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Trigg J, Rich J, Williams E, Baker A, Bauld L, Borland R, Bullen C, Daglish M, Dunlop A, Gartner C, Jacka D, Lubman D, Manning V, McCrohan R, Segan C, Walker N, Bonevski B. A qualitative study of using nicotine products for smoking cessation after discharge from residential drug and alcohol treatment in Australia. Drug Alcohol Rev 2024; 43:1116-1131. [PMID: 38653554 DOI: 10.1111/dar.13850] [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: 03/06/2023] [Revised: 03/08/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
INTRODUCTION Tobacco smoking is highly prevalent among alcohol and other drugs (AOD) service clients and, despite interest in quitting, abstinence is rarely sustained. Nicotine products may assist after discharge from residential treatment services, but little is known about client receptivity to them. This study examined AOD withdrawal service clients' experiences of two types of nicotine products for smoking cessation post-discharge, combination nicotine replacement therapy (cNRT) and nicotine vaping products (NVP). METHODS We held semi-structured telephone interviews with 31 Australian AOD service clients in a clinical trial of a 12-week smoking cessation intervention using Quitline support plus cNRT or NVP delivered post-discharge from a smoke-free residential service. We asked about health and social factors, nicotine cravings, Quitline experience, and barriers and facilitators to cNRT or NVP, then thematically analysed data. RESULTS cNRT and NVP were described by participants as feasible and acceptable for smoking cessation. For most participants, cost limited cNRT access post study, as did difficulty navigating NVP prescription access. Quitline support was valued, but not consistently used, with participants noting low assistance with NVP-facilitated cessation. Participants considered both cessation methods acceptable and socially supported, and sought information on decreasing nicotine use via NVP. DISCUSSION AND CONCLUSIONS AOD service clients highly valued receiving cNRT or NVP with behavioural support for smoking reduction or abstinence. Both interventions were acceptable to service clients. Findings suggest a potential need to examine both whether NVP use should be permitted in this context, and guidance on the individual suitability of cNRT or NVP.
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Affiliation(s)
- Joshua Trigg
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Jane Rich
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Edwina Williams
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
| | - Amanda Baker
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Ron Borland
- School of Psychological Sciences and Honorary Professor, School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Chris Bullen
- The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Mark Daglish
- Faculty of Medicine, University of Queensland, and Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - Adrian Dunlop
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, Australia
| | - Coral Gartner
- School of Public Health, University of Queensland, Brisbane, Australia
| | - David Jacka
- Department of Drug and Alcohol Treatment, Monash Health, Melbourne, Australia
| | - Dan Lubman
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia
- Turning Point, Eastern Health, Monash University, Melbourne, Australia
| | - Victoria Manning
- Turning Point, Eastern Health, Monash University, Melbourne, Australia
| | | | | | - Natalie Walker
- The National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Billie Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
- School of Medicine and Public Health, College of Medicine, Health and Wellbeing, University of Newcastle, Newcastle, Australia
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Miller AP, Bogdan R, Agrawal A, Hatoum AS. Generalized genetic liability to substance use disorders. J Clin Invest 2024; 134:e172881. [PMID: 38828723 PMCID: PMC11142744 DOI: 10.1172/jci172881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Lifetime and temporal co-occurrence of substance use disorders (SUDs) is common and compared with individual SUDs is characterized by greater severity, additional psychiatric comorbidities, and worse outcomes. Here, we review evidence for the role of generalized genetic liability to various SUDs. Coaggregation of SUDs has familial contributions, with twin studies suggesting a strong contribution of additive genetic influences undergirding use disorders for a variety of substances (including alcohol, nicotine, cannabis, and others). GWAS have documented similarly large genetic correlations between alcohol, cannabis, and opioid use disorders. Extending these findings, recent studies have identified multiple genomic loci that contribute to common risk for these SUDs and problematic tobacco use, implicating dopaminergic regulatory and neuronal development mechanisms in the pathophysiology of generalized SUD genetic liability, with certain signals demonstrating cross-species and translational validity. Overlap with genetic signals for other externalizing behaviors, while substantial, does not explain the entirety of the generalized genetic signal for SUD. Polygenic scores (PGS) derived from the generalized genetic liability to SUDs outperform PGS for individual SUDs in prediction of serious mental health and medical comorbidities. Going forward, it will be important to further elucidate the etiology of generalized SUD genetic liability by incorporating additional SUDs, evaluating clinical presentation across the lifespan, and increasing the granularity of investigation (e.g., specific transdiagnostic criteria) to ultimately improve the nosology, prevention, and treatment of SUDs.
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Affiliation(s)
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Alexander S. Hatoum
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
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Smiley SL, Shin H. Motivation to Quit Smoking Among Black Adults Residing in Los Angeles County Communities With Menthol Cigarette Sales Restrictions. Subst Use Misuse 2024; 59:727-731. [PMID: 38226661 DOI: 10.1080/10826084.2023.2294984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
Background: Research is needed to identify the determinants of motivation to quit smoking among non-Hispanic Black (NHB) adults who smoke menthol cigarettes and reside in communities covered by menthol cigarette bans. Objectives: This study examined the associations between motivation to quit smoking and a range of individual-level predictors, including measures of demographics, harm/risk perception of menthol cigarettes, and awareness of a ban on menthol cigarettes in Los Angeles County unincorporated communities. Self-identified NHB adults who currently smoke menthol cigarettes (N=50; M=47.2 years; SD=13.7; 46% female) were recruited in Los Angeles County unincorporated communities. Participants completed an interviewer-administered cross-sectional survey between January to September 2021. Results: Participants (74%) reported an annual household income of less than $25,000. Participants' mean age at cigarette initiation was 15.7 years old (SD=5.68). Most (88%) were aware of the ordinance banning menthol cigarette sales. Employing multivariable linear regression analysis, harm/risk perception of menthol cigarettes (B=14.69, p<0.01) and awareness of the local menthol ban (B=26.18, p<0.05) were found to be independently associated with motivation to quit smoking. Conclusions: Findings from this community-based sample suggest that among NHB adults who smoke menthol cigarettes, motivation to quit smoking is influenced by their perception of menthol cigarettes as harmful and awareness of local policy banning the sale of menthol cigarettes. Findings underscore the need for community-centered and culturally grounded interventions to facilitate quitting among NHB adults who smoke in order for communities covered by menthol bans to achieve health equity in reducing preventable racial inequities due to menthol cigarettes.
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Affiliation(s)
- Sabrina L Smiley
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, California, USA
| | - Heesung Shin
- Division of Health Promotion and Behavioral Science, School of Public Health, College of Health and Human Services, San Diego State University, San Diego, California, USA
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Jurek L, Montègue S, Larrieu A, Icard C, Rolland B. Compared Profile of Late-Onset Versus Childhood-Onset ADHD: A Case-Control Study Among Treatment-Seeking Adult Patients. J Atten Disord 2023; 27:1630-1637. [PMID: 37565344 DOI: 10.1177/10870547231191756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
OBJECTIVE To compare the characteristics of childhood-onset versus late-onset Attention Deficit Hyperactivity Disorder (ADHD) in a sample of treatment-seeking patients. METHOD Among total of 101 adult patients who were recently diagnosed for ADHD, using the Diagnostic Interview for Adult ADHD (DIVA 2.0), 56 subjects exhibited childhood-onset ADHD, versus 45 displayed late-onset ADHD. Both groups were compared according to their sociodemographic, clinical, and neuropsychological features, providing crude (OR) and adjusted odds ratios (aOR), and their 95% confidence intervals [95% CI]. RESULTS Compared to late-onset ADHD, patients with childhood-onset had a lower educational score, (OR = 0.52; 95% CI [0.35, 0.76]), a greater score of impulsivity (aOR = 1.09; 95% CI [1.03, 1.16]), an increased number of hyperactive-impulsive ADHD symptoms (aOR = 1.9; 95% CI [1.46, 2.47]), and higher rates childhood trauma (aOR = 1.07; 95% CI [1.01, 1.13]), cannabis use disorder (aOR = 1.07; 95% CI [1.01, 1.13]), and working memory impairment. No difference was observed concerning age, sex, psychiatric symptoms, quality of life, and autonomy. CONCLUSION Childhood-onset adult ADHD displayed a more severe profile, relative to late-onset ADHD.
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Affiliation(s)
- Lucie Jurek
- Centre Hospitalier Le Vinatier, Bron, France
- Université Claude Bernard Lyon 1, Lyon, France
| | | | | | | | - Benjamin Rolland
- Centre Hospitalier Le Vinatier, Bron, France
- Hospices Civils de Lyon, Lyon, France
- Centre de Recherche en Neurosciences de Lyon, Bron, France
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Chen H, Zha R, Lai X, Liu Y, Wei Z, Wang M, Zuo H, Hong W, Fan C, Jin C, Cui G, Tao R, Liang P, Zhang X. Internet gaming disorder and tobacco use disorder share neural connectivity patterns between the subcortical and the motor network. Hum Brain Mapp 2023; 44:2607-2619. [PMID: 36807959 PMCID: PMC10028654 DOI: 10.1002/hbm.26233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/09/2023] [Accepted: 01/26/2023] [Indexed: 02/22/2023] Open
Abstract
Internet gaming disorder (IGD) and tobacco use disorder (TUD) are globally common, non-substance-related disorders and substance-related disorders worldwide, respectively. Recognizing the commonalities between IGD and TUD will deepen understanding of the underlying mechanisms of addictive behavior and excessive online gaming. Using node strength, 141 resting-state data were collected in this study to compute network homogeneity. The participants included participants with IGD (PIGD: n = 34, male = 29, age: 15-25 years), participants with TUD (PTUD: n = 33, male = 33, age: 19-42 years), and matched healthy controls (control-for-IGD: n = 41, male = 38, age: 17-32 years; control-for-TUD: n = 33, age: 21-27 years). PIGD and PTUD exhibited common enhanced node strength between the subcortical and motor networks. Additionally, a common enhanced resting-state functional connectivity (RSFC) was found between the right thalamus and right postcentral gyrus in PIGD and PTUD. Node strength and RSFC were used to distinguish PIGD and PTUD from their respective healthy controls. Interestingly, models trained on PIGD versus controls could classify PTUD versus controls and vice versa, suggesting that these disorders share common neurological patterns. Enhanced connectivity may indicate a greater association between rewards and behaviors, inducing addiction behaviors without flexible and complex regulation. This study discovered that the connectivity between the subcortical and motor networks is a potential biological target for developing addiction treatment in the future.
