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Aristides Dos Santos AM, Triaca LM, Leivas PHS. How is smoking distributed in relation to socioeconomic status? Evidence from Brazil in the years 2013 and 2019. ECONOMICS AND HUMAN BIOLOGY 2023; 49:101240. [PMID: 37044042 DOI: 10.1016/j.ehb.2023.101240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 02/19/2023] [Accepted: 03/18/2023] [Indexed: 05/08/2023]
Abstract
The present study aimed to analyze income-related inequality in tobacco consumption in Brazil using data from the National Health Survey at two points in time (2013 and 2019). This study contributes to the growing literature analyzing socioeconomic inequalities in tobacco use by investigating income-related inequalities in the consumption of different tobacco products in Brazil. The inequality measure is the concentration index with an Erreygers correction (EI), and the analysis of its decomposition allows the identification of the factors that determine such inequality. There is inequality in smoking concentrated in the poorest persons, and this pattern also occurs for manufactured cigarettes and roll-your-own cigarettes (RYO), while inequality in smoking cessation is concentrated among the wealthiest. Smoking inequalities were greater in men, older age groups, and RYO. In terms of evolution, the overall results indicated a small decline in smoking inequality. For the decomposition analysis, the results show that the main factors that affect tobacco inequality in terms of concentration in the poorest are education, income, and having private health insurance. The region variable, by contrast, has a positive contribution, since the wealthiest regions have individuals who are more likely to smoke. These results have important implications that serve as a basis for formulating public health policies. For example, greater inequalities for men and older individuals can be targeted by public policies with a special focus on these cases.
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Affiliation(s)
| | - Lívia Madeira Triaca
- Departament of Economics, Federal University of Rio Grande Foundation (Fundação Universidade Federal do Rio Grande - FURG), Rio Grande, Brazil; Posgraduate Program in Economics, Federal University of Pelotas (Universidade Federal de Pelotas - UFPel), Rio Grande Do Sul, Brazil
| | - Pedro Henrique Soares Leivas
- Departament of Economics, Federal University of Rio Grande Foundation (Fundação Universidade Federal do Rio Grande - FURG), Brazil
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Obeid S, Hallit S, Sacre H, Salameh P. Factors associated with the onset of smoking and alcohol consumption: A cross-sectional study among Lebanese adolescents in schools. Arch Pediatr 2022; 29:194-199. [PMID: 35094905 DOI: 10.1016/j.arcped.2022.01.002] [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: 04/11/2021] [Revised: 11/06/2021] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This study aimed to evaluate factors and profiles associated with the earlier onset of cigarette/waterpipe smoking and alcohol consumption among Lebanese adolescents in schools. METHODS A total of 4000 adolescents (mean age = 15.31 ± 2.01 years) participated in this cross-sectional study. The standardized questionnaire was taken from the Health Behavior in School Children (HBSC) study in different countries (France, Belgium, and the USA) and adjusted to the Lebanese population. K-means clustering analysis was conducted to classify participants into three clusters according to their patterns (surrounded by smokers, surrounded by drinkers, and ease of talking to family members and friends) and Cox regression analyzes were conducted. RESULTS Participants were divided into three clusters. Cluster 1 (16.75% of participants) included adolescents with the lowest ease of talking to a family member or friend, with the latter smoking and drinking a lot (worst cluster). Cluster 2 (54.95%) included adolescents with moderate ease of talking to a family member and more to friends, surrounded by low-to-moderate smoking and alcohol consumption, particularly for a best friend (positive influence cluster). Finally, cluster 3 (28.30%) included adolescents with low ease of talking to friends, moderate ease of talking to a family member, and low-to-moderate smoking and alcohol consumption (low influence cluster). The results of the Cox regressions (taking the age at onset of smoking cigarettes and waterpipes as the dependent variables) showed that older age at onset of cigarette and waterpipe smoking was significantly associated with female participants and those belonging to clusters 2 and 3 compared to cluster 1. Moreover, a younger age at first alcohol use and getting drunk was significantly associated with living outside Beirut, whereas female gender and belonging to clusters 2 or 3 compared to cluster 1 were significantly associated with older age at first alcohol use and getting drunk. CONCLUSION This study identified risk factors (ease of talking as well as smoking and alcohol-drinking status of parents, siblings, and friends) and profiles related to early alcohol and cigarette/waterpipe use. These risk factors and profiles could help implement prevention campaigns to reduce substance use and improve adolescent health.
