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Nwosu NC, Ede MO, Onah NG, Ekwueme HU, Obumse NA, Amoke CV, Chukwu CL, Onah SO, Amadi K, Ezurike CA, Oneli JO. Cognitive behavioral therapy for challenges to quitting tobacco smoking among social science and religion students. Medicine (Baltimore) 2022; 101:e31913. [PMID: 36451466 PMCID: PMC9704878 DOI: 10.1097/md.0000000000031913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Tobacco smoking is a public health issue. The aim of this investigation was to determine the effect of cognitive behavioral therapy (CBT) on the disputation of challenges to quitting tobacco smoking among students enrolled in the Social Science and religious Education programmes. METHODS The study adopted a pretest-posttest randomized controlled group design with follow-up. The population comprised of 76 tobacco smokers (randomized into 1 of 2 groups: n = 38 for the treatment group, n = 38 for the waitlist control group) completed the study. A self-report scale measuring dependence on cigarettes was used as the outcome measure. The treatment group was exposed to a 12-weeks CBT intervention. The treatment and waitlisted groups were evaluated at 3 time points: pretest, post-test, and follow-up. Statistical analyses were achieved using ANOVA. RESULTS The result showed that CBT had a significant effect in reducing the challenges to quitting tobacco smoking among the student smokers in the treatment group in comparison with the waitlist control group. The positive behavioral gains after the CBT program also persisted at follow-up in the treatment group compared with the waitlist control group. CONCLUSION Therefore, this study suggests that CBT intervention is a time-effective treatment method for disputation of challenges to quitting tobacco smoking among students enrolled in the Social Science and Religious Education Programmes.
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Affiliation(s)
- Nneka C. Nwosu
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
| | - Moses Onyemaechi Ede
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
| | - Nkechi G. Onah
- Department of Religion and Cultural Studies, Faculty of Social Sciences, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
| | - Hope Uchechukwu Ekwueme
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
| | - Nneka Anthonia Obumse
- Department of Educational Foundations, Faculty of Education, Chukwuemeka Odumegwu Ojukwu University, Anambra State, Nigeria
| | - Chijioke V. Amoke
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
| | - Chinyere Loveth Chukwu
- Department of Social Science Education, Faculty of Education, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
- * Correspondence: Joy Obiageli Oneli, Teleo Network International School of Theology, Pastoral Ministry Grace Training International Bible Institute, Gambia (e-mail: ) and Chinyere Loveth Chukwu, Department of Social Science Education, Faculty of Education, University of Nigeria, Nsukka. P.M.B. Enugu State 410001, Nigeria (e-mail: )
| | - Sebastian O. Onah
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
| | - Kingsley Amadi
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
| | - Chukwuemeka A. Ezurike
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka. P.M.B., Enugu State, Nigeria
| | - Joy Obiageli Oneli
- Teleo Network International School of Theology, Pastoral Ministry Grace Training International Bible Institute, Gambia
- * Correspondence: Joy Obiageli Oneli, Teleo Network International School of Theology, Pastoral Ministry Grace Training International Bible Institute, Gambia (e-mail: ) and Chinyere Loveth Chukwu, Department of Social Science Education, Faculty of Education, University of Nigeria, Nsukka. P.M.B. Enugu State 410001, Nigeria (e-mail: )
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Antoniu SA, Buculei I, Mihaltan F, Crisan Dabija R, Trofor AC. Pharmacological strategies for smoking cessation in patients with chronic obstructive pulmonary disease: a pragmatic review. Expert Opin Pharmacother 2020; 22:835-847. [PMID: 33372557 DOI: 10.1080/14656566.2020.1858796] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is progressive inflammatory disease of the lungs in which smoking plays a significant pathogenic role. Smoking cessation is the only therapeutic intervention which was demonstrated to interfere with disease progression. Smoking cessation intervention can benefit from pharmacological therapies such as nicotine replacement therapies, bupropion, or varenicline which can be given individually or in combination, their effectiveness being demonstrated in various clinical trials enrolling COPD patients.Areas covered: The authors provide a pragmatic discussion of the clinical data of the main studies evaluating therapies for smoking cessation within COPD starting with the seminal Lung Health Study and continuing with more recent ones.Expert opinion: Smoking cessation is one of the most difficult therapeutic interventions in COPD, despite having the highest impact on disease progression and despite the demonstrated benefit of the discussed pharmacological therapies. Potential approaches to maximize its chance of success might be represented by prolonging the time of administration, combinational options, or sequential pharmacotherapy.
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Affiliation(s)
- Sabina Antonela Antoniu
- Dept of Medicine II-Nursing/Palliative Care, University of Medicine and Pharmacy "Grigore T Popa", Iasi, Romania
| | - Ioana Buculei
- In-training Physician, University of Medicine and Pharmacy "Grigore T Popa", Iasi, Romania
| | - Florin Mihaltan
- Faculty of Medicine-Department 4-Pulmonary Disease, University of Medicine and Pharmacy Carol Davila, Bucuresti, Romania
| | - Radu Crisan Dabija
- Dept of Medicine II-Pulmonary Disease, University of Medicine and Pharmacy "Grigore T Popa", Iasi, Romania
| | - Antigona Carmen Trofor
- Dept of Medicine II-Pulmonary Disease, University of Medicine and Pharmacy "Grigore T Popa", Iasi, Romania
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Kanmodi K. The role of dentists in clinical tobacco cessation interventions: The status in Nigeria. POPULATION MEDICINE 2020. [DOI: 10.18332/popmed/128323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kagabo R, Thiese MS, Eden E, Thatcher AC, Gonzalez M, Okuyemi K. Truck Drivers' Cigarette Smoking and Preferred Smoking Cessation Methods. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 14:1178221820949262. [PMID: 32848405 PMCID: PMC7427133 DOI: 10.1177/1178221820949262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/16/2020] [Indexed: 12/02/2022]
Abstract
Introduction: Some studies show that truck drivers use tobacco and other stimulants to stay awake as they drive. Despite their increased risks for many of tobacco-related health disparities, there is limited engagement of truck drivers in smoking cessation programs. The objective of this study was to describe smoking characteristics and identify their preferred smoking cessation methods among truck drivers. Methods: This was a cross-sectional mixed methods study. Participants were truck drivers recruited at trucking companies in Utah in 2019. Participants were either individually interviewed (n = 4), or filled out a survey (n = 33). We conducted qualitative data analysis of the interviews followed by descriptive statistics of smoking and cessation characteristics from the survey. Results: Reasons for smoking included, staying awake, stress reduction, or something to do while driving. Of the drivers surveyed, 68.8% were daily smokers while 97% had smoked at least 100 cigarettes in their life time. The mean number of cigarettes per day (cpd) was 15.7, and 25 among those who had 10 or more cpd. Sixty-one percent had made at least a quit attempt. In addition to counseling or brief advice, 68% reported interest in using Nicotine Replacement Therapy (NRT) either as gum or patch to help them quit. 21% reported interest in telephone text messaging to engage them in treatment. Conclusion: Cigarette smoking is a public health problem among truck drivers. Our findings suggest that truck drivers are interested in quitting smoking. Evidence based interventions tailored to this population are needed to help them quit and reduce their smoking-related morbidity.