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Affiliation(s)
- Hui Chen
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Rujing Zha
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Xin Lai
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Yan Liu
- Application Technology Center of Physical Therapy to Brain Disorders, Institute of Advanced Technology, University of Science and Technology of China, Hefei, Anhui, China
| | - Zhengde Wei
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Min Wang
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Huilin Zuo
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Wei Hong
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Chuan Fan
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Chen Jin
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Guanbao Cui
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
| | - Ran Tao
- Beijing Shijian Integrated Medicine Science Institute, Beijing, China
| | - Peipeng Liang
- School of Psychology, Beijing Key Laboratory of Learning and Cognition, Capital Normal University, Beijing, China
| | - Xiaochu Zhang
- Hefei National Research Center for Physical Sciences at the Microscale, and Department of Radiology, the First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Department of Psychology, School of Humanities & Social Science, University of Science and Technology of China, Hefei, Anhui, China
- Application Technology Center of Physical Therapy to Brain Disorders, Institute of Advanced Technology, University of Science and Technology of China, Hefei, Anhui, China
- Institute of Health and Medicine, Hefei Comprehensive National Science Center, Hefei, Anhui, China
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Brandt L, Hu MC, Liu Y, Castillo F, Odom GJ, Balise RR, Feaster DJ, Nunes EV, Luo SX. Risk of Experiencing an Overdose Event for Patients Undergoing Treatment With Medication for Opioid Use Disorder. Am J Psychiatry 2023; 180:386-394. [PMID: 36891640 DOI: 10.1176/appi.ajp.20220312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
OBJECTIVE Overdose risk during a course of treatment with medication for opioid use disorder (MOUD) has not been clearly delineated. The authors sought to address this gap by leveraging a new data set from three large pragmatic clinical trials of MOUD. METHODS Adverse event logs, including overdose events, from the three trials (N=2,199) were harmonized, and the overall risk of having an overdose event in the 24 weeks after randomization was compared for each study arm (one methadone, one naltrexone, and three buprenorphine groups), using survival analysis with time-dependent Cox proportional hazard models. RESULTS By week 24, 39 participants had ≥1 overdose event. The observed frequency of having an overdose event was 15 (5.30%) among 283 patients assigned to naltrexone, eight (1.51%) among 529 patients assigned to methadone, and 16 (1.15%) among 1,387 patients assigned to buprenorphine. Notably, 27.9% of patients assigned to extended-release naltrexone never initiated the medication, and their overdose rate was 8.9% (7/79), compared with 3.9% (8/204) among those who initiated naltrexone. Controlling for sociodemographic and time-varying medication adherence variables and baseline substance use, a proportional hazard model did not show a significant effect of naltrexone assignment. Significantly higher probabilities of experiencing an overdose event were observed among patients with baseline benzodiazepine use (hazard ratio=3.36, 95% CI=1.76, 6.42) and those who either were never inducted on their assigned study medication (hazard ratio=6.64, 95% CI=2.12, 19.54) or stopped their medication after initial induction (hazard ratio=4.04, 95% CI=1.54, 10.65). CONCLUSIONS Among patients with opioid use disorder seeking medication treatment, the risk of overdose events over the next 24 weeks is elevated among those who fail to initiate or discontinue medication and those who report benzodiazepine use at baseline.
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Affiliation(s)
- Laura Brandt
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
| | - Mei-Chen Hu
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
| | - Ying Liu
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
| | - Felipe Castillo
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
| | - Gabriel J Odom
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
| | - Raymond R Balise
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
| | - Daniel J Feaster
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
| | - Edward V Nunes
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
| | - Sean X Luo
- Department of Psychology, City College of New York, New York (Brandt); Division on Substance Use Disorders, New York State Psychiatric Institute, New York (Castillo, Nunes, Luo); Department of Psychiatry, Columbia University Irving Medical Center, New York (Hu, Liu, Nunes, Luo); Department of Biostatistics, Florida International University, Miami (Odom); Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami (Balise, Feaster)
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Freire APCF, Medina BAS, Leite MR, Lopes TO, Santos ET, Ferreira MM, Silva BSA, Cavalcante MA, Pacagnelli FL. Consumption, nicotine dependence and motivation for smoke cessation during early stages of COVID-19 pandemic in Brazil: A cross-sectional study. Tob Prev Cessat 2022; 8:17. [PMID: 35601561 PMCID: PMC9074835 DOI: 10.18332/tpc/146545] [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: 10/09/2021] [Revised: 12/29/2021] [Accepted: 02/01/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The COVID-19 pandemic may have changed smoking habits. For the smoking population, information regarding smoking habits and the pandemic could potentially aid COVID-19 prevention and control measures. Our study aimed to analyze the effects of the COVID-19 pandemic on tobacco consumption, nicotine dependence levels, and motivation for smoking cessation. We also collected information from smokers regarding their awareness of the consequences of tobacco use and the increased risks smokers have for severe complications from COVID-19. METHODS In the survey for this observational cross-sectional study, 122 smokers responded to an online form. The participants provided general data about their smoking history, their smoking habits in the months of April and May 2020, and the effect of the pandemic on their smoking habits. They also completed a Fagerström test and were measured by the Wisconsin Smoking Withdrawal Scale. RESULTS When compared to pre-pandemic levels, the majority of smokers reported increased tobacco consumption of between 1 and 10 cigarettes per day (37.7%). Their motivation to quit smoking (59.8%) and desire to smoke (53.2%) were unchanged by the pandemic. Most participants demonstrated an awareness of the increased risks smokers have for severe COVID-19-related complications (p<0.001). We identified the following correlations: cigarettes/day before pandemic and motivation for smoking cessation (r=0.19; p=0.030), cigarettes/day and nicotine dependence level (r=0.61; p<0.001), and load consumption and nicotine dependence level (r=0.69; p<0.001). No significant correlations were observed between load consumption and motivation to quit (r=0.13; p=0.120). CONCLUSIONS Most smokers are well aware of their increased risks for severe COVID-19-related complications. In the early stages of the COVID-19 pandemic in Brazil, most smokers reported increased cigarette consumption. In addition, motivation to quit and desire to smoke were unchanged for the majority of smokers.
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Affiliation(s)
- Ana P. C. F. Freire
- Department of Health Sciences, Central Washington University, Ellensburg, United States
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Bruna A. S. Medina
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Marceli R. Leite
- Medicine Department, University of Western Guaruja (UNOESTE), São Paulo, Brazil
| | - Tainá O. Lopes
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Ester T. Santos
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Milena M. Ferreira
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Bruna S. A. Silva
- Exercise and Immunometabolism Research Group, Program in Movement Sciences, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, Sao Paulo, Brazil
| | - Margaret A. Cavalcante
- Medicine Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
| | - Francis L. Pacagnelli
- Physiotherapy Department, University of Western Presidente Prudente (UNOESTE), São Paulo, Brazil
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Validity of the DSM-5 tobacco use disorder diagnostics in adults with problematic substance use. Drug Alcohol Depend 2022; 234:109411. [PMID: 35338898 PMCID: PMC9035622 DOI: 10.1016/j.drugalcdep.2022.109411] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND DSM-5 tobacco use disorder (TUD) nosology differs from DSM-IV nicotine dependence (ND) by including craving and DSM-IV abuse criteria, a lower threshold (≥ 2 criteria), and severity levels (mild; moderate; severe). We assessed concurrent and prospective validity of the DSM-5 TUD diagnosis and severity and compared validity with DSM-IV ND diagnosis. METHODS The sample included U.S. adults with current problematic substance use and past year cigarette smoking (N = 396). Baseline assessment collected information on DSM-IV ND and DSM-5 TUD criteria, smoking-related variables, and psychopathology. Over the following 90 days, electronic daily assessments queried smoking and cigarette craving. Variables expected to be related to TUD were validators: cigarette consumption, cigarette craving scale, Fagerström Test for Nicotine Dependence, and psychiatric disorders. Regression models estimated the association of each validator with DSM-5 TUD and severity levels, and differential association between DSM-5 TUD and DSM-IV ND diagnoses. RESULTS DSM-5 TUD and DSM-IV ND were associated with most baseline validators (p-values < 0.05), with significantly stronger associations with DSM-5 TUD for number of days smoked (p = 0.023) and cigarette craving scale (p = 0.007). Baseline DSM-5 TUD and DSM-IV ND predicted smoking and craving on any given day during follow-up, with stronger associations for DSM-5 TUD (association difference [95% CI%]: any smoking, 0.53 [0.27, 0.77]; number of cigarettes smoked, 1.36 [0.89, 1.78]; craving scale, 0.19 [0.09, 0.28]). Validators were associated with TUD severity in a dose-dependent manner. CONCLUSION DSM-5 TUD diagnostic measures as operationalized here demonstrated concurrent and prospective validity. Inclusion of new criteria, particularly craving, improved validity and clinical relevance.
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Sharma MK, Suman LN, Srivastava K, Suma N, Vishwakarma A. Psychometric properties of Fagerstrom Test of Nicotine Dependence: A systematic review. Ind Psychiatry J 2021; 30:207-216. [PMID: 35017802 PMCID: PMC8709504 DOI: 10.4103/ipj.ipj_51_21] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 11/25/2022] Open
Abstract
The Fagerstrom test for nicotine dependence (FTND) is a widely used test for assessing physical nicotine dependence. However, there is a need to assess the psychometric properties of FTND to assess its role in treatment outcome studies. The aim of the present investigation was to review the psychometric properties of the FTND. A broad systematic literature search was performed from Pubmed and PsycINFO from 2000 to 2019. The publication language was limited to English. Two review authors performed the study selection and extracted the data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Rayyan software used to screen relevant studies. A total of 1471 articles retrieved from the search, of which 33 studies fulfilled the inclusion criteria. Eleven studies related to testing the reliability of the FTND were analyzed. Twenty-five studies evaluated the Cronbach alpha of the test. Analysis of the studies revealed the questionable psychometric qualities of the adapted versions of the test across different cultures and ethnicity. It also suggested that it may not tap the appropriate constructs that would predict smoking patterns in light smokers, e-cigarette smokers, and smokeless tobacco users. Thus, further research must focus on improving the psychometric properties of FTND to enhance the measurement of nicotine dependence.
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Affiliation(s)
- Manoj Kumar Sharma
- SHUT Clinic (Service for Healthy Use of Technology), Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - L N Suman
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Kalpana Srivastava
- Department of Psychiatry, Defence Research and Development Service, Armed Forces Medical College, Pune, Maharashtra, India
| | - N Suma
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Akash Vishwakarma
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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10
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Rudasingwa G, Kim Y, Lee C, Lee J, Kim S, Kim S. Comparison of Nicotine Dependence and Biomarker Levels among Traditional Cigarette, Heat-Not-Burn Cigarette, and Liquid E-Cigarette Users: Results from the Think Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4777. [PMID: 33947137 PMCID: PMC8124521 DOI: 10.3390/ijerph18094777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 11/21/2022]
Abstract
This study aimed to compare Korean smokers' smoking-related biomarker levels by tobacco product type, including heat-not-burn cigarettes (HNBC), liquid e-cigarettes (EC), and traditional cigarettes (TC). Nicotine dependence levels were evaluated in Korean adult study participants including TC-, EC-, HNBC-only users and nonsmokers (n = 1586) from March 2019 to July 2019 in Seoul and Cheonan/Asan South Korea using the Fagerström Test Score. Additionally, urine samples (n = 832) were collected for the measurement of urinary nicotine, cotinine, OH-cotinine, NNAL(4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), CYMA(N-acetyl-S-(2-cyanoehtyl)-L-cysteine), or CEMA (2-cyanoethylmercapturic acid) using LC-MS/MS. The median(interquartile range) nicotine dependence level was not different among the three types of smokers, being 3.0 (2.0-5.0) for TC- (n = 726), 3.0 (1.0-4.0) for EC- (n = 316), and 3.0 (2.0-4.0) for HNBC- (n = 377) only users. HNBC-only users presented similar biomarker levels compared to TC-only users, except for NNAL (HNBC: 14.5 (4.0-58.8) pg/mL, TC: 32.0 (4.0-69.6) pg/mL; p = 0.0106) and CEMA (HNBC: 60.4 (10.0-232.0) ng/mL, TC: 166.1 (25.3-532.1) ng/mL; p = 0.0007). TC and HNBC users showed increased urinary cotinine levels as early as the time after the first smoke of the day. EC users' biomarker levels were possibly lower than TC or HNBC users' but higher than those of non-smokers.
