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Ruckle D, Chang A, Jesurajan J, Carlson B, Gulbrandsen M, Rice RC, Wongworawat MD. Does Marijuana Smoking Increase the Odds of Surgical Site Infection After Orthopaedic Surgery? A Retrospective Cohort Study. J Orthop Trauma 2024; 38:571-575. [PMID: 39325055 DOI: 10.1097/bot.0000000000002866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVES Does marijuana smoking increase the risk of surgical site infection (SSI) after open reduction and internal fixation of fractures? METHODS DESIGN Retrospective. SETTING Single academic level 1 trauma center in Southern California. PATIENT SELECTION CRITERIA Adult patients who underwent open treatment for closed fractures between January 2009 and December 2021, had hardware placed, and had at least 6 months of postoperative follow-up. OUTCOME MEASURES AND COMPARISONS Risk factors associated with the development of SSI were compared between current inhalational marijuana users and nonmarijuana users. RESULTS Complete data were available on 4802 patients after exclusion of 82 who did not have a complete variable set. At the time of surgery, 24% (1133 patients) were current users of marijuana. At the final follow-up (minimum 6 months), there was a 1.6% infection rate (75 patients). The average age of the infection-free group was 46.1 ± 23.1 years, and the average age of the SSI group was 47.0 ± 20.3 (P = 0.73) years. In total, 2703 patients (57%) in the infection-free group were male compared with 48 (64%) in the SSI group (P = 0.49). On multivariate analysis, longer operative times (OR 1.002 [95% CI, 1.001-1.004]), diabetic status (OR 2.084 [95% CI, 1.225-3.547]), and current tobacco use (OR 2.493 [95% CI, 1.514-4.106]) (P < 0.01 for all) were associated with an increased risk of SSI; however, current marijuana use was not (OR 0.678 [95% CI, 0.228-2.013], P = 0.48). CONCLUSIONS Tobacco use, diabetes, and longer operative times were associated with the development of SSI after open reduction and internal fixation of fractures; however, marijuana smoking was not shown to be associated with the development of SSI. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- David Ruckle
- Department of Orthopaedic Surgery, Loma Linda University Health, Loma Linda, CA; and
| | - Alexander Chang
- Department of Orthopaedic Surgery, University of California San Diego, San Diego, CA
| | - Jose Jesurajan
- Department of Orthopaedic Surgery, Loma Linda University Health, Loma Linda, CA; and
| | - Bradley Carlson
- Department of Orthopaedic Surgery, Loma Linda University Health, Loma Linda, CA; and
| | - Matthew Gulbrandsen
- Department of Orthopaedic Surgery, Loma Linda University Health, Loma Linda, CA; and
| | - R Casey Rice
- Department of Orthopaedic Surgery, Loma Linda University Health, Loma Linda, CA; and
| | - M Daniel Wongworawat
- Department of Orthopaedic Surgery, Loma Linda University Health, Loma Linda, CA; and
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Bold KW, Sharma A, Haeny A, Gueorguieva R, Buta E, Baldassarri S, Lempert L, Krishnan-Sarin S, O'Malley S. A randomized controlled trial of potential tobacco policies prohibiting menthol flavor in cigarettes and e-cigarettes: a study protocol. BMC Psychiatry 2024; 24:201. [PMID: 38475757 DOI: 10.1186/s12888-024-05619-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/15/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Menthol cigarette use remains a large public health problem and disproportionately affects Black adults in the United States. The Food and Drug Administration has proposed prohibiting menthol flavor in cigarettes to protect public health. However, e-cigarettes are available in menthol flavor and are a popular alternative product adults might switch to if menthol is prohibited in cigarettes. Research is needed to understand how availability of menthol (vs. tobacco) flavored e-cigarettes could impact cigarette use among adults who smoke menthol cigarettes. METHODS We will recruit 150 adults who currently smoke menthol cigarettes and will randomize them to 1 of 3 conditions modeling different regulatory scenarios. We will recruit equal numbers of participants identifying as Black vs. non-Black and will stratify randomization by race. To promote standardization and adherence, cigarette and e-cigarette products will be provided for 8 weeks based on the assigned condition: (A) no menthol restriction (menthol cigarette and menthol flavored e-cigarette), (B) menthol prohibited in cigarettes only (non-menthol cigarette and menthol flavored e-cigarette), (C) menthol prohibited in both cigarettes and e-cigarettes (non-menthol cigarette and tobacco flavored e-cigarette). A follow-up visit will occur at week 12 to assess tobacco use status. The study aims are to (1) examine the impact of prohibiting menthol flavor in cigarettes and e-cigarettes on smoking behavior and (2) investigate whether outcomes differ by race to understand the impact of menthol policies on Black (vs. non-Black) individuals given high rates of menthol cigarette use in this population. The primary outcome will evaluate changes in the number of cigarettes smoked per day during the 8-week study period and will examine differences by regulatory scenario. Secondary outcomes will compare percent days smoke-free, changes in nicotine dependence, and motivation, confidence, and intentions to quit smoking by the regulatory scenarios. We will examine whether changes in the outcomes differ by Black vs. non-Black participants to compare the magnitude of the effect of the various menthol policy scenarios by race. DISCUSSION Results will contribute critical information regarding menthol in cigarettes and e-cigarettes to inform regulatory policies that maximize reductions in cigarette smoking and reduce tobacco-related health disparities. TRIAL REGISTRATION NCT05259566. Yale IRB protocol #2000032211, last approved 12/8/2023.
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Affiliation(s)
- Krysten W Bold
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA.
- Yale Cancer Center, New Haven, CT, USA.
| | - Akshika Sharma
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Angela Haeny
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
| | - Ralitza Gueorguieva
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Eugenia Buta
- Yale Center for Analytical Sciences, Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Stephen Baldassarri
- Department of Internal Medicine, Section of Pulmonary, Critical Care, and Sleep Medicine, Yale School of Medicine, New Haven, CT, USA
- Program in Addiction Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Lauren Lempert
- Department of Pediatrics, Division of Adolescent Medicine, Stanford University, Palo Alto, CT, USA
- Center for Tobacco Control Research and Education, University of California, San Francisco, CA, USA
| | | | - Stephanie O'Malley
- Yale School of Medicine, Department of Psychiatry, New Haven, CT, USA
- Yale Cancer Center, New Haven, CT, USA
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Du X, Choa FS, Chiappelli J, Bruce H, Kvarta M, Summerfelt A, Ma Y, Regenold WT, Walton K, Wittenberg GF, Hare S, Gao S, van der Vaart A, Zhao Z, Chen S, Kochunov P, Hong LE. Combining neuroimaging and brain stimulation to test alternative causal pathways for nicotine addiction in schizophrenia. Brain Stimul 2024; 17:324-332. [PMID: 38453003 PMCID: PMC11445730 DOI: 10.1016/j.brs.2024.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 03/09/2024] Open
Abstract
The smoking rate is high in patients with schizophrenia. Brain stimulation targeting conventional brain circuits associated with nicotine addiction has also yielded mixed results. We aimed to identify alternative circuitries associated with nicotine addiction in both the general population and schizophrenia, and then test whether modulation of such circuitries may alter nicotine addiction behaviors in schizophrenia. In Study I of 40 schizophrenia smokers and 51 non-psychiatric smokers, cross-sectional neuroimaging analysis identified resting state functional connectivity (rsFC) between the dorsomedial prefrontal cortex (dmPFC) and multiple extended amygdala regions to be most robustly associated with nicotine addiction severity in healthy controls and schizophrenia patients (p = 0.006 to 0.07). In Study II with another 30 patient smokers, a proof-of-concept, patient- and rater-blind, randomized, sham-controlled rTMS design was used to test whether targeting the newly identified dmPFC location may causally enhance the rsFC and reduce nicotine addiction in schizophrenia. Although significant interactions were not observed, exploratory analyses showed that this dmPFC-extended amygdala rsFC was enhanced by 4-week active 10Hz rTMS (p = 0.05) compared to baseline; the severity of nicotine addiction showed trends of reduction after 3 and 4 weeks (p ≤ 0.05) of active rTMS compared to sham; Increased rsFC by active rTMS predicted reduction of cigarettes/day (R = -0.56, p = 0.025 uncorrected) and morning smoking severity (R = -0.59, p = 0.016 uncorrected). These results suggest that the dmPFC-extended amygdala circuit may be linked to nicotine addiction in schizophrenia and healthy individuals, and future efforts targeting its underlying pathophysiological mechanisms may yield more effective treatment for nicotine addiction.