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Affiliation(s)
- Robert Kagabo
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Matthew S Thiese
- The Rocky Mountain Center for Occupational and Environment Health, University of Utah, Salt Lake City, Utah, USA
| | - Emilee Eden
- The Rocky Mountain Center for Occupational and Environment Health, University of Utah, Salt Lake City, Utah, USA
| | - Andria Colvin Thatcher
- The Rocky Mountain Center for Occupational and Environment Health, University of Utah, Salt Lake City, Utah, USA
| | - Melissa Gonzalez
- The Rocky Mountain Center for Occupational and Environment Health, University of Utah, Salt Lake City, Utah, USA
| | - Kolawole Okuyemi
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Liberman K, Van Schuerbeek P, Herremans S, Meysman M, De Mey J, Buls N. The effect of nicotine patches on craving in the brain: A functional MRI study on heavy smokers. Medicine (Baltimore) 2018; 97:e12415. [PMID: 30278517 PMCID: PMC6181594 DOI: 10.1097/md.0000000000012415] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Smoking is a common phenomenon and kills over 6 million people every year. Many smokers try to quit smoking by using nicotine replacement therapy (NRT). Most of the time, relapse occurs in less than six months after finishing the program of NRT. We performed a single blinded study in which our aim was to figure out what the effect of the nicotine patch is on craving in the brain of smokers deprived from smoking. METHODS Five heavy smokers (Fagerström Test for Nicotine Dependence ≥4) underwent a functional magnetic resonance imaging (fMRI) in 4 random conditions: smoking (S); smoking deprivation (SD); SD combined with a NP (SD + NP); SD combined with a placebo patch (SD + PP). Visual stimulation provoked craving in block design by randomly displaying images of smoking related scenes. After image preprocessing, a fixed-effect analysis was performed to compare average group activations. The Questionnaire for Smoking Urges (QSU) was obtained before and after each scan. RESULTS The fMRI results showed higher activation in areas involved in craving in S compared with SD + NP, SD + PP, and SD. In the SD + NP, limbic circuit and attention area were higher activated compared with SD and SD + PP. The SD + PP and SD showed higher activation in the frontal cortex and limbic system compared with S and SD + NP. Nonsmokers showed higher limbic activation compared with SD.The QSU increased significantly after the fMRI experiment in S (P = .036).The SD had higher QSU scores compared with the S before (P = .002), and also after (P = .022) the fMRI experiment. The NP showed lower scores than the SD before the experiment (P = .046). CONCLUSION The fMRI experiment revealed lower activity in areas associated with attention when subjects were nicotine deprived (SD + PP and SD). Areas involved with craving showed less activity when nicotine is present (S and SD + NP). The QSU showed a significant difference between SD and when nicotine is present (S and SD + NP).
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Affiliation(s)
- Keliane Liberman
- Gerontology Department, Vrije Universiteit Brussel (VUB)
- Departement of Radiology
| | | | | | - Marc Meysman
- Department of Pneumology, Universitair Ziekenhis Brussel (UZ Brussel), Brussels, Belgium
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Shah D, Shah A, Tan X, Sambamoorthi U. Trends in utilization of smoking cessation agents before and after the passage of FDA boxed warning in the United States. Drug Alcohol Depend 2017; 177:187-193. [PMID: 28605678 PMCID: PMC5568118 DOI: 10.1016/j.drugalcdep.2017.03.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 03/08/2017] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND In 2009, the FDA required a black box warning (BBW) on bupropion and varenicline, the two commonly prescribed smoking cessation agents due to reports of adverse neuropsychiatric events. We investigated if there was a decline in use of bupropion and varenicline after the BBW by comparing the percent using these medications before and after BBW. METHODS We conducted a retrospective observational study using data from the Medical Expenditure Panel Survey from 2007 to 2014. The study sample consisted of adult smokers, who were advised by their physicians to quit smoking. We divided the time period into "pre-warning", "post-warning: immediate", and "post-warning: late." Unadjusted analysis using chi-square tests and adjusted analyses using logistic regressions were conducted to evaluate the change in bupropion and varenicline use before and after the BBW. Secondary analyses using piecewise regression were also conducted. RESULTS On an average, 49.04% of smokers were advised by their physicians to quit smoking. We observed a statistically significant decline in varenicline use from 22.1% in year 2007 to 9.23% in 2014 (p value<0.001). In the logistic (Adjusted Odds Ratio=0.36, 95% CI=0.22-0.58) and piecewise regressions (Odds Ratio=0.64, 95% CI=0.41-0.99) smokers who were advised to quit smoking by their physicians were less likely to use varenicline in the immediate post-BBW period as compared to pre-BBW period. While the use of varenicline continued to be significantly low in the late post-BBW period (AOR=0.45, 95% CI=0.31-0.64) as compared to the pre-BBW period, the trend in use as seen in piecewise regression remained stable (OR=0.90, 95% CI=0.75-1.06). We did not observe significant differences in bupropion use between the pre- and post-BBW periods. CONCLUSION The passage of the FDA boxed warning was associated with a significant decline in the use of varenicline, but not in the use of bupropion.
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Affiliation(s)
- Drishti Shah
- West Virginia University, Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA.
| | - Anuj Shah
- West Virginia University, Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA; Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Xi Tan
- West Virginia University, Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Usha Sambamoorthi
- West Virginia University, Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
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Goldstein RB, Chou SP, Saha TD, Smith SM, Jung J, Zhang H, Pickering RP, Ruan WJ, Huang B, Grant BF. The Epidemiology of Antisocial Behavioral Syndromes in Adulthood: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III. J Clin Psychiatry 2017; 78:90-98. [PMID: 27035627 PMCID: PMC5025322 DOI: 10.4088/jcp.15m10358] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 11/16/2015] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To present current, nationally representative US findings on prevalence, correlates, psychiatric comorbidity, disability, and treatment of DSM-5 antisocial personality disorder (ASPD) and adulthood antisocial behavioral syndrome without conduct disorder before 15 years of age (AABS). METHOD Face-to-face interviews were conducted with respondents (N = 36,309) in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. DSM-5 alcohol, nicotine, and specific drug use disorders and selected mood, anxiety, trauma-related, eating, and personality disorders were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. RESULTS Prevalences of ASPD and AABS were 4.3% and 20.3%, respectively, and were highest among male, white, Native American, younger, and unmarried respondents, those with high school or less education, lower incomes, and Western residence. Both antisocial syndromes were significantly associated with 12-month and lifetime substance use, dysthymia/persistent depressive, bipolar I, posttraumatic stress, and borderline and schizotypal personality disorders (odds ratios [ORs] = 1.2-7.0). ASPD was additionally associated with 12-month agoraphobia and lifetime generalized anxiety disorder (ORs = 1.3-1.6); AABS, with 12-month and lifetime major depressive and 12-month generalized anxiety disorders (ORs = 1.2-1.3). Both were associated with significant disability (P < .001 to .01). Most antisocial survey respondents were untreated. CONCLUSIONS One in 4 US adults exhibits syndromal antisocial behavior, with similar sociodemographic and psychiatric correlates and disability regardless of whether onset occurred before 15 years of age, illustrating the clinical and public health significance of both ASPD and AABS. In addition to laying groundwork for estimates of social and economic costs, and further etiologic and nosologic research, these findings highlight the urgency of effectively preventing and treating antisocial syndromes, including investigation of whether treatment for comorbidity hastens symptomatic remission and improves quality-of-life outcomes.
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Affiliation(s)
- Risë B Goldstein
- Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Blvd, Room 7B13C, MS 7510, Bethesda, MD 20892-7510.