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Affiliation(s)
- Guillaume Rudasingwa
- Integrated Research Center of Risk Assessment, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea;
| | - Yeonjin Kim
- Department of ICT Environmental Health System, Graduate School, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea;
| | - Cheolmin Lee
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 06236, Korea;
| | - Jeomkyu Lee
- Division of Respiratory and Allergy Disease Research, Department of Chronic Disease Convergence Research, National Institute of Health (NIH), Korea Disease Control and Prevention Agency (KDCA), Osong 28159, Korea; (J.L.); (S.K.)
| | - Seunghyun Kim
- Division of Respiratory and Allergy Disease Research, Department of Chronic Disease Convergence Research, National Institute of Health (NIH), Korea Disease Control and Prevention Agency (KDCA), Osong 28159, Korea; (J.L.); (S.K.)
| | - Sungroul Kim
- Integrated Research Center of Risk Assessment, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea;
- Department of ICT Environmental Health System, Graduate School, Soonchunhyang University, Soonchunhyang-Ro 22, Asan 31538, Korea;
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Hebebrand J, Gearhardt AN. The concept of "food addiction" helps inform the understanding of overeating and obesity: NO. Am J Clin Nutr 2021; 113:268-273. [PMID: 33448280 DOI: 10.1093/ajcn/nqaa344] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Overeating is a complex behavioral phenotype in terms of both physiology and psychology. The mere transference of the diagnostic criteria for substance use disorders to define food addiction is too simplistic, for the following reasons: 1) a range of somatic and mental disorders require exclusion; 2) food addiction requires distinction from the physiological need to ingest sufficient calories to maintain a high body weight; 3) intentional weight loss can induce an eating behavior mimicking food addiction; 4) the concept lacks validation, especially in light of the high prevalence of "food addiction" in patients with anorexia nervosa; and 5) this construct has not led to novel and successful treatments for overeating and obesity. The concept of food addiction has the potential to distract from the need for focus on environmental influencers to combat the obesity pandemic.
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Affiliation(s)
- Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
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12
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Tan XW, Chong SA, Abdin E, Vaingankar J, Shafie S, Zhang Y, Chang S, Shahwan S, Heng D, Subramanian M. Comorbidities within mental illnesses in a multiethnic urban population. Asian J Psychiatr 2020; 51:102018. [PMID: 32247879 DOI: 10.1016/j.ajp.2020.102018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 01/08/2023]
Abstract
The prevalence and patterns of comorbidities among mental illnesses including substance misuse have been rarely documented in urban communities. In this study, we aimed to examine the prevalence, diagnostic patterns, common risk factors and functioning associated with comorbid mental illness among community residents in an urban population. Using data from Singapore Mental Health Study (SMHS) 2010 (n = 6616) and SMHS 2016 (n = 6126), we investigated the changes in the overall prevalence of comorbid mental illness and the diagnostic patterns of multiple affective disorders, affective disorder comorbid with substance misuse and multiple substance misuse. The most common diagnostic pair of comorbid affective disorder was major depressive disorder (MDD) and obsessive-compulsive disorder (OCD) (0.4 % at 2010 and 0.7 % at 2016). Among comorbid substance misuse, comorbidity of MDD and alcohol related disorder (ARD) was most frequent (0.5 % and 0.7 % respectively), while comorbidity of nicotine dependence (ND) with ARD decreased from 0.5 % to 0.1 %. Logistic regression was utilized to identify the associations of socio-demographics/clinical characteristics with patterns of comorbid mental illness and the associations of number of comorbid mental illness with impaired functioning. The risk profileassociated with comorbid mental illnesses differed among various comorbidity groups. Moreover, in SMHS 2016, higher number of comorbidities within mental illness was associated with higher odds of functioning impairment. The increase in the prevalence of comorbid mental illnesses indicates the need for early diagnosis and integrated disease management. Moreover, certain subgroups in the general population are more at risk of comorbid mental illnesses.
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Affiliation(s)
- Xiao Wei Tan
- Research Division, Institute of Mental Health, 539747, Singapore; Department of Mood and Anxiety Disorder, Institute of Mental Health, 539747, Singapore.
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 539747, Singapore; Lee Kong Chian School of Medicine, Nanyang Technology University of Singapore, 308232, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, 539747, Singapore
| | | | - Saleha Shafie
- Research Division, Institute of Mental Health, 539747, Singapore
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, 539747, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, 539747, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, 539747, Singapore
| | - Derrick Heng
- Ministry of Health of Singapore, 169854, Singapore
| | - Mythily Subramanian
- Research Division, Institute of Mental Health, 539747, Singapore; Lee Kong Chian School of Medicine, Nanyang Technology University of Singapore, 308232, Singapore
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13
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Kangiser MM, Thomas AM, Kaiver CM, Lisdahl KM. Nicotine Effects on White Matter Microstructure in Young Adults. Arch Clin Neuropsychol 2020; 35:10-21. [PMID: 31009035 DOI: 10.1093/arclin/acy101] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 03/11/2018] [Accepted: 12/06/2018] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Nicotine use is widely prevalent among youth, and is associated with white matter microstructural changes as measured by diffusion tensor imaging (DTI). In adults, nicotine use is generally associated with lower fractional anisotropy (FA), but in adolescents/young adults (≤30 years), microstructure appears healthier, indicated by higher FA. This cross-sectional study examined associations between nicotine use and white matter microstructure using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in young adults. METHODS Fifty-three participants (18 nicotine users [10 female]/35 controls [17 female]) ages 18-25 underwent MRI scan, neuropsychological battery, toxicology screening, and drug use interview. Nicotine group associations with FA and MD were examined in various white matter tracts. In significant tracts, AD and RD were measured. Exploratory correlations were conducted between significant tracts and verbal memory and sustained attention/working memory performance. RESULTS Nicotine users exhibited significantly lower FA than controls in the left anterior thalamic radiation, left inferior longitudinal fasciculus, left superior longitudinal fasciculus-temporal, and left uncinate fasciculus. In these tracts, AD and RD did not differ, nor did MD differ in any tract. White matter quality was positively correlated with sustained attention/working memory performance. CONCLUSIONS Cigarette smoking may disrupt white matter microstructure. These results are consistent with adult studies, but inconsistent with adolescent/young adult studies, likely due to methodological and sample age differences. Further studies should examine longitudinal effects of nicotine use on white matter microstructure in a larger sample.
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Affiliation(s)
- Megan M Kangiser
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Alicia M Thomas
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Christine M Kaiver
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
| | - Krista M Lisdahl
- University of Wisconsin-Milwaukee, Department of Psychology, Milwaukee, WI, USA
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Paik SH, Yeo CD, Jeong JE, Kim JS, Lee SH, Kim SJ, Kim DJ. Prevalence and analysis of tobacco use disorder in patients diagnosed with lung cancer. PLoS One 2019; 14:e0220127. [PMID: 31490942 PMCID: PMC6730883 DOI: 10.1371/journal.pone.0220127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 07/09/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Tobacco use disorder (TUD), previously known as nicotine dependence, was associated with increased risk of lung cancer. However, little is known about the prevalence of TUD and symptom manifestation in smokers with lung cancer. OBJECTIVES The aim of the present study was to investigate the prevalence of TUD using DSM-5 diagnostic criteria in patients diagnosed with lung cancer and analyze their tobacco use characteristics. METHODS A total of 200 histologically confirmed lung cancer patients who used tobacco within the prior 12-month period at the time of diagnosis were recruited for this study. Participants were assessed using interviewer-administered questionnaires to determine TUD symptoms and smoking-related behaviors, and self-administered Fagerstrom Test for Nicotine Dependence (FTND) was also administered. RESULTS The prevalence of DSM-5 TUD was 92.0% (n = 184). Of a total of 200 subjects, 23 (11.5%), 35 (17.5%), and 126 (63.0%) were classified into mild, moderate, and severe TUD categories, respectively. A total of 19 (81.3%) moderate TUD and 98 (77.8%) severe TUD patients had attempted smoking cessation. Of these subjects, 21 (21.4%) severe TUD and 12 (63.2%) moderate TUD patients tried more than three times. The number of satisfied criteria under DSM-5 TUD was positively correlated with FTND score, cumulative lifetime smoking amount, and daily smoking levels. CONCLUSIONS Smokers diagnosed with lung cancer showed a high prevalence of DSM-5 TUD. Their heavy and consistent tobacco use suggests reduced motivation to abstain from smoking.
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Affiliation(s)
- Soo-Hyun Paik
- Addiction Center, Keyo Hospital, Ojeon-ro, Uiwang-city, Gyeonggi-do, Republic of Korea
| | - Chang Dong Yeo
- Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Jo-Eun Jeong
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Ju Sang Kim
- Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Sang Haak Lee
- Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Seung Joon Kim
- Division of Pulmonology, Department of Internal Medicine, The Cancer Research Institute, College of Medicine, The Catholic University of Korea, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
| | - Dai-Jin Kim
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Banpo-daero, Seocho-gu, Seoul, Republic of Korea
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15
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Kangiser MM, Lochner AM, Thomas AM, Lisdahl KM. Gender Moderates Chronic Nicotine Cigarette Effects on Verbal Memory in Young Adults. Subst Use Misuse 2019; 54:1812-1824. [PMID: 31094617 DOI: 10.1080/10826084.2019.1613432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Rates of nicotine use remain a prominent public health concern, especially among young adults. Previous findings have demonstrated that chronic exposure to nicotine during adolescence may be linked to various neurocognitive deficits. Nicotine differentially affects the brain by gender. Objectives: The present study investigated the effects of gender and chronic nicotine use on cognition in the developing brain. Methods: From 2008 to 2011, 57 young adult (ages 18-25) participants were recruited as part of a larger cross-sectional neuroimaging study and divided into 21 nicotine users (12 female) and 36 non-using controls (17 female). Participants completed various questionnaires, drug use interview, neuropsychological battery, and MRI scan in a university setting. A series of multiple regressions was conducted with nicotine group and gender*nicotine group interaction as predictors. Results: After controlling for gender, nicotine group status alone was not associated with neuropsychological performance. A gender x nicotine interaction was significantly associated with performance on trial 1, short delay free recall, and long delay free recall of the CVLT-II. Female smokers demonstrated better performance on trial 1 and short and long delay free recall than female controls. Male smokers performed more poorly than male controls on short and long delay free recall. Conclusions: These preliminary findings suggest that cognitive effects of chronic nicotine use are moderated by gender. Further research is needed to determine causality, and identify underlying brain structures and function that may be responsible for differences in verbal memory.
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Affiliation(s)
- Megan M Kangiser
- a Department of Psychology , University of Wisconsin-Milwaukee , Milwaukee , WI , USA
| | - Angelina M Lochner
- a Department of Psychology , University of Wisconsin-Milwaukee , Milwaukee , WI , USA
| | - Alicia M Thomas
- a Department of Psychology , University of Wisconsin-Milwaukee , Milwaukee , WI , USA
| | - Krista M Lisdahl
- a Department of Psychology , University of Wisconsin-Milwaukee , Milwaukee , WI , USA
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16
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Use of the Fagerström test to assess differences in the degree of nicotine dependence in smokers from five ethnic groups: The HELIUS study. Drug Alcohol Depend 2019; 194:197-204. [PMID: 30447512 DOI: 10.1016/j.drugalcdep.2018.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/03/2018] [Accepted: 10/09/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND The prevalence of smoking varies across ethnic groups in developed countries, but little is known about ethnic variations in specific aspects of nicotine dependence (ND). We conducted item-response analyses in current smokers to compare ND factors across five ethnic groups. METHODS Data were obtained from a population-based, multi-ethnic cohort study conducted in the Netherlands. The Fagerström Test for Nicotine Dependence (FTND) was assessed in 1147 Dutch, 991 South-Asian Surinamese, 1408 African Surinamese, 1396 Turkish, and 584 Moroccan smokers (N = 5526). We tested whether the factorial structure of the FTND was invariant across ethnic groups using a multi-group confirmatory factor analysis. FTND item and total scores and factor means were compared across groups. RESULTS The two-factor model representing "morning smoking" and "smoking patterns" provided an adequate fit. The items "Cigarettes smoked daily" and "Time until first cigarette" showed differential item functioning (DIF) as a function of ethnicity. Three out of four ethnic minority groups scored significantly higher on both factors compared to the Dutch origin group (all p < 0.001) before and after taking DIF into account, while the African Surinamese scored higher only on "morning smoking" when DIF was accounted for. DISCUSSION The factor structure of the FTND is not measurement invariant across ethnic groups in this population-based sample. Accounting for DIF affecting the nicotine dependence factor scores, although South-Asian Surinamese, Turkish, and Moroccan groups showed higher levels of dependence than the Dutch origin group, genetic as well as environmental factors may account for the observed differences.
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Pedersen W, Soest TV. How is low parental socioeconomic status associated with future smoking and nicotine dependence in offspring? A population-based longitudinal 13-year follow-up. Scand J Public Health 2017; 45:16-24. [PMID: 27913689 DOI: 10.1177/1403494816680800] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIMS Low socioeconomic status (SES) characterizes smoking and nicotine dependence in adult samples. However, less is known about how parental SES is linked to smoking in offspring and the potential mechanisms at work. METHODS A population-based longitudinal study ( n=1380) from Norway was used. Participants were followed from their mid-teens until their late 20s using survey and register data. Data were collected on parental education, parental smoking, educational aspirations and expectations, school grades and school-related conduct problems. Register data monitored education, unemployment and social welfare assistance. Risk factors for smoking and nicotine dependence were identified by means of multinomial logistic regression analyses. Mediation analyses were used to investigate the pathways between parental SES and future smoking. RESULTS Future smokers were recruited from families with low educational levels. Poor school grades, school dropout and low educational aspirations were also predictors. Unemployment and social welfare assistance additionally increased the risk. Parental smoking, no high school exam and welfare assistance were mediators between low parental education and high levels of nicotine dependence in young adulthood. CONCLUSIONS Socialization to smoking reflects a multifaceted process fuelled by low parental SES. However, parental influences may be masked behind influences from schools or peers. Future research should try to capture the multiple sources of SES-related influence at work. Prevention strategies should target adolescents from low SES backgrounds, who orient towards the manual working class and who have problems entering the labour force.
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Affiliation(s)
- Willy Pedersen
- 1 Department of Sociology and Human Geography, University of Oslo, Norway.,2 Norwegian Social Research, Oslo and Akershus University College of Applied Sciences, Norway
| | - Tilmann Von Soest
- 2 Norwegian Social Research, Oslo and Akershus University College of Applied Sciences, Norway.,3 Department of Psychology, University of Oslo, Norway
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Li M, Wei C, Wen Y, Wang T, Lu Q. Detecting Gene-Gene Interactions Associated with Multiple Complex Traits with U-Statistics. Curr Genomics 2016; 17:403-415. [PMID: 28479869 PMCID: PMC5320542 DOI: 10.2174/1389202917666160513100946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 05/26/2015] [Accepted: 06/06/2015] [Indexed: 12/02/2022] Open
Abstract
Many complex diseases, such as psychiatric and behavioral disorders, are commonly characterized through various measurements that reflect physical, behavioral and psychological aspects of diseases. While it remains a great challenge to find a unified measurement to characterize a disease, the available multiple phenotypes can be analyzed jointly in the genetic association study. Simultaneously testing these phenotypes has many advantages, including considering different aspects of the disease in the analysis, and utilizing correlated phenotypes to improve the power of detecting disease-associated variants. Furthermore, complex diseases are likely caused by the interplay of multiple genetic variants through complicated mechanisms. Considering gene-gene interactions in the joint association analysis of complex diseases could further increase our ability to discover genetic variants involving complex disease pathways. In this article, we propose a stepwise U-test for joint association analysis of multiple loci and multiple phenotypes. Through simulations, we demonstrated that testing multiple phenotypes simultaneously could attain higher power than testing one single phenotype at a time, especially when there are shared genes contributing to multiple phenotypes. We also illustrated the proposed method with an application to Nicotine Dependence (ND), using datasets from the Study of Addition, Genetics and Environment (SAGE). The joint analysis of three ND phenotypes identified two SNPs, rs10508649 and rs2491397, and reached a nominal P-value of 3.79e-13. The association was further replicated in two independent datasets with P-values of 2.37e-05 and 7.46e-05.
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Affiliation(s)
- Ming Li
- 1Department of Epidemiology and Biostatistics, Indiana University at Bloomington, Bloomington, IN 47405, U.S.A; 2Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, TX 76107, U.S.A; 3Department of Statistics, University of Auckland, Auckland 1010, New Zealand; 4Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China; 5Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, U.S.A
| | - Changshuai Wei
- 1Department of Epidemiology and Biostatistics, Indiana University at Bloomington, Bloomington, IN 47405, U.S.A; 2Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, TX 76107, U.S.A; 3Department of Statistics, University of Auckland, Auckland 1010, New Zealand; 4Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China; 5Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, U.S.A
| | - Yalu Wen
- 1Department of Epidemiology and Biostatistics, Indiana University at Bloomington, Bloomington, IN 47405, U.S.A; 2Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, TX 76107, U.S.A; 3Department of Statistics, University of Auckland, Auckland 1010, New Zealand; 4Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China; 5Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, U.S.A
| | - Tong Wang
- 1Department of Epidemiology and Biostatistics, Indiana University at Bloomington, Bloomington, IN 47405, U.S.A; 2Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, TX 76107, U.S.A; 3Department of Statistics, University of Auckland, Auckland 1010, New Zealand; 4Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China; 5Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, U.S.A
| | - Qing Lu
- 1Department of Epidemiology and Biostatistics, Indiana University at Bloomington, Bloomington, IN 47405, U.S.A; 2Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, TX 76107, U.S.A; 3Department of Statistics, University of Auckland, Auckland 1010, New Zealand; 4Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China; 5Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, U.S.A
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Bidwell LC, Palmer RHC, Brick L, McGeary JE, Knopik VS. Genome-wide single nucleotide polymorphism heritability of nicotine dependence as a multidimensional phenotype. Psychol Med 2016; 46:2059-69. [PMID: 27052577 PMCID: PMC4925274 DOI: 10.1017/s0033291716000453] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Heritability estimates from twin studies of the multi-faceted phenotype of nicotine dependence (ND) range from moderate to high (31-60%), but vary substantially based on the specific ND-related construct examined. The current study estimated the aggregate role of common genetic variants on key ND constructs. METHOD Genomic-relationship-matrix restricted maximum likelihood (GREML) was used to decompose phenotypic variance across multiple ND indices using 796 125 polymorphisms from 2346 unrelated 'lifetime ever smokers' of European ancestry. Measures included DSM-IV ND and Fagerström Test for Nicotine Dependence (FTND) summary measures and constituent constructs (e.g. withdrawal severity, tolerance, heaviness of smoking and time spent smoking). Exploratory and confirmatory factor models were used to describe the covariance structure across ND measures; resulting factor(s) were the subject(s) of GREML analyses. RESULTS Factor models indicated highly correlated DSM-IV and FTND factors for ND (0.545, 95% confidence interval 0.50-0.60) that could be represented as a higher-order factor (NIC DEP). Additive genetic influence on NIC DEP was 33% (s.e. = 0.14, p = 0.009). Post-hoc analyses indicated moderate genetic effects on the DSM-IV (34%, s.e. = 0.14, p = 0.008) and FTND (26%, s.e. = 0.14, p = 0.032) factors, both of which were influenced by the same genetic effects (r G-SNP = 1.00, s.e. = 0.09, p < 0.00001). CONCLUSIONS Overall, common single nucleotide polymorphisms accounted for a large proportion of the genetic influences on ND-related phenotypes that have been observed in twin studies. Genetic contributions across distinct ND scales were largely influenced by shared genetic factors.
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Affiliation(s)
- L C Bidwell
- Institute of Cognitive Science,University of Colorado at Boulder,Boulder, CO,USA
| | - R H C Palmer
- Department of Psychiatry and Human Behavior,Alpert Medical School of Brown University,Providence, RI,USA
| | - L Brick
- Division of Behavioral Genetics,Department of Psychiatry,Rhode Island Hospital,Providence, RI,USA
| | - J E McGeary
- Department of Psychiatry and Human Behavior,Alpert Medical School of Brown University,Providence, RI,USA
| | - V S Knopik
- Department of Psychiatry and Human Behavior,Alpert Medical School of Brown University,Providence, RI,USA
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Almogbel YS, Abughosh SM, Almeman AA, Sansgiry SS. Factors associated with the willingness to quit smoking among a cohort of university students in the KSA. J Taibah Univ Med Sci 2016. [DOI: 10.1016/j.jtumed.2016.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ussher M, Kakar G, Hajek P, West R. Dependence and motivation to stop smoking as predictors of success of a quit attempt among smokers seeking help to quit. Addict Behav 2016; 53:175-80. [PMID: 26547043 DOI: 10.1016/j.addbeh.2015.10.020] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 10/21/2015] [Accepted: 10/27/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION It is not known how well motivation to stop smoking predicts abstinence in a clinical sample relative to the most widely used measure of cigarette dependence. METHODS A secondary analysis was conducted from a trial with 864 smokers making quit attempt. Fagerström Test of Cigarette Dependence (FTCD), Heaviness of Smoking Index (HSI), and motivation to stop smoking (composite of determination to quit and importance of quitting) were measured at baseline. Continuous smoking abstinence, validated by expired-air carbon monoxide, was assessed at 4weeks, 6months and 12months post-quit date. FTCD, HSI, non-HSI items in FTCD, and motivation were assessed as predictors of abstinence. RESULTS In multiple-logistic regressions, controlling for age, gender and medication use, lower scores for FTCD, HSI and non-HSI all significantly predicted abstinence at all follow-ups, while motivation did not predict abstinence at any time. Likelihood ratio tests showed that the FTCD contributed most to the model at 4weeks and 6months; at 12months FTCD and non-HSI equally contributed most to the model. At 4weeks and 6months, predictions were improved by combining HSI and non-HSI components, compared with using these components alone. CONCLUSIONS Cigarette dependence, measured by the FTCD, or by its HSI or non-HSI components, predicts both short-term and medium-term outcomes of attempts to stop smoking in treatment-seeking smokers involved in a clinical trial, whereas strength of motivation to stop predicts neither. Both the HSI and non-HSI components may be considered as briefer alternatives to the full FTCD.
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Nicotine dependence in an isolated population of Kashubians from North Poland: a population survey. BMC Public Health 2015; 15:80. [PMID: 25652844 PMCID: PMC4319221 DOI: 10.1186/s12889-015-1455-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/22/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Tobacco use is a complex, multistage behaviour. The particular stages of this behaviour, including nicotine dependence (ND), are influenced by both genetics and the environment. Surveys on factors influencing tobacco use and ND, conducted in ethnically homogenous populations, can provide results less influenced by genetic and cultural heterogeneity. We aimed to assess ND in a sample of current smokers, derived from the geographically and culturally isolated population of Kashubians from North Poland, and evaluate its potential association with age, sex, and self-reported comorbidities. In addition, we attempted to replicate - for the first time in this population - previous findings on the association between ND and several variants within the CHRNA5A3-A5-B4 nicotine receptor subunit gene cluster. METHODS The study sample consisted of 969 unrelated subjects who were all current smokers. ND was evaluated using four measures: the Fagerstrom Test for Nicotine Dependence (FTND), the Heavy Smoking Index (HSI), the number of cigarettes per day (CPD) and the time to first cigarette after waking (TTF). All subjects underwent genotyping for CHRNA5 rs16969968, CHRNA3 rs578776, and CHRNB4 rs12914008 variants. Multivariate regression analysis was used for the assessment of the studied correlations. A significance level of 0.05 with the Bonferroni correction for multiple testing was set for a type 1 error in the analyses. RESULTS The mean CPD, FTND and HSI scores in the study sample were 17.3 ± 7.7, 3.9 ± 2.3 and 2.6 ± 1.5, respectively. No association between ND defined by FTND, HSI or TTF and age was found. In turn, heavy smoking was significantly associated with older age (odds ratio (OR) = 1.72, 95% confidence interval (CI): 1.14-2.59, p = 0.009), and men were more likely than women to be heavy smokers (OR = 1.70, 95% CI: 1.09-2.65, p = 0.018). Chronic comorbidity did not significantly influence ND. An analysis of association of studied polymorphisms with ND showed a borderline association of rs16969968 with CPD (OR = 1.63, 95% CI: 1.09-2.45, p = 0.017). CONCLUSION Our study showed a low to moderate level of ND in the Kashubians, influenced by age, sex, as well as the CHRNA5 rs16969968 variant.
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Foulds J, Veldheer S, Yingst J, Hrabovsky S, Wilson SJ, Nichols TT, Eissenberg T. Development of a questionnaire for assessing dependence on electronic cigarettes among a large sample of ex-smoking E-cigarette users. Nicotine Tob Res 2014; 17:186-92. [PMID: 25332459 DOI: 10.1093/ntr/ntu204] [Citation(s) in RCA: 310] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Electronic cigarettes (e-cigs) are becoming increasingly popular, but little is known about their dependence potential. This study aimed to assess ratings of dependence on electronic cigarettes and retrospectively compare them with rated dependence on tobacco cigarettes among a large sample of ex-smokers who switched to e-cigs. METHODS A total of 3,609 current users of e-cigs who were ex-cigarette smokers completed a 158-item online survey about their e-cig use, including 10 items designed to assess their previous dependence on cigarettes and 10 almost identical items, worded to assess their current dependence on e-cigs (range 0-20). RESULTS Scores on the 10-item Penn State (PS) Cigarette Dependence Index were significantly higher than on the comparable PS Electronic Cigarette Dependence Index (14.5 vs. 8.1, p < .0001). In multivariate analysis, those who had used e-cigs longer had higher e-cig dependence scores, as did those using more advanced e-cigs that were larger than a cigarette and had a manual button. Those using zero nicotine liquid had significantly lower e-cig dependence scores than those using 1-12 mg/ml, who scored significantly lower than those using 13 or greater mg/ml nicotine liquid (p < .003). CONCLUSIONS Current e-cigarette users reported being less dependent on e-cigarettes than they retrospectively reported having been dependent on cigarettes prior to switching. E-cig dependence appears to vary by product characteristics and liquid nicotine concentration, and it may increase over time.
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Affiliation(s)
- Jonathan Foulds
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, College of Medicine, Penn State University, Hershey, PA;
| | - Susan Veldheer
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, College of Medicine, Penn State University, Hershey, PA
| | - Jessica Yingst
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, College of Medicine, Penn State University, Hershey, PA
| | - Shari Hrabovsky
- Department of Public Health Sciences, Tobacco Center of Regulatory Science, College of Medicine, Penn State University, Hershey, PA
| | - Stephen J Wilson
- Department of Psychology, Penn State University, State College, PA
| | - Travis T Nichols
- Department of Psychology, Penn State University, State College, PA
| | - Thomas Eissenberg
- Center for the Study of Tobacco Products, Virginia Commonwealth University, Richmond, VA
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Loukola A, Wedenoja J, Keskitalo-Vuokko K, Broms U, Korhonen T, Ripatti S, Sarin AP, Pitkäniemi J, He L, Häppölä A, Heikkilä K, Chou YL, Pergadia ML, Heath AC, Montgomery GW, Martin NG, Madden PAF, Kaprio J. Genome-wide association study on detailed profiles of smoking behavior and nicotine dependence in a twin sample. Mol Psychiatry 2014; 19:615-24. [PMID: 23752247 PMCID: PMC3883996 DOI: 10.1038/mp.2013.72] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 03/28/2013] [Accepted: 04/29/2013] [Indexed: 01/11/2023]
Abstract
Smoking is a major risk factor for several somatic diseases and is also emerging as a causal factor for neuropsychiatric disorders. Genome-wide association (GWA) and candidate gene studies for smoking behavior and nicotine dependence (ND) have disclosed too few predisposing variants to account for the high estimated heritability. Previous large-scale GWA studies have had very limited phenotypic definitions of relevance to smoking-related behavior, which has likely impeded the discovery of genetic effects. We performed GWA analyses on 1114 adult twins ascertained for ever smoking from the population-based Finnish Twin Cohort study. The availability of 17 smoking-related phenotypes allowed us to comprehensively portray the dimensions of smoking behavior, clustered into the domains of smoking initiation, amount smoked and ND. Our results highlight a locus on 16p12.3, with several single-nucleotide polymorphisms (SNPs) in the vicinity of CLEC19A showing association (P<1 × 10(-6)) with smoking quantity. Interestingly, CLEC19A is located close to a previously reported attention-deficit hyperactivity disorder (ADHD) linkage locus and an evident link between ADHD and smoking has been established. Intriguing preliminary association (P<1 × 10(-5)) was detected between DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) ND diagnosis and several SNPs in ERBB4, coding for a Neuregulin receptor, on 2q33. The association between ERBB4 and DSM-IV ND diagnosis was replicated in an independent Australian sample. Recently, a significant increase in ErbB4 and Neuregulin 3 (Nrg3) expression was revealed following chronic nicotine exposure and withdrawal in mice and an association between NRG3 SNPs and smoking cessation success was detected in a clinical trial. ERBB4 has previously been associated with schizophrenia; further, it is located within an established schizophrenia linkage locus and within a linkage locus for a smoker phenotype identified in this sample. In conclusion, we disclose novel tentative evidence for the involvement of ERBB4 in ND, suggesting the involvement of the Neuregulin/ErbB signalling pathway in addictions and providing a plausible link between the high co-morbidity of schizophrenia and ND.
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Affiliation(s)
- Anu Loukola
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
| | - Juho Wedenoja
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
| | | | - Ulla Broms
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
- National Institute for Health and Welfare, Helsinki,
Finland
| | - Tellervo Korhonen
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
- National Institute for Health and Welfare, Helsinki,
Finland
| | - Samuli Ripatti
- National Institute for Health and Welfare, Helsinki,
Finland
- Institute for Molecular Medicine Finland FIMM, University
of Helsinki, Finland
- Wellcome Trust Sanger Institute, Cambridge, UK
| | - Antti-Pekka Sarin
- National Institute for Health and Welfare, Helsinki,
Finland
- Institute for Molecular Medicine Finland FIMM, University
of Helsinki, Finland
| | - Janne Pitkäniemi
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
| | - Liang He
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
| | - Anja Häppölä
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
| | - Kauko Heikkilä
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
| | - Yi-Ling Chou
- Washington University School of Medicine, Saint Louis,
USA
| | | | - Andrew C Heath
- Washington University School of Medicine, Saint Louis,
USA
| | | | | | | | - Jaakko Kaprio
- Department of Public Health, Hjelt Institute, University of
Helsinki, Finland
- National Institute for Health and Welfare, Helsinki,
Finland
- Institute for Molecular Medicine Finland FIMM, University
of Helsinki, Finland
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Nishizawa D, Fukuda KI, Kasai S, Ogai Y, Hasegawa J, Sato N, Yamada H, Tanioka F, Sugimura H, Hayashida M, Ikeda K. Association Between KCNJ6 (GIRK2) Gene Polymorphism rs2835859 and Post-operative Analgesia, Pain Sensitivity, and Nicotine Dependence. J Pharmacol Sci 2014; 126:253-63. [DOI: 10.1254/jphs.14189fp] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Raisamo S, Patja K, Broms U, Kaprio J, Rimpelä A. Does Self-Rated Addiction and the Heaviness of Smoking Index Predict Nicotine Replacement Therapy Product Use in Adolescent Smokers? JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2013. [DOI: 10.1080/1067828x.2012.747889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Huang W, DiFranza JR, Kennedy DN, Zhang N, Ziedonis D, Ursprung S, King JA. Progressive levels of physical dependence to tobacco coincide with changes in the anterior cingulum bundle microstructure. PLoS One 2013; 8:e67837. [PMID: 23861816 PMCID: PMC3701580 DOI: 10.1371/journal.pone.0067837] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 05/22/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The tobacco withdrawal syndrome indicates the development of neurophysiologic dependence. Clinical evidence indicates that neurophysiologic dependence develops through a set sequence of symptom presentation that can be assessed with a new 3-item survey measure of wanting, craving, and needing tobacco, the Level of Physical Dependence (PD). This study sought to determine if advancing neurophysiologic dependence as measured by the Level of PD correlates with characteristics of white matter structure measured by Fractional Anisotropy (FA). METHODS Diffusion-MRI based FA and diffusion tensor imaging probabilistic tractography were used to evaluate 11 smokers and 10 nonsmokers. FA was also examined in relation to two additional measures of dependence severity, the Hooked on Nicotine Checklist (HONC), and the Fagerström Test for Nicotine Dependence (FTND). RESULTS Among smokers, FA in the left anterior cingulate bundle (ACb) correlated negatively with the Level of PD (r = -0.68, p = 0.02) and HONC scores (r = -0.65, p = 0.03), but the correlation for the FTND did not reach statistical significance (r = -49, p = 0.12). With advancing Levels of PD, the density of streamlines between the ACb and precuneus increased (r = -0.67, p<0.05) and those between the ACb and white matter projecting to the superior-frontal cortex (r = -0.86, p = 0.0006) decreased significantly. CONCLUSIONS The correlations between neural structure and both the clinical Level of PD survey measure and the HONC suggest that the Level of PD and the HONC may reflect the microstructural integrity of white matter, as influenced by tobacco abuse. Given that the Level of PD is measuring a sequence of symptoms of neurophysiologic dependence that develops over time, the correlation between the Level of PD and neural structure suggests that these features might represent neuroplastic changes that develop over time to support the development of neurophysiologic dependence.
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Affiliation(s)
- Wei Huang
- Center for Comparative NeuroImaging, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Joseph R. DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - David N. Kennedy
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Nanyin Zhang
- Center for Comparative NeuroImaging, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Douglas Ziedonis
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Sanouri Ursprung
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Jean A. King
- Center for Comparative NeuroImaging, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
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The Young Adults' Cigarette Dependence (YACD) score: an improved tool for cigarette dependence assessment in university students. Addict Behav 2013; 38:2174-9. [PMID: 23454882 DOI: 10.1016/j.addbeh.2013.01.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 11/27/2012] [Accepted: 01/10/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Cigarette smoking induces dependence in young smokers. PURPOSE The primary objective of this work was to validate the use of the Fagerström Test for Nicotine Dependence (FTND) in young Lebanese university students, and to improve it eventually by adding new items covering DSM-IV and ICD-10 dependence components. METHODS We used data from a cross-sectional study on university students. A standardized questionnaire was administered, with items related to cigarette dependence: the FTND and the new Young Adults' Cigarette Dependence (YACD) scale. For both tools, factor and reliability analyses were performed. RESULTS Although the FTND test showed satisfactory psychometric properties, the YACD showed better construct validity and reliability, covered dependence concept better and discriminated better between those who wanted to stop smoking and those who did not. CONCLUSIONS FTND could be used in university students' population; however, the YACD scale could be more useful.
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Li X, Hartwell KJ, Owens M, Lematty T, Borckardt JJ, Hanlon CA, Brady KT, George MS. Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex reduces nicotine cue craving. Biol Psychiatry 2013; 73:714-20. [PMID: 23485014 PMCID: PMC3615051 DOI: 10.1016/j.biopsych.2013.01.003] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Revised: 01/04/2013] [Accepted: 01/04/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Repetitive transcranial magnetic stimulation (rTMS) can noninvasively stimulate the brain and transiently amplify or block behaviors mediated through a region. We hypothesized that a single high-frequency rTMS session over the left dorsolateral prefrontal cortex (DLPFC) would reduce cue craving for cigarettes compared with a sham TMS session. METHODS Sixteen non-treatment-seeking, nicotine-dependent participants were randomized to receive either real high-frequency rTMS (10 Hz, 100% resting motor threshold, 5-sec on, 10-sec off for 15 min; 3000 pulses) or active sham (eSham) TMS over the DLPFC in two visits with 1 week between visits. The participants received cue exposure before and after rTMS and rated their craving after each block of cue presentation. RESULTS Stimulation of the left DLFPC with real, but not sham, rTMS reduced craving significantly from baseline (64.1±5.9 vs. 45.7±6.4, t = 2.69, p = .018). When compared with neutral cue craving, the effect of real TMS on cue craving was significantly greater than the effect of sham TMS (12.5±10.4 vs. -9.1±10.4; t = 2.07, p = .049). More decreases in subjective craving induced by TMS correlated positively with higher Fagerström Test for Nicotine Dependence score (r = .58, p = .031) and more cigarettes smoked per day (r = .57, p = .035). CONCLUSIONS One session of high-frequency rTMS (10 Hz) of the left DLPFC significantly reduced subjective craving induced by smoking cues in nicotine-dependent participants. Additional studies are needed to explore rTMS as an aid to smoking cessation.
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Affiliation(s)
- Xingbao Li
- Medical University of South Carolina, Charleston, SC 29425, USA.
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The Lebanese Cigarette Dependence (LCD) Score: a comprehensive tool for cigarette dependence assessment. Int J Behav Med 2013; 21:385-93. [PMID: 23494718 DOI: 10.1007/s12529-012-9288-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cigarette smoking induces dependence. PURPOSE The primary objective of this work was to validate the use of the Fagerström test for nicotine dependence (FTND) in the Lebanese population, and to broaden it eventually by adding new items covering DSM-IV and ICD-10 dependence components. METHODS We used data from two samples: a cross-sectional national study and a case-control study. A standardized questionnaire was administered, with items related to cigarette dependence: the FTND and the new Lebanon Cigarette Dependence (LCD) scale. For both tools, an exploratory factor analysis was performed on sample 1, while confirmatory factor analysis was performed on sample 2. RESULTS Although the FTND test showed satisfactory psychometric properties, the LCD showed better validity and reliability, covered dependence concept better, and showed a higher correlation with the number of times the participant tried to stop smoking (r = -0.087; p = 0.029 versus r = -0.215; p < 0.001). CONCLUSIONS FTND could be used in the Lebanese population; however, the LCD scale may be more useful.
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DiFranza JR, Wellman RJ, Savageau JA, Beccia A, Ursprung WWSA, McMillen R. What aspect of dependence does the fagerström test for nicotine dependence measure? ISRN ADDICTION 2012; 2013:906276. [PMID: 25969829 PMCID: PMC4403618 DOI: 10.1155/2013/906276] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 10/15/2012] [Indexed: 11/17/2022]
Abstract
Although the Fagerström Test for Nicotine Dependence (FTND) and the Heaviness of Smoking Index (HSI) are widely used, there is a uncertainty regarding what is measured by these scales. We examined associations between these instruments and items assessing different aspects of dependence. Adult current smokers (n = 422, mean age 33.3 years, 61.9% female) completed a web-based survey comprised of items related to demographics and smoking behavior plus (1) the FTND and HSI; (2) the Autonomy over Tobacco Scale (AUTOS) with subscales measuring Withdrawal, Psychological Dependence, and Cue-Induced Cravings; (3) 6 questions tapping smokers' wanting, craving, or needing experiences in response to withdrawal and the latency to each experience during abstinence; (4) 3 items concerning how smokers prepare to cope with periods of abstinence. In regression analyses the Withdrawal subscale of the AUTOS was the strongest predictor of FTND and HSI scores, followed by taking precautions not to run out of cigarettes or smoking extra to prepare for abstinence. The FTND and its six items, including the HSI, consistently showed the strongest correlations with withdrawal, suggesting that the behaviors described by the items of the FTND are primarily indicative of a difficulty maintaining abstinence because of withdrawal symptoms.
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Affiliation(s)
- Joseph R. DiFranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Robert J. Wellman
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Judith A. Savageau
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Ariel Beccia
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - W. W. Sanouri A. Ursprung
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA
| | - Robert McMillen
- Department of Psychology and Social Science Research Center, Mississippi State University, Starkville, MS 39762, USA
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Transdermal nicotine administration and the electroencephalographic activity of substance abusers in treatment. J Addict Med 2012; 2:202-14. [PMID: 19347067 DOI: 10.1097/adm.0b013e31818b4e27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES It is widely recognized that individuals with alcohol or illicit substance abuse disorders often smoke cigarettes. However, few studies have examined the direct effects of nicotine among substance abuse subgroups. The current study examined patterns of electroencephalographic (EEG) activity in alcohol-dependent (AD), stimulant-dependent (StimD), alcohol- and stimulant-dependent (ASD) participants, as well as community controls (CC). All participants were regular smokers. METHODS After overnight nicotine abstinence, subjects were administered either a high (14 or 21 mg) or low (7mg) dose transdermal nicotine patch. EEG data were collected during a 2 minute eyes open and 5 minute eyes closed baseline recording session, which occurred as part of a larger study of brain electrophysiology. RESULTS The most interesting finding was a differential pattern of nicotine dose effects by group. EEGs of Controls and ASD participants did not distinguish between high and low nicotine doses; whereas, nicotine administration in the AD and StimD groups resulted in opposite findings across a range of spectral bands. CONCLUSIONS Although further research is warranted, these results may have implications for the study of smoking cessation and attentional functioning among substance abusers in treatment. These data suggest that nicotine-related changes in neurophysiology may be associated with specific brain areas and/or specific drug histories and reinforce the need for caution in generalizing among such groups.
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Changes in smoking prevalence and number of cigarettes smoked per day following the implementation of a comprehensive tobacco control plan in New York City. J Urban Health 2012; 89:802-8. [PMID: 22544658 PMCID: PMC3462825 DOI: 10.1007/s11524-012-9683-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The New York City (NYC) Health Department has implemented a comprehensive tobacco control plan since 2002, and there was a 27% decline in adult smoking prevalence in NYC from 2002 to 2008. There are conflicting reports in the literature on whether residual smoker populations have a larger or smaller share of "hardcore" smokers. Changes in daily consumption and daily and nondaily smoking prevalence, common components used to define hardcore smokers, were evaluated in the context of the smoking prevalence decline. Using the NYC Community Health Survey, an annual random digit dial, cross-sectional survey that samples approximately 10,000 adults, the prevalence of current heavy daily, light daily, and nondaily smokers among NYC adults was compared between 2002 and 2008. A five-level categorical cigarettes per day (CPD) variable was also used to compare the population of smokers between the 2 years. From 2002 to 2008, significant declines were seen in the prevalence of daily smoking, heavy daily smoking, and nondaily smoking. Among daily smokers, there is also evidence of population declines in all but the lowest smoking category (one to five CPD). The mean CPD among daily smokers declined significantly, from 14.6 to 12.5. After an overall decline in smoking since 2002, the remaining smokers may be less nicotine dependent, based on changes in daily consumption and daily and nondaily smoking prevalence. These findings suggest the need to increase media and cessation efforts targeted towards lighter smokers.
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Cigarette and waterpipe smoking decrease respiratory quality of life in adults: results from a national cross-sectional study. Pulm Med 2012; 2012:868294. [PMID: 22988502 PMCID: PMC3439984 DOI: 10.1155/2012/868294] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 07/25/2012] [Accepted: 07/28/2012] [Indexed: 11/18/2022] Open
Abstract
Background. Chronic obstructive pulmonary disease (COPD) is gaining an importance over the world, and its effect on quality of life is better grasped. Our objective was to use the Clinical COPD Questionnaire (CCQ) to describe the respiratory quality of life in the Lebanese population, stressing on differences between smokers and nonsmokers. Methods. Using data from a cross-sectional national study, we checked the construct validity and reliability of the CCQ. Factors and items correlation with postbronchodilator FEV1/FVC were reported, in addition to factors and scale association with COPD and its severity. We then conducted a multiple regression to find predictors of quality of life. Results. The CCQ demonstrated excellent psychometric properties, with adequacy to the sample and high consistency. Smokers had a decreased respiratory quality of life versus nonsmokers, independently of their respiratory disease status and severity. This finding was confirmed in COPD individuals, where several environmental factors, lower education, and cumulative smoking of cigarette and of waterpipe were found to be independent predictors of a lower quality of life, after adjusting for COPD severity. Conclusions. Smoking decreases the respiratory quality of life of Lebanese adults; this issue has to be further emphasized during smoking cessation and patients' education.
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Abstract
Nicotine addiction (NA) is a common and devastating disease, such that the annual number of deaths (world-wide) from tobacco-related diseases will double from 5 million in the year 2000 to 10 million in 2020. Nicotine is the only substance in tobacco which animals and humans will self-administer. NA, as a lifetime diagnosis, has been assessed in various approaches, including the concept of cigarettes per day (CPD). Other assessments of NA are somewhat more comprehensive, such as the Fagerstrom Test for Nicotine Dependence or the American Psychiatric Association's Diagnostic and Statistical Manual (fourth edition) diagnosis of nicotine dependence. These different measures have moderate agreement with one another. Twin, family and adoption studies have shown that these different assessments of NA have substantial heritability (that fraction of risk attributable to genetic factors). The heritability of NA has been estimated at 50-75%, depending on the definition and the population under study. DNA-based studies of NA have been somewhat successful in identifying a common haplotype, which increases risk for NA among European-origin populations. This haplotype explains a small amount of variance, accounting for ∼1 CPD, and it includes the α5 and the α3 nicotinic receptor subunit genes (CHRNA5 and CHRNA3). The review will focus on this implicated region. In this risk region, there is a common (among European-origin people) mis-sense single-nucleotide polymorphism in the CHRNA5 gene (D398N), which changes a conserved amino acid from aspartic acid to asparagine. The risk allele (398N) confers decreased calcium permeability and more extensive desensitization, according to in vitro cellular studies, raising the possibility that a positive allosteric modulator of the (α4β2)(2)α5 type of nicotinic receptor might have therapeutic potential in NA. There are other genetic influences on NA in this region, apart from the mis-sense variant, and additional biological experiments must be done to understand them.
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Affiliation(s)
- W H Berrettini
- Department of Psychiatry, Center for Neurobiology and Behavior, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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Sofuoglu M, LeSage MG. The reinforcement threshold for nicotine as a target for tobacco control. Drug Alcohol Depend 2012; 125:1-7. [PMID: 22622242 PMCID: PMC3419325 DOI: 10.1016/j.drugalcdep.2012.04.023] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 04/17/2012] [Accepted: 04/24/2012] [Indexed: 11/22/2022]
Abstract
BACKGROUND Cigarette smoking represents an enormous public health problem worldwide that leads to over 5 million deaths per year. The gradual reduction of the nicotine content of cigarettes below the threshold that is required to develop addiction is one strategy that might substantially reduce the number of addicted smokers and prevent adolescents from becoming addicted to nicotine (Benowitz and Henningfield, 1994). While the potential public health benefits of this approach are enormous, the guiding concepts and relevant empirical evidence needed to support the implementation of a nicotine reduction policy require a critical examination. METHODS The purpose of this paper is to briefly review the current concepts and research regarding nicotine reduction while also discussing the utility of the addictive threshold for nicotine in this approach. The accurate determination of the nicotine addiction threshold presents some conceptual challenges as there is a lack of consensus on how to best measure nicotine addiction. This difficulty can impede the progress for developing a science-based tobacco control policy. As an alternative, the nicotine reinforcement threshold is a relatively clear concept, and well-accepted methods and criteria are available to measure nicotine reinforcement. RESULTS However, there are many gaps in our current knowledge concerning the nicotine reinforcement threshold in humans. The threshold for nicotine reinforcement remains to be determined in controlled settings using different populations of current or potential tobacco users. In addition, the value of the nicotine reinforcement threshold in predicting tobacco use in real-world settings needs to be examined. The results of such studies will determine the potential utility of the estimated threshold for nicotine reinforcement in developing science-based tobacco control policies.
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Affiliation(s)
- Mehmet Sofuoglu
- Yale University, School of Medicine, Department of Psychiatry and VA Connecticut Healthcare System, West Haven, CT 06516, United States.
