Cross-sectional study on the relationship between smoking or smoking cessation and trait anxiety

Association among smoking, depression, and anxiety: findings from a representative sample of Korean adolescents

This study investigated the relationship between smoking and depression and anxiety using data from a nationwide survey representing Korean adolescents. Subjects were 6,489 adolescents in middle and high school (age 13-18) who had participated in the 2011 Korean Study of Promotion Policies on Children and Adolescents-Mental Health (KSPCAM). Daily smoking number of times for current smokers was classified as 1-2 times, 2-4 times and over 5 times. The odds ratio for the statistical test was presented using hierarchical logistic regression. When adjusted for covariates (gender, age, household economy, type of residing city, type of school, school record, satisfaction with school life, subjective health status, satisfaction with relationship with parents, and drinking experience), smokers more significantly likely to have depression (OR = 1.27, 95% CI [1.02-1.57]), and anxiety (OR = 1.49, 95% CI [1.14-1.96]) than non-smokers (p < 0.05). In addition, adolescents who smoke more than 5 cigarettes a day were 1.5 times more likely to have depression (OR = 1.48, 95% CI [1.13-1.92]) and anxiety (OR = 1.49, 95% CI [1.07-2.08]) than those who do not smoke. Smoking in adolescence was found to be significantly related with depression and anxiety. To promote the mental health of adolescents, effective smoking cessation programs are required.

Spectrum of corrosive esophageal injury after intentional paraquat ingestion

INTRODUCTION

This is an observational study that examines the clinical features, the degrees of esophageal injury, physiological markers, and clinical outcomes after paraquat ingestion and seeks to determine what association, if any, may exist between these findings.

METHODS

The study included 16 of 1410 paraquat subjects who underwent endoscopies at Chang Gung Memorial Hospital between 1980 and 2007.

RESULTS

Corrosive esophageal injuries were classified as grade 1 in 8, 2a in 5, and 2b in 3 patients. No patients had grade 0, 3a, or 3b esophageal injuries. After paraquat ingestion, systemic toxicity occurred, with rapid development of hypoxia, hepatitis, and renal failure in many cases. Hypoxia occurred in 1 (12.5%), 5 (100%), and 3 (100%) patients with grades 1, 2a, and 2b esophageal injury, respectively. There were more hypoxic patients with grades 2a and 2b than those with grade 1 esophageal injury (P < .05). The nadir Pao(2) was lower in patients with grades 2a and 2b than those with grade 1 esophageal injury (P < .05). However, there were no significant differences in terms of acute hepatitis, peak serum alanine aminotransferase, acute renal failure, and peak serum creatinine between the 3 groups (P > .05). Kaplan-Meier analysis did not find any difference in survival between the groups (P > .05).

CONCLUSION

Paraquat, a mild caustic agent, produces only grades 1, 2a, and 2b esophageal injury. Our findings showed a potential relationship between the degree of hypoxia, mortality, and degree of esophageal injury, although such a low number of study subjects limits the conclusions that can be made by this study.

Psychobiological Theories of Smoking and Smoking Motivation

Abstract. Theories of smoking have been developed about the conditions and causes of smoking as well as for explaining its maintenance. Moreover, factors of smoking motivation have been identified, which describe incentives to smoke and types of smoking behavior. The most frequently reported motives are psychosocial smoking, sensorimotor smoking, indulgent smoking, stimulation smoking, sedation smoking, dependent smoking, and automatic smoking. In the first phase after the start of smoking, psychosocial smoking is the dominating motive, which is best represented by theories of social psychology. Sensorimotor smoking may be best explained by theories of classical and operant conditioning. Indulgent smoking (= smoking for pleasure) may be explained by neurochemical theories and by the neurobiological theories of dependence emphasizing nicotine-induced activation of mesolimbic dopaminergic reinforcement. Stimulation smoking and sedation smoking are related to arousal models. Moreover, sedation smoking is also explained by aspects of reducing negative affect (as claimed by theories of affect regulation) and by biochemical theories emphasizing serotonergic mechanisms in modulating anxiety as well as by theories of dependence. Dependent smoking, which is mostly based on negative reinforcement (suppression of withdrawal symptoms) may be explained by neurochemical theories as well as by neurobiological theories of psychological and physical dependence explaining blunted dopaminergic and serotonergic responsivity as due to desensitization of respective receptors. Also automatic smoking may be explained by processes of habit learning and neurobiological theories of dependence. Finally, personality theories have been applied to all of these smoking motives.

Trait anxiety and nicotine dependence in adolescents: a report from the DANDY study

The Revised Children's Manifest Anxiety Scale (RCMAS) and the Hooked on Nicotine Checklist (HONC) were used to measure trait anxiety and tobacco dependence in a population of 581 adolescents. Smokers demonstrated higher mean RCMAS scores (9.3, S.D.=6.5) than nonsmokers did (7.4, S.D.=6.2, t=-3.7, P<.001). Participants with symptoms of tobacco dependence had higher RCMAS scores (mean=11.6, S.D.=6.0, n=115) than did the participants without symptoms (mean=7.8, S.D.=6.0, n=177, t=-5.3, P<.001). Scores on the RCMAS and the HONC correlated positively (n=292, r=.32, P<.001). Participants who had felt relaxed in response to their first exposure to nicotine were also more likely to develop dependence and to report that stress caused cravings or a need to smoke. Trait anxiety and relaxation in response to the first dose of nicotine were unrelated and appear to be independent risk factors for the development of nicotine dependence and a reliance on tobacco to cope with stress.