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - S Patricia Chou
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Tulshi D Saha
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Sharon M Smith
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Jeesun Jung
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Haitao Zhang
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Roger P Pickering
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - W June Ruan
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Boji Huang
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
| | - Bridget F Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA
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Chou SP, Goldstein RB, Smith SM, Huang B, Ruan WJ, Zhang H, Jung J, Saha TD, Pickering RP, Grant BF. The Epidemiology of DSM-5 Nicotine Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions-III. J Clin Psychiatry 2016; 77:1404-1412. [PMID: 27135834 PMCID: PMC8154113 DOI: 10.4088/jcp.15m10114] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 10/07/2015] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To present nationally representative information on the prevalence, correlates, psychiatric comorbidity, and treatment of DSM-5 nicotine use disorder (NUD) and the public health burden of US cigarette consumption among adults with NUD and other psychiatric disorders. METHODS Using data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309), we conducted weighted cross-tabulations and multivariate logistic regression analyses to estimate prevalences and examine comorbidity of NUD. RESULTS Prevalences of 12-month and lifetime DSM-5 NUD were 20.0% and 27.9%, respectively. Nicotine use disorder was more frequent among men, non-Hispanic whites, younger individuals, the previously married, those with less education and lower incomes, and those residing in rural areas. Adjusting for sociodemographic characteristics and additional psychiatric comorbidity, 12-month NUD and lifetime NUD were significantly associated with other substance use and antisocial personality disorders (odds ratios [ORs] = 1.5-5.1, 12-month; 1.5-5.6, lifetime). Twelve-month severe NUD was generally associated with major depressive, bipolar I, bipolar II, panic, generalized anxiety, posttraumatic stress, and schizotypal, borderline, and antisocial personality disorders (ORs = 1.3-2.5). Individuals with current NUD and at least 1 psychiatric disorder comprised 11.1% of US adults but smoked 53.6% of total cigarettes consumed. Treatment was utilized by 20.3% of respondents with 12-month and 18.8% with lifetime NUD. CONCLUSIONS Findings underscore the need to address nicotine use in clinical settings. Recognition of psychiatrically vulnerable subpopulations may inform etiologic research, prevention, and treatment of NUD.
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Affiliation(s)
- S. Patricia Chou
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Risë B. Goldstein
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Sharon M. Smith
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Boji Huang
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - W. June Ruan
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Haitao Zhang
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Jeesun Jung
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Tulshi D. Saha
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Roger P. Pickering
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
| | - Bridget F. Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural
Clinical and Biological Research, National Institute on Alcohol Abuse and
Alcoholism, National Institutes of Health, Bethesda, MD 20892
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Budzynska B, Skalicka-Wozniak K, Kruk-Slomka M, Wydrzynska-Kuzma M, Biala G. In vivo modulation of the behavioral effects of nicotine by the coumarins xanthotoxin, bergapten, and umbelliferone. Psychopharmacology (Berl) 2016; 233:2289-300. [PMID: 27080866 PMCID: PMC4873531 DOI: 10.1007/s00213-016-4279-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 03/14/2016] [Indexed: 12/14/2022]
Abstract
RATIONALE Nicotine, a dominant alkaloid found in tobacco, is responsible for physical dependence, as well as addiction to cigarette smoking; consequently, smoking cessation is a very difficult process. Hepatic cytochrome P-450 2A6 (CYP2A6) is involved in the 70-80 % of the initial metabolism of nicotine and its co-metabolites. As this metabolism is slowed by inhibitors of CYP2A6, this kind of enzymatic inhibition has been proposed as a novel target for smoking cessation. OBJECTIVES Nicotine administered alone improved memory acquisition and consolidation as well as exerted antidepressive activity in animal models. These effects persist for 24 h. However, they are completely extinguished 48 h after administration. METHODS To investigate if the coumarins prolong the behavioral effects of nicotine, the forced swimming test (FST)-animal models of depression, and passive avoidance (PA) test-memory and learning paradigm were used. RESULTS This study revealed that three CYP2A6 inhibitors: two furanocoumarins, xanthotoxin (15 mg/kg) and bergapten (25 mg/kg), and the simple coumarin umbelliferone (25 mg/kg), prolonged the antidepressive and procognitive effects of nicotine. CONCLUSIONS These natural products may offer a new approach to the treatment of nicotinism as antidepressant and memory improvement actions are one of the main factors of nicotine dependence.
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Affiliation(s)
- Barbara Budzynska
- Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Lublin, Poland.
| | - Krystyna Skalicka-Wozniak
- />Department of Pharmacognosy with Medicinal Plants Unit, Medical University of Lublin, Lublin, Poland
| | - Marta Kruk-Slomka
- />Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Lublin, Poland
| | | | - Grazyna Biala
- />Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Lublin, Poland
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Lee DC, Budney AJ, Brunette MF, Hughes JR, Etter JF, Stanger C. Outcomes from a computer-assisted intervention simultaneously targeting cannabis and tobacco use. Drug Alcohol Depend 2015; 155:134-40. [PMID: 26307942 PMCID: PMC4671818 DOI: 10.1016/j.drugalcdep.2015.08.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 08/03/2015] [Accepted: 08/05/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Cannabis users frequently report concurrent tobacco use, and tobacco use is associated with poorer outcomes during treatment for cannabis use disorders (CUD). Interventions that simultaneously target both tobacco and cannabis use disorders may enhance cessation outcomes for either or both substances. METHODS This study evaluated an intervention integrating highly effective treatments for cannabis and tobacco use disorders. Thirty-two participants meeting diagnostic criteria for CUD and reporting daily tobacco use were enrolled in a 12-week computer-assisted behavioral treatment for CUD. Participants were encouraged to participate in a tobacco intervention that included a computer-assisted behavioral treatment tailored for tobacco and cannabis co-users, and nicotine-replacement therapy (NRT). Cannabis and tobacco outcomes were evaluated using descriptive statistics and were compared to a historical control group that received treatment for CUD but not tobacco. RESULTS Participants achieved 3.6±4.3 consecutive weeks of cannabis abstinence, which was comparable to the historical control group (3.1±4.4). A majority of the sample (78%) completed at least one tobacco module and 44% initiated NRT. Over half (56%) initiated tobacco quit attempts, and 28% were tobacco abstinent for at least two consecutive weeks. Participants showed greater reduction in tobacco use (cigarettes per day) than the historical control group, but differences in tobacco abstinence rates during the final month of treatment were not statistically significant (12.5% vs. 4%). CONCLUSION Findings suggest that providing a tobacco intervention during treatment for CUD is feasible and may positively impact tobacco use without negatively affecting cannabis use outcomes.
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Affiliation(s)
- Dustin C Lee
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Rivermill Complex, Suite B3-1, 85 Mechanic St., Lebanon, NH 03766, United States.
| | - Alan J Budney
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Rivermill Complex, Suite B3-1, 85 Mechanic St., Lebanon, NH 03766, United States
| | - Mary F Brunette
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Rivermill Complex, Suite B3-1, 85 Mechanic St., Lebanon, NH 03766, United States
| | - John R Hughes
- Departments of Psychiatry and Psychological Science, University of Vermont, UHC Campus/OH3, Stop # 482, 1 South Prospect St., Burlington, VT 05401, United States
| | - Jean-Francois Etter
- Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, CMU. 1, rue Michel-Servet, 1211 Genève 4, Switzerland
| | - Catherine Stanger
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Rivermill Complex, Suite B3-1, 85 Mechanic St., Lebanon, NH 03766, United States
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Mental health status of varenicline and bupropion users during a quit attempt compared to current smokers, other quitters, and non-smokers. Drug Alcohol Depend 2015; 154:132-8. [PMID: 26169448 DOI: 10.1016/j.drugalcdep.2015.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/10/2015] [Accepted: 06/16/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Varenicline and bupropion are commonly prescribed non-nicotine containing smoking cessation agents. Post-marketing reports suggest an increased incidence of psychiatric disturbances associated with varenicline and bupropion. However, pre-existing psychiatric disorders may confound the association between these smoking cessation agents and psychiatric disturbances. We compared the mental health status of individuals using varenicline or bupropion to that of people quitting without medication, current smokers, and non-smokers while controlling for pre-existing conditions. METHODS A cross-sectional design was used. Data were from 2006-2011 Medical Expenditure Panel Survey. Mental health status was assessed using the mental component summary (MCS) from the 12-item Short Form survey (SF-12v2), 2-item Patient Health Questionnaire (PHQ-2), and Kessler 6 Scale (K6). Differences in MCS score were compared using linear regression. Logistic regressions were used to compare positive screenings for depression using PHQ-2 and for psychological distress using K6. RESULTS Of 578 use episodes, 453 (78.38%) were bupropion and 125 (21.62%) were varenicline. After adjusting for potential confounders, mental health status of varenicline users was not different from current smokers or people who quit smoking without medication, but worse than non-smokers; bupropion was strongly associated with lower mental health status relative to all groups across all three measures. CONCLUSION Varenicline was not associated with worse mental health compared to smokers or those who quit without medication, after adjusting for pre-existing psychiatric disorders. Bupropion was associated with worse mental health status than smokers, former smokers who quit without medication, and nonsmokers, even after adjusting for pre-existing psychiatric disorders.