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Boudrez H, De Bacquer D. A Dutch version of the modified reasons for smoking scale: factorial structure, reliability and validity. J Eval Clin Pract 2012; 18:799-806. [PMID: 21501339 DOI: 10.1111/j.1365-2753.2011.01676.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The Modified Reasons for Smoking Scale (MRSS) is a widely accepted scale that measures psychological functions of smoking. The scale has been translated in Dutch and has been validated, in order to be used in clinical smoking cessation practice in the Dutch-speaking part of Belgium. This study examined the factorial structure, reliability and validity of the scale in a sample of smokers, who are characterized by a high level of dependence and an explicit motivation to stop smoking. METHOD The participants were 383 smokers, who volunteered at the stop-smoking clinic of a Belgian university hospital, and completed the translated scale. They were administered the translated MRSS, the Fagerstrom Test for Nicotine Dependence (FTND). Through a clinical interview, smoking behaviour and smoking history was assessed (daily smoking consumption, years smoking, number of quit attempts, weeks stopped, alcohol and coffee consumption, CO level). Exploratory factor analysis was performed. Internal consistency was studied in order to examine the reliability. The concurrent validity was assessed by means of manova, anova and correlation analysis. RESULTS Factor analysis identified four factors, named stimulation, pleasure of smoking, social smoking and automatism of smoking. Cronbach's alpha ranged from 0.65 (automatism) to 0.72 (stimulation). manova indicated the influence of the variables age, sex, daily consumption and the FTND (the latter two variables showed a dose-dependent association with each subscale). Regression analysis revealed a relationship with dependence indicators, namely: the daily consumption, the number and duration of previous quit attempts, FTND, CO level and daily coffee intake. CONCLUSIONS The Dutch translation of the MRSS identified four factors and revealed acceptable validity and reliability. The adapted version of the translated scale as a component of the psychological assessment procedure in a smoking cessation treatment in Dutch-speaking areas should be implemented.
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Affiliation(s)
- Hedwig Boudrez
- Stop-Smoking Clinic, Ghent University Hospital, Ghent, Belgium.
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Difranza JR, Savageau JA, Wellman RJ. A comparison of the autonomy over tobacco scale and the Fagerström test for nicotine dependence. Addict Behav 2012; 37:856-61. [PMID: 22472522 DOI: 10.1016/j.addbeh.2012.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 02/28/2012] [Accepted: 03/12/2012] [Indexed: 11/29/2022]
Abstract
The autonomy over tobacco scale (AUTOS) is a 12-item theory-based instrument used to measure tobacco dependence in smokers. It provides separate measures of three factors that make smoking cessation more difficult: withdrawal symptoms, psychological dependence, and cue-induced urges to use tobacco. We compared the internal reliability and concurrent validity of the AUTOS to those of the Fagerström test for nicotine dependence (FTND). Adult current smokers (n=422; 62% female; 86.8% white; mean age 33.3 years, SD=13.7; 57% daily smokers) completed an anonymous web-based survey that included the AUTOS, the FTND and 11 smoking-related behavioral measures. Cronbach's α was .94 for the AUTOS and α>.75 for each of the 3 subscales; α=.73 for the FTND. The AUTOS and its subscales correlated with all measures of concurrent validity (r=.70 between AUTOS & FTND). The AUTOS correlated better than the FTND with the Hooked on Nicotine Checklist, the longest period of abstinence, latency to wanting, percentage of time a person smokes because of momentary need, pleasure from smoking, days smoked per month, and concern about deprivation. The measures showed similar correlations with the latencies to craving and needing. The FTND correlated better with the duration of smoking and cigarettes smoked per day. Based on these results and those from prior studies, we conclude that the AUTOS offers researchers a valid and highly reliable, theory-based measure that is more versatile in its applications than the FTND.
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Affiliation(s)
- Joseph R Difranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
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Park S, Lee JY, Song TM, Cho SI. Age-associated changes in nicotine dependence. Public Health 2012; 126:482-9. [DOI: 10.1016/j.puhe.2012.02.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 11/02/2011] [Accepted: 02/10/2012] [Indexed: 11/16/2022]
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Chung T, Martin CS, Maisto SA, Cornelius JR, Clark DB. Greater prevalence of proposed DSM-5 nicotine use disorder compared to DSM-IV nicotine dependence in treated adolescents and young adults. Addiction 2012; 107:810-8. [PMID: 22092543 PMCID: PMC3290741 DOI: 10.1111/j.1360-0443.2011.03722.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS Compared to DSM-IV nicotine dependence, proposed DSM-5 nicotine use disorder (NUD) would lower the threshold from three to two symptoms, and increase the number of criteria used for diagnosis from seven to 11. The impact of the proposed changes on nicotine disorder prevalence and the concurrent validity of diagnostic criteria were examined. DESIGN Cross-sectional survey to compare DSM-IV and proposed DSM-5 algorithms. SETTING AND PARTICIPANTS Adolescent (n = 179) and young adult (n = 292) past-year cigarette users recruited from addictions treatment. MEASUREMENTS Semi-structured clinical interview to evaluate DSM-IV nicotine dependence, and 10 of the 11 proposed DSM-5 NUD criteria; 30-day time-line follow-back; and the Fagerström Test for Nicotine Dependence (FTND). FINDINGS Prevalence of proposed DSM-5 NUD (two-symptom threshold) was much higher (adolescents: 68.7%, young adults: 86.0%) than DSM-IV nicotine dependence (33.0% and 59.6%, respectively), although prevalence of DSM-5 severe NUD (four-symptom threshold) was similar to DSM-IV nicotine dependence. Concurrent validity analyses in both samples indicated consistent support for DSM-5 severe NUD diagnosis (four symptoms) but not for the moderate NUD (two symptoms) diagnosis, which had modest relations with only FTND score. IRT analyses indicated strong support for the new craving item, but not for the proposed interpersonal problems and hazardous use items. CONCLUSIONS The proposed DSM-5 nicotine use disorder criteria have substantial limitations when applied to adolescents and young adults, and appear to have low concurrent validity.
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Affiliation(s)
- Tammy Chung
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA, USA.
| | - Christopher S. Martin
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, Pennsylvania 15213
| | | | - Jack R. Cornelius
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, Pennsylvania 15213
| | - Duncan B. Clark
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, Pennsylvania 15213
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Underner M, Le Houezec J, Perriot J, Peiffer G. [Tests for evaluating tobacco dependence]. Rev Mal Respir 2012; 29:462-74. [PMID: 22542405 DOI: 10.1016/j.rmr.2011.09.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Accepted: 09/13/2011] [Indexed: 02/08/2023]
Abstract
The primary reason why there is such a heavy burden of tobacco smoking induced illness and death is dependence on nicotine which makes it difficult for smokers to quit. For clinical or research purposes, the degree of dependence, the intensity of the withdrawal syndrome and/or craving have been evaluated by different scales. This review provides a list of questionnaires that are used in smoking cessation. It pays particular attention to the validated and translated resources that are available in French. Research should be conducted in order to provide French speaking smoking cessation specialists with all the relevant scales allowing better evaluation of tobacco dependence.
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Affiliation(s)
- M Underner
- Unité de tabacologie, service de pneumologie, CHU La-Milétrie, Poitiers cedex, France.
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Keskitalo-Vuokko K, Hällfors J, Broms U, Pergadia ML, Saccone SF, Loukola A, Madden PAF, Kaprio J. Chromosome 20 shows linkage with DSM-IV nicotine dependence in Finnish adult smokers. Nicotine Tob Res 2012; 14:153-60. [PMID: 22039074 PMCID: PMC3265743 DOI: 10.1093/ntr/ntr153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Accepted: 06/21/2011] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Chromosome 20 has previously been associated with nicotine dependence (ND) and smoking cessation. Our aim was to replicate and extend these findings. METHODS First, a total of 759 subjects belonging to 206 Finnish families were genotyped with 18 microsatellite markers residing on chromosome 20, in order to replicate previous linkage findings. Then, the replication data were combined to an existing whole-genome linkage data resulting in a total of 1,302 genotyped subjects from 357 families. ND diagnosed by DSM-IV criteria, the Fagerström Test for Nicotine Dependence (FTND) score, and the lifetime maximum number of cigarettes smoked within a 24-hr period (MaxCigs24) were used as phenotypes in the nonparametric linkage analyses. RESULTS We replicated previously reported linkage to DSM-IV ND, with a maximum logarithm of odd (LOD) score of 3.8 on 20p11, with females contributing more (maximum LOD [MLOD] score 3.4 on 20q11) than males (MLOD score 2.6 on 20p11). With the combined sample, a suggestive LOD score of 2.3 was observed for DSM-IV ND on 20p11. Sex-specific analyses revealed that the signal was driven by females with a maximum LOD score of 3.3 (on 20q11) versus LOD score of 1.3 in males (on 20q13) in the combined sample. No significant linkage signals were obtained for FTND or MaxCigs24. CONCLUSIONS Our results provide further evidence that chromosome 20 harbors genetic variants influencing ND in adult smokers.
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Affiliation(s)
| | - Jenni Hällfors
- Hjelt Institute, Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Ulla Broms
- Hjelt Institute, Department of Public Health, University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Michele L. Pergadia
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Scott F. Saccone
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Anu Loukola
- Hjelt Institute, Department of Public Health, University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Pamela A. F. Madden
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Jaakko Kaprio
- Hjelt Institute, Department of Public Health, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare (THL), Helsinki, Finland
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Difranza JR, Wellman RJ, Savageau JA. Does progression through the stages of physical addiction indicate increasing overall addiction to tobacco? Psychopharmacology (Berl) 2012; 219:815-22. [PMID: 21779781 DOI: 10.1007/s00213-011-2411-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 07/01/2011] [Indexed: 11/27/2022]
Abstract
RATIONALE With physical addiction to tobacco, abstinence triggers a desire to smoke. As physical addiction advances, the desire to smoke changes in quality and intensity from wanting, to craving, to needing. A prior study in adolescents suggested that this progression signifies increasing addiction. OBJECTIVE We sought to determine if the sequential appearance of wanting, craving and needing provides an indication of the intensity of other markers of tobacco addiction including psychological and behavioral indicators. METHODS A web-based survey was completed by 422 smokers ages 18-78 years. Subjects were assigned to one of four qualitatively distinct stages of physical addiction based on their most advanced symptom: 1-none, 2-wanting, 3-craving, or 4-needing. Using linear Chi square and ANOVA, we determined if higher stages were associated with higher levels of tobacco addiction on more than a dozen measures. RESULTS 16.8% of subjects were in stage 1, 26.1% in stage 2, 17.1% in stage 3 and 40.0% in stage 4. Each step up in stage was associated with higher levels of addiction as measured by the Fagerström Test for Nicotine Dependence, the Hooked on Nicotine Checklist, the Autonomy over Tobacco Scale, and higher levels of psychological dependence, duration of tobacco use, frequency of tobacco use, daily cigarette consumption, and 10 additional measures. CONCLUSIONS In this cross-sectional study, each sequential stage of physical addiction was associated with higher levels of every indicator of addiction. The data suggest that the stages of progression of physical addiction provide a global indication of the severity of tobacco addiction.
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Affiliation(s)
- Joseph R Difranza
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.
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Broms U, Wedenoja J, Largeau MR, Korhonen T, Pitkäniemi J, Keskitalo-Vuokko K, Häppölä A, Heikkilä KH, Heikkilä K, Ripatti S, Sarin AP, Salminen O, Paunio T, Pergadia ML, Madden PAF, Kaprio J, Loukola A. Analysis of detailed phenotype profiles reveals CHRNA5-CHRNA3-CHRNB4 gene cluster association with several nicotine dependence traits. Nicotine Tob Res 2012; 14:720-33. [PMID: 22241830 DOI: 10.1093/ntr/ntr283] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The role of the nicotinic acetylcholine receptor gene cluster on chromosome 15q24-25 in the etiology of nicotine dependence (ND) is still being defined. In this study, we included all 15 tagging single nucleotide polymorphisms (SNPs) within the CHRNA5-CHRNA3-CHRNB4 cluster and tested associations with 30 smoking-related phenotypes. METHODS The study sample was ascertained from the Finnish Twin Cohort study. Twin pairs born 1938-1957 and concordant for a history of cigarette smoking were recruited along with their family members (mainly siblings), as part of the Nicotine Addiction Genetics consortium. The study sample consisted of 1,428 individuals (59% males) from 735 families, with mean age 55.6 years. RESULTS We detected multiple novel associations for ND. DSM-IV ND symptoms associated significantly with the proxy SNP Locus 1 (rs2036527, p = .000009) and Locus 2 (rs578776, p = .0001) and tolerance factor of the Nicotine Dependence Syndrome Scale (NDSS) showed suggestive association to rs11636753 (p = .0059), rs11634351 (p = .0069), and rs1948 (p = .0071) in CHRNB4. Furthermore, we report significant association with DSM-IV ND diagnosis (rs2036527, p = .0003) for the first time in a Caucasian population. Several SNPs indicated suggestive association for traits related to ages at smoking initiation. Also, rs11636753 in CHRNB4 showed suggestive association with regular drinking (p = .0029) and the comorbidity of depression and ND (p = .0034). CONCLUSIONS We demonstrate novel associations of DSM-IV ND symptoms and the NDSS tolerance subscale. Our results confirm and extend association findings for other ND measures. We show pleiotropic effects of this gene cluster on multiple measures of ND and also regular drinking and the comorbidity of ND and depression.
