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Tomaz PRX, Gonçalves TS, Santos JR, Scholz J, Abe TO, Gaya PV, Figueiredo EC, de Faria HD, Martins I, Pego AMF, Bismara BA, Yonamine M, Pereira AC, Santos PCJL. Evaluation of the nicotine metabolite ratio in smoking patients treated with varenicline and bupropion. Front Pharmacol 2022; 13:900112. [PMID: 35935834 PMCID: PMC9354088 DOI: 10.3389/fphar.2022.900112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Smoking is the leading cause of preventable death worldwide. It is responsible for several types of cancer, cardiovascular diseases, and diseases of the reproductive system, among others. Therefore, advances in research are increasingly necessary in order to make smoking cessation treatment more effective. Some studies have investigated the association of the nicotine metabolite ratio (NMR) with general characteristics and treatment outcomes. In the present study, the main aim was to evaluate the NMR in smoking patients from an Assistance Program of a tertiary cardiology hospital. Methodology: Serum samples were collected from 185 patients at T0 (while patients were still smoking and before starting pharmacological treatment). Cotinine and hydroxycotinine analytes were measured using liquid-chromatography tandem mass-spectrometry (LC-MS/MS). By looking at the relationship between hydroxycotinine and cotinine, we can obtain the NMR, with which it is possible to classify patients into slow metabolizers (NMR < 0.31), as well as normal or fast metabolizers (NMR ≥ 0.31). Results: From 185 patients, 55 were considered slow metabolizers and 130 as normal/fast. The metabolite averages were associated with the number of cigarettes smoked per day (p < 0.001 for cotinine and 0.023 hydroxycotinine). However, we were unable to analyze the association of the NMR with general and clinical characteristics of patients under smoking cessation treatment. Conclusion: We were able to evaluate the NMR, and to observe categories of metabolizers in Brazilian patients under pharmacological treatments. Thus, this study can contribute to the indication of a form of analysis, which might form part of the customization of smoking cessation treatments and, consequently, improve the success rates.
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Affiliation(s)
- Paulo Roberto Xavier Tomaz
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracão (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazi
| | - Thuane Sales Gonçalves
- Laboratory of Clinical Pharmacology and Translational Research, Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo EPM-Unifesp, São Paulo, Brazil
| | - Juliana Rocha Santos
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracão (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazi
| | - Jaqueline Scholz
- Smoking Cessation Program Department, Instituto do Coracão (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Tânia Ogawa Abe
- Smoking Cessation Program Department, Instituto do Coracão (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Patrícia Viviane Gaya
- Smoking Cessation Program Department, Instituto do Coracão (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Eduardo Costa Figueiredo
- Laboratory of Toxicant and Drug Analyses - LATF, Federal University of Alfenas - Unifal-MG, Alfenas, MG, Brazil
| | - Henrique Dipe de Faria
- Laboratory of Toxicant and Drug Analyses - LATF, Federal University of Alfenas - Unifal-MG, Alfenas, MG, Brazil
| | - Isarita Martins
- Laboratory of Toxicant and Drug Analyses - LATF, Federal University of Alfenas - Unifal-MG, Alfenas, MG, Brazil
| | - Ana Miguel Fonseca Pego
- John Jay College of Criminal Justice, City University of New York, New York City, GA, United States
| | - Beatriz Aparecida Bismara
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Maurício Yonamine
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Alexandre Costa Pereira
- Laboratory of Genetics and Molecular Cardiology, Instituto do Coracão (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazi
| | - Paulo Caleb Júnior Lima Santos
- Laboratory of Clinical Pharmacology and Translational Research, Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo EPM-Unifesp, São Paulo, Brazil
- *Correspondence: Paulo Caleb Júnior Lima Santos,
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Vogel EA, Benowitz NL, Skan J, Schnellbaecher M, Prochaska JJ. Correlates of the nicotine metabolite ratio in Alaska Native people who smoke cigarettes. Exp Clin Psychopharmacol 2022; 30:359-364. [PMID: 33856821 PMCID: PMC8517031 DOI: 10.1037/pha0000461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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
Research on nicotine metabolism has primarily focused on white adults. This study examined associations between nicotine metabolism, tobacco use, and demographic characteristics among Alaska Native adults who smoke cigarettes. Participants (N = 244) were Alaska Native adults who smoked and who provided a plasma sample at baseline (70.1%) or follow-up (29.9%) of a randomized controlled trial of a cardiovascular risk behavior intervention. At baseline, participants self-reported age, sex, Alaska Native heritage, cigarettes per day, time to first cigarette upon wakening, menthol use, perceived difficulty staying quit, tobacco withdrawal symptoms, and past-month tobacco product use, binge drinking, and cannabis use. At 3-, 6-, 12-, and 18-month follow-ups, participants self-reported 7-day point prevalence abstinence from smoking. Height and weight were measured to calculate body mass index (BMI). Participants' nicotine metabolite ratio (NMR), calculated as the ratio of plasma cotinine and trans-3' hydroxycotinine, was log-transformed. The sample (52.0% male, age M = 47.0 years [SD = 13.8], 60.3% of Inupiaq heritage) averaged 12.5 cigarettes per day (SD = 10.5); 64.0% smoked within 30 min of wakening. NMR was not significantly associated with age, sex, Alaska Native heritage, BMI, cigarettes per day, time to first cigarette upon wakening, menthol use, perceived difficulty staying quit, past-month dual tobacco product use, withdrawal symptoms, past-month binge drinking, past-month cannabis use, or abstinence from smoking (all p-values > .050). Characteristics that relate to NMR in Alaska Native adults may differ from those typically identified among white adults. Specifically, results may suggest that Alaska Native adults with slower nicotine metabolism do not titrate their nicotine intake when smoking. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Erin A. Vogel
- Stanford Prevention Research Center, Department of Medicine, Stanford University
| | - Neal L. Benowitz
- Clinical Pharmacology Program, Division of Cardiology, Department of Medicine, University of California, San Francisco
| | - Jordan Skan
- Alaska Native Tribal Health Consortium, Cardiology Department, Anchorage, AK
| | | | - Judith J. Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University
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Menthol Smoking and Nicotine Dependence among Black/African American Women Smokers Living in Low-Resource, Rural Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010877. [PMID: 34682623 PMCID: PMC8535496 DOI: 10.3390/ijerph182010877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 12/23/2022]
Abstract
Black/African American women from low-resource, rural communities bear a disproportionate burden of tobacco-related morbidity and mortality. This study examined associations between menthol smoking and socioeconomic deprivation with nicotine dependence and quitting behaviors among Black/African American women cigarette and/or little cigar/cigarillo smokers, aged 18–50 living in low-resource, rural communities. Baseline survey data from a randomized controlled behavioral/intervention trial (#NCT03476837) were analyzed (n = 146). Outcomes included time to first tobacco product (cigarette/little cigar/cigarillo) use within 5 min of waking, Fagerstrom Test for Nicotine Dependence (FTND) score, and ever attempting to quit cigarettes. Socioeconomic deprivation measures included education, income, and receiving supplemental nutritional assistance (SNAP) program benefits. In adjusted regression analyses, menthol smoking was associated with both greater FTND scores and time to first tobacco product use within 5 min of waking, but not ever attempting to quit cigarettes. Regardless of menthol status, only 25.0% of smokers reported that they would quit smoking if menthol cigarettes were banned. The proportion of smokers who smoked their first tobacco product within 5 min of waking increased slightly with greater socioeconomic deprivation. Additional research and targeted efforts are needed to reduce nicotine dependence among Black/African American women smokers living in rural, low-resource communities where access to cessation services is limited.
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Ho JTK, Tyndale RF, Baker TB, Amos CI, Chiu A, Smock N, Chen J, Bierut LJ, Chen LS. Racial disparities in intensity of smoke exposure and nicotine intake among low-dependence smokers. Drug Alcohol Depend 2021; 221:108641. [PMID: 33652379 PMCID: PMC8335796 DOI: 10.1016/j.drugalcdep.2021.108641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Compared to white smokers, Black smokers are at disproportionately higher risk for smoking-related disease, despite consuming fewer cigarettes per day (CPD). To examine racial disparities in biobehavioral influences on smoking and disease risk, we analyzed the relationship between self-reported tobacco dependence and intensity of tobacco smoke exposure per cigarette, on the one hand, and intensity of nicotine intake per cigarette, on the other. METHODS In 270 Black and 516 white smokers, smoke exposure was measured by expired carbon monoxide (CO), and nicotine intake was measured by plasma cotinine (COT) and cotinine+3'-hydroxycotinine ([COT + 3HC]). Using linear regression analyses, we analyzed how the Fagerström Test for Cigarette Dependence (FTCD) predicted intensity of smoke exposure per cigarette (CO/CPD) and intensity of nicotine intake per cigarette (COT/CPD; [COT + 3HC]/CPD), and how race moderated these relations. RESULTS Overall, Black smokers consumed fewer CPD than white smokers and had higher levels of CO/CPD, COT/CPD, and [COT + 3HC]/CPD. These elevations were most pronounced at lower levels of dependence: amongst Black smokers, FTCD negatively predicted intensity of smoke exposure as measured by CO/CPD (B = -0.12, 95% CI = -0.18, -0.05, p = 0.0003) and intensity of nicotine intake as measured by [COT + 3HC]/CPD (B = -1.31, 95% CI = -2.15, -0.46, p = 0.002). CONCLUSIONS Low-dependence Black smokers had higher intensities of both smoke exposure and nicotine intake per cigarette compared to similarly dependent white smokers, suggesting that measures of dependence, exposure, and intake underestimate incremental risk of each cigarette to Black smokers.
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Affiliation(s)
- Jolie T K Ho
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Pharmacology & Toxicology, and Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Timothy B Baker
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Christopher I Amos
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA; Department of Medicine, Baylor College of Medicine, Institute for Clinical and Translational Research, Houston, TX, USA
| | - Ami Chiu
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Nina Smock
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingling Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA
| | - Li-Shiun Chen
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO, USA.
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