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Affiliation(s)
- Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon; Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Hala Sacre
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon; Faculty of Pharmacy, Lebanese University, Beirut, Lebanon; University of Nicosia Medical School, Nicosia, Cyprus
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Noorbakhsh S, Afzali MH, Boers E, Conrod PJ. Cognitive Function Impairments Linked to Alcohol and Cannabis Use During Adolescence: A Study of Gender Differences. Front Hum Neurosci 2020; 14:95. [PMID: 32317950 PMCID: PMC7154290 DOI: 10.3389/fnhum.2020.00095] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/02/2020] [Indexed: 11/13/2022] Open
Abstract
Major neurocognitive changes occur during adolescence, making this phase one of the most critical developmental periods of life. Furthermore, this phase in life is also the time in which youth substance use begins. Several studies have demonstrated the differential associations of alcohol and cannabis use concerning the neurocognitive functioning of both males and females. Past and contemporary literature on gender-specific effects in neuroscience of addiction is predominantly based on cross-sectional datasets and data that is limited in terms of measurement variability. Given the importance of gender-specific effects in addiction studies, and in order to address the two above-mentioned gaps in the literature, the present study aimed to compare neurocognitive functioning of male and female adolescents in the context of cannabis and alcohol use, while employing a longitudinal design with multiple repeated measurements. Participants were 3,826 high school students (47% female; mean age, 12.7), who were recruited from 31 high schools in the greater Montreal area. Participants were requested to complete annual surveys for five consecutive years, from 7th to 11th grade, assessing their alcohol/cannabis use and neurocognitive functioning (working memory, delayed recall memory, perceptual reasoning, and inhibition control). The analytical strategy focused on the longitudinal association between each predictor (female, male) and each of the outcomes (domains of neurocognitive functioning). Multilevel linear models assessed the association of alcohol and cannabis consumption and the four domains of neurocognitive functioning. Results revealed a gender by within-subject interaction, suggesting a weaker effect of yearly fluctuation of cannabis use on working memory among males compared to females. Our findings suggest a different pattern of neurocognitive impairment of female and male working memory after using cannabis over the course of adolescence. Early initiation of cannabis use potentially results in more spatial working memory deficits in female adolescents. This may negatively influence young females' capacity in academic settings and lead to significant impairment in adulthood, which critically decreases the individual's quality of life.
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Affiliation(s)
- Simasadat Noorbakhsh
- Département de Psychiatrie, Université de Montréal, Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
| | - Mohammad H Afzali
- Département de Psychiatrie, Université de Montréal, Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
| | - Elroy Boers
- Département de Psychiatrie, Université de Montréal, Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
| | - Patricia J Conrod
- Département de Psychiatrie, Université de Montréal, Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
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Swayampakala K, Thrasher JF, Hardin JW, Titus AR, Liu J, Fong GT, Fleischer NL. Factors associated with changing cigarette consumption patterns among low-intensity smokers: Longitudinal findings across four waves (2008-2012) of ITC Mexico Survey. Addict Behav Rep 2018; 8:154-163. [PMID: 30364679 PMCID: PMC6197769 DOI: 10.1016/j.abrep.2018.10.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/04/2018] [Accepted: 10/06/2018] [Indexed: 01/08/2023] Open
Abstract
Background Light and intermittent smoking has become increasingly prevalent as smokers shift to lower consumption in response to tobacco control policies. We examined changes in cigarette consumption patterns over a four-year period and determined which factors were associated with smoking transitions. Methods We used data from a cohort of smokers from the 2008–2012 ITC Mexico Survey administrations to investigate transitions from non-daily (ND; n = 669), daily light (DL; ≤5 cigarettes per day (cpd); n = 643), and daily heavy (DH; >5 cpd; n = 761) smoking patterns. To identify which factors (i.e., sociodemographic measures, perceived addiction, quit behavior, social norms) were associated with smoking transitions, we stratified on smoking status at time t (ND, DL, DH) and used multinomial (ND, DL) and binomial (DH) logistic regression to examine transitions (quitting/reducing or increasing versus same level for ND and DL, quitting/reducing versus same level for DH). Results ND smokers were more likely to quit at follow-up than DL or DH smokers. DH smokers who reduced their consumption to ND were more likely to quit eventually compared to those who continued as DH. Smokers who perceived themselves as addicted had lower odds of quitting/reducing smoking consumption at follow-up compared to smokers who did not, regardless of smoking status at the prior survey. Quit attempts and quit intentions were also associated with quitting/reducing consumption. Conclusions Reducing consumption may eventually lead to cessation, even for heavier smokers. The findings that perceived addiction and quit behavior were important predictors of changing consumption for all groups may offer insights into potential interventions. Smoking transitions were evaluated in a cohort of Mexican smokers. The cohort consisted mostly of understudied light and intermittent smokers (LITS). Reductions in smoking intensity were found to facilitate smoking cessation. Greater perceived addiction inhibited cessation for smokers at all levels of intensity. LITS patterns warrant attention as number of low-intensity smokers worldwide grows.
