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Lizhnyak PN, Noggle B, Wei L, Edmiston J, Becker E, Black RA, Sarkar M. Understanding heterogeneity among individuals who smoke cigarettes and vape: assessment of biomarkers of exposure and potential harm among subpopulations from the PATH Wave 1 Data. Harm Reduct J 2022; 19:90. [PMID: 35978343 PMCID: PMC9387076 DOI: 10.1186/s12954-022-00673-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 08/04/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction People who both smoke cigarettes and vape are often considered as a homogenous group even though multiple subgroups may exist. We examined biomarkers of exposure (BOE) and biomarkers of potential harm (BOPH) to differentiate between subgroups of people who smoke and vape based on PATH Study Wave 1 (2013–2014) data. Methods We compared people who only smoke cigarettes everyday (Group A, n = 2442) and people who only vape everyday (Group C, n = 169) against people who smoke and vape segmented into subgroups of people who frequently smoke and vape (Group B1, n = 169), frequently smoke and infrequently vape (Group B2, n = 678), frequently vape and infrequently smoke (Group B3, n = 57), and infrequently smoke and vape (Group B4, n = 66). Eighteen BOEs (representing exposure to TSNAs, nicotine, heavy metals, PAHs, and volatile organic compounds) and four BOPHs (representing inflammation and oxidative stress) were compared within the subgroups.
Results Levels of many BOEs/BOPHs were higher among Group B2 relative to Groups B1, B3, and B4. Compared to Group A, many BOEs were significantly lower in Groups B3 (15/18) and B4 (17/18), and some BOEs were higher among B2 (4/18). Compared to Group C, significantly lower BOEs were observed for Group B4 (2/18).
Conclusions Overall, the levels of BOEs and BOPHs in people who smoke and vape are associated with frequency of cigarette smoking. Our findings indicate that not all people who smoke and vape are the same, and tobacco product use frequency should be considered when categorizing people who smoke and vape. Supplementary Information The online version contains supplementary material available at 10.1186/s12954-022-00673-x.
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Affiliation(s)
- Pavel N Lizhnyak
- Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA, 23219, USA
| | - Brendan Noggle
- Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA, 23219, USA
| | - Lai Wei
- Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA, 23219, USA
| | - Jeffery Edmiston
- Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA, 23219, USA
| | - Elizabeth Becker
- Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA, 23219, USA
| | - Ryan A Black
- Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA, 23219, USA
| | - Mohamadi Sarkar
- Altria Client Services LLC, 601 E. Jackson Street, Richmond, VA, 23219, USA.
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Collado A, Felton J, Grunevski S, Doran K, Yi R. Working Memory Training Reduces Cigarette Smoking Among Low-Income Individuals With Elevated Delay Discounting. Nicotine Tob Res 2022; 24:890-896. [PMID: 35018452 PMCID: PMC9048952 DOI: 10.1093/ntr/ntac005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/11/2021] [Accepted: 01/05/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The competing neurobehavioral decision systems theory conceptualizes addictive behavior, such as cigarette smoking, as arising from the imbalance between stronger impulsive relative to weaker executive decision processes. Working memory trainings may enhance executive decision processes, yet few studies have evaluated its efficacy on substance misuse, with mixed evidence. The current study is the first to evaluate the efficacy of a working memory training on cigarette smoking. We consider the moderating role of delay discounting (DD), or the preference for smaller, immediately available rewards relative to larger, delayed rewards, which has been associated with smoking onset, progression, and resumption. The investigation focuses on individuals living in high-poverty, low-resource environments due high burden of tobacco-related disease they experience. AIMS AND METHODS The study utilized a subset of data (N = 177 individuals who smoke) generated from a randomized clinical trial that is evaluating the efficacy of working memory training for improving health-related outcomes. Participants were randomized to complete up to 15 sessions of the active, working memory training or a control training. RESULTS Findings showed that among participants who were randomized to the working memory condition, those with higher rates of baseline DD demonstrated decreases in cigarette smoking (p = .05). Conversely, individuals randomized to the control condition, who had higher rates of baseline DD exhibited increases in cigarette smoking (p = .025). CONCLUSIONS Results suggest that DD may be an important indicator of working memory training outcomes and a possible approach for effectively targeting treatments in the future. IMPLICATIONS DD is important indicator of working memory training outcomes on cigarette smoking. The findings suggest the possibility to effectively target treatments considering the impact of DD. Given that rates of DD tend to be higher among individuals from low-resource communities, and that computer-based working memory training programs are relatively low-cost and scalable, these findings suggest this approach may have specific utility for adults at heightened risk for cigarette use.This study was registered with ClinicalTrials.gov (Identifier NCT03501706).