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Affiliation(s)
- Ulla Broms
- Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland
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Covey LS, Hu MC, Green CA, Brigham G, Hurt RD, Adler L, Winhusen T. An exploration of site effects in a multisite trial of OROS-methylphenidate for smokers with attention deficit/hyperactivity disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2011; 37:392-9. [PMID: 21854282 DOI: 10.3109/00952990.2011.596979] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Multisite trials, the gold standard for conducting studies in community-based settings, can mask variability across sites resulting in misrepresentation of effects in specific sites. In a placebo-controlled trial of osmotic-release oral system methylphenidate (OROS-MPH) as augmentation treatment for smokers with attention deficit hyperactivity/impulsivity disorder (ADHD), three types of sites were selected according to their clinical research specialty (ADHD, smoking cessation, and general mental health). OBJECTIVE Analysis was conducted to determine if clinical outcomes, that is, reduction in ADHD symptoms and smoking cessation rates, and the effect of treatment on these outcomes would differ by type of site. METHOD A total of 255 adult smokers diagnosed with ADHD were enrolled in three clinic types: 72 in ADHD, 79 in tobacco dependence, and 104 in the mental health clinics. RESULTS The three site-types were similar in demographic characteristics, smoking history, baseline level of ADHD symptoms, and history of psychiatric illness. Site-type but not a site-type by treatment interaction predicted prolonged smoking abstinence. A significant three-way interaction of site-type, treatment, and time-predicted improvement in ADHD symptoms. Moderate to strong effects of OROS-MPH relative to placebo were observed in the mental health and the ADHD clinics; a weak effect was observed in the tobacco dependence clinics. CONCLUSION OROS-MPH benefit varied by site for reducing ADHD symptoms but not for improving smoking abstinence. SCIENTIFIC SIGNIFICANCE Assessment of site-type effects can indicate the generalizability of findings from multisite trials and should be routinely incorporated in the design of multisite trials.
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Affiliation(s)
- Lirio S Covey
- New York State Psychiatric Institute, Department of Psychiatry, Columbia University Medical Center, New York, USA.
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Agrawal A, Scherrer JF, Pergadia ML, Lynskey MT, Madden PAF, Sartor CE, Grant JD, Duncan AE, Haber JR, Jacob T, Bucholz KK, Xian H. A latent class analysis of DSM-IV and Fagerström (FTND) criteria for nicotine dependence. Nicotine Tob Res 2011; 13:972-81. [PMID: 21778154 DOI: 10.1093/ntr/ntr105] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Nicotine dependence is associated with considerable morbidity and mortality. Two predominant classification systems, the Diagnostic and Statistical Manual (DSM-IV) and Fagerström Test for Nicotine Dependence (FTND), have been used to measure liability to nicotine dependence, yet few studies have attempted to simultaneously examine both sets of criteria. METHODS Using a sample of 624 regular smoking individuals who are offspring of Vietnam Era Twin fathers ascertained for an offspring of twin study, we applied latent class analysis to the 7 DSM-IV and the 6 FTND criteria to classify individuals by their nicotine dependence symptom profiles. Post-hoc across-class comparisons were conducted using a variety of smoking-related variables and aspects of psychopathology. Whether a single class identified offspring at high genetic and environmental vulnerability was also investigated. RESULTS The cross-diagnosis kappa was .30. A 4-class solution fit these data best. The classes included a low DSM-low FTND class and a high DSM-high FTND class; a moderate DSM-moderate FTND class, which was distinguished by moderate levels of smoking and intermediate levels of comorbid psychopathology; and a light smoking-moderate FTND class consisting primarily of lighter smokers with a more recent onset of regular smoking. High genetic and environmental vulnerability to nicotine dependence was noted in all classes with no statistically significant across-class differences. CONCLUSIONS In general, the DSM-IV and FTND criteria performed similarly to define a continuum of risk for nicotine dependence. The emerging class of light smokers should be further investigated to assess whether they transition to another class or remain as such.
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Affiliation(s)
- Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA.
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Luo S, Ainslie G, Giragosian L, Monterosso JR. Striatal hyposensitivity to delayed rewards among cigarette smokers. Drug Alcohol Depend 2011; 116:18-23. [PMID: 21177048 PMCID: PMC3169847 DOI: 10.1016/j.drugalcdep.2010.11.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Revised: 11/07/2010] [Accepted: 11/08/2010] [Indexed: 01/09/2023]
Abstract
BACKGROUND Brain regions that track value (including the ventral striatum) respond more during the anticipation of immediate than delayed rewards, even when the delayed rewards are larger and equally preferred to the immediate. The anticipatory response to immediate vs. delayed rewards has not previously been examined in association with cigarette smoking. METHODS Smokers (n=35) and nonsmokers (n=36) performed a modified monetary incentive functional Magnetic Resonance Imaging (fMRI) task (Knutson et al., 2000) that included opportunities to win either immediate or delayed rewards. The delayed rewards were larger and equally preferred to the immediate rewards. RESULTS Across groups, greater activation was observed in regions previously shown to track value including bilateral ventral/dorsal striatum during the anticipation of immediate relative to delayed rewards. This effect was significantly greater among smokers than nonsmokers within the right ventral striatum. This group difference was driven particularly by low striatal activation among smokers during delayed reward trials. CONCLUSIONS The general tendency for striatal reward anticipatory activity to be attenuated when rewards are delayed is exaggerated among smokers relative to comparison participants. Among possible explanations of this relationship are that (1) low anticipatory response to delayed rewards is a phenotypic risk factor for smoking and (2) smoking-related neuroadaptations result in reduced recruitment during the anticipation of delayed rewards.
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Affiliation(s)
- Shan Luo
- Department of Psychology, University of Southern California, SGM 501, 3620 South McClintock Avenue, Los Angeles, CA 90089-1061
| | - George Ainslie
- Coatesville VA Medical Center, 100 Blackhorse Rd, Coatesville, PA 19320
| | - Lisa Giragosian
- Department of Psychology, University of Southern California, SGM 501, 3620 South McClintock Avenue, Los Angeles, CA 90089-1061
| | - John R. Monterosso
- Department of Psychology, University of Southern California, SGM 501, 3620 South McClintock Avenue, Los Angeles, CA 90089-1061,Brain and Creativity Institute, University of Southern California, 3641 Watt Way, Suite 126, Los Angeles, CA 90089-2520,Neuroscience Graduate Program, University of Southern California, 3641 Watt Way, Suite 126, Los Angeles, CA 90089-2520,Correspondence to: John Monterosso, University of Southern California, Hedco Neuroscience Bldg, Rm 117, 3641 Watt Way, Los Angeles, CA 90089, , Phone: (213)-740-6982 Fax: (213)-746-9082
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Covey LS, Hu MC, Weissman J, Croghan I, Adler L, Winhusen T. Divergence by ADHD subtype in smoking cessation response to OROS-methylphenidate. Nicotine Tob Res 2011; 13:1003-8. [PMID: 21652734 DOI: 10.1093/ntr/ntr087] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric condition subclassified in DSM-IV according to its core symptoms domains as (a) predominantly inattentive (ADHD-IN), (b) predominantly hyperactive/impulsive (ADHD-H), and (c) combined inattentive and hyperactive/impulsive (ADHD-C). Whether these subtypes represent distinct clinical entities or points on a severity continuum is controversial. Divergence in treatment response is a potential indicator of qualitative heterogeneity. This study examined smoking cessation response by ADHD subtype to osmotic-release oral system methylphenidate (OROS-MPH). METHODS Male and female adult smokers (ADHD-C = 167 and ADHD-IN = 87) were randomized to receive OROS-MPH or placebo as augmentation treatment to nicotine patch and counseling. Logistic regression was conducted to test the effect of OROS-MPH versus placebo on prolonged smoking abstinence by ADHD subtype. RESULTS The subtypes were similar in baseline demographic, smoking, and psychiatric history but differed in smoking cessation response to OROS-MPH or placebo as a function of nicotine dependence level. The 3-way interaction was significant; χ(2)(1) = 8.22, p < .01. Among highly dependent smokers, the prolonged abstinence rates were greater with OROS-MPH than with placebo in the ADHD-C group (60% vs. 31.3%, respectively, p < .05) but higher with placebo than with OROS-MPH in the ADHD-IN group (60% vs. 11.8%, respectively, p < .01). Abstinence rates did not differ by subtype or treatment among smokers who were less nicotine dependent. CONCLUSION Contrasting treatment response and divergence in the impact of nicotine dependence level support the hypothesis of ADHD subtypes as distinct clinical entities and may indicate the need and directions for personalized targeted treatments of smokers with ADHD.
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Affiliation(s)
- Lirio S Covey
- New York State Psychiatric Institute, Columbia University Medical Center, Psychiatry, Clinical Therapeutics, New York, NY, USA.
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The relationship between nicotine dependence scores and biomarkers of exposure in adult cigarette smokers. Regul Toxicol Pharmacol 2011; 60:79-83. [DOI: 10.1016/j.yrtph.2011.02.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 02/15/2011] [Accepted: 02/16/2011] [Indexed: 11/22/2022]
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Huang CL, Lin HH, Wang HH. Cigarette dependence questionnaire: development and psychometric testing with male smokers. J Adv Nurs 2010; 66:2341-9. [PMID: 20722804 DOI: 10.1111/j.1365-2648.2010.05393.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM This paper is a report of a study conducted to develop and test a theoretically derived Cigarette Dependence Questionnaire for adult male smokers. BACKGROUND Fagerstrom questionnaires have been used worldwide to assess cigarette dependence. However, these assessments lack any theoretical perspective. A theory-based approach is needed to ensure valid assessment. METHODS In 2007, an initial pool of 103 Cigarette Dependence Questionnaire items was distributed to 109 adult smokers in Taiwan. Item analysis was conducted to select items for inclusion in the refined scale. The psychometric properties of the Cigarette Dependence Questionnaire were further evaluated 2007-08, when it was administered to 256 respondents and their saliva was collected and analysed for cotinine levels. Criterion validity was established through the Pearson correlation between the scale and saliva cotinine levels. Exploratory factor analysis was used to test construct validity. Reliability was determined with Cronbach's alpha coefficient and a 2-week test-retest coefficient. RESULTS The selection of 30 items for seven perspectives was based on item analysis. One factor accounting for 44.9% of the variance emerged from the factor analysis. The factor was named as cigarette dependence. Cigarette Dependence Questionnaire scores were statistically significantly correlated with saliva cotinine levels (r = 0.21, P = 0.01). Cronbach's alpha was 0.95 and test-retest reliability using an intra-class correlation was 0.92. CONCLUSION The Cigarette Dependence Questionnaire showed sound reliability and validity and could be used by nurses to set up smoking cessation interventions based on assessment of cigarette dependence.
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Affiliation(s)
- Chih-Ling Huang
- Department of Nursing, Chang Jung Christian University, Tainan, Taiwan
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