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Affiliation(s)
- Kamala Swayampakala
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James F. Thrasher
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Departamento de Investigación sobre Tabaco, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - James W. Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Andrea R. Titus
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada
| | - Nancy L. Fleischer
- Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Corresponding author at: Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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McHugh RK, Votaw VR, Sugarman DE, Greenfield SF. Sex and gender differences in substance use disorders. Clin Psychol Rev 2017; 66:12-23. [PMID: 29174306 DOI: 10.1016/j.cpr.2017.10.012] [Citation(s) in RCA: 457] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 12/18/2022]
Abstract
The gender gap in substance use disorders (SUDs), characterized by greater prevalence in men, is narrowing, highlighting the importance of understanding sex and gender differences in SUD etiology and maintenance. In this critical review, we provide an overview of sex/gender differences in the biology, epidemiology and treatment of SUDs. Biological sex differences are evident across an array of systems, including brain structure and function, endocrine function, and metabolic function. Gender (i.e., environmentally and socioculturally defined roles for men and women) also contributes to the initiation and course of substance use and SUDs. Adverse medical, psychiatric, and functional consequences associated with SUDs are often more severe in women. However, men and women do not substantively differ with respect to SUD treatment outcomes. Although several trends are beginning to emerge in the literature, findings on sex and gender differences in SUDs are complicated by the interacting contributions of biological and environmental factors. Future research is needed to further elucidate sex and gender differences, especially focusing on hormonal factors in SUD course and treatment outcomes; research translating findings between animal and human models; and gender differences in understudied populations, such as those with co-occurring psychiatric disorders and gender-specific populations, such as pregnant women.
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Affiliation(s)
- R Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States.
| | - Victoria R Votaw
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States
| | - Dawn E Sugarman
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
| | - Shelly F Greenfield
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA 02478, United States; Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA 02155, United States
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Kurti AN, Klemperer EM, Zvorsky I, Redner R, Priest JS, Higgins ST. Some context for understanding the place of the general educational development degree in the relationship between educational attainment and smoking prevalence. Prev Med 2016; 92:141-147. [PMID: 26902876 PMCID: PMC4992659 DOI: 10.1016/j.ypmed.2016.02.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/16/2016] [Accepted: 02/18/2016] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Individuals with a General Educational Development (GED) degree have the highest smoking prevalence of any education level, including high school dropouts without a GED. Yet little research has been reported providing a context for understanding the exception that the GED represents in the otherwise graded inverse relationship between educational attainment and smoking prevalence. We investigated whether the GED may be associated with a general riskier profile that includes but is not limited to increased smoking prevalence. METHOD Data were obtained from three years (2011-2013) of the National Survey on Drug Use and Health ([NSDUH], N=55,940]). Prevalence of risky repertoire indicators (e.g., ever arrested, seldom/never wears a seatbelt), indicators of social instability (e.g., frequent relocations), and risky demographic characteristics (e.g., male gender) were compared among high school dropouts, GED holders, and high school graduates using Rao-Scott chi square goodness-of-fit tests and multiple logistic regression. RESULTS Those with GEDs differed significantly between both high school dropouts and high school graduates across 19 of 27 (70.4%) risk indicators. Controlling for risky profile characteristics accounted for a significant but limited (25-30%) proportion of the variance in smoking prevalence across these three education levels. CONCLUSION GED holders exhibit a broad high-risk profile of which smoking is just one component. Future research evaluating additional risk indicators and mechanisms that may underpin this generalized risky repertoire are likely needed for a more complete understanding of GED's place in the important relationship between educational attainment and smoking prevalence.
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Affiliation(s)
- Allison N Kurti
- Vermont Center on Behavior and Health, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States.
| | - Elias M Klemperer
- Vermont Center on Behavior and Health, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Psychological Science, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States
| | - Ivori Zvorsky
- Vermont Center on Behavior and Health, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Psychological Science, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States
| | - Ryan Redner
- Vermont Center on Behavior and Health, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Behavior Analysis and Therapy Program, Rehabilitation Institute, Southern Illinois University, Carbondale, IL 62901, United States
| | - Jeff S Priest
- Vermont Center on Behavior and Health, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Biostatistics, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Psychiatry, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States; Department of Psychological Science, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, United States
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Hasin DS, Grant BF. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1609-40. [PMID: 26210739 PMCID: PMC4618096 DOI: 10.1007/s00127-015-1088-0] [Citation(s) in RCA: 270] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/28/2015] [Indexed: 01/12/2023]
Abstract
PURPOSE The NESARC, a "third-generation" psychiatric epidemiologic survey that integrated detailed measures of alcohol and drug use and problems has been the data source for over >850 publications. A comprehensive review of NESARC findings and their implications is lacking. METHOD NESARC was a survey of 43,093 participants that covered alcohol, drug and psychiatric disorders, risk factors, and consequences. Wave 1 of the NESARC was conducted in 2001-2002. Three years later, Wave 2 follow-up re-interviews were conducted with 34,653 of the original participants. Scopus and Pubmed were used to search for NESARC papers, which were sorted into topic areas and summarized. RESULT The most common disorders were alcohol and posttraumatic stress disorders, and major depression. Females had more internalizing disorders and males had more externalizing disorders, although the preponderance of males with alcohol disorders (the "gender gap") was less pronounced than it was in previous decades. A race/ethnic "paradox" (lower risk among disadvantaged minorities than whites) remains unexplained. Younger participants had higher risk for substance and personality disorders, but not unipolar depressive or anxiety disorders. Psychiatric comorbidity was extensive and often formed latent trans-diagnostic domains. Since 1991-1992, risk for marijuana and prescription drug disorders increased, while smoking decreased, although smoking decreases were less pronounced among those with comorbidity. A nexus of comorbidity, social support, and stress predicted transitions in diagnostic status between Waves 1 and 2. Childhood maltreatment predicted psychopathology. Alcohol and drug use disorders were seldom treated; attitudinal barriers (little perceived need, perceived alcoholism stigma, pessimism about efficacy) were more important in predicting non-treatment than financial barriers. CONCLUSIONS Understanding comorbidity and the effects of early stressors will require research incorporating biologic components, e.g., genetic variants and brain imaging. The lack of treatment for alcohol and drug disorders, predicted by attitudinal rather than financial variables, suggests an urgent need for public and professional education to reduce the stigma associated with these disorders and increase knowledge of treatment options.
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Affiliation(s)
- Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, New York, NY, 10032, USA
- Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Bridget F Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3077, Rockville, MD, 20852, USA.
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Thompson AB, Tebes JK, McKee SA. Gender differences in age of smoking initiation and its association with health. ADDICTION RESEARCH & THEORY 2015; 23:413-420. [PMID: 27499723 PMCID: PMC4972043 DOI: 10.3109/16066359.2015.1022159] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND It is generally accepted that smoking starts in adolescence and earlier initiation is associated with more negative health outcomes. Some research suggests that women initiate smoking at later ages and have more negative health outcomes than men. The purpose of this study was to examine gender differences in age of initiation and its association with health. METHODS The sample included men (n=8,506) and women (n=8,479) with a history of smoking from the 2001-2002 National Epidemiological Survey of Alcohol Related Conditions. Logistic regression was used to examine gender differences in the effect of late smoking initiation on physical and mental health status after adjusting for covariates. RESULTS At mostly all ages after 16, women exceeded men in rates of smoking initiation (59.8% vs. 50.3%, p<.001). Among late initiators (≥16), women were more likely than men to have hypertension (OR:1.24,CI:1.09-1.41), heart disease (OR:1.20,CI:1.00-1.45), major depressive disorder (OR:2.54,CI:2.22-2.92) and generalized anxiety disorder (OR:2.34,CI:1.84-2.99). Among early initiators (<16), women were more likely than men to have major depressive disorder (OR:2.42,CI:2.11-2.77) and generalized anxiety disorder (OR:2.01,CI:1.59-2.54) but there were no gender differences in the likelihood of having hypertension (OR:1.04,CI:0.89-1.22) and heart disease (OR:1.11,CI:0.90-1.36). CONCLUSIONS In late adolescence and adulthood, women exceed men in smoking initiation. Late initiation was associated with more significant physical health risks for women than men. Our findings raise questions about generally accepted notions on the age at which smoking initiation occurs and its association with health.
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Affiliation(s)
- Azure B. Thompson
- The National Center on Addiction and Substance Abuse at Columbia University, New York, NY, USA
| | - Jacob K. Tebes
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Sherry A. McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Jiang F, Li S, Pan L, Zhang N, Jia C. Association of anxiety disorders with the risk of smoking behaviors: a meta-analysis of prospective observational studies. Drug Alcohol Depend 2014; 145:69-76. [PMID: 25456325 DOI: 10.1016/j.drugalcdep.2014.10.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/13/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Published articles reported controversial results about the association of anxiety disorders with the risk of smoking behaviors. A meta-analysis was performed to assess this association between anxiety disorders and smoking behaviors. METHODS A comprehensive search was performed to identify prospective observational studies (from January, 1990 to March, 2014) of the aforementioned association. The Q test and I(2) statistic were used to examine between-study heterogeneity. Fixed or random effect model was selected based on heterogeneity test among studies. Meta-regression and the "leave one out" sensitive analysis were used to explore potential sources of between-study heterogeneity. Publication bias was estimated using Egger's regression asymmetry test. RESULTS Fifteen articles were included. After excluding studies that were the key contributors to between-study heterogeneity, the meta-analysis showed a significant association of anxiety disorders with increased risk of regular smoking (OR = 1.41, 95% CI: 1.23-1.62) and nicotine dependence (OR = 1.58, 95% CI: 1.45-1.73). No significant influence and publication bias were observed both before and after excluding the key contributors to heterogeneity. CONCLUSION This meta-analysis suggested that anxiety disorders had significant positive effect on the risk of smoking behaviors. This association needs to be confirmed by further studies.
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Affiliation(s)
- Fan Jiang
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Suyun Li
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Lulu Pan
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Nan Zhang
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China
| | - Chongqi Jia
- Department of Epidemiology and Biostatistics, Shandong University, Jinan 250012, Shandong, PR China.
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Moss HB, Chen CM, Yi HY. Early adolescent patterns of alcohol, cigarettes, and marijuana polysubstance use and young adult substance use outcomes in a nationally representative sample. Drug Alcohol Depend 2014; 136:51-62. [PMID: 24434016 DOI: 10.1016/j.drugalcdep.2013.12.011] [Citation(s) in RCA: 301] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2013] [Revised: 12/09/2013] [Accepted: 12/14/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Alcohol, tobacco and marijuana are the most commonly used drugs by adolescents in the U.S. However, little is known about the patterning of early adolescent substance use, and its implications for problematic involvement with substances in young adulthood. We examined patterns of substance use prior to age 16, and their associations with young adult substance use behaviors and substance use disorders in a nationally representative sample of U.S. adolescents. METHOD Using data from Wave 4 of the Add Health Survey (n=4245), we estimated the prevalence of various patterns of early adolescent use of alcohol, cigarettes, and marijuana use individually and in combination. Then we examined the effects of patterns of early use of these substances on subsequent young adult substance use behaviors and DSM-IV substance use disorders. RESULTS While 34.4% of individuals reported no substance use prior to age 16, 34.1% reported either early use of both alcohol and marijuana or alcohol, marijuana and cigarettes, indicating the relatively high prevalence of this type of polysubstance use behavior among U.S. adolescents. Early adolescent use of all three substances was most strongly associated with a spectrum of young adult substance use problems, as well as DSM-IV substance use disorder diagnoses. CONCLUSIONS This research confirms the elevated prevalence and importance of polysubstance use behavior among adolescents prior to age 16, and puts early onset of alcohol, marijuana and cigarette use into the context of use patterns rather than single drug exposures.
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Affiliation(s)
| | - Chiung M Chen
- Alcohol Epidemiologic Data System, CSR, Incorporated, United States
| | - Hsiao-Ye Yi
- Alcohol Epidemiologic Data System, CSR, Incorporated, United States
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Bot M, Vink J, Milaneschi Y, Smit JH, Kluft C, Neuteboom J, Penninx B. Plasma cotinine levels in cigarette smokers: impact of mental health and other correlates. Eur Addict Res 2014; 20:183-91. [PMID: 24481322 DOI: 10.1159/000356809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 10/17/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS We examined in cigarette smokers whether cotinine was associated with depressive and/or anxiety disorders. METHODS Data were derived from 1,026 smoking adults with and without depressive and/or anxiety disorders participating in the Netherlands Study of Depression and Anxiety (NESDA). Depressive and anxiety disorders were ascertained with the DSM-IV Composite International Diagnostic Interview. Cigarette consumption was inquired about during an interview. Cotinine was assessed in plasma. RESULTS Currently depressed and/or anxious smokers (n=692) reported smoking a higher number of cigarettes per day (CPD) than smokers with a remitted disorder (n=190) and smokers with no lifetime disorder (n=144). After controlling for CPD and other covariates, depressed and/or anxious smokers had lower cotinine levels compared to smokers with no lifetime disorder (B=-56.0, p=0.001). In the full regression model, CPD was positively associated with cotinine levels, whereas current depression and/or anxiety and high body mass index were inversely associated with cotinine. CONCLUSION After considering CPD, the presence of current depressive and/or anxiety disorders was associated with lower cotinine levels, which may point to a different smoking topography or a faster cotinine metabolism in individuals with affective disorders. The latter could help to explain the higher number of cigarettes smoked and poorer cessation rates among depressed or anxious patients.
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Affiliation(s)
- Mariska Bot
- Department of Psychiatry, EMGO Institute of Health and Care Research, Neuroscience Campus Amsterdam, VU University Medical Center, and GGZinGeest, Amsterdam, The Netherlands
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12
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Smoking and obesity associatedBDNFgene variance predicts total and cardiovascular mortality in smokers. Heart 2013; 99:949-53. [DOI: 10.1136/heartjnl-2013-303634] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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13
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Moylan S, Jacka FN, Pasco JA, Berk M. Cigarette smoking, nicotine dependence and anxiety disorders: a systematic review of population-based, epidemiological studies. BMC Med 2012; 10:123. [PMID: 23083451 PMCID: PMC3523047 DOI: 10.1186/1741-7015-10-123] [Citation(s) in RCA: 141] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 10/19/2012] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized. METHODS We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders. RESULTS In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified. CONCLUSIONS Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of panic disorder and generalized anxiety disorder. The literature assessing anxiety disorders increasing smoking and nicotine dependence is inconsistent. Potential issues with the current literature are discussed and directions for future research are suggested.
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Affiliation(s)
- Steven Moylan
- Deakin University School of Medicine, Barwon Health, Geelong, Victoria, Australia.
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14
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Sundin Ö, Soares J, Grossi G, Macassa G. Burnout among foreign-born and native Swedish women: a longitudinal study. Women Health 2012; 51:643-60. [PMID: 22082245 DOI: 10.1080/03630242.2011.618529] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
The authors of this study addressed burnout experiences (generally defined as chronic depletion of an individual's energetic resources') over time in relation to other factors (e.g., distress, sleep difficulties, job demands, etc.) among foreign-born women and Swedish native women living in Stockholm. The study design was a longitudinal panel survey with two waves one year apart. In the first wave, 3,616 of 6,000 randomly selected women took part, and 2,300 of the initial 3,616 women also participated in the second wave; 427 were foreign-born women, and 1,873 were Swedish native women. Baseline/emerging distress, emerging sleep difficulties, worsening general social support, job demands at baseline/escalating during the assessment period, emerging unemployment, constraints in social support at work, and sustained/emerging financial strain were associated with future burnout, regardless of background. More foreign-born women than Swedish native women reported burnout, with these differences maintained at one-year follow-up. The factors related to burnout were largely the same in both groups, but smoking and cardiovascular disease were related to burnout only among foreign-born women. Younger age, job demands, and working hours were associated with burnout among Swedish native women. The authors found that the women had concurrent problems such as burnout, distress, and sleep problems, but foreign background was not independently related to burnout.
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Affiliation(s)
- Örjan Sundin
- Department of Social Sciences, Division of Psychology, Mid Sweden University, Sundsvall, Sweden
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15
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Ignatyev Y, Assimov M, Aichberger MC, Ivens S, Mir J, Dochshanov D, Ströhle A, Heinz A, Mundt AP. Psychometric properties of a Russian version of the General Health Questionnaire-28. Psychopathology 2012; 45:252-8. [PMID: 22653333 DOI: 10.1159/000334918] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 11/08/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND The 28-item General Health Questionnaire (GHQ-28) is a scaled version of the General Health Questionnaire that has been used internationally to screen for mental disorders in nonpsychiatric populations. There is great need to validate international screening instruments in the Russian language for their use in post-Soviet countries. METHODS 200 persons were surveyed in a deprived area of Almaty, Kazakhstan using the Russian version of the GHQ-28 and socioeconomic measures (income level, employment situation and education). We calculated the median and the mean GHQ-28 scores for different socioeconomic subgroups. The internal reliability was tested using Cronbach's α coefficient and intersubscale correlations. We conducted an exploratory factor analysis using varimax rotation. RESULTS The median score of the GHQ-28 was 2 (mean = 3.56; SD = 5.09) for the total sample. Higher age, unemployment and female gender were significantly associated with high mean GHQ-28 scores. Cronbach's α coefficient was 0.92 for the total scale. Exploratory factor analysis revealed four factors explaining 50.07% of the variance. The factor Anxiety/Insomnia accounted for 14.87%, Severe Depression for 13.74%, Social Dysfunction for 13.47% and Somatic Symptoms for 8.81% of the variance. CONCLUSIONS The test showed good internal consistency. The median GHQ-28 score was relatively low compared to other countries. The subscale Severe Depression including items on suicidal ideation may have a lower acceptance than the other subscales Somatic Symptoms, Anxiety/Insomnia and Social Dysfunction.