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Affiliation(s)
- Anahi Collado
- Cofrin Logan Center for Addiction Research and Treatment, Department of Psychology, University of Kansas, Lawrence, GB, USA
| | - Julia Felton
- Center for Health Policy & Health Services Research, Henry Ford Health Systems, Detroit, MI, USA
| | - Sergej Grunevski
- Cofrin Logan Center for Addiction Research and Treatment, Department of Psychology, University of Kansas, Lawrence, GB, USA
| | - Kelly Doran
- Department of Family and Community Health, University of Maryland Baltimore, School of Nursing, Baltimore, MD, USA
| | - Richard Yi
- Cofrin Logan Center for Addiction Research and Treatment, Department of Psychology, University of Kansas, Lawrence, GB, USA
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Phiri MM, Summers AD, Kress AC, de Quevedo IG, Caraballo R, Twentyman E. Demographic characteristics associated with awareness of cigarette health warnings and thinking about quitting among current adult cigarette smokers in Zambia, 2017. Tob Prev Cessat 2022; 8:05. [PMID: 35224314 PMCID: PMC8832506 DOI: 10.18332/tpc/144772] [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: 08/31/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Noticing health warnings on cigarette packages has been associated with thinking about quitting. This study examined sociodemographic characteristics associated with awareness of health warnings on cigarette packages and thinking about quitting because of health warning labels among adults who currently smoked tobacco. METHODS We analyzed data from the 2017 Zambia WHO STEPS survey (STEPwise approach to surveillance) for noncommunicable disease risk factors. Descriptive analyses and logistic regression were performed to assess the association of select sociodemographic characteristics with awareness of health warnings and thinking about quitting because of health warnings. RESULTS Adults who currently smoked tobacco who were aged 30–44 years, of Chewa ethnicity, or with a formal education, were more likely to be aware of health warnings than those aged 18–29 years (adjusted prevalence ratio, APR=1.26; 95% CI: 1.02–1.54), of Bemba ethnicity (APR=1.43; 95% CI: 1.17–1.74), or with no formal education (APR: 2.61–5.95). Among all adults who currently smoked, those of Chewa ethnicity (APR=1.55; 95% CI: 1.03–2.35), or with a formal education (APR:1.80–4.38), were more likely to report thinking about quitting because of health warnings than those who were of Bemba ethnicity or with less than primary school education level. Women who currently smoked were 49% less likely (APR=0.51; 95% CI: 0.23–0.84) to report thinking about quitting than men. Among a subset of adults who currently smoked who were aware of health warning labels, no sociodemographic characteristics were significantly associated with thinking about quitting in unadjusted or adjusted models. CONCLUSIONS Sociodemographic characteristics such as sex, ethnicity, and education level were significantly associated with awareness of cigarette health warnings. Among cigarette smokers aware of health warnings, no sociodemographic differences in thinking about quitting were found. Tobacco control campaigns may need to target people of ethnicities with the highest smoking prevalence in the country.
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Affiliation(s)
- Masauso M. Phiri
- Tobacco Control Scholars Program Fellow Centre for Primary Care Research, School of Medicine, University of Zambia, Ridgeway, Zambia
| | - April D. Summers
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
| | - Alissa C. Kress
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
| | - Isabel Garcia de Quevedo
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
| | - Ralph Caraballo
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
| | - Evelyn Twentyman
- Global Tobacco Control Branch, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States
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Joint effect of particulate matter and cigarette smoke on women's sex hormones. BMC Womens Health 2022; 22:3. [PMID: 34996432 PMCID: PMC8742359 DOI: 10.1186/s12905-021-01586-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although relationships between exposure to air pollution and reproductive health are broadly studied, mechanisms behind these phenomena are still unknown. The aim of the study was to assess whether exposure to particulate matter (PM10) and tobacco smoking have an impact on menstrual profiles of 17β-estradiol (E2) and progesterone (P) and the E2/P ratio. METHODS Levels of sex hormones were measured daily in saliva during the entire menstrual cycle among 132 healthy, urban women. Exposure to smoking (active or passive) was assessed by questionnaire, whilst exposure to PM10 with municipal monitoring data. RESULTS During the early luteal phase, profiles of E2 were elevated among women with higher versus lower exposure to PM10 (p = 0.02, post-hoc tests). Among those who were exposed versus unexposed to tobacco smoking, the levels of mean E2 measured during the entire cycle were higher (p = 0.02). The difference in mean E2 levels between the group of joint exposure (i.e. to high PM10 and passive or active smoking) versus the reference group (low PM10, no smoking) was statistically significant at p = 0.03 (18.4 vs. 12.4 pmol/l, respectively). The E2/P ratios were higher among women with higher versus lower exposure to PM10 and this difference was seen only in the early luteal phase (p = 0.01, exploratory post-hoc tests). CONCLUