on puffing topography, subjective effects and smoking behaviour over two weeks of e-cigarette (EC) use. METHODS EC naïve smokers (N = 50; 64% female) were randomly allocated to a cigalike (18 mg/mL) or tank containing either 18 (Tank18) or 6 mg/mL nicotine concentrations (Tank6). In 3 separate sessions (Baseline, 1 and 2 weeks post-baseline), participants vaped 20 min ad-libitum. Puff duration, puff number, inter-puff intervals (IPI), exhaled carbon monoxide (CO), cigarettes per day (CPD), cigarette dependence, craving, withdrawal, and subjective effects were recorded. RESULTS Two weeks post-baseline, puff duration and IPI significantly increased whilst puff number decreased. Cigalikes were associated with greater puff number and shorter IPI compared to Tanks; there was no difference between Tank18 and Tank6. CPD, CO and cigarette dependence reduced significantly from baseline to week1 but did not differ between conditions. During each session, there was a significant reduction in craving, whilst withdrawal symptoms were only alleviated in week1 and 2; there was no difference between conditions. Tank18 consistently rated highest on positive effects including satisfaction; satisfaction scores for Cigalikes and Tank6 declined overtime. CONCLUSIONS Cigalikes and tanks were both effective for reducing craving, withdrawal symptoms and CPD although for the former, this may only be achieved through more frequent puffing. That the Tank18 yielded greater satisfaction suggests tank devices and higher nicotine concentrations may be more suitable in the early stage of a smoking cessation attempt.
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Affiliation(s)
- C F Kimber
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom.
| | - K Soar
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom
| | - L E Dawkins
- London South Bank University, 103 Borough Road, London SE1 0AA, United Kingdom
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196
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Cohen G, Goldenson NI, Bailey PC, Chan S, Shiffman S. Changes in Biomarkers of Cigarette Smoke Exposure After 6 Days of Switching Exclusively or Partially to Use of the JUUL System with Two Nicotine Concentrations: A Randomized Controlled Confinement Study in Adult Smokers. Nicotine Tob Res 2021; 23:2153-2161. [PMID: 34161586 PMCID: PMC8570669 DOI: 10.1093/ntr/ntab134] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 06/21/2021] [Indexed: 02/07/2023]
Abstract
Introduction Evidence suggests that cigarette smokers who switch to electronic nicotine delivery systems (ENDS) reduce their exposure to harmful toxicants and carcinogens. It is unclear if dual-use is associated with decreases in exposure to toxicants. Methods This parallel-group confinement study assessed changes in biomarkers of exposure (BOEs) over six days among healthy adult smokers who were randomized into 1 of 11 study groups: eight JUUL-brand System (JUUL) groups (4 JUUL flavors [Virginia Tobacco, Menthol, Mint, Mango] × 2 nicotine concentrations [5.0% or 3.0% by weight]); Dual-Use group used preferred JUUL flavor (5.0% nicotine) and ≤50% usual brand (UB) cigarettes/day; UB Cigarette group and one group abstained from all tobacco/nicotine product use (Abstinence group). Urine and blood analysis assessed changes in primary BOE endpoints (NNAL, 3-HPMA, MHBMA, S-PMA COHb) and secondary BOE endpoints (NNN, HMPMA, CEMA, 1-OHP, O-toluidine, 2-NA, 4-ABP) among 279 adult smokers. Results In JUUL groups, median percent reductions in primary BOEs (Day 6–Baseline) were 90%–≥100% of Abstinence; there were no significant differences between JUUL groups and Abstinence. All reductions in JUUL groups were substantially and statistically significantly greater than reductions in the UB Cigarette group (ps < 0.025). Median reductions in primary BOEs in the Dual-Use group were 43%–55% of Abstinence. Similar results were observed for secondary BOEs. Conclusion This study suggests that the use of JUUL as a complete or partial substitute (i.e., dual-use with ≥50% reduction in cigarette consumption) for combustible cigarettes can substantially reduce exposure to multiple toxins associated with cigarette smoking. Implications This study adds to the growing body of evidence supporting the utility of ENDS products as potentially reduced-harm alternatives to cigarettes for adult smokers. Adult smokers who switched completely from cigarette smoking to use of the JUUL System (“JUUL”) in two nicotine concentrations (5.0% and 3.0%) and four flavors significantly reduced their exposure to multiple classes of cigarette-related toxicants. Additionally, smokers who used JUUL and continued smoking but reduced their daily cigarette consumption by ≥50% (dual users) also significantly reduced their toxicant exposure compared to cigarette smoking.
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Affiliation(s)
- Gal Cohen
- Juul Labs, Inc., Washington, DC, USA
- Corresponding Author: Gal Cohen, PhD, Juul Labs, Inc., 1000 F Street NW, Suite 800, Washington, D.C, 20004, USA. E-mail:
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197
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Fediuk DJ, Sweeney K, Sahasrabudhe V, McRae T, Byon W. Population pharmacokinetics and exposure-response analyses of varenicline in adolescent smokers. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2021; 10:769-781. [PMID: 34062053 PMCID: PMC8302239 DOI: 10.1002/psp4.12645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 12/04/2022]
Abstract
Varenicline is an approved smoking cessation aid in adults. Population pharmacokinetics (popPK) and exposure–response (ER) (continuous abstinence rates [CAR] weeks 9‒12 and nausea/vomiting incidence) for varenicline in adolescent smokers were characterized using data from two phase 1 and one phase 4 studies. A one‐compartment popPK model with first‐order absorption and elimination adequately fitted the observed data. The effect of female sex on apparent clearance was significant. Apparent volume of distribution increased with body weight and decreased by 24%, 15%, and 14% for black race, “other” race, and female sex, respectively. The observed range of exposure in the phase 4 study was consistent with that expected for each dose and body‐weight group from the results obtained in adolescent PK studies, supporting that varenicline dose and administration were appropriate in the study. The relationship between CAR9‒12 and varenicline area under the concentration–time curve (AUC) from 0 to 24 hours (AUC24) was nonsignificant (p = 0.303). Nausea/vomiting incidence increased with AUC24 (p < 0.001) and was higher in females. Varenicline PK and ER for tolerability in adolescent smokers were comparable with adults, while ER for efficacy confirmed the negative results reported in the phase 4 study.
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198
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Rusmaully J, Tvardik N, Martin D, Billmann R, Cénée S, Antoine M, Blons H, Laurent-Puig P, Trédaniel J, Wislez M, Stücker I, Guénel P, Radoï L. Risk of lung cancer among women in relation to lifetime history of tobacco smoking: a population-based case-control study in France (the WELCA study). BMC Cancer 2021; 21:711. [PMID: 34134640 PMCID: PMC8207748 DOI: 10.1186/s12885-021-08433-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 06/03/2021] [Indexed: 01/12/2023] Open
Abstract
Background This study aims to provide new insights on the role of smoking patterns and cigarette dependence in female lung cancer, and to examine differences by histological subtype. Methods We conducted a population-based case-control study in the great Paris area among women including 716 incident cases diagnosed between 2014 and 2017 and 757 age-matched controls. Detailed data on smoking history was collected during in-person interviews to assess intensity and duration of tobacco smoking, time since cessation, smoking habits (depth of smoke inhalation, use of filter, type of tobacco, and type of cigarettes) and Fagerström test for cigarette dependence. The comprehensive smoking index (CSI), a score modelling the combined effects of intensity, duration and time since quitting smoking was determined for each subject. Multivariable logistic regression models were fitted to calculate odds ratios (ORs) and their confidence intervals (95%CI) of lung cancer associated with smoking variables. Results Lung cancer risk increased linearly with intensity and duration of tobacco smoking while it decreased with time since cessation, to reach the risk in never-smokers after 20 years of abstinence. The combined effect of intensity and duration of tobacco smoking was more than multiplicative (p-interaction 0.012). The OR in the highest vs the lowest quartile of CSI was 12.64 (95%CI 8.50; 18.80) (p-trend < 0.001). The risk of small cell or squamous cell carcinomas increased with the CSI more sharply than the risk of adenocarcinomas. Deep smoke inhalation, dark vs blond tobacco, conventional vs light cigarettes, and unfiltered vs filtered cigarettes, as well as having mixed smoking habits, were found to be independent risk factors. Having high cigarette addiction behaviours also increased the risk after adjusting for CSI. Conclusion This study provides additional insights on the effects of tobacco smoking patterns on lung cancer risk among women. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08433-z.