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Affiliation(s)
- Yuriy Ignatyev
- Department of Communication Skills, Psychotherapy, General and Medical Psychology, Kazakh National Medical University, Almaty, Kazakhstan
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16
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Goodwin RD, Pagura J, Spiwak R, Lemeshow A, Sareen J. Predictors of persistent nicotine dependence among adults in the United States. Drug Alcohol Depend 2011; 118:127-33. [PMID: 21514748 PMCID: PMC3337717 DOI: 10.1016/j.drugalcdep.2011.03.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 03/08/2011] [Accepted: 03/11/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Evidence suggests that nicotine dependence is the key barrier to successful smoking cessation. No previous study has documented predictors of persistent nicotine dependence among adults in the community. The goal of this study is to prospectively identify predictors of continued nicotine dependence over a 3-year period among adults. METHODS Data were drawn from Waves I and II of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a nationally representative sample of 34,653 adults in the United States. Logistic regression analyses were used to estimate the odds of persistent nicotine dependence at Wave 2 given the presence of various sociodemographic and psychiatric predictors at Wave 1. RESULTS Mood, anxiety, personality and illicit substance use disorders were associated with significantly increased risk of persistent nicotine dependence. The strength of these relationships was attenuated slightly after adjusting for demographic differences, but remained statistically significant. Persistent nicotine dependence was more common among unmarried, younger females with lower income levels and lower educational attainment. CONCLUSIONS To our knowledge, this study is the first to prospectively identify predictors of persistent nicotine dependence among adults. Our results suggest that the incorporation of mental health treatment into alternative smoking cessation approaches may help to increase the effectiveness of these programs and that a greater focus of these services on vulnerable segments of the population is needed in order to reduce continued disparities in smoking in the general population.
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Affiliation(s)
- Renee D Goodwin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th St, Rm 1505, New York, NY 10032, USA.
| | - Jina Pagura
- Department of Psychiatry, University of Manitoba, PZ-430 PsycHealth Centre, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4
| | - Rae Spiwak
- Department of Psychiatry, University of Manitoba, PZ-430 PsycHealth Centre, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4
| | - Adina Lemeshow
- Department of Epidemiology, Mailman School of Public Health Columbia University, 722 West 168th St, Rm 1505, New York, New York 10032, Ph 212-342-0422, Fax 212-342-5168
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, PZ-430 PsycHealth Centre, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4
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Hahn C, Neuhaus AH, Pogun S, Dettling M, Kotz SA, Hahn E, Brüne M, Güntürkün O. Smoking reduces language lateralization: A dichotic listening study with control participants and schizophrenia patients. Brain Cogn 2011; 76:300-9. [PMID: 21524559 DOI: 10.1016/j.bandc.2011.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2011] [Revised: 03/21/2011] [Accepted: 03/22/2011] [Indexed: 12/30/2022]
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Giatti L, Barreto SM. Tabagismo, situação no mercado de trabalho e gênero: análise da PNAD 2008. CAD SAUDE PUBLICA 2011; 27:1132-42. [DOI: 10.1590/s0102-311x2011000600010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2010] [Accepted: 03/18/2011] [Indexed: 11/21/2022] Open
Abstract
O presente estudo teve como objetivo verificar se o tabagismo atual está associado à inserção no mercado de trabalho, após ajuste por escolaridade, renda e saúde em homens e mulheres; objetivou, também, discutir hipóteses explicativas. Foram estudados indivíduos de 15 a 64 anos, residentes em regiões metropolitanas brasileiras, pertencentes à população economicamente ativa, incluídos na Pesquisa Nacional por Amostra de Domicílios (2008). Razão de prevalência (RP) e intervalo de 95% de confiança (IC95%) foram obtidos pela regressão de Poisson. Após ajustes, o tabagismo foi estatisticamente maior em indivíduos inseridos no trabalho sem proteção social (homens, RP = 1,31, IC95%: 1,24-1,38; mulheres, RP = 1,22, IC95%: 1,12-1,31) e desempregados (homens, RP = 1,31, IC95%: 1,18-1,44; mulheres, RP = 1,16, IC95%: 1,03-1,32). Prevalências mais altas de tabagismo foram observadas nos homens inseridos no trabalho sem proteção social. Nossos resultados confirmam que a situação no mercado de trabalho é uma dimensão independente das desigualdades sociais no tabagismo. O gradiente social observado foi mais acentuado nos homens, mas a associação entre inserção no trabalho e tabagismo está presente nos dois gêneros.
