1
|
Saygin D, Alexanderson H, DiRenzo D, Raaphorst J, de Visser M, Ren D, Regardt M, de Groot I, Sarver C, Kim JY, Lodin K, Beer K, Needham M, Park JK, Christopher-Stine L, Mecoli CA. The impact of pain on daily activities in patients with idiopathic inflammatory myopathies: Report from the OMERACT myositis working group. Semin Arthritis Rheum 2024; 67:152476. [PMID: 38851171 DOI: 10.1016/j.semarthrit.2024.152476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/20/2024] [Accepted: 04/05/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND International focus groups with patients with idiopathic inflammatory myopathies (IIM) conducted by the OMERACT Myositis Working Group over the years demonstrated the pain as an important symptom experienced by these patients. In this study, we aimed to examine the frequency and degree of pain interference, the aspects of daily life impacted by pain, and the factors associated with pain interference in adults with IIM. METHODS This was a prospective observational study with two visits. The patients who fulfilled the probable/definite IIM (ACR/EULAR Myositis Classification Criteria) were enrolled. Pain interference was assessed with PROMIS pain interference form (6a). Myositis core set measures and PROMIS fatigue (7a) and physical function (8b) were obtained at both visits. Logistic regression and linear mixed models were performed to assess the association between pain interference and other parameters. RESULTS A total of 129 patients with IIM (60 % females) were recruited from U.S., South Korea, Netherlands, Sweden, and Australia. Approximately 71 % reported pain interference. The patients in the greater pain interference group were more likely to be female, had significantly worse patient/physician global disease activity, fatigue, and physical function than those in the lower pain interference group. The most commonly impacted life aspect was household chores. Manual muscle testing, patient/physician global disease activity, fatigue, and physical function were all significantly associated with pain interference score >60. CONCLUSION The majority of the patients with IIM experience the impact of pain on their daily activities, particularly household chores. Myositis disease activity, duration, and subtype could be associated with greater pain interference.
Collapse
Affiliation(s)
- Didem Saygin
- Division of Rheumatology, Department of Medicine, University of Pittsburgh, USA.
| | - Helene Alexanderson
- Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital and Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Dana DiRenzo
- Division of Rheumatology, Department of Medicine, University of Pennsylvania
| | - Joost Raaphorst
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Marianne de Visser
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Dianxu Ren
- Health and Community Systems, University of Pittsburgh, Pittsburgh, PA, USA
| | - Malin Regardt
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet and Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | | | | | - Ju Yeon Kim
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Karin Lodin
- Department of Medicine, Division of Rheumatology, Karolinska Institutet, Solna, Stockholm, Sweden; Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Kelly Beer
- Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and University of Notre Dame, Perth, Australia
| | - Merrilee Needham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, USA
| | - Jin Kyun Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | | | | |
Collapse
|
2
|
Farris SG, Smith JE, Steinberg DR, Altman BR, Lambert-Messerlian GM, Dunsiger SI, Williams DM, Saladin ME, Abrantes AM. Methodological approach for an integrated female-specific study of anxiety and smoking comorbidity. Front Psychiatry 2023; 14:1267753. [PMID: 38076702 PMCID: PMC10704195 DOI: 10.3389/fpsyt.2023.1267753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 11/08/2023] [Indexed: 02/12/2024] Open
Abstract
Two primary ovarian hormones that fluctuate across the female menstrual cycle-estradiol and progesterone-have been independently linked in separate literatures to nicotine reinforcement and anxiety psychopathology. We identify existing methodological limitations in these literatures, describe an example protocol that was developed to address such limitations, highlight case examples, and offer insights on the resulting advantages and challenges. This protocol was an observational, prospective, within-subjects study of female cigarette smokers who were followed over the course of a complete menstrual cycle. Non-treatment seeking, female cigarette smokers (N = 50), between the ages of 18-40 who have a normal menstrual cycle (25-35 days in length) were recruited from the community. Females with anxiety or mood psychopathology represented 38.0% of the sample. Salivary progesterone and estradiol were assessed each morning via at-home saliva collection methods. Self-reported within-day momentary ratings of anxiety and nicotine reinforcement were collected using ecological momentary assessment (EMA) via a mobile app. Protocol compliance was >85%. Within- and between-subjects heterogeneity was observed in the progesterone and estradiol, anxiety, and nicotine craving measures, especially in the context of anxiety psychopathology. We aimed to integrate the anxiety and nicotine dependence literatures and advance the empirical study of the role of ovarian hormones. This protocol reflects an intensive, yet feasible approach to collecting daily-level naturalistic data related to estradiol, progesterone, anxiety, and nicotine reinforcement.
Collapse
Affiliation(s)
- Samantha G. Farris
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Jacqueline E. Smith
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Dana R. Steinberg
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Brianna R. Altman
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| | - Geralyn M. Lambert-Messerlian
- Pathology and Laboratory Medicine and Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI, United States
| | - Shira I. Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - David M. Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States
| | - Michael E. Saladin
- Department of Health Science and Research, Medical University of South Carolina, Charleston, SC, United States
| | - Ana M. Abrantes
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, United States
- Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence, RI, United States
| |
Collapse
|
3
|
Oncken C, Litt MD, Thurlow S, Mead-Morse EL, Wang L, Hatsukami DK. Manipulation of Menthol and Nicotine Content in Cigarettes: Effects on Smoking Behavior and Toxicant Exposure in Women Menthol Smokers. Nicotine Tob Res 2023; 25:665-673. [PMID: 36156108 PMCID: PMC10032200 DOI: 10.1093/ntr/ntac225] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/26/2022] [Accepted: 09/23/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND The purpose of this study was to determine the effects of smoking and other outcomes of assigning cigarettes with reduced nicotine and/or no menthol to female menthol smokers. AIMS AND METHODS Nontreatment-seeking female menthol smokers (N = 263) participated in a randomized controlled trial in which levels of menthol and nicotine in cigarettes were manipulated using experimental cigarettes. After a baseline period, participants were assigned to the following conditions for 6 weeks: (1) their own brand of cigarette (conventional nicotine with menthol), (2) a conventional nicotine cigarette with no menthol, (3) a cigarette with reduced nicotine (RNC) with menthol, or (4) a RNC cigarette and no menthol. Participants then returned to using their own brand and were followed for another 6 weeks. Outcomes included cigarettes smoked, biomarkers of exposure, and dependence measures. RESULTS Results indicated that, after an initial increase, rates of smoking of all three experimental cigarettes were at or below baseline rates of smoking of one's own brand. Levels of biomarkers also decreased during the experimental phase but rebounded somewhat after participants resumed smoking their own brand. There was evidence that the overall amount of smoking decreased similarly among women who switched to non-menthol and/or RNC cigarettes. CONCLUSIONS These results suggest that no detrimental effect will occur in nicotine or toxicant exposure levels with a ban on characterizing menthol and/or a product standard on nicotine content in cigarettes. IMPLICATIONS The implication of this work is that there would be no risk to women menthol smokers associated with regulations restricting nicotine and eliminating menthol in cigarettes.
Collapse
Affiliation(s)
- Cheryl Oncken
- University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Mark D Litt
- University of Connecticut School of Medicine, Farmington, CT 06030, USA
- University of Connecticut School of Dental Medicine, Farmington, CT 06030, USA
| | - Sheila Thurlow
- University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Erin L Mead-Morse
- University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | - Lanqing Wang
- Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | | |
Collapse
|
4
|
Lee HS, Su SJ, Yen ST, Tan AK. Cigarette smoking and quitting by individuals in Malaysia. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2091490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Helen S.H. Lee
- School of Social Sciences, Universiti Sains Malaysia, Minden, Malaysia
| | - Shew-Jiuan Su
- Department of Geography, National Taiwan Normal University, Taipei, Taiwan
| | - Steven T. Yen
- Department of Agricultural Economics, National Taiwan University, Taipei, Taiwan
| | - Andrew K.G. Tan
- School of Social Sciences, Universiti Sains Malaysia, Minden, Malaysia
| |
Collapse
|
5
|
Perez Diaz M, Pochon JB, Ghahremani DG, Dean AC, Faulkner P, Petersen N, Tyndale RF, Donis A, Paez D, Cahuantzi C, Hellemann GS, London ED. Sex Differences in the Association of Cigarette Craving With Insula Structure. Int J Neuropsychopharmacol 2021; 24:624-633. [PMID: 33830218 PMCID: PMC8378076 DOI: 10.1093/ijnp/pyab015] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 03/01/2021] [Accepted: 04/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cigarette craving, which can negatively impact smoking cessation, is reportedly stronger in women than in men when they initiate abstinence from smoking. Identifying approaches to counteract craving in people of different sexes may facilitate the development of personalized treatments for Tobacco Use Disorder, which disproportionately affects women. Because cigarette craving is associated with nicotine dependence and structure of the insula, this study addressed whether a person's sex influences these associations. METHODS The research participants (n = 99, 48 women) reported daily cigarette smoking and provided self-reports of nicotine dependence. After overnight abstinence from smoking, they underwent structural magnetic resonance imaging scanning to determine cortical thickness of the left and right anterior circular insular sulcus, and self-rated their cigarette craving before and after their first cigarette of the day. RESULTS Women reported stronger craving than men irrespective of smoking condition (i.e., pre- and post-smoking) (P = .048), and smoking reduced craving irrespective of sex (P < .001). A 3-way interaction of sex, smoking condition, and right anterior circular insular sulcus thickness on craving (P = .033) reflected a negative association of cortical thickness with pre-smoking craving in women only (P = .012). No effects of cortical thickness in the left anterior circular insular sulcus were detected. Nicotine dependence was positively associated with craving (P < .001) across groups and sessions, with no sex differences in this association. CONCLUSIONS A negative association of right anterior insula thickness with craving in women only suggests that this region may be a relevant therapeutic target for brain-based smoking cessation interventions in women.
Collapse
Affiliation(s)
- Maylen Perez Diaz
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Jean-Baptiste Pochon
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Andy C Dean
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Paul Faulkner
- Department of Psychology, University of Roehampton, London, UK
| | - Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Rachel F Tyndale
- Department of Pharmacology and Toxicology and Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction & Mental Health, Toronto, ON, Canada
| | - Andrea Donis
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Diana Paez
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Citlaly Cahuantzi
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Gerhard S Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California, USA
- Department of Molecular and Medical Pharmacology
- Brain Research Institute, University of California, Los Angeles, California, USA
| |
Collapse
|
6
|
Koul S, Schaal VL, Chand S, Pittenger ST, Nanoth Vellichirammal N, Kumar V, Guda C, Bevins RA, Yelamanchili SV, Pendyala G. Role of Brain Derived Extracellular Vesicles in Decoding Sex Differences Associated with Nicotine Self-Administration. Cells 2020; 9:cells9081883. [PMID: 32796722 PMCID: PMC7464419 DOI: 10.3390/cells9081883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 02/06/2023] Open
Abstract
Smoking remains a significant health and economic concern in the United States. Furthermore, the emerging pattern of nicotine intake between sexes further adds a layer of complexity. Nicotine is a potent psychostimulant with a high addiction liability that can significantly alter brain function. However, the neurobiological mechanisms underlying nicotine’s impact on brain function and behavior remain unclear. Elucidation of these mechanisms is of high clinical importance and may lead to improved therapeutics for smoking cessation. To fill in this critical knowledge gap, our current study focused on identifying sex-specific brain-derived extracellular vesicles (BDEV) signatures in male and female rats post nicotine self-administration. Extracellular vesicles (EVs) are comprised of phospholipid nanovesicles such as apoptotic bodies, microvesicles (MVs), and exosomes based on their origin or size. EVs are garnering significant attention as molecules involved in cell–cell communication and thus regulating the pathophysiology of several diseases. Interestingly, females post nicotine self-administration, showed larger BDEV sizes, along with impaired EV biogenesis compared to males. Next, using quantitative mass spectrometry-based proteomics, we identified BDEV signatures, including distinct molecular pathways, impacted between males and females. In summary, this study has identified sex-specific changes in BDEV biogenesis, protein cargo signatures, and molecular pathways associated with long-term nicotine self-administration.
Collapse
Affiliation(s)
- Sneh Koul
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (S.K.); (V.L.S.); (S.C.); (S.V.Y.)
| | - Victoria L. Schaal
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (S.K.); (V.L.S.); (S.C.); (S.V.Y.)
| | - Subhash Chand
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (S.K.); (V.L.S.); (S.C.); (S.V.Y.)
| | - Steven T. Pittenger
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE 68588, USA; (S.T.P.); (R.A.B.)
| | - Neetha Nanoth Vellichirammal
- Department of Genetics Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE 68198, USA; (N.N.V.); (C.G.)
| | - Vikas Kumar
- Mass Spectrometry and Proteomics Core Facility, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - Chittibabu Guda
- Department of Genetics Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, NE 68198, USA; (N.N.V.); (C.G.)
| | - Rick A. Bevins
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE 68588, USA; (S.T.P.); (R.A.B.)
| | - Sowmya V. Yelamanchili
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (S.K.); (V.L.S.); (S.C.); (S.V.Y.)
| | - Gurudutt Pendyala
- Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE 68198, USA; (S.K.); (V.L.S.); (S.C.); (S.V.Y.)
- Correspondence: ; Tel.: +1-402-559-8690
| |
Collapse
|
7
|
Nicotine reduction does not alter essential value of nicotine or reduce cue-induced reinstatement of nicotine seeking. Drug Alcohol Depend 2020; 212:108020. [PMID: 32362438 PMCID: PMC7293915 DOI: 10.1016/j.drugalcdep.2020.108020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 03/09/2020] [Accepted: 04/13/2020] [Indexed: 01/10/2023]
Abstract
Reduction of nicotine content in tobacco products is a regulatory control strategy intended to decrease smoking dependence, and is hypothesized to produce gradual reductions of nicotine intake. Rats were initially trained to self-administer 0.06 mg/kg/infusion nicotine (Phase 1), which was followed by a threshold procedure to determine nicotine demand via a behavioral economics (BE) paradigm (Phase 2). Rats then either self-administered the training dose (high dose group), or were switched to a low dose of nicotine (0.001 mg/kg/infusion; low dose group) in Phase 3. Both groups then underwent a second threshold procedure and demand curves were re-determined (Phase 4). In Phase 5, responding for nicotine was extinguished over the course of 21 sessions. Cue-induced reinstatement was then evaluated (Phase 6). Rats in the low dose group maintained a steady amount of infusions, and thus, did not compensate for nicotine reduction. Rats in the low dose group also showed similar demand elasticity and nicotine seeking (Phase 6) compared to the high dose group, indicating that nicotine reduction did not decrease nicotine demand or seeking. Further, both groups displayed resistance to extinction, indicating that nicotine reduction did not facilitate extinction learning. These results suggest that although compensation of intake does not occur, decreasing the dose of nicotine does not alter nicotine reinforcement value or relapse vulnerability. Further, these results indicate persistence of nicotine-motivated behavior after self-administration of a low nicotine dose. Translationally, these results suggest that alternative strategies may be needed to achieve positive smoking cessation outcomes.
Collapse
|
8
|
Streck JM, Davis DR, Pang RD, Sigmon SC, Bunn JY, Bergeria CL, Tidey JW, Heil SH, Gaalema DE, Hughes JR, Stitzer ML, Reed E, Higgins ST. Potential Moderating Effects of Sex/Gender on the Acute Relative Reinforcing and Subjective Effects of Reduced Nicotine Content Cigarettes in Vulnerable Populations. Nicotine Tob Res 2020; 22:878-884. [PMID: 31225625 PMCID: PMC7395666 DOI: 10.1093/ntr/ntz098] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 06/18/2019] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Reports in relatively healthy smokers suggest men are more sensitive than women to the subjective effects of reduced nicotine content cigarettes (RNCCs). We know of no reports examining sex differences in the relative reinforcing effects of RNCCs, an important outcome in assessing smoking's addiction potential. The aim of the present study is to address this gap by examining sex/gender differences on reinforcing effects while examining whether sex differences in subjective effects are discernible in vulnerable populations. METHODS Secondary analysis of a within-subject, double-blinded experiment examining acute effects of cigarettes varying in nicotine content (0.4, 2.4, 5.2, 15.8 mg/g) among 169 adult smokers with psychiatric conditions or socioeconomic disadvantage. Effects of dose, sex, and their interaction were examined on reinforcing (concurrent-choice and Cigarette Purchase Task [CPT] testing), and subjective effects (Cigarette Evaluation Questionnaire [CEQ] and craving/withdrawal ratings). RESULTS Reducing nicotine content decreased the relative reinforcing effects of smoking in concurrent-choice and CPT testing (p's < .05) with no significant effects of sex nor dose × sex/gender interactions. Reducing nicotine content decreased CEQ ratings with only a single significant effect of sex (higher Psychological Reward scores among women than men, p = .02) and no significant dose × sex/gender interactions. Results on craving/withdrawal paralleled those on the CEQ. CONCLUSIONS Reducing nicotine content decreases the addiction potential of smoking independent of sex in populations highly vulnerable to smoking and addiction, with no indication that women are less sensitive to subjective effects of RNCCs or would benefit less from a policy reducing the nicotine content of cigarettes. IMPLICATIONS A policy reducing the nicotine content of cigarettes has the potential to reduce the addiction potential of smoking across men and women who are especially vulnerable to smoking, addiction, and tobacco-related adverse health impacts.
Collapse
Affiliation(s)
- Joanna M Streck
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| | - Danielle R Davis
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Stacey C Sigmon
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| | - Janice Y Bunn
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| | - Cecilia L Bergeria
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jennifer W Tidey
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI
| | - Sarah H Heil
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| | - Diann E Gaalema
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| | - John R Hughes
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| | - Maxine L Stitzer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ellaina Reed
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| | - Stephen T Higgins
- Vermont Center on Tobacco Regulatory Science, Departments of Psychiatry and Psychological Science, University of Vermont,Burlington, VT
| |
Collapse
|
9
|
Berman ML, Glasser AM. Nicotine Reduction in Cigarettes: Literature Review and Gap Analysis. Nicotine Tob Res 2020; 21:S133-S144. [PMID: 31867659 PMCID: PMC6939782 DOI: 10.1093/ntr/ntz162] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 08/28/2019] [Indexed: 11/13/2022]
Abstract
BACKGROUND The US Food and Drug Administration (FDA) is considering reducing nicotine levels in cigarettes to "minimally or non-addictive levels." However, important research gaps remain, and the FDA must determine when the available research is sufficient to support moving forward. METHODS The authors conducted a systematic review of research articles in PubMed relating to nicotine reduction. Building on a review of risk assessment best practices, the authors also developed a risk assessment framework for tobacco regulation and used it to guide a gap analysis of nicotine reduction research. RESULTS The final sample consisted of 78 articles. The majority examined either nicotine dependence on very low nicotine cigarettes (VLNCs) or markers of potential health effects of using VLNCs. One-third of the identified articles reported results from four large randomized controlled trials (RCTs). While these studies report promising results and suggest that a nicotine reduction rule would be a powerful tool to reduce cigarette smoking, our gap analysis suggests that there is a need for studies that better reflect the use and availability of a wide range of tobacco/nicotine products and the potential for dual- or multi-product use. CONCLUSION The current body of research on nicotine reduction is weighted towards RCTs, which is appropriate for a policy that has not yet been implemented anywhere in the world. The FDA must consider a wide range of factors that may impact a product standard's public health impact, including those difficult to assess in RCTs, such as a nicotine reduction rule's impact on smoking initiation and relapse. IMPLICATIONS This systematic review presents a gap analysis based on a risk assessment framework to help identify remaining research priorities to inform FDA's potential product standard to reduce nicotine levels in cigarettes. Quickly addressing those gaps would support the FDA's effort to develop a nicotine reduction product standard that will be effective and withstand legal challenges.
Collapse
Affiliation(s)
- Micah L Berman
- College of Public Health, Ohio State University, Columbus, OH.,Moritz College of Law, Ohio State University, Columbus, OH
| | | |
Collapse
|
10
|
Kotlyar M, Vogel RI, Dufresne SR, Mills AM, Vuchetich JP. Effect of nicotine lozenge use prior to smoking cue presentation on craving and withdrawal symptom severity. Drug Alcohol Depend 2020; 206:107706. [PMID: 31757519 PMCID: PMC7461336 DOI: 10.1016/j.drugalcdep.2019.107706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/09/2019] [Accepted: 10/23/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Smokers are often advised to use nicotine lozenge after cravings or withdrawal symptoms are present, which may be too late to prevent lapses. This study assesses if lozenge use prior to smoking cue exposure attenuates cue-induced increases in symptom severity. METHODS In this randomized, cross-over study, participants completed three laboratory sessions at which they proceeded through 4 "rooms" in a virtual reality environment. The first and last "rooms" contained neutral cues and the others contained smoking cues. At one session, a 4 mg nicotine lozenge was not given until after cue exposure (to approximate current use: i.e., after craving and withdrawal symptoms occur). At the other two sessions either a nicotine or placebo lozenge was used 15 min before cue exposure procedures. Craving and withdrawal symptoms were measured throughout each laboratory session. RESULTS Of 58 participants randomized; 40 completed all 3 labs. Absolute levels of craving and withdrawal symptom severity during cue exposure were lower when placebo or active lozenge was used prior to cue presentation procedures vs. no treatment until after cue presentation procedures (all p-values <0.05). There were no differences among conditions in the magnitude of symptom severity increase occurring between the first neutral room and the cue rooms. CONCLUSIONS Lozenge use prior to cue exposure may minimize cue induced symptom severity but when taken 15 min prior to cues the decrease is not different than placebo. Research is needed to determine if another time-frame relative to cue exposure would be more effective.
Collapse
Affiliation(s)
- Michael Kotlyar
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, 308 Harvard Street SE, Minneapolis, MN 55455, United States; Department of Psychiatry, University of Minnesota, United States.
| | - Rachel I Vogel
- Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota
| | - Sheena R Dufresne
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota; 308 Harvard Street SE, Minneapolis, MN 55455
| | - Anne M Mills
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota; 308 Harvard Street SE, Minneapolis, MN 55455
| | | |
Collapse
|
11
|
Farris SG, Matsko SV, Uebelacker LA, Brown RA, Price LH, Abrantes AM. Anxiety sensitivity and daily cigarette smoking in relation to sleep disturbances in treatment-seeking smokers. Cogn Behav Ther 2019; 49:137-148. [PMID: 30947621 DOI: 10.1080/16506073.2019.1583277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although the association between anxiety and sleep disturbance is well-documented, the underlying mechanisms are less clear. Anxiety sensitivity (AS), the fear of physiological arousal and bodily sensations, is a risk factor for anxiety and poor sleep. Smoking also contributes to poor sleep and may compound the effects of AS on sleep quality. This study evaluated the main and interactive effects of AS and cigarettes/day on sleep quality among smokers. Participants (n = 190) were adult treatment-seeking daily smokers who completed a baseline assessment as part of a larger smoking cessation trial. Sleep quality was self-reported. Results indicated that AS was significantly correlated with greater disturbance in sleep duration, subjective sleep quality, sleep onset latency, sleep disturbance, daytime dysfunction, and sleep medication use. There was a significant interaction between AS and cigarettes/day in terms of sleep onset latency, but not other sleep quality indices. AS was associated with significantly longer sleep onset latency minutes among heavier smokers, but not lighter smokers. Specifically, the association between AS and sleep onset latency was significant for those who smoked ≥ 33 cigarettes/day. AS is a psychological factor that may contribute to poor sleep quality, especially in heavy smokers, and thus may be a promising intervention target.
Collapse
Affiliation(s)
- Samantha G Farris
- Department of Psychology, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Stephen V Matsko
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Lisa A Uebelacker
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Butler Hospital, Providence, RI, USA
| | - Richard A Brown
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Lawrence H Price
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Butler Hospital, Providence, RI, USA
| | - Ana M Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Butler Hospital, Providence, RI, USA
| |
Collapse
|
12
|
McCarthy JM, Dumais KM, Zegel M, Pizzagalli DA, Olson DP, Moran LV, Janes AC. Sex differences in tobacco smokers: Executive control network and frontostriatal connectivity. Drug Alcohol Depend 2019; 195:59-65. [PMID: 30592997 PMCID: PMC6625360 DOI: 10.1016/j.drugalcdep.2018.11.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 11/19/2018] [Accepted: 11/19/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Women experience greater difficulty quitting smoking than men, which may be explained by sex differences in brain circuitry underlying cognitive control. Prior work has linked reduced interhemispheric executive control network (ECN) coupling with poor executive function, shorter time to relapse, and greater substance use. Lower structural connectivity between a key ECN hub, the dorsolateral prefrontal cortex (DLPFC), and the dorsal striatum (DS) also contributes to less efficient cognitive control recruitment, and reduced intrahemispheric connectivity between these regions has been associated with smoking relapse. Therefore, sex differences were probed by evaluating interhemispheric ECN and intrahemispheric DLPFC-DS connectivity. To assess the potential sex by nicotine interaction, a pilot sample of non-smokers was evaluated following acute nicotine and placebo administration. METHODS Thirty-five smokers (19 women) completed one resting state functional magnetic resonance imaging scan. Seventeen non-smokers (8 women) were scanned twice using a repeated measures design where they received 2 and 0 mg nicotine. RESULTS In smokers, women had less interhemispheric ECN and DLPFC-DS coupling than men. In non-smokers, there was a drug x sex interaction where women, relative to men, had weaker ECN coupling following nicotine but not placebo administration. CONCLUSIONS The current work indicates that nicotine-dependent women, versus men, have weaker connectivity in brain networks critically implicated in cognitive control. How these connectivity differences contribute to the behavioral aspects of smoking requires more testing. However, building on the literature, it is likely these deficits in functional connectivity contribute to the lower abstinence rates noted in women relative to men.
Collapse
Affiliation(s)
- Julie M McCarthy
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA.
| | - Kelly M Dumais
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - Maya Zegel
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA
| | - Diego A Pizzagalli
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - David P Olson
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - Lauren V Moran
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| | - Amy C Janes
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, 02215, USA
| |
Collapse
|
13
|
Longitudinal association between tobacco use and the onset of depressive symptoms among Swedish adolescents: the Kupol cohort study. Eur Child Adolesc Psychiatry 2019; 28:695-704. [PMID: 30315361 PMCID: PMC6514114 DOI: 10.1007/s00787-018-1237-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 10/08/2018] [Indexed: 11/08/2022]
Abstract
Tobacco use in adolescence has been linked to the onset of depressive symptoms, but results of previous studies are inconsistent. The aim of this study was to clarify if tobacco use during early adolescence may affect the short-term onset of depressive symptoms. The study is based on Swedish Kupol study (3959 students). Current cigarette smoking, snus use, and tobacco dependence were assessed using questionnaires at baseline and 1-year follow-up. Outcome was the onset of depressive symptoms measured with the CES-DC scale, using a cut-off ≥ 30 as threshold. Adjusted linear and logistic regression models were employed to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI). CES-DC mean score at baseline was 14.3, higher in females than males (17.5 vs 10.9). The incidence of depressive symptoms at follow-up was 8.3%, greater in current than never smokers at baseline (13.7% vs 3.1%). Current cigarette smoking at the age of 13 years was strongly associated with the onset of depressive symptoms 1 year later, particularly in males (OR 12.7, 95% CI: 2.5-63.9), with a significant interaction between tobacco use and sex; feeling dependent on tobacco was also associated with depressive symptoms in males but not in females. Snus and overall tobacco use were not associated with the onset of depressive symptoms. Tobacco use during adolescence appears to influence the onset of depressive symptoms, with a stronger association in males than females. Pubertal maturation and sex-specific response patterns to the scale instrument may explain the moderating effect of sex.
Collapse
|
14
|
Petersen N, London ED. Addiction and Dopamine: Sex Differences and Insights from Studies of Smoking. Curr Opin Behav Sci 2018; 23:150-159. [PMID: 30746429 PMCID: PMC6368096 DOI: 10.1016/j.cobeha.2018.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Mesolimbic dopaminergic function influences addiction through effects on reinforcement learning, decision-making, and impulsivity. This review covers sex differences in dopaminergic neurochemistry, their hormonal and genetic determinants, and how differences in dopaminergic tone interact with sex and/or ovarian hormone status to affect cognitive functions. Findings from research on cigarette smoking reveal sex differences in striatal and midbrain dopamine D2-type receptor availability and striatal dopamine release that suggest mechanisms of nicotine dependence, and stronger subjective responses to nicotine and efficacy of nicotine replacement therapies in male smokers than in their female counterparts. Opportunities exist to extend such efforts in studies of how sex and hormone status influence other addictions.
Collapse
Affiliation(s)
- Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA, 90024
| | - Edythe D. London
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA, 90024,Department of Molecular and Medical Pharmacology, University of California Los Angeles, Los Angeles, CA, USA, 90024,Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA, 90024,Corresponding author: Dr. Edythe D. London, Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90025, USA, Tel: 310 825 0606, Fax: 310 825-0812,
| |
Collapse
|
15
|
Hsu CL, Hsueh KC, Chou MY, Yu HC, Mar GY, Chen HJ, West R. Long-term smoking cessation rates in elderly versus other adult smokers: A 3-year follow-up study in Taiwan. Addict Behav Rep 2018; 8:62-65. [PMID: 30094324 PMCID: PMC6072966 DOI: 10.1016/j.abrep.2018.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/26/2018] [Accepted: 07/01/2018] [Indexed: 11/16/2022] Open
Abstract
Introduction Smoking cessation improves life expectancy at any age. There is some evidence that elderly smokers have at least as good a chance of successfully stopping as other smokers but direct comparisons with long-term follow up are rare. This study aimed to compare success rates up to 3 years in smokers aged 65+ versus other adult smokers with and without adjustment for a range of other smoker characteristics. Methods This was a prospective study of 1065 smokers who attended a stop-smoking clinic in Taiwan. Participants (896 < 65 years, 169 65+ years) were followed up by telephone 3, 6, 12 and 36 months after the initial quit date. Prolonged abstinence (abstinent at all follow-ups) and point prevalence abstinence (7 days prior to final follow up) were compared between ‘elderly’ participants aged 65+ years versus ‘non-elderly’ participants aged <65 years with and without adjustment for a range of baseline smoker characteristics (sex, educational level, previous quit attempts, cigarette dependence score). Non-responders were considered to be smoking. Results Prolonged 36-month abstinence rates were 20.1% (N = 34) and 15.3% (N = 137) in the elderly and non-elderly participants respectively (p = 0.137). Point prevalence 36-month abstinence rates were 37.3% (N = 63) and 26.5% (N = 237) in the elderly and non-elderly participants respectively (p = 0.005). The odds ratios comparing elderly versus non-elderly abstinence rates after adjustment for baseline variables were 1.17 (95%CI = 0.75–1.83) and 1.52 (95%CI = 1.05–2.20) for prolonged abstinence and point prevalence abstinence respectively. Conclusions Elderly smokers attending smoker clinics in Taiwan appear to be at least as likely to achieve long-term abstinence as other adult smokers. Prolonged 36-month abstinence rates were higher in the elderly group. Point prevalence 36-month abstinence rates were also higher in the elderly group. and non-elderly participants respectively.
Collapse
Affiliation(s)
- Chiao-Lin Hsu
- Department of Physical Examination Center, Kaohsiung Veterans General Hospital, Taiwan.,Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Taiwan.,Department of Family Medicine, Kaohsiung Veterans General Hospital, Taiwan
| | - Kuang-Chieh Hsueh
- Department of Physical Examination Center, Kaohsiung Veterans General Hospital, Taiwan.,Shu-Zen College of Medicine and Management, Kaohsiung, Taiwan
| | - Ming-Yueh Chou
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Taiwan.,School of Medicine, National Yang-Ming University, Taiwan
| | - Hsien-Chung Yu
- Department of Physical Examination Center, Kaohsiung Veterans General Hospital, Taiwan.,Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Guang-Yuan Mar
- Department of Physical Examination Center, Kaohsiung Veterans General Hospital, Taiwan.,Division of Cardiology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hong-Jhe Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Taiwan
| | - Robert West
- Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London
| |
Collapse
|
16
|
Mercincavage M, Lochbuehler K, Wileyto EP, Benowitz NL, Tyndale RF, Lerman C, Strasser AA. Association of Reduced Nicotine Content Cigarettes With Smoking Behaviors and Biomarkers of Exposure Among Slow and Fast Nicotine Metabolizers: A Nonrandomized Clinical Trial. JAMA Netw Open 2018; 1:e181346. [PMID: 30627706 PMCID: PMC6322845 DOI: 10.1001/jamanetworkopen.2018.1346] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IMPORTANCE The US Food and Drug Administration (FDA) has announced its intention to reduce the nicotine content in combustible cigarettes but must base regulation on public health benefits. Fast nicotine metabolizers may be at risk for increased smoking following a national nicotine reduction policy. We hypothesized that using reduced nicotine content (RNC) cigarettes would be associated with increases in smoking behaviors and exposure among smokers with a fast-but not slow-nicotine-metabolite ratio (NMR). OBJECTIVES To examine the association of RNC cigarettes with smoking behaviors and biomarkers of exposure and to compare these associations in fast and slow metabolizers of nicotine based on the NMR. DESIGN SETTING AND PARTICIPANTS A 35-day, 3-period, within-participant nonrandomized clinical trial was conducted at an academic medical center in Philadelphia, Pennsylvania. A 5-day baseline period using the smokers' preferred brand of cigarettes was followed by 2 consecutive 15-day periods using free investigational RNC cigarettes. A total of 100 daily, non-treatment-seeking, nonmenthol cigarette smokers (59 fast, 41 slow metabolizers) were recruited from December 24, 2013, to December 2, 2015. Data analysis was performed from December 12, 2016, to January 3, 2018. INTERVENTIONS Two 15-day periods using cigarettes containing 5.2 mg (RNC1) and 1.3 mg (RNC2) of nicotine per gram of tobacco. MAIN OUTCOMES AND MEASURES Smoking behaviors (number of cigarettes per day [CPD], total puff volume) and biomarkers of exposure (carbon monoxide [CO], urine total nicotine equivalents [TNE], and 4-[methylnitrosamino]-1-[3-pyridyl]-1-butanol [NNAL]). RESULTS Smokers (73 [73.0%] men; 74 [74.0%] white; mean [SD] age, 43.02 [12.13] years; mean [SD] CPD, 17.31 [5.72]) consumed 2.62 (95% CI, 1.54-3.70) more CPD during the RNC1 period vs their preferred brand during baseline (P < .001) and approximated baseline CPD during the RNC2 period (mean difference, 0.96 [95% CI, -0.36 to 2.28]; P = .24). Additional outcome measures were lower during both RNC periods vs baseline (total puff volume, mean [95% CI]: RNC1, 537 mL [95% CI, 479-595 mL]; RNC2, 598 mL [95% CI, 547-649 mL] vs baseline, 744 mL [95% CI, 681-806 mL]; TNE, mean [95% CI]: RNC1, 30.9 nmoL/mg creatinine [95% CI, 26.0-36.6 nmoL/mg]; RNC2, 22.8 nmoL/mg creatinine [95% CI, 17.8-29.0 nmoL/mg] vs baseline, 54.6 nmoL/mg creatinine [95% CI, 48.1-62.1 nmoL/mg]; and NNAL, mean [95% CI]: RNC1, 229 pg/mg creatinine [95% CI, 189-277 pg/mg]; RNC2, 190 pg/mg creatinine [95% CI, 157-231 pg/mg] vs baseline, 280 pg/mg creatinine [95% CI, 231-339 pg/mg]; all P < .001). Carbon monoxide measures were similar across study periods (CO boost [SD], RNC1, 4.6 ppm [4.1-5.1 ppm]; RNC2, 4.2 ppm [3.7-4.6 ppm]; and baseline, 4.4 ppm [3.8-4.9 ppm]). The RNC cigarette associations did not differ by NMR. CONCLUSIONS AND RELEVANCE Both RNC cigarettes were associated with decreased puffing and urinary biomarker exposure but not with decreased daily cigarette consumption or CO levels. The NMR did not moderate associations at the nicotine levels tested, suggesting that fast metabolizers may not be at greater risk of increasing use or exposure from these products should the FDA mandate an RNC standard for cigarettes.
Collapse
Affiliation(s)
- Melissa Mercincavage
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Kirsten Lochbuehler
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - E. Paul Wileyto
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Biostatistics & Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Neal L. Benowitz
- Department of Medicine, University of California, San Francisco
- Department of Bioengineering & Therapeutic Sciences, University of California, San Francisco
| | - Rachel F. Tyndale
- Centre for Addiction and Mental Health, Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
- Division of Brain & Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Caryn Lerman
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Abramson Cancer Center, University of Pennsylvania, Philadelphia
| | - Andrew A. Strasser
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Abramson Cancer Center, University of Pennsylvania, Philadelphia
| |
Collapse
|
17
|
Faulkner P, Petersen N, Ghahremani DG, Cox CM, Tyndale RF, Hellemann GS, London ED. Sex differences in tobacco withdrawal and responses to smoking reduced-nicotine cigarettes in young smokers. Psychopharmacology (Berl) 2018; 235:193-202. [PMID: 29022071 PMCID: PMC6726112 DOI: 10.1007/s00213-017-4755-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/02/2017] [Indexed: 12/30/2022]
Abstract
RATIONALE Policies that establish a standard for reduced nicotine content in cigarettes can decrease the prevalence of smoking in the USA. Cigarettes with nicotine yields as low as 0.05 mg produce substantial occupancy of nicotinic acetylcholine receptors (26%), but women and men respond differently to these cigarettes. OBJECTIVE This study aimed to measure responses to smoking cigarettes that varied widely in nicotine yields, investigating whether sex differences in the effects on craving, withdrawal, and affect would be observed at even lower nicotine yields than previously studied, and in young smokers. METHODS Overnight abstinent young smokers (23 men, 23 women, mean age 22.18) provided self-reports of craving, withdrawal, and affect before and after smoking cigarettes with yields of 0.027, 0.110, 0.231, or 0.763 mg nicotine, and evaluated characteristics of each cigarette. RESULTS Compared to abstinent young men, abstinent young women reported greater negative affect, psychological withdrawal, and sedation, all of which were relieved equally by all cigarettes. Men but not women reported greater craving reduction, perceived nicotine content, and cigarette liking with increasing nicotine dose. CONCLUSIONS Men may experience less smoking-related relief of craving, and enjoy cigarettes less, if nicotine yields are reduced to very low levels. Conversely, women respond equally well to cigarettes with nicotine yields as low as 0.027 mg as to cigarettes with nicotine yields 28-fold higher (0.763 mg). These differences are relevant for policy regarding reduced nicotine in cigarettes and may influence the efficacy and acceptability of reduced-nicotine cigarettes as smoking cessation aids.
Collapse
Affiliation(s)
- Paul Faulkner
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90025, USA
| | - Nicole Petersen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90025, USA
| | - Dara G Ghahremani
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90025, USA
| | - Chelsea M Cox
- Department of Psychology, University of Illinois, Chicago, IL, USA
| | - Rachel F Tyndale
- Department of Pharmacology and Toxicology, and Department of Psychiatry, University of Toronto, 1 King's College Circle, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), 33 Russell Street, Toronto, ON, Canada
| | - Gerhard S Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90025, USA
| | - Edythe D London
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA, 90025, USA.
- Department of Molecular and Medical Pharmacology, University of California Los Angeles, California, Los Angeles, USA.
- The Brain Research Institute, University of California Los Angeles, California, Los Angeles, USA.
| |
Collapse
|
18
|
Oliveira RMD, Santos JLF, Furegato ARF. Tobacco addiction in the psychiatric population and in the general population. Rev Lat Am Enfermagem 2017; 25:e2945. [PMID: 29211192 PMCID: PMC5738870 DOI: 10.1590/1518-8345.2202.2945] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 08/02/2017] [Indexed: 11/21/2022] Open
Abstract
Objective: To estimate the degree of tobacco addiction and identify independently associated
factors by comparing the psychiatric population of secondary and tertiary care
with the general population of the primary healthcare network. Method: This is a cross-sectional epidemiological study, conducted in a municipality of
São Paulo, with 134 smokers of a Mental Health Outpatient Unit (MHOU), a
Psychiatric Hospital (PH), and a Primary Healthcare Unit (PHU). Data were
collected by means of individual interviews, recorded on a mobile device. Data
were statistically processed using Stata/12 Results: Of the 134 participants, 54.5% were women. While 49.1% of the psychiatric
population (MHOU/PH) had medium/high nicotine addiction, 58.3% of smokers of the
general population had very low/low dependency. The Poisson regression model
indicated a higher prevalence of smokers with high dependence among men (PR =
1.41), people aged 49 years or less (15 - 29 years, PR = 4.06, 30 - 39 PR = 2.96
years, 40 - 49 years PR = 1.84), with severe mental disorders (PR = 3.05), with
anxiety disorders/other (PR = 3.98), and with high suicide risk (PR = 1.55). Conclusion: Nicotine dependence was greater in the psychiatric population than in the general
population. The independent factors associated with severe dependence were sex,
age group, diagnosis, and current risk of suicide. These results trigger
reflection among nurses on the need to focus more attention on a neglected subject
in mental health services.
Collapse
Affiliation(s)
| | - Jair Lício Ferreira Santos
- PhD, Full Professor, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Antonia Regina Ferreira Furegato
- PhD, Full Professor, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, PAHO/WHO Collaborating Centre for Nursing Research Development, Ribeirão Preto, SP, Brazil
| |
Collapse
|
19
|
Reduced nicotine content cigarette advertising: How false beliefs and subjective ratings affect smoking behavior. Drug Alcohol Depend 2017; 173:99-106. [PMID: 28214392 PMCID: PMC5366263 DOI: 10.1016/j.drugalcdep.2016.12.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/06/2016] [Accepted: 12/21/2016] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Tobacco advertising can create false beliefs about health harms that are reinforced by product design features. Reduced nicotine content (RNC) cigarettes may reduce harm, but research has not addressed advertising influences. This study examined RNC cigarette advertising effects on false harm beliefs, and how these beliefs - along with initial subjective ratings of RNC cigarettes - affect subsequent smoking behaviors. We further explored whether subjective ratings moderate associations between false beliefs and behavior. METHODS Seventy-seven daily, non-treatment-seeking smokers (66.2% male) participated in the first 15days of a randomized, controlled, open-label RNC cigarette trial. Participants viewed an RNC cigarette advertisement at baseline before completing a 5-day period of preferred brand cigarette use, followed by a 10-day period of RNC cigarette use (0.6mg nicotine yield). Participants provided pre- and post-advertisement beliefs, and subjective ratings and smoking behaviors for cigarettes smoked during laboratory visits. RESULTS Viewing the advertisement increased beliefs that RNC cigarettes contain less nicotine and are healthier than regular cigarettes (p's<0.001 and 0.011), and decreased the belief that they are less likely to cause cancer (p=0.046). Neither false beliefs nor subjective ratings directly affected smoking behaviors. Significant interactions of strength and taste ratings with beliefs (p's<0.001), however, indicated that among smokers with less negative initial subjective ratings, greater false beliefs were associated with greater RNC cigarette consumption. CONCLUSIONS Smokers may misconstrue RNC cigarettes as less harmful than regular cigarettes. These beliefs, in conjunction with favorable subjective ratings, may increase product use.
Collapse
|
20
|
Allen A, Vogel RI, Meier E, Anderson A, Jensen J, Severson HH, Hatsukami D. Gender differences in snus versus nicotine gum for cigarette avoidance among a sample of US smokers. Drug Alcohol Depend 2016; 168:8-12. [PMID: 27610935 PMCID: PMC5215723 DOI: 10.1016/j.drugalcdep.2016.08.624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/12/2016] [Accepted: 08/17/2016] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Women are more susceptible to the harmful effects of cigarette smoking. Thus, identifying effective harm reduction approaches for women is necessary. The goal of this project was to examine gender differences in response to snus versus nicotine gum for cigarette avoidance, as a means of harm reduction. METHODS Participants were randomly assigned to use snus or nicotine gum as a method to avoid cigarette smoking. Participants attended clinic visits to receive study product, as well as provide biological samples to assess smoking avoidance and biomarkers and report on use of study product and cigarettes. A secondary analysis comparing men and women by randomization to study product was conducted. RESULTS Participants (n=391; 47% women) were randomized into the snus group (n=196; 45% women) and the gum group (n=195; 49% women). Men used more snus whereas women used more gum (p=0.02). During treatment, men in the snus group had higher total nicotine equivalent values whereas women did not vary by group (p=0.03). Overall, fewer men in the snus group completely avoided cigarettes compared to men in the gum group (e.g., continuous abstinence at Week 12: odds ratio=0.43, 95% confidence interval=0.20-0.93). Among women, there were no differences by randomization in cigarette avoidance. CONCLUSIONS Despite a number of gender differences in response to snus versus nicotine gum, these data suggest that snus may not be an optimal harm reduction approach for either gender.