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12
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Budzynska B, Boguszewska-Czubara A, Kruk-Slomka M, Kurzepa J, Biala G. Mephedrone and nicotine: oxidative stress and behavioral interactions in animal models. Neurochem Res 2015; 40:1083-93. [PMID: 25862193 PMCID: PMC4422847 DOI: 10.1007/s11064-015-1566-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 03/12/2015] [Accepted: 03/30/2015] [Indexed: 12/13/2022]
Abstract
The purpose of our experiment was to examine the influence of co-administration of nicotine and mephedrone on anxiety-like behaviors, cognitive processes and the nicotine-induced behavioral sensitization as well as processes connected with induction of oxidative stress in the brain of male Swiss mice. The results revealed that co-administration of subthreshold doses of mephedrone and nicotine (0.05 mg/kg each) exerted marked anxiogenic profile in the elevated plus maze and displayed pro-cognitive action in the passive avoidance paradigm (nicotine 0.05 mg/kg and mephedrone 2.5 mg/kg). Furthermore, one of the main findings of the present study was that mephedrone, administered alone at the dose not affecting locomotor activity of mice (1 mg/kg), enhanced the expression of nicotine-induced locomotor sensitization. Moreover, mephedrone administered with nicotine decreased general antioxidant status and catalase activity as well as antioxidant enzymes activity in the hippocampus and prefrontal cortex and increased concentration of malondialdehyde, an indicator of lipid peroxidation processes. Considering the likelihood that mephedrone is taken as a part of polydrug combination with nicotine, the effects of this combination on mammalian organisms have been confirmed in our study. Understanding the consequences of co-administration of psychoactive substances on the central nervous system and oxidative processes in the brain provide the important toxicological significance, and may be useful in polydrug intoxication treatment.
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Affiliation(s)
- Barbara Budzynska
- Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, 4A Chodzki Street, 20-093, Lublin, Poland,
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Abstract
In the United States, the rate of cigarette smoking has significantly declined over the past 2 decades, but much more work is needed, as almost 20% of adults still smoke and smoking continues to be the leading preventable cause of death. Furthermore, rates of smoking in certain subpopulations have remained relatively stable and have historically been neglected in smoking cessation research. Pharmacotherapy (both prescription and over-the-counter) and behavioral support are known to aid cessation, and their combination is more effective than either alone. There are significant barriers to access, use, and adherence, however, especially with pharmacotherapy. Therefore, the purpose of this review is to provide an update and overview of the numerous behavioral approaches that have been used to enhance smoking cessation. The research described can be classified into the type of approach used, the setting in which it is delivered, and the population targeted. Regardless of the classification, all the approaches attempt to provide smokers with the information, motivation, and behavioral skills thought to be necessary for achieving initial cessation and sustained abstinence. Recommendations for future research on behavioral smoking cessation are also included.
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Affiliation(s)
- Joseph T. Ciccolo
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York (JTC)
- Department of Psychiatry and Human Behavior, Centers for Behavioral & Preventive Medicine, Alpert Medical School of Brown University and The Miriam Hospital, Providence, Rhode Island (AMB)
| | - Andrew M. Busch
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York (JTC)
- Department of Psychiatry and Human Behavior, Centers for Behavioral & Preventive Medicine, Alpert Medical School of Brown University and The Miriam Hospital, Providence, Rhode Island (AMB)
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14
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Herman AI, DeVito EE, Jensen KP, Sofuoglu M. Pharmacogenetics of nicotine addiction: role of dopamine. Pharmacogenomics 2015; 15:221-34. [PMID: 24444411 DOI: 10.2217/pgs.13.246] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The neurotransmitter dopamine (DA) plays a central role in addictive disorders, including nicotine addiction. Specific DA-related gene variants have been studied to identify responsiveness to treatment for nicotine addiction. Genetic variants in DRD2, DRD4, ANKK1, DAT1, COMT and DBH genes show some promise in informing personalized prescribing of smoking cessation pharmacotherapies. However, many trials studying these variants had small samples, used retrospective design or were composed of mainly self-identified Caucasian individuals. Furthermore, many of these studies lacked a comprehensive measurement of nicotine metabolism rate, did not assess the roles of sex or the menstrual cycle, and did not investigate the role of rare variants and/or epigenetic factors. Future work should be conducted addressing these limitations to more effectively utilize DA genetic information to unlock the potential of smoking cessation pharmacogenetics.
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Affiliation(s)
- Aryeh I Herman
- Yale University, School of Medicine, Department of Psychiatry & VA Connecticut Healthcare System, VA Medical Center, 950 Campbell Avenue, West Haven, CT 06516, USA
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15
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Abstract
Nicotine dependence is a chronic, relapsing disorder with complex biological mechanisms underlying the motivational basis for this behavior. Although more than 70 % of current smokers express a desire to quit, most relapse within one year, underscoring the need for novel treatments. A key focus of translational research models addressing nicotine dependence has been on cross-validation of human and animal models in order to improve the predictive value of medication screening paradigms. In this chapter, we review several lines of research highlighting the utility of cross-validation models in elucidating the biological underpinnings of nicotine reward and reinforcement, identifying factors which may influence individual response to treatment, and facilitating rapid translation of findings to practice.
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Lee DC, Budney AJ, Brunette MF, Hughes JR, Etter JF, Stanger C. Treatment models for targeting tobacco use during treatment for cannabis use disorder: case series. Addict Behav 2014; 39:1224-30. [PMID: 24813547 PMCID: PMC4066896 DOI: 10.1016/j.addbeh.2014.04.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/13/2014] [Accepted: 04/02/2014] [Indexed: 12/13/2022]
Abstract
Approximately 50% of individuals seeking treatment for cannabis use disorders (CUD) also smoke tobacco, and tobacco smoking is a predictor of poor outcomes for those in treatment for CUD. Quitting tobacco is associated with long-term abstinence from alcohol and illicit drugs, yet there are no established treatments for CUD that also target tobacco smoking. This report highlights issues related to cannabis and tobacco co-use and discusses potential treatment approaches targeting both substances. Data is shared from the first six participants enrolled in an intervention designed to simultaneously target tobacco use in individuals seeking treatment for CUD. The twelve-week program comprised computer-assisted delivery of Motivational Enhancement Therapy, Cognitive Behavioral Therapy, and Contingency Management, i.e., abstinence-based incentives for CUD. In addition, participants were encouraged to complete an optional tobacco intervention consisting of nicotine-replacement therapy and computer-assisted delivery of a behavioral treatment tailored for tobacco and cannabis users. All participants completed the cannabis intervention and at least a portion of the tobacco intervention: all completed at least one tobacco computer module (mean=2.5 modules) and 50% initiated nicotine replacement therapy. Five of six participants achieved abstinence from cannabis. The number of tobacco quit attempts was lower than expected, however all participants attempted to reduce tobacco use during treatment. Simultaneously targeting tobacco during treatment for CUD did not negatively impact cannabis outcomes. Participation in the tobacco intervention was high, but cessation outcomes were poor suggesting that alternative strategies might be needed to more effectively prompt quit attempts and enhance quit rates.