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Affiliation(s)
- Xiaoming Du
- Louis A. Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Fow-Sen Choa
- Department of Electrical Engineering and Computer Science, University of Maryland Baltimore County, Baltimore, MD, USA
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Heather Bruce
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mark Kvarta
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ann Summerfelt
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Yizhou Ma
- Louis A. Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - William T Regenold
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Program, National Institute of Mental Health, National Institutes of Health, NIH Clinical Center, Bethesda, MD, USA
| | - Kevin Walton
- Clinical Research Grants Branch, Division of Therapeutics and Medical Consequences, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA
| | - George F Wittenberg
- Human Engineering Research Laboratories, VA RR&D Center of Excellence, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA; Rehabilitation Neural Engineering Laboratories, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie Hare
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Si Gao
- Louis A. Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Andrew van der Vaart
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Zhiwei Zhao
- Department of Mathematics, University of Maryland, College Park, USA
| | - Shuo Chen
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Peter Kochunov
- Louis A. Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - L Elliot Hong
- Louis A. Faillace Department of Psychiatry and Behavioral Sciences at McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Dibor C, Lim A, Montgomery J. Ex-smokers referred urgently to ENT: reasons for quitting and smoking cessation methods utilised. JOURNAL OF SUBSTANCE USE 2023. [DOI: 10.1080/14659891.2022.2140717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Charles Dibor
- Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Alison Lim
- Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Jenny Montgomery
- Department of Otolaryngology, Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK
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Flocke SA, Ishler K, Albert E, Cavallo D, Lim R, Trapl E. Measuring nicotine dependence among adolescent and young adult cigarillo users. Nicotine Tob Res 2022; 24:1789-1797. [PMID: 35512368 PMCID: PMC9596997 DOI: 10.1093/ntr/ntac117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 03/11/2022] [Accepted: 05/02/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Current measures of nicotine dependence (ND) were developed and validated for cigarette smokers only, limiting their utility for other combustible tobacco users. This study evaluates the psychometric properties of a pool of new and adapted items to measure ND among cigarillo and multiple tobacco product users. METHODS Items were drawn from the PROMIS Nicotine Dependence Item Bank which were adapted to be product neutral and new items were developed from a qualitative study of 60 adolescent and young adult cigarillo smokers. A total of 42 ND items were included in a web-based survey. Eligible participants were 14 to 28 year olds who smoked a minimum of 2 cigarillos per week. Analyses included confirmatory factor analysis, item response theory analysis, analysis of differential item functioning (DIF) and reliability. Ordinary least square regression was used to test the association of ND score with deciles of nicotine consumption. RESULTS Among the 1089 participants, the median number of cigarillos smoked per week was 20; 54% of participants also smoked cigarettes. All PROMIS items and 8 of 10 new items met the IRT fit criteria. Two PROMIS items had non-ignorable DIF. The pool of 40 items had good score reliability for a range of 2 standard deviations. Twenty-, eight-, and four-item short forms showed similarly good measurement properties; each was positively associated with decile of nicotine consumption, p<.001; R 2 = 0.33. CONCLUSIONS This adapted bank of ND items is psychometrically sound and includes items that are product neutral, making it suitable for assessing ND among cigarillo and polytobacco users. IMPLICATIONS This study rigorously evaluates adapted items to measure ND among cigarillo and polytobacco users and reports the reliability initial evidence of validity of short form scores.
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Affiliation(s)
- Susan A Flocke
- Department of Family Medicine, Oregon Health & Science University, Portland OR, USA
| | - Karen Ishler
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland OH, USA
| | - Elizabeth Albert
- Center for Community Health Integration, Case Western Reserve University, Cleveland OH,USA
| | - David Cavallo
- Department of Nutrition, Case Western Reserve University, Cleveland OH, USA
| | - Rock Lim
- Case Western Reserve University, Center for Community Health Integration, Cleveland OH, USA
| | - Erika Trapl
- Department of Population and Quantitative Health Sciences and the Prevention Research Center for Healthy Neighborhoods, Case Western Reserve University, Cleveland OH, USA
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Piper ME, Baker TB, Benowitz NL, Smith SS, Jorenby DE. E-cigarette Dependence Measures in Dual Users: Reliability and Relations With Dependence Criteria and E-cigarette Cessation. Nicotine Tob Res 2020; 22:756-763. [PMID: 30874804 DOI: 10.1093/ntr/ntz040] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 03/08/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Electronic cigarettes (e-cigarettes) have drastically changed the nicotine and tobacco product landscape. However, their potential public health impact is still unclear. A reliable and valid measure of e-cigarette dependence would likely advance assessment and prognostication of the public health impact of e-cigarettes. The aim of this research was to examine the internal consistency, structure, and validity of three e-cigarette dependence scales. METHODS Adult dual users (smokers who also vape, N = 256) enrolled in an observational cohort study (45.1% women, 70.7% white). At baseline, participants completed the e-cigarette Fagerström Test of Cigarette Dependence (e-FTCD), the e-cigarette Wisconsin Inventory of Smoking Dependence Motives (e-WISDM), and the Penn State Electronic Cigarette Dependence Index (PS-ECDI). All participants provided a urine sample for cotinine analysis and reported e-cigarette use at 1 year. RESULTS The e-WISDM subscales had the highest internal consistency (α = .81-.96), then the PS-ECDI (α = .74) and e-FTCD (α = .51). A single-factor structure for the e-FTCD and an 11-factor structure for the e-WISDM were supported, but the PS-ECDI did not have a single-factor structure. All three e-cigarette dependence scales were highly correlated with validation criteria including continued e-cigarette use at 1 year, but not with e-liquid nicotine concentration or cotinine. CONCLUSIONS The e-WISDM and PS-ECDI had stronger internal consistency than did the e-FTCD, despite the e-FTCD's single-factor structure, but all 3 measures appear to be valid measures of e-cigarette dependence as suggested by their significant relations with self-perceived addiction, heavy use, early use after overnight deprivation, and continued use over time. IMPLICATIONS This research provides empirical support for three e-cigarette dependence measures: the e-FTCD, the PS-ECDI, and the e-WISDM among dual users of e-cigarettes and combustible cigarettes. The PS-ECDI and e-WISDM are more reliable, but all three measures were strongly correlated with key dependence constructs such as heavy use and continued use over time.
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Affiliation(s)
- Megan E Piper
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Timothy B Baker
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Neal L Benowitz
- Department of Medicine and Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, CA
| | - Stevens S Smith
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
| | - Douglas E Jorenby
- Department of Medicine, Center for Tobacco Research and Intervention, School of Medicine and Public Health, University of Wisconsin, Madison, WI
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Morean ME, Krishnan-Sarin S, Sussman S, Foulds J, Fishbein H, Grana R, O’Malley SS. Psychometric Evaluation of the E-cigarette Dependence Scale. Nicotine Tob Res 2019; 21:1556-1564. [PMID: 29301008 PMCID: PMC6821314 DOI: 10.1093/ntr/ntx271] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 12/30/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Psychometrically sound measures of e-cigarette dependence are lacking. METHODS We modified the PROMIS Item Bank v1.0-Smoking: Nicotine Dependence for All Smokers for use with e-cigarettes and evaluated the psychometrics of the 22-, 8-, and 4-item adapted versions, referred to as The E-cigarette dependence scale (EDS). Adults (1009) who reported using e-cigarettes at least weekly completed an anonymous survey in summer 2016 (50.2% male, 77.1% White, mean age 35.81 [10.71], 66.4% daily e-cigarette users, 72.6% current cigarette smokers). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, examination of mean-level differences, convergent validity, and test-criterion relationships with e-cigarette use outcomes. RESULTS All EDS versions had confirmable, internally consistent latent structures that were scalar invariant by sex, race, e-cigarette use (nondaily/daily), e-liquid nicotine content (no/yes), and current cigarette smoking status (no/yes). Daily e-cigarette users, nicotine e-liquid users, and cigarette smokers reported being more dependent on e-cigarettes than their counterparts. All EDS versions correlated strongly with one another, evidenced convergent validity with the Penn State E-cigarette Dependence Index and time to first e-cigarette use in the morning, and evidenced test-criterion relationships with vaping frequency, e-liquid nicotine concentration, and e-cigarette quit attempts. Similar results were observed when analyses were conducted within subsamples of exclusive e-cigarette users and duals-users of cigarettes and e-cigarettes. CONCLUSIONS Each EDS version evidenced strong psychometric properties for assessing e-cigarette dependence in adults who either use e-cigarette exclusively or who are dual-users of cigarettes and e-cigarettes. However, results indicated little benefit of the longer versions over the 4-item EDS, which provides an efficient assessment of e-cigarette dependence. IMPLICATIONS The availability of the novel, psychometrically sound EDS can further research on a wide range of questions related to e-cigarette use and dependence. In addition, the overlap between the EDS and the original PROMIS that was developed for assessing nicotine dependence to cigarettes provides consistency within the field.