Collapse
Affiliation(s)
- Alicia Allen
- University of Minnesota, Family Medicine and Community Health, Minneapolis, MN, United States; University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States.
| | - Rachel Isaksson Vogel
- University of Minnesota, Gynecologic Oncology, Minneapolis, MN, United States,University of Minnesota, Masonic Comprehensive Cancer Center – Biostatistics and Bioinformatics Core, Minneapolis, MN, United States
| | - Ellen Meier
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | - Amanda Anderson
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | - Joni Jensen
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States
| | | | - Dorothy Hatsukami
- University of Minnesota, Tobacco Research Programs, Minneapolis, MN, United States,University of Minnesota, Psychiatry, Minneapolis, MN, United States
| |
Collapse
|
21
|
Hatsukami DK, Vogel RI, Severson HH, Jensen JA, O'Connor RJ. Perceived Health Risks of Snus and Medicinal Nicotine Products. Nicotine Tob Res 2016; 18:794-800. [PMID: 26386473 PMCID: PMC5896824 DOI: 10.1093/ntr/ntv200] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 09/01/2015] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Perceived health risk (PHR) of a tobacco product may influence both uptake and continued use. In this study, we examined PHRs of snus and medicinal nicotine using the PHR scale and the relationship of PHR responses to use of these products in smokers seeking an alternative to smoking. METHODS Smokers were randomly assigned to snus or to medicinal nicotine for a period of 12 weeks and asked to only use the assigned product. The PHR scale involves rating the extent of perceived risk of a product for different diseases and was given at baseline and weeks 4 and 12 during treatment. Relationships between PHR scale scores and study attrition, compliance with only using the product, and continued use of the product after treatment were determined. RESULTS Response to the PHR scale showed no significant differences between the snus and medicinal nicotine for perceived risks for lung cancer, emphysema, and bronchitis. However, significant differences were observed for other cancers, heart disease, stroke and risk for addiction, particularly after product use, with higher scores among those assigned to snus. Scores on the PHR scale were not related to any of the trial outcome variables. CONCLUSIONS Among smokers seeking an alternative to smoking in a clinic setting, PHR of a product changes after product use but may not be related to product use patterns. IMPLICATIONS PHRs of snus or medicinal nicotine in smokers assigned to these products become more accurate after product use. PHR does not appear to be associated with patterns of product use; rather satisfaction with a product is a better indicator as to whether a smoker is compliant with only using the product or continues to use the product.
Collapse
Affiliation(s)
- Dorothy K Hatsukami
- Department of Psychiatry, Tobacco Research Programs, University of Minnesota, Minneapolis, MN;
| | - R I Vogel
- Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN
| | - Herb H Severson
- Department of Psychology, Oregon Research Institute, Eugene, OR
| | - Joni A Jensen
- Department of Psychiatry, Tobacco Research Programs, University of Minnesota, Minneapolis, MN
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| |
Collapse
|
22
|
Wetherill RR, Franklin TR, Allen SS. Ovarian hormones, menstrual cycle phase, and smoking: a review with recommendations for future studies. CURRENT ADDICTION REPORTS 2016; 3:1-8. [PMID: 27134810 DOI: 10.1007/s40429-016-0093-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cigarette smoking continues to be the leading cause of preventable morbidity and mortality. Similar to other addictive substances, the prevalence of cigarette smoking is greater among men than women, yet women are less successful at quitting smoking. Preclinical and clinical research suggests that ovarian hormones (i.e., estradiol and progesterone), which fluctuate over the course of the menstrual cycle, may contribute to these sex differences. Specifically, research suggests that progesterone may protect against cigarette smoking and nicotine addiction; whereas estradiol may underlie enhanced vulnerability. In this review, we discuss new research on ovarian hormone and menstrual cycle phase effects on smoking-related responses and behavior in women, including studies examining neural responses to smoking cues, hormonal influences on medication-assisted smoking cessation, and acute smoking abstinence. We highlight innovative studies with strong research methodology and provide suggestions for future research that may allow evidence-based knowledge for immediate translation to the clinic to guide novel, hormonally-informed treatment strategies. Thus, rigorous scientific study holds the potential to reduce relapse rates, thus improving the health and saving the lives of the many thousands of women who unfortunately do not respond to current treatments.
Collapse
Affiliation(s)
- Reagan R Wetherill
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania; Mailing Address: 3900 Chestnut Street, Philadelphia, Pennsylvania, USA 19104;
| | - Teresa R Franklin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania; Mailing Address: 3900 Chestnut Street, Philadelphia, Pennsylvania, USA 19104;
| | - Sharon S Allen
- Department of Family Medicine & Community Health, Medical School, University of Minnesota; Mailing Address: 420 Delaware Street SE, MMC 381 Mayo, Minneapolis, Minnesota, USA 55455;
| |
Collapse
|
23
|
Allen AM, Scheuermann TS, Nollen N, Hatsukami D, Ahluwalia JS. Gender Differences in Smoking Behavior and Dependence Motives Among Daily and Nondaily Smokers. Nicotine Tob Res 2015; 18:1408-13. [PMID: 26136526 DOI: 10.1093/ntr/ntv138] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 06/16/2015] [Indexed: 12/21/2022]
Abstract
INTRODUCTION While the overall prevalence of smoking has declined, nondaily smoking is on the rise. Among daily smokers (DS) men tend to smoke more cigarettes per day and have higher dependence. Unfortunately little is known about gender differences in nondaily smokers (NDS). METHODS This secondary-data analysis utilized data from a cross-sectional online survey. Participants reported on smoking behavior (eg, cigarettes per day, history of quit attempts) and nicotine dependence motives as assessed by the Brief Wisconsin Inventory of Dependence Motives via the primary and secondary subscales (ie, core features of tobacco dependence such as craving and accessory motives such as weight control, respectively). RESULTS Participants were 1175 DS (60% women) and 1201 NDS (56% women). Two interactions between group and gender were noted suggesting that the NDS had greater gender differences in past quit attempts (P < .01) and reported change in smoking behavior over the past year (P < .01). Further, among the NDS group, men scored significantly higher than women on both the primary and secondary dependence motives subscales (3.6±0.1 vs. 2.9±0.1, P < .0001; 3.8±0.1 vs. 3.3±0.1, P < .0001; respectively). There were no significant differences in dependence motives in the DS group (P > .05). CONCLUSIONS Gender differences in smoking behavior and dependence motives varied between NDS and DS. Specifically, gender differences in smoking behavior and smoking dependence motives may be larger among NDS compared to DS. Additional research is needed to explore how these relationships may relate to smoking cessation in NDS.
Collapse
Affiliation(s)
- Alicia M Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, Minneapolis, MN;
| | - Taneisha S Scheuermann
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Nicole Nollen
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS
| | - Dorothy Hatsukami
- Department of Psychiatry, Medical School, University of Minnesota, Minneapolis, MN
| | - Jasjit S Ahluwalia
- Department of Epidemiology, School of Public Health, Rutgers, State University of New Jersey, Piscataway, NJ
| |
Collapse
|
24
|
al'Absi M, Nakajima M, Allen S, Lemieux A, Hatsukami D. Sex differences in hormonal responses to stress and smoking relapse: a prospective examination. Nicotine Tob Res 2015; 17:382-9. [PMID: 25762747 PMCID: PMC4481709 DOI: 10.1093/ntr/ntu340] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 12/16/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Dysregulation in the hypothalamic-pituitary-adrenal axis has been shown to be associated with smoking relapse. No study has directly examined the role of sex differences in this relationship. METHODS Nicotine dependent men (n = 52) and women (n = 46) interested in cessation completed 2 laboratory stress sessions during ad libitum smoking and after 48 hr of abstinence. The laboratory session included baseline, stress, and recovery periods. Blood and saliva samples were collected at the end of each period for the measurement of cortisol and adrenocorticotropic hormone. Self-report measures of craving and withdrawal symptoms were also collected. Participants attended 4 weekly follow-up sessions for counseling where they provided biological samples and self-report measures including smoking status. Relapse was defined by smoking cigarettes for 7 consecutive days post-cessation. RESULTS Results showed that 60 participants relapsed during the 4-week period. Cox regression models from the abstinence session showed that cortisol levels regardless of source were predictive of relapse but the direction of prediction was sex dependent (Sex × Hormone, all ps < .05). Follow-up analyses further revealed that lower cortisol levels predicted relapse in men whereas greater cortisol levels predicted relapse in women (ps < .05). Enhanced craving predicted early smoking relapse in men but not in women (ps < .05). Data from the ad libitum session showed no differences in predicting relapse. CONCLUSION These findings highlight that sex differences in the hormonal response to stress and subjective craving during nicotine withdrawal are critical predictors of risk for understanding early relapse.