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Affiliation(s)
- Dustin C Lee
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Rivermill Complex, Suite B3-1, 85 Mechanic St., Lebanon, NH 03766, United States.
| | - Alan J Budney
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Rivermill Complex, Suite B3-1, 85 Mechanic St., Lebanon, NH 03766, United States
| | - Mary F Brunette
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Rivermill Complex, Suite B3-1, 85 Mechanic St., Lebanon, NH 03766, United States
| | - John R Hughes
- Department of Psychiatry, University of Vermont, UHC Campus/OH3, Stop # 482, 1 South Prospect St., Burlington, VT 05401, United States
| | - Jean-Francois Etter
- Institute of Social and Preventive Medicine, Faculty of Medicine, University of Geneva, CMU. 1, rue Michel-Servet, 1211 Genève 4, Switzerland
| | - Catherine Stanger
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Rivermill Complex, Suite B3-1, 85 Mechanic St., Lebanon, NH 03766, United States
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Ciccolo JT, Williams DM, Dunsiger SI, Whitworth JW, McCullough AK, Bock BB, Marcus BH, Myerson M. Efficacy of Resistance Training as an Aid to Smoking Cessation: Rationale and Design of the Strength To Quit Study. Ment Health Phys Act 2014; 7:95-103. [PMID: 25157265 PMCID: PMC4141705 DOI: 10.1016/j.mhpa.2014.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Despite recent declines in the rates of cigarette smoking, smoking remains prevalent among individuals with lower income, less education, and those with mental illness or HIV. Exercise is promoted as an aid to smoking cessation; however, the evidence for this recommendation is equivocal. To date, the majority of studies have only examined aerobic exercise; there is a poor understanding of the mechanisms of action; and there is an under-representation of male smokers. The goal of this trial is to produce new data that will help to address each of these gaps. A total of 206 male and female smokers will receive a brief smoking cessation education session prior to being randomized into a 12-week Resistance Training (RT) or Wellness Contact Control group. Both groups will have the option of using nicotine replacement therapy (NRT), and both will meet on-site twice per week during the 12-week program (24 total sessions). Follow-up assessments will occur at the end of the 12-weeks (3-month), and at a 6-month and 12-month (post-randomization) visit. Participants will not receive any additional smoking cessation treatment during follow-up; however, the RT group will receive a 9-month membership to a fitness center to encourage continued resistance training as a way to maintain cessation, and attendance will be tracked. The primary outcome is salivary-cotinine-verified 7-Day Point Prevalence Abstinence (PPA) at the 3-month assessment, and at the 6 and 12-month follow-ups. Secondary outcomes include effects of resistance training on nicotine withdrawal symptoms, indicators of mental health, and markers of disease risk.
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Affiliation(s)
- Joseph T. Ciccolo
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY 10027, USA
| | - David M. Williams
- Department of Behavioral and Social Sciences, Brown University, School of Public Health, Box G-S121-4, Providence, RI 02912, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 167 Point Street, Providence, RI 02903 USA
| | - Shira I. Dunsiger
- Department of Behavioral and Social Sciences, Brown University, School of Public Health, Box G-S121-4, Providence, RI 02912, USA
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 167 Point Street, Providence, RI 02903 USA
| | - James W. Whitworth
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY 10027, USA
| | - Aston K. McCullough
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 West 120th St., New York, NY 10027, USA
| | - Beth B. Bock
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 167 Point Street, Providence, RI 02903 USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 167 Point Street, Providence, RI 02903 USA
| | - Bess H. Marcus
- Department of Family and Preventive Medicine, U.C. San Diego Health Sciences, 9500 Gilman Drive, 0628, La Jolla, CA. 92093, USA
| | - Merle Myerson
- Center for Cardiovascular Disease Prevention, Mount Sinai St. Luke’s and Roosevelt Hospital, 1111 Amsterdam Avenue, New York, NY 10025, USA
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Yilmazel Ucar E, Araz O, Yilmaz N, Akgun M, Meral M, Kaynar H, Saglam L. Effectiveness of pharmacologic therapies on smoking cessation success: three years results of a smoking cessation clinic. Multidiscip Respir Med 2014; 9:9. [PMID: 24495744 PMCID: PMC3916028 DOI: 10.1186/2049-6958-9-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 01/15/2014] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pharmacologic therapies have an important role in the success of interventions for smoking cessation. This study aims to determine the efficacy of several pharmacologic treatments in patients who applied to a smoking cessation clinic. METHODS This retrospective study includes 422 patients who presented to our smoking cessation clinic between January 2010 and June 2013, used the pharmacologic treatment as prescribed and completed the one-year follow-up period. All patients were assessed using the Fagerström Test for Nicotine Dependence (FTND) and received both behavioral therapy and pharmacotherapy. Patients' smoking status at one year was assessed by telephone interview. RESULTS The patients were 24.3% female (103/422) and 75.7% male (319/422) with a mean age of 38 ± 10 years. Patients were divided into three groups: varenicline (166 patients), bupropion (148 patients) and nicotine replacement therapy (108 patients).The smoking cessation rates of these groups were 32.5%, 23% and 52.8%, respectively, and were statistically significant (p > 0.001). The overall success rate was 35%. Further analysis revealed that pharmacologic therapy (p > 0.001) and gender (p = 0.01) were factors that showed statistically significant effects on smoking cessation rates. Males had higher success rates than females. The overall relapse rate was 21.6% and the bupropion group showed the highest relapse rate among treatment groups. Lack of determination emerged as the most important factor leading to relapse. CONCLUSION Nicotine replacement therapy was found to be more effective at promoting abstinence from smoking than other pharmacologic therapies.
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Affiliation(s)
- Elif Yilmazel Ucar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
- Yakutiye Medical Research Center, Chest Disease Department, Erzurum, Yakutiye 25240, Turkey
| | - Omer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Nafiye Yilmaz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Metin Akgun
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Mehmet Meral
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Hasan Kaynar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Leyla Saglam
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
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Aubin HJ, Luquiens A, Berlin I. Pharmacotherapy for smoking cessation: pharmacological principles and clinical practice. Br J Clin Pharmacol 2014; 77:324-36. [PMID: 23488726 PMCID: PMC4014023 DOI: 10.1111/bcp.12116] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 02/11/2013] [Indexed: 11/30/2022] Open
Abstract
Strategies for assisting smoking cessation include behavioural counselling to enhance motivation and to support attempts to quit and pharmacological intervention to reduce nicotine reinforcement and withdrawal from nicotine. Three drugs are currently used as first line pharmacotherapy for smoking cessation, nicotine replacement therapy, bupropion and varenicline. Compared with placebo, the drug effect varies from 2.27 (95% CI 2.02, 2.55) for varenicline, 1.69 (95% CI 1.53, 1.85) for bupropion and 1.60 (95% CI 1.53, 1.68) for any form of nicotine replacement therapy. Despite some controversy regarding the safety of bupropion and varenicline, regulatory agencies consider these drugs as having a favourable benefit/risk profile. However, given the high rate of psychiatric comorbidity in dependent smokers, practitioners should closely monitor patients for neuropsychiatric symptoms. Second-line pharmacotherapies include nortriptyline and clonidine. This review also offers an overview of pipeline developments and issues related to smoking cessation in special populations such as persons with psychiatric comorbidity and pregnant and adolescent smokers.
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Affiliation(s)
- Henri-Jean Aubin
- Centre d'enseignement, de recherche, et de traitement des addictions, Hôpital Paul Brousse, Pars-Sud 11 UniversityINSERM U669, 94800, Villejuif, France
| | - Amandine Luquiens
- Centre d'enseignement, de recherche, et de traitement des addictions, Hôpital Paul Brousse, Pars-Sud 11 UniversityINSERM U669, 94800, Villejuif, France
| | - Ivan Berlin
- Département de Pharmacologie, Université P.&M. Curie, Faculté de médecine, Hôpital Pitié-Salpêtrière75013, Paris, France
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Philibert RA, Beach S, Brody GH. The DNA methylation signature of smoking: an archetype for the identification of biomarkers for behavioral illness. NEBRASKA SYMPOSIUM ON MOTIVATION. NEBRASKA SYMPOSIUM ON MOTIVATION 2014; 61:109-27. [PMID: 25306781 PMCID: PMC4543297 DOI: 10.1007/978-1-4939-0653-6_6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Smoking is perhaps the foremost public health challenge in the United States and in the world. In a series of rapidly emerging studies, we and others have demonstrated that cigarette smoking is associated with changes in the DNA methylation signature of peripheral blood cells. The changes associated with this type of substance use are both dose and time dependent. These changes in DNA methylation are also accompanied by changes in gene transcription and protein expression whose patterns are furthermore indicative of increased vulnerability to other forms of complex illness. In the past, our efforts to translate this knowledge into actionable information has been stymied by a lack of methods through which to systematically to assess these changes. The rapid advance of DNA methylation assessment technologies changes that dynamic and presents the possibility that methylation-based clinical tools to aid the ascertainment of smoking status or effectiveness of treatment can be developed. In this chapter, we will review the latest advances in this field and discuss how these advances allow us insight as to methods through which to prevent smoking and shed insight into optimizing strategies through which to identify biomarkers for other behavioral illnesses which share similar contributions from environmental and gene- environmental interaction effects.