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Beard E, McNeill A, Aveyard P, Fidler J, Michie S, West R. Use of nicotine replacement therapy for smoking reduction and during enforced temporary abstinence: a national survey of English smokers. Addiction 2011; 106:197-204. [PMID: 21083833 DOI: 10.1111/j.1360-0443.2010.03215.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To assess the prevalence of nicotine replacement therapy (NRT) use for smoking reduction (SR) and temporary abstinence (TA), the association between the two and the strength of the association between NRT use for SR or TA and socio-demographic characteristics, cigarette consumption and past quit attempts. DESIGN Cross-sectional monthly surveys. SETTING England. PARTICIPANTS A total of 11, 414 smokers. MEASUREMENTS Participants were asked (i) whether they were reducing the amount they smoked: if so, whether they used NRT; and (ii) whether they used NRT for TA. Demographic characteristics, daily cigarette consumption and whether a quit attempt had been made in the past 12 months were also assessed. FINDINGS Of the participants, 56% were attempting SR, 14% were using NRT for SR and 14% were using NRT for TA. Use of NRT for SR and TA were highly correlated. The nicotine patch was the most commonly used form of NRT. The use of NRT for SR, compared with unassisted SR, was more common among older smokers, while the use of NRT for TA was more common among women. Cigarette consumption was higher in those using NRT for SR than those attempting SR without NRT. The use of NRT for SR and TA was associated positively with past quit attempts. CONCLUSIONS Nicotine replacement therapy use for smoking reduction and temporary abstinence is common in England. The use of NRT for SR and TA does not appear to be associated with lower cigarette consumption relative to SR or TA without NRT, but is associated with a higher rate of past quit attempts.
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Affiliation(s)
- E Beard
- UK Centre for Tobacco Control Studies, University College London, London, UK.
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Heffner JL, Johnson CS, Blom TJ, Anthenelli RM. Relationship between cigarette smoking and childhood symptoms of inattention and hyperactivity/impulsivity in alcohol-dependent adults without attention-deficit hyperactivity disorder. Nicotine Tob Res 2010; 12:243-50. [PMID: 20083646 DOI: 10.1093/ntr/ntp200] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Symptoms of inattention and hyperactivity/impulsivity that fall below the DSM-IV diagnostic threshold for attention-deficit hyperactivity disorder (ADHD) may be associated with the high prevalence of smoking among individuals with alcohol dependence, yet no studies to date have examined the relationship between subthreshold ADHD symptoms and cigarette smoking in this group. We hypothesized that increasing levels of ADHD symptoms would be associated with increasing risk of lifetime smoking and nicotine dependence, concentration problems secondary to nicotine withdrawal, and maintenance of smoking. METHODS Participants were alcohol-dependent adults (n = 242) who did not meet criteria for ADHD or a current Axis I disorder other than alcohol and nicotine dependence. All participants were involved in treatment for alcohol dependence but not smoking cessation. The Semi-Structured Assessment for the Genetics of Alcoholism was administered to collect demographic and smoking history data and to assess symptoms of ADHD and other psychiatric disorders. RESULTS A higher number of self-reported ADHD symptoms were associated with increased likelihood of ever smoking (p = .026), nicotine dependence (p = .017), and impaired concentration as a symptom of nicotine withdrawal (p = .046). There was no relationship between the number of ADHD symptoms and classification as a former versus current smoker (p = .333). CONCLUSIONS Childhood symptoms of inattention and hyperactivity/impulsivity are related to cigarette smoking and nicotine dependence among alcohol-dependent individuals at levels below the ADHD diagnostic threshold. Conceptualization of ADHD symptoms as occurring on a continuum may aid identification of and early intervention for individuals who are at highest risk for initiating smoking and developing nicotine dependence.
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Affiliation(s)
- Jaimee L Heffner
- Tri-State Tobacco and Alcohol Research Center, University of Cincinnati Reading Campus, 2120 E. Galbraith Road, Building A, Cincinnati, OH 45237, USA.
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Higgins ST, Chilcoat HD. Women and smoking: an interdisciplinary examination of socioeconomic influences. Drug Alcohol Depend 2009; 104 Suppl 1:S1-5. [PMID: 19586726 PMCID: PMC2805006 DOI: 10.1016/j.drugalcdep.2009.06.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 06/03/2009] [Indexed: 10/20/2022]
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