Collapse
Affiliation(s)
- Mustafa al'Absi
- Duluth Medical Research Institute, University of Minnesota Medical School, Duluth, MN; Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School, Duluth, MN; Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN; Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Motohiro Nakajima
- Duluth Medical Research Institute, University of Minnesota Medical School, Duluth, MN; Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School, Duluth, MN
| | - Sharon Allen
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Andrine Lemieux
- Duluth Medical Research Institute, University of Minnesota Medical School, Duluth, MN; Department of Biobehavioral Health and Population Sciences, University of Minnesota Medical School, Duluth, MN
| | - Dorothy Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| |
Collapse
|
25
|
Perkins KA, Karelitz JL. Sex differences in acute relief of abstinence-induced withdrawal and negative affect due to nicotine content in cigarettes. Nicotine Tob Res 2015; 17:443-8. [PMID: 25762754 PMCID: PMC4425834 DOI: 10.1093/ntr/ntu150] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Accepted: 07/24/2014] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Acute cigarette smoking may relieve withdrawal and negative affect due to tobacco abstinence to a greater extent in women versus men. Yet, the relative contribution of the cigarette's nicotine content to this sex difference is not clear. METHODS Non-quitting dependent adult smokers (N = 44; 21 males, 23 females) participated in 2 virtually identical sessions, each after abstaining overnight (CO < 10 ppm) and differing only in the nicotine content of the designated cigarette. While blind to brand markings, they consumed a total of 24 puffs in controlled fashion for 2 hr in each session, either from a nicotine (Quest 1, 0.6 mg) or denicotinized (Quest 3, 0.05 mg) cigarette. Withdrawal symptoms were obtained before and after smoking, and negative affect was assessed after each period of cigarette exposure consisting of 6 puffs every 25 min. RESULTS Men and women did not differ in baseline withdrawal and negative affect due to overnight abstinence, but reductions in each symptom were significantly influenced by the interaction of sex × nicotine/denicotinized cigarette (both p < .05). In men, but not in women, each symptom was generally decreased more by the nicotine versus denicotinized cigarette, and the nicotine cigarette reduced each to a greater degree in men versus women. CONCLUSIONS Sex differences in relief of abstinence-induced withdrawal and negative affect due to the nicotine content in cigarettes are consistent with prior research indicating that nicotine per se, compared to non-nicotine smoke stimuli, is less rewarding in women versus men.
Collapse
|
26
|
Walton KM, Abrams DB, Bailey WC, Clark D, Connolly GN, Djordjevic MV, Eissenberg TE, Fiore MC, Goniewicz ML, Haverkos L, Hecht SS, Henningfield JE, Hughes JR, Oncken CA, Postow L, Rose JE, Wanke KL, Yang L, Hatsukami DK. NIH electronic cigarette workshop: developing a research agenda. Nicotine Tob Res 2014; 17:259-69. [PMID: 25335949 DOI: 10.1093/ntr/ntu214] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) represent an emerging public health issue. These devices deliver nicotine along with other constituents, including flavorants, via an inhalable aerosol. Their uptake is rapidly increasing in both adults and youths, primarily among current smokers. Public debate is increasing on how these devices should be regulated and used, yet only limited peer-reviewed research exists. To develop a informed policy for e-cigarettes, their effects on human behavior, physiology, and health need to be understood. PURPOSE This paper describes proceedings from a National Institutes of Health-sponsored workshop, which was held in November 2013, to identify research needs related to the effects of e-cigarettes. Discussion topics included e-cigarette risks and abuse potential; the potential role for e-cigarettes in harm reduction and smoking cessation; unintended consequences of e-cigarette use, such as becoming a gateway to conventional cigarettes; and dual use of both e-cigarettes and conventional cigarettes. RESULTS AND CONCLUSIONS The research needs identified by the workshop participants included the following: standards to measure the contents and emissions of e-cigarettes; biomarkers of exposure; physiological effects of e-cigarettes on tissues and organ systems, including pulmonary and cardiovascular; information on e-cigarette users, how the devices are used, and identification of the best tools to assess these measures; factors that drive use and influence patterns of use; and appropriate methods for evaluating a potential role for e-cigarettes in smoking or nicotine cessation. To understand fully the challenges and the opportunities that e-cigarettes represent, expertise will be needed in basic, behavioral, translational, and clinical sciences.
Collapse
Affiliation(s)
- Kevin M Walton
- Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD;
| | - David B Abrams
- Schroeder Institute at Legacy, Washington, DC, and Department of Health, Behavior and Society, Johns Hopkins School of Public Health, Baltimore, MD
| | - William C Bailey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - David Clark
- Behavioral and Social Sciences Research Branch, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD
| | - Gregory N Connolly
- Schools of Law and Bouve Health Sciences , Northeastern University, Boston, MA
| | - Mirjana V Djordjevic
- Tobacco Control Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Michael C Fiore
- Center for Tobacco Research and Intervention, University of Wisconsin, Madison, WI
| | - Maciej L Goniewicz
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Lynne Haverkos
- Child Development and Behavior Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Stephen S Hecht
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Jack E Henningfield
- Pinney Associates, Bethesda, MD, and Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - John R Hughes
- Department of Psychological Science, University of Vermont College of Medicine, Burlington, VT
| | - Cheryl A Oncken
- Department of Medicine, University of Connecticut Health Center, Farmington, CT
| | - Lisa Postow
- Airway Biology and Disease Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Jed E Rose
- Center for Smoking Cessation, Duke University Medical Center, Durham, NC
| | - Kay L Wanke
- Office of Disease Prevention, National Institutes of Health, Bethesda, MD
| | - Lucie Yang
- Division of Nonprescription Clinical Evaluation, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD
| | | |
Collapse
|
27
|
Weinberger AH, Smith PH, Kaufman M, McKee SA. Consideration of sex in clinical trials of transdermal nicotine patch: a systematic review. Exp Clin Psychopharmacol 2014; 22:373-83. [PMID: 25133506 PMCID: PMC4180800 DOI: 10.1037/a0037692] [Citation(s) in RCA: 24] [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] [Indexed: 11/08/2022]
Abstract
Transdermal nicotine patch (TNP) is 1 of the most commonly used smoking cessation treatments; however, the efficacy of TNP by sex is not yet clear. The purpose of the current review was to synthesize how sex has been considered in published clinical trials of TNP for smoking cessation. The specific aims of the study were to examine the inclusion of sex in analyses of cessation outcomes, TNP-related variables (compliance, side effects), and quit-related variables (withdrawal, cravings); to review the consideration of sex-related variables (menstrual cycle phase, pregnancy); and to identify needs for future research. Potential articles published through December 31, 2013 were identified through a MEDLINE search of the terms "clinical trial," "nicotine patch," and "smoking cessation." Forty-two studies used all 3 terms and met the inclusion criteria. Approximately half of the studies reported that they considered sex in smoking cessation outcomes, with 15 studies finding no difference by sex and 7 studies finding better outcomes for men versus women. Only 5 studies reported data on outcomes by sex in their publications. No studies reported analysis of TNP compliance or withdrawal by sex. In the 1 study that examined side effects by sex, more women than men reported discontinuing TNP because of skin irritation. No study examined the association of cessation outcomes with menstrual cycle phase. There is a need to include sex in research on TNP, as well as other pharmacological and behavioral smoking treatments, to clarify the picture of treatment efficacy for women compared with men.
Collapse
Affiliation(s)
- Andrea H Weinberger
- Department of Psychiatry, Yale University School of Medicine Cancer Prevention and Control Research Program, Yale Cancer Center
| | - Philip H Smith
- Department of Psychiatry, Yale University School of Medicine
| | | | - Sherry A McKee
- Department of Psychiatry, Yale University School of Medicine Cancer Prevention and Control Research Program, Yale Cancer Center
| |
Collapse
|