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Affiliation(s)
- Jennifer Rusmaully
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Nastassia Tvardik
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Diane Martin
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Régine Billmann
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Sylvie Cénée
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Martine Antoine
- AP-HP, Tenon Hospital, Pathology, 4 rue de la Chine, Paris, France.,UPMC Univ Paris 06, GRC No.04, Theranoscan, Paris, France
| | - Hélène Blons
- Assistance Publique Hôpitaux de Paris, Paris Cancer Institute CARPEM, AP-HP.Centre - Université de Paris, Department of Biology Physiology and Genetics, Hopital Européen Georges Pompidou, Paris, France.,Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Pierre Laurent-Puig
- Assistance Publique Hôpitaux de Paris, Paris Cancer Institute CARPEM, AP-HP.Centre - Université de Paris, Department of Biology Physiology and Genetics, Hopital Européen Georges Pompidou, Paris, France.,Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université de Paris, Paris, France
| | - Jean Trédaniel
- Groupe Hospitalier Paris Saint Joseph, Université de Paris, Unité INSERM UMR-S 1124, Toxicologie, pharmacologie et signalisation cellulaire, Paris, France
| | - Marie Wislez
- AP-HP.Centre - Université de Paris, Hôpital Cochin, Unité d'Oncologie Thoracique, Service de Pneumologie, Paris, France.,Centre de Recherche des Cordeliers, Université de Paris, UMRS 1138 « Complement, Inflammation and Cancer », Paris, France
| | - Isabelle Stücker
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France
| | - Pascal Guénel
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France.
| | - Loredana Radoï
- Université Paris-Saclay, UVSQ, Inserm U1018, CESP, Team Exposome and Heredity, Villejuif, France.,AP-HP Nord - Université de Paris, Hôpital Louis Mourier, UFR d'odontologie, Paris, France
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199
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Kaye JT, Baker TB, Beckham JC, Cook JW. Tobacco Withdrawal Symptoms Before and After Nicotine Deprivation in Veteran Smokers with Posttraumatic Stress Disorder and with Major Depressive Disorder. Nicotine Tob Res 2021; 23:1239-1247. [PMID: 33245346 PMCID: PMC8186424 DOI: 10.1093/ntr/ntaa242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 11/20/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The high smoking prevalence amongst individuals with psychiatric disorders constitutes a major public health disparity. Negative reinforcement models of addiction posit that severe tobacco withdrawal symptoms, related to the affective vulnerabilities of these smokers, may thwart their quitting smoking successfully. However, relatively few studies have prospectively examined the effects of nicotine deprivation on withdrawal symptoms in these groups. METHODS This study compared the level of withdrawal symptoms both before and after nicotine deprivation in those diagnosed with posttraumatic stress disorder (PTSD) or major depressive disorder (MDD) and in those without psychiatric diagnoses. Participants were US veterans who smoked (≥10 cigarettes/day) and met diagnostic criteria for PTSD (n = 38), MDD (n = 43), or no psychiatric diagnosis ("controls" n = 44). Participants attended study visits before and during 48-hour nicotine deprivation to report tobacco withdrawal symptoms. Analyses evaluated withdrawal symptom levels (baseline and during nicotine deprivation) and the change in symptoms related to nicotine deprivation and compared (1) participants with a psychiatric diagnosis versus controls, and (2) participants with PTSD versus MDD. RESULTS Contrary to hypotheses, nicotine deprivation produced greater increases in most withdrawal symptoms amongst controls than in those with psychiatric diagnoses. Compared with controls, those with PTSD or MDD reported elevated symptom levels both before and after tobacco deprivation for most withdrawal symptoms. CONCLUSIONS These findings suggest that chronically high levels of distress and craving, rather than acute increases in withdrawal symptoms because of nicotine deprivation, may account for the quitting difficulties of those with comorbid conditions such as PTSD and MDD. IMPLICATIONS Severe tobacco withdrawal may account for the higher quitting difficulties of smokers with either posttraumatic stress disorder (PTSD) or major depressive disorder (MDD). Paradoxically, this study showed that individuals with no psychiatric diagnosis had greater increases in tobacco withdrawal severity because of nicotine deprivation than did those with either PTSD or MDD. Those with either PTSD or MDD showed high stable levels of withdrawal symptom severity both before and during two days of abstinence, suggesting that their quitting difficulties may be related to their chronically high levels of distress rather than nicotine deprivation per se.