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Affiliation(s)
| | - S.R.H. Beach
- The Center for Family Research, University of Georgia, Athens, GA
| | - Gene H. Brody
- The Center for Family Research, University of Georgia, Athens, GA
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Swanson AN, Shoptaw S, Heinzerling KG, Wade AC, Worley M, McCracken J, Wilson SA, Asarnow J, London ED. Up in smoke? A preliminary open-label trial of nicotine replacement therapy and cognitive behavioral motivational enhancement for smoking cessation among youth in Los Angeles. Subst Use Misuse 2013; 48:1553-62. [PMID: 23822739 DOI: 10.3109/10826084.2013.808218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In 2008-2009, we conducted a 6-week, open-label trial of transdermal nicotine replacement therapy and practical counseling for 34 adolescents seeking smoking cessation in Los Angeles. Dependent outcomes were study retention, use of the patch, and 7-day quit status at the end-of-study and at follow-up visits. Predictors of outcomes included cigarette dependence, withdrawal symptoms, demographic and psychiatric measures, and other substance use. Variables significant in bivariate analysis (p < .10) were retained in a multivariate model. Subjects had significant pre-to-post reductions in quit rates, dependence, and withdrawal symptoms. Subjects also reported a high number of comorbidities. Implications for clinicians are discussed.
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Affiliation(s)
- Aimee-Noelle Swanson
- 1Department of Family Medicine, UCLA David Geffen School of Medicine , Los Angeles, California , USA
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Sobkowiak R, Musidlak J, Lesicki A. In vitrogenoprotective and genotoxic effect of nicotine on human leukocytes evaluated by the comet assay. Drug Chem Toxicol 2013; 37:322-8. [DOI: 10.3109/01480545.2013.851693] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Hill KP, Toto LH, Lukas SE, Weiss RD, Trksak GH, Rodolico JM, Greenfield SF. Cognitive behavioral therapy and the nicotine transdermal patch for dual nicotine and cannabis dependence: a pilot study. Am J Addict 2013; 22:233-8. [PMID: 23617864 DOI: 10.1111/j.1521-0391.2012.12007.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 01/04/2012] [Accepted: 02/21/2012] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES We assessed the feasibility of a new cognitive behavioral therapy (CBT) manual, plus transdermal patch nicotine replacement therapy (NRT), to treat co-occurring nicotine and cannabis dependence. METHOD Seven of 12 (58.3%) adults with DSM-IV diagnoses of both nicotine and cannabis dependence completed 10 weeks of individual CBT and NRT. RESULTS Participants smoked 12.6 ± 4.9 tobacco cigarettes per day at baseline, which was reduced to 2.1 ± 4.2 at the end of treatment (F[5] = 23.5, p < .0001). The reduction in cannabis use from 10.0 ± 5.3 inhalations per day at baseline to 8.0 ± 5.3 inhalations per day at 10 weeks was not significant (F[5] = 1.12, p = .37). There was a significant decrease from the mean baseline Fagerstrom Test for Nicotine Dependence scores at weeks 4, 6, 8, and 10 of treatment (F[4] = 19.8, p < .001) and mean Client Satisfaction Questionnaire scores were uniformly high (30.6 ± 1.9). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE A CBT plus NRT treatment program significantly reduced tobacco smoking but did not significantly reduce cannabis use in individuals with co-occurring nicotine and cannabis dependence. There was no compensatory increase in cannabis use following the reduction in tobacco smoking, suggesting that clinicians can safely pursue simultaneous treatment of co-occurring nicotine and cannabis dependence. The intervention was well-liked by the 7 of the 12 enrollees who completed the study.
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Affiliation(s)
- Kevin P Hill
- Division of Alcohol and Drug Abuse, McLean Hospital, Belmont, Massachusetts, USA.
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Budzynska B, Boguszewska-Czubara A, Kruk-Slomka M, Skalicka-Wozniak K, Michalak A, Musik I, Biala G, Glowniak K. Effects of imperatorin on nicotine-induced anxiety- and memory-related responses and oxidative stress in mice. Physiol Behav 2013; 122:46-55. [PMID: 23999469 DOI: 10.1016/j.physbeh.2013.08.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 08/25/2013] [Indexed: 01/02/2023]
Abstract
The purpose of the reported experiments was to examine the effects of imperatorin [9-[(3-methylbut-2-en-1-yl)oxy]-7H-furo[3,2-g]chromen-7-one] on anxiety and memory-related responses induced by nicotine in mice and their relation to the level of nicotine-induced oxidative stress in brain as well as in the hippocampus and the prefrontal cortex. Male Swiss mice were tested for anxiety in the elevated plus maze test (EPM), and for cognition using passive avoidance (PA) procedures. Imperatorin, purified by high-speed counter-current chromatography from methanol extract of fruits of Angelica officinalis, acutely administered at the doses of 10 and 20mg/kg impaired the anxiogenic effect of nicotine (0.1mg/kg, s.c.). Furthermore, acute injections of subthreshold dose of imperatorin (1mg/kg, i.p.) improved processes of memory acquisition when co-administered with nicotine used at non-active dose of 0.05 mg/kg, s.c. Additionally, repeated administration of imperatorin (1mg/kg, i.p., twice daily, for 6 days) improved different stages of memory processes (both acquisition and consolidation) when injected in combination with non-active dose of nicotine (0.05 mg/kg, s.c.) in the PA task. Oxidative stress was assessed by determination of antioxidant enzymes (glutathione peroxidases (GPx), superoxide dismutase (SOD), glutathione reductase (GR)) activities as well as of malondialdehyde (MDA) concentration in the whole brain, the hippocampus and the prefrontal cortex after repeated administration of imperatorin (1mg/kg, 6 days) and single nicotine injection (0.05 mg/kgs.c.) on the seventh day. The results of our research suggest strong behavioural interaction between imperatorin and nicotine at the level of anxiety- and cognitive-like processes. Furthermore, imperatorin inhibited nicotine-induced changes in examined indicators of oxidative stress, especially in the hippocampus and the cortex.
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Affiliation(s)
- Barbara Budzynska
- Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, Poland.
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Carson KV, Brinn MP, Robertson TA, To-A-Nan R, Esterman AJ, Peters M, Smith BJ. Current and emerging pharmacotherapeutic options for smoking cessation. Subst Abuse 2013; 7:85-105. [PMID: 23772176 PMCID: PMC3668891 DOI: 10.4137/sart.s8108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tobacco smoking remains the single most preventable cause of morbidity and mortality in developed countries and poses a significant threat across developing countries where tobacco use prevalence is increasing. Nicotine dependence is a chronic disease often requiring multiple attempts to quit; repeated interventions with pharmacotherapeutic aids have become more popular as part of cessation therapies. First-line medications of known efficacy in the general population include varenicline tartrate, bupropion hydrochloride, nicotine replacement therapy products, or a combination thereof. However, less is known about the use of these products in marginalized groups such as the indigenous, those with mental illnesses, youth, and pregnant or breastfeeding women. Despite the efficacy and safety of these first line pharmacotherapies, many smokers continue to relapse and alternative pharmacotherapies and cessation options are required. Thus, the aim of this review is to summarize the existing and developing pharmacotherapeutic and other options for smoking cessation, to identify gaps in current clinical practice, and to provide recommendations for future evaluations and research.