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Affiliation(s)
- Meghan E Morean
- Department of Psychology, Oberlin College, Oberlin, OH
- Department of Psychiatry, Yale School of Medicine, New Haven, CT
| | | | - Steve Sussman
- Institute for Health Promotion & Disease Prevention Research, University of Southern California, Los Angeles, CA
| | - Jonathan Foulds
- Penn State Tobacco Center of Regulatory Science, Penn State University, College of Medicine, Hershey, PA
| | | | - Rachel Grana
- Tobacco Control Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD
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Chrea C, Acquadro C, Afolalu EF, Spies E, Salzberger T, Abetz-Webb L, Cano S, Arnould B, Mainy N, Rose J, Weitkunat R. Developing fit-for-purpose self-report instruments for assessing consumer responses to tobacco and nicotine products: the ABOUT™ Toolbox initiative. F1000Res 2018; 7:1878. [PMID: 30906527 PMCID: PMC6415329 DOI: 10.12688/f1000research.16810.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2018] [Indexed: 12/24/2022] Open
Abstract
Background. Determining the public health impact of tobacco harm reduction strategies requires the assessment of consumer perception and behavior associated with tobacco and nicotine products (TNPs) with different exposure and risk profiles. In this context, rigorous methods to develop and validate psychometrically sound self-report instruments to measure consumers' responses to TNPs are needed. Methods. Consistent with best practice guidelines, including the U.S. Food and Drug Administration's "Guidance for Industry Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims," scientifically designed, fit-for-purpose, reliable, and valid instruments are now being applied to tobacco regulatory research. Results. This brief report presents the ABOUT™ Toolbox ( Assessment of Behavioral OUtcomes related to Tobacco and nicotine products) initiative. This communication: (1) describes the methodological steps followed for the development and validation of the measurement instruments included in the ABOUT™ Toolbox, (2) presents a summary of the high-priority tobacco-related domains that are currently covered in the ABOUT™ Toolbox (i.e., risk perception, dependence, product experience, health and functioning, and use history), and (3) details how the measurement instruments are made accessible to the scientific community. Conclusions. By making the ABOUT™ Toolbox available to the tobacco research and public health community, we envision a rapidly expanding knowledge base, with the goals of (1) supporting consumer perception and behavior research to allow comparisons across a wide spectrum of TNPs, (2) enabling public health and regulatory communities to make better-informed decisions for future regulation of TNPs, and (3) enhancing surveillance activities associated with the impact of TNPs on population health.
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Affiliation(s)
- Christelle Chrea
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
| | - Catherine Acquadro
- Patient-Centered Sciences, Mapi, an ICON plc Company, Lyon, 69003, France
| | - Esther F. Afolalu
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
| | - Erica Spies
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
| | - Thomas Salzberger
- Institute for Statistics and Mathematics, Institute for Marketing Management, Vienna University of Economics and Business, Vienna, 1020, Austria
| | - Linda Abetz-Webb
- Patient-Centered Outcomes Assessments Ltd, Macclesfield, Cheshire, SK10 5LQ, UK
| | - Stefan Cano
- Modus Outcomes, Letchworth Garden City, SG6 4ET, UK
| | - Benoit Arnould
- Patient-Centered Sciences, Mapi, an ICON plc Company, Lyon, 69003, France
| | - Nelly Mainy
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
| | - Jed Rose
- Rose Research Center, Raleigh, NC, 27617, USA
| | - Rolf Weitkunat
- PMI R&D, Philip Morris Products S.A., Neuchâtel, CH-2000, Switzerland
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Healthcare provider counseling to quit smoking and patient desire to quit: The role of negative smoking outcome expectancies. Addict Behav 2018; 85:8-13. [PMID: 29793182 DOI: 10.1016/j.addbeh.2018.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/10/2018] [Accepted: 05/14/2018] [Indexed: 11/23/2022]
Abstract
AIMS The U.S. Public Health Service Clinical Practice Guideline on treating tobacco use and dependence recommends providing advice to quit to every tobacco user seen in a healthcare setting. However, the mechanism through which counseling encourages patients to quit has not been adequately studied. This study tests whether the association between receiving healthcare provider counseling and desire to quit is accounted for by negative health and psychosocial outcome expectancies of smoking. METHODS Data were collected online from 721 adult smokers who had seen a healthcare provider in the past 12 months. Associations between counseling to quit, negative outcome expectancies of smoking, and desire to quit were tested, as well as whether outcome expectancies and desire to quit differed by type of counseling (counseling only vs. counseling plus assistance) and level of smoking. RESULTS Bivariate associations indicated a stronger desire to quit among patients receiving counseling, particularly when it included healthcare provider assistance to quit. SEM results indicated that the association between counseling and desire to quit was fully accounted for by patients' negative health and psychosocial outcome expectancies for smoking. These associations were found across levels of smoking in the case of health expectancies, but were limited to moderate and heavy smokers in the case of psychosocial expectancies. CONCLUSION Results suggest that the time devoted to counseling patients about smoking should include providing some assistance to quit, such as recommending a product, prescription or program. Regardless of smoking level, this counseling should incorporate techniques to elicit patients' negative health and psychosocial expectancies of smoking.
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Bold KW, Sussman S, O'Malley SS, Grana R, Foulds J, Fishbein H, Krishnan-Sarin S. Measuring E-cigarette dependence: Initial guidance. Addict Behav 2018; 79:213-218. [PMID: 29174664 PMCID: PMC5807200 DOI: 10.1016/j.addbeh.2017.11.015] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 11/06/2017] [Accepted: 11/09/2017] [Indexed: 12/20/2022]
Abstract
E-cigarette use rates are increasing among youth and adults, despite limited knowledge about the safety, risks, and potential for this product in substituting for or reducing other tobacco use. Understanding how to characterize and assess e-cigarette dependence will be important for evaluating the public health impact of e-cigarettes and considering prevention and intervention strategies. To provide an initial review of constructs to consider when assessing e-cigarette dependence, a content expert group within the Tobacco Center for Regulatory Science (TCORS) Measurement Workgroup engaged in a review of published manuscripts and 12 tobacco dependence measures, followed by review of suggested dependence domains by a 10-person external subject-matter expert panel. The final domains selected to be considered in the development of a measure of e-cigarette dependence included: 1) Quantity and frequency of use, 2) Tolerance, 3) Perceived benefits, 4) Withdrawal symptoms, 5) Craving/urge to use, 6) Use despite harm, 7) Impaired control, 8) Automaticity, 9) Preferred over competing rewards, and 10) Sensory dependence. Similarities and differences in potential features of e-cigarette dependence compared with dependence on other tobacco products is discussed. Future work will evaluate these dependence items and constructs in a sample of e-cigarette users with a goal of developing a valid, brief, standardized measure of e-cigarette dependence.
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Affiliation(s)
| | | | | | - Rachel Grana
- Tobacco Control Research Branch, National Cancer Institute, United States
| | - Jonathan Foulds
- Pennsylvania State University, College of Medicine, Hershey, PA, United States
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Dunbar MS, Shadel WG, Tucker JS, Edelen MO. Use of and reasons for using multiple other tobacco products in daily and nondaily smokers: Associations with cigarette consumption and nicotine dependence. Drug Alcohol Depend 2016; 168:156-163. [PMID: 27664553 PMCID: PMC5086264 DOI: 10.1016/j.drugalcdep.2016.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 08/05/2016] [Accepted: 09/06/2016] [Indexed: 11/24/2022]
Abstract
BACKGROUND Use of other tobacco products (OTPs) among smokers is increasing. Little is known about types of OTP used and the reasons for use, and how OTP use and reasons for use correlate with smoking patterns and nicotine dependence in daily and nondaily smokers. This paper addresses these gaps in the literature. METHODS 656 daily smokers and 203 nondaily smokers provided information on their use of different OTPs (hookah, e-cigarettes, chew/snuff, snus, cigars, dissolvables), and reasons for using OTPs (e.g., "to cut down on smoking"), as well as their cigarette consumption and nicotine dependence. Logistic regression models assessed the association of smoking status with OTP use (ever and current) and reasons for use. Within each smoking group, separate logistic regression models examined the associations of OTP use and reasons for use with cigarette consumption and nicotine dependence. RESULTS Compared to daily smokers, nondaily smokers were more likely to use hookah and cigars, less likely to use dissolvables, and less likely to endorse using OTPs to reduce their smoking. Among non-daily smokers, nicotine dependence was associated with a higher likelihood of current OTP use (OR=1.04 [95% CI 1.01-1.07]; p<0.05), whereas cigarette consumption was not. CONCLUSIONS Results suggest OTP use in nondaily smokers does not correlate with less frequent smoking, but may correlate with higher nicotine dependence. Use of combustible OTPs among nondaily smokers may offset any potential benefits achieved through less frequent cigarette consumption. Providers should explicitly address OTP use when discussing cigarette cessation and reduction.
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Affiliation(s)
- Michael S Dunbar
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA.
| | - William G Shadel
- RAND Corporation, 4750 Fifth Avenue, Suite 600, Pittsburgh, PA 15213, USA
| | - Joan S Tucker
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA
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