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Affiliation(s)
- Jesse T Kaye
- William S. Middleton Memorial Veterans Hospital, Madison, WI
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health (UW-CTRI), Madison, WI
| | - Timothy B Baker
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health (UW-CTRI), Madison, WI
| | - Jean C Beckham
- Durham Veterans Affairs Medical Center, Durham, NC
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Jessica W Cook
- William S. Middleton Memorial Veterans Hospital, Madison, WI
- Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health (UW-CTRI), Madison, WI
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200
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Jao NC, Levin ED, Simon MA, Hitsman B. Differences in Cognitive Task Performance, Reinforcement Enhancement, and Nicotine Dependence Between Menthol and Nonmenthol Cigarette Smokers. Nicotine Tob Res 2021; 23:1902-1910. [PMID: 34086950 DOI: 10.1093/ntr/ntab120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 06/02/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Menthol has been shown to target similar brain regions and neural receptors as nicotine, yet the association between menthol cigarette use and cognitive performance remains unknown. AIMS AND METHODS This study examined differences in cognitive task performance between menthol (MS) and nonmenthol (NMS) cigarette smokers after acute cigarette consumption. Sixty white and black and/or African American, nonabstinent, MS (n = 30) and NMS (n = 30) were assessed presmoking and postsmoking their preferred cigarette on four computerized tasks: Continuous Performance Task (CPT; alerting attention), N-Back Task (working memory), Finger Tapping Task (motor control), and Apple Picker Task (reinforcement enhancement). Self-reported nicotine dependence and objective smoking topography measures were also compared between groups. RESULTS Initial unadjusted analyses showed a significant effect of cigarette type × time on CPT speed (p = .042), where MS improved while NMS group worsened in CPT speed after smoking. After controlling for baseline cigarette craving and cigarette nicotine levels, the effect of cigarette type × time for all cognitive outcomes was statistically nonsignificant (ps > .05). However, there remained a significant effect of cigarette type, where MS versus NMS had poorer CPT (p = .046) and N-Back Task accuracy (p = .006) but faster N-Back speed (p = .039). There were no statistically significant differences between groups on reinforcement enhancement, nicotine dependence, or smoking behavior outcomes (ps > .05). CONCLUSIONS Contrary to our hypotheses, results did not find a significant effect of cigarette type on the change in cognitive performance after acute smoking in nonabstinent smokers. Further studies are needed to clarify the specific pharmacological effects of nicotine and menthol on cognitive functioning. IMPLICATIONS The current study is the first to compare the potential enhancement of cognitive task performance after acute cigarette smoking between satiated menthol and nonmenthol cigarette smokers. Study results suggest that acute menthol cigarette use may not enhance cognitive function above and beyond nonmenthol cigarettes to increase dependence among menthol smokers. However, the contribution of other psychological factors (eg, craving, mood) and cigarette characteristics (eg, nicotine content) may be involved in cognitive function enhancement to perpetuate dependence and smoking persistence for menthol smokers.
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Affiliation(s)
- Nancy C Jao
- Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, and Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Edward D Levin
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Melissa A Simon
- Departments of Obstetrics and Gynecology, Preventive Medicine, and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brian Hitsman
- Departments of Preventive Medicine, Medical Social Sciences, and Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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