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Affiliation(s)
- Kristin V. Carson
- The Clinical Practice Unit, The Basil Hetzel Institute for Translational Health Research, Adelaide, Australia
| | - Malcolm P. Brinn
- The Clinical Practice Unit, The Basil Hetzel Institute for Translational Health Research, Adelaide, Australia
- Respiratory Medicine, The Queen Elizabeth Hospital, Adelaide, Australia
| | - Thomas A. Robertson
- Therapeutics Research Centre, School of Pharmacy and Medical Sciences, University of South Australia and The Basil Hetzel Institute for Translational Health Research, Adelaide, Australia
| | - Rachada To-A-Nan
- Therapeutics Research Centre, School of Pharmacy and Medical Sciences, University of South Australia and The Basil Hetzel Institute for Translational Health Research, Adelaide, Australia
| | - Adrian J. Esterman
- School of Nursing and Midwifery, The University of South Australia, Adelaide, Australia
| | - Matthew Peters
- Thoracic Medicine, The Concord Hospital, Sydney, Australia
| | - Brian J. Smith
- The Clinical Practice Unit, The Basil Hetzel Institute for Translational Health Research, Adelaide, Australia
- Respiratory Medicine, The Queen Elizabeth Hospital, Adelaide, Australia
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Mannelli P, Wu LT, Peindl KS, Gorelick DA. Smoking and opioid detoxification: behavioral changes and response to treatment. Nicotine Tob Res 2013; 15:1705-13. [PMID: 23572466 DOI: 10.1093/ntr/ntt046] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The relevance of tobacco use in opioid addiction (OA) has generated a demand for available and more effective interventions. Thus, further analysis of less explored nicotine-opioid clinical interactions is warranted. METHODS A post-hoc analysis of OA participants in a double-blind, randomized very low dose naltrexone (VLNTX) inpatient detoxification trial evaluated measures of opioid withdrawal and tobacco use. Intreatment smokers were compared with nonsmokers, or smokers who were not allowed to smoke. RESULTS A total of 141 (81%) of 174 OA participants were smokers, all nicotine-dependent. Inpatient smoking was a predictor of opioid withdrawal discomfort. Intreatment smokers (n = 96) showed significantly higher opioid craving (F = 3.7, p < .001) and lower detoxification completion rate (χ(2) = 7.9, p < .02) compared with smokers who were not allowed to smoke (n = 45) or nonsmokers (n = 33). Smoking during treatment was associated with more elevated cigarette craving during detoxification (F = 4.1, p < .001) and a higher number of cigarettes smoked at follow-up (F = 3.6, p < .02). Among intreatment smokers, VLNTX addition to methadone taper was effective in easing opioid withdrawal and craving more than other treatments, whereas the combination VLNTX-clonidine was associated with significantly reduced cigarette craving and smoking during detoxification. CONCLUSIONS Failure to address tobacco use may negatively affect pharmacologically managed opioid discontinuation. Opioid detoxification may offer a window of opportunity to expand smoking cessation treatment, hence improving OA outcomes. The observed effects support testing of VLNTX-clonidine in smoking cessation trials among individuals with or without substance abuse.
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Affiliation(s)
- Paolo Mannelli
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
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Abstract
Many pharmacological approaches have been used in managing substance use disorders. Conventional pharmacological agents have relatively short durations of action which make them vulnerable to non-adherence and relapse to substance use disorder. To overcome this problem, long-acting preparations have been developed with the aim of reducing the frequency of use and hence improving adherence. This review takes a broad overview of the long-acting preparations available for the management of substance use disorders. The pharmacology, advantages and disadvantages of these preparations are discussed. Many of these preparations hold promise for improving patient outcomes.
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Affiliation(s)
- Aditya Hegde
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Sofuoglu M, Herman AI, Li Y, Waters AJ. Galantamine attenuates some of the subjective effects of intravenous nicotine and improves performance on a Go No-Go task in abstinent cigarette smokers: a preliminary report. Psychopharmacology (Berl) 2012; 224:413-20. [PMID: 22700039 PMCID: PMC3636552 DOI: 10.1007/s00213-012-2763-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 05/31/2012] [Indexed: 02/08/2023]
Abstract
RATIONALE Galantamine (GAL), a reversible and competitive inhibitor of acetylcholinesterase, is used clinically in the treatment of Alzheimer's dementia. Some preclinical and clinical studies support the potential efficacy of cholinesterase inhibitors for smoking cessation, although their effects on the behavioral and physiological responses to nicotine have not been examined. The goal of this study was to characterize GAL's actions on multiple outcomes, including withdrawal severity and cognitive performance, as well as subjective and physiological responses to nicotine administered intravenously. METHODS A total of 12 smokers participated in a double-blind, placebo-controlled, crossover study. Smokers had two 4-day treatment periods, assigned in random sequence, to GAL (8 mg/day) or placebo treatment. On day 4 of each treatment phase, smokers had an experimental session in which they received an intravenous (IV) dose of saline or 1 mg/70 kg nicotine, 1 h apart, in a random order. RESULTS GAL attenuated the self-reported rating of "craving for cigarettes" and prevented decrements in performance in a Go/No-Go task. In response to IV nicotine, GAL treatment attenuated the self-report ratings of "like the drug effects," "good drug effects," "bad drug effects," and "stimulated." CONCLUSIONS These findings support the potential utility of GAL as a treatment for smoking cessation.
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Affiliation(s)
- Mehmet Sofuoglu
- School of Medicine, Department of Psychiatry, VA Connecticut Healthcare System, Yale University, 950 Campbell Ave, Bldg 36/116A4, West Haven, CT, USA.
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Sofuoglu M, LeSage MG. The reinforcement threshold for nicotine as a target for tobacco control. Drug Alcohol Depend 2012; 125:1-7. [PMID: 22622242 PMCID: PMC3419325 DOI: 10.1016/j.drugalcdep.2012.04.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 04/17/2012] [Accepted: 04/24/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cigarette smoking represents an enormous public health problem worldwide that leads to over 5 million deaths per year. The gradual reduction of the nicotine content of cigarettes below the threshold that is required to develop addiction is one strategy that might substantially reduce the number of addicted smokers and prevent adolescents from becoming addicted to nicotine (Benowitz and Henningfield, 1994). While the potential public health benefits of this approach are enormous, the guiding concepts and relevant empirical evidence needed to support the implementation of a nicotine reduction policy require a critical examination. METHODS The purpose of this paper is to briefly review the current concepts and research regarding nicotine reduction while also discussing the utility of the addictive threshold for nicotine in this approach. The accurate determination of the nicotine addiction threshold presents some conceptual challenges as there is a lack of consensus on how to best measure nicotine addiction. This difficulty can impede the progress for developing a science-based tobacco control policy. As an alternative, the nicotine reinforcement threshold is a relatively clear concept, and well-accepted methods and criteria are available to measure nicotine reinforcement. RESULTS However, there are many gaps in our current knowledge concerning the nicotine reinforcement threshold in humans. The threshold for nicotine reinforcement remains to be determined in controlled settings using different populations of current or potential tobacco users. In addition, the value of the nicotine reinforcement threshold in predicting tobacco use in real-world settings needs to be examined. The results of such studies will determine the potential utility of the estimated threshold for nicotine reinforcement in developing science-based tobacco control policies.
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Affiliation(s)
- Mehmet Sofuoglu
- Yale University, School of Medicine, Department of Psychiatry and VA Connecticut Healthcare System, West Haven, CT 06516, United States.
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31
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Abstract
Cigarette smokers experience greater rates of morbidity and mortality. Despite the known health risks, use of tobacco products remains high throughout the United States (approximately 19.3% of adults). Tobacco use is associated with higher rates of cardiovascular illness, cardiovascular risk factors (ie, hypertension and atherosclerosis), chronic obstructive pulmonary disease, emphysema, and various types of cancer. Pharmacologic smoking cessation therapies have been used to facilitate abstinence from smoking. This article provides clinicians with instructions for the use of pharmacologic agents for smoking cessation, including considerations for special populations.
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Affiliation(s)
- Abby M Bailey
- UK HealthCare, Department of Pharmacy Services, University of Kentucky, Lexington, Kentucky 40536-0293, USA
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Semenova S, Contet C, Roberts AJ, Markou A. Mice lacking the β4 subunit of the nicotinic acetylcholine receptor show memory deficits, altered anxiety- and depression-like behavior, and diminished nicotine-induced analgesia. Nicotine Tob Res 2012; 14:1346-55. [PMID: 22573727 DOI: 10.1093/ntr/nts107] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
RATIONALE The role of β4-containing nicotinic acetylcholine receptors (nAChRs) in cognition, anxiety, depression, and analgesia in the absence of nicotine is unclear. METHODS Wild-type (β4(+/+)) and knockout (β4(-/-)) mice for the nAChR β4 subunit were tested in behavioral tests assessing cognitive function, affective behaviors, and nociception. RESULTS There were no learning and memory deficits in β4(-/-) mice compared with β4(+/+) mice during the acquisition of the Barnes maze, contextual fear conditioning, and Y maze tasks. In the Barnes maze memory retention test, male β4(-/-) mice showed reduced use of the spatial search strategy, indicating small spatial memory deficits compared with β4(+/+) mice. In the cue-induced fear conditioning memory retention test, β4(-/-) mice exhibited reduced freezing time compared with β4(+/+) mice. Compared with β4(+/+) mice, β4(-/-) mice exhibited decreased anxiety-like behavior in the light-dark box. Depression-like behavior in β4(-/-) mice was decreased in the tail suspension test and increased in the forced swim test compared with β4(+/+) mice. β4(-/-) mice did not differ from β4(+/+) mice in basal nociception but were less sensitive to the antinociceptive effect of nicotine in 2 tests of acute thermal pain. CONCLUSIONS Lack of β4-containing nAChRs resulted in small deficits in hippocampus- and amygdala-dependent memory retention functions. β4-containing nAChRs are involved in anxiety- and depression-like behaviors and contribute to the analgesic effects of nicotine.
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Affiliation(s)
- Svetlana Semenova
- Department of Psychiatry, School of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0603, USA
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Herman AI, Waters AJ, McKee SA, Sofuoglu M. Effects of pregabalin on smoking behavior, withdrawal symptoms, and cognitive performance in smokers. Psychopharmacology (Berl) 2012; 220:611-7. [PMID: 21947318 PMCID: PMC3654651 DOI: 10.1007/s00213-011-2507-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Accepted: 09/14/2011] [Indexed: 12/16/2022]
Abstract
RATIONALE In preclinical and clinical studies, medications enhancing the GABA neurotransmission attenuate nicotine reward. Pregabalin, a GABA analogue, presumably interacts with brain glutamate and GABA neurotransmission. The goal of this study was to determine pregabalin's effects on smoking behavior, nicotine withdrawal, craving for cigarettes, and cognitive performance. METHODS Twenty-four smokers participated in an outpatient double-blind, placebo-controlled, crossover study. Subjects had a 4-day treatment period with either pregabalin (300 mg/day) or placebo and following a washout period were then crossed over for 4 days to the other treatment. In each treatment period, starting at midnight of day 1, participants were asked to stop smoking until the experimental session on day 4. During the experimental session measures of ad lib smoking behavior, tobacco withdrawal, craving for cigarettes, and cognitive performance were obtained. RESULTS Pregabalin treatment, compared to placebo, did not reduce the smoking behavior during the first 3 days of treatment or during ad lib smoking period. Pregabalin treatment attenuated some tobacco withdrawal symptoms including ratings of anxious, irritable, and frustrated in abstinent smokers. Pregabalin treatment also attenuated the subjective ratings of "liking" in response to smoking. Under pregabalin treatment, smokers made more errors in a sustained attention task. CONCLUSIONS These findings provide limited support for pregabalin as a treatment for nicotine addiction.
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Affiliation(s)
- Aryeh I Herman
- School of Medicine, Department of Psychiatry and VA Connecticut Healthcare System, Yale University, 950 Campbell Ave., Bldg. 36/116A4, West Haven, CT 06516, USA
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Abstract
In this article the epidemiology of substance use and substance disorders in the United States and their association with liver disease are reviewed. The relevance of tobacco use and issues of candidacy as it pertains to substance use are discussed. The use of alcohol while on the waitlist and short sobriety are also addressed. The merits of monitoring of patients are discussed, and the outcomes of these patients after liver transplantation are examined. The article concludes with a summary of recommendations for clinicians working with these patients and possible future directions for both clinical care and research.
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Affiliation(s)
- Andrea DiMartini
- Consultation Liaison to the Liver Transplant Program, Starzl Transplant Institute, University of Pittsburgh Medical Center, PA 15213, USA.
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Gerretsen P, Pollock BG. Drugs with anticholinergic properties: a current perspective on use and safety. Expert Opin Drug Saf 2011; 10:751-65. [DOI: 10.1517/14740338.2011.579899] [Citation(s) in RCA: 110] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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37
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Abstract
The public health effects of adolescent substance abuse disorders (SUD) reaches further than the immediate intoxicating effects. Medications play a limited role in the treatment of youth beyond addressing short-term symptoms but may improve longer-term outcomes for some patients. Given the potential devastating consequences of SUD, clinicians should become familiar with all available treatment options. This article reviews the pharmacotherapy for adolescent SUD to inform clinicians considering the use of this modality for selected groups of patients.
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Affiliation(s)
- Gabriel Kaplan
- Department of Psychiatry, Hoboken University Medical Center, Hoboken, NJ 07030, USA.
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Paterson NE. Translational research in addiction: toward a framework for the development of novel therapeutics. Biochem Pharmacol 2011; 81:1388-407. [PMID: 21216239 DOI: 10.1016/j.bcp.2010.12.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 12/13/2010] [Accepted: 12/15/2010] [Indexed: 12/16/2022]
Abstract
The development of novel substance use disorder (SUD) therapeutics is insufficient to meet the medical needs of a growing SUD patient population. The identification of translatable SUD models and tests is a crucial step in establishing a framework for SUD therapeutic development programs. The present review begins by identifying the clinical features of SUDs and highlights the narrow regulatory end-point required for approval of a novel SUD therapeutic. A conceptual overview of dependence is provided, followed by identification of potential intervention targets in the addiction cycle. The main components of the addiction cycle provide the framework for a discussion of preclinical models and their clinical analogs, all of which are focused on isolated behavioral end-points thought to be relevant to the persistence of compulsive drug use. Thus, the greatest obstacle to successful development is the gap between the multiplicity of preclinical and early clinical end-points and the regulatory end-point of sustained abstinence. This review proposes two pathways to bridging this gap: further development and validation of the preclinical extended access self-administration model; inclusion of secondary end-points comprising all of the measures highlighted in the present discussion in Phase 3 trials. Further, completion of the postdictive validation of analogous preclinical and clinical assays is of high priority. Ultimately, demonstration of the relevance and validity of a variety of end-points to the ultimate goal of abstinence will allow researchers to identify truly relevant therapeutic mechanisms and intervention targets, and establish a framework for SUD therapeutic development that allows optimal decision-making and resource allocation.
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Affiliation(s)
- Neil E Paterson
- Behavioral Pharmacology, PsychoGenics, Inc., 765 Old Saw Mill River Rd., Tarrytown, NY 10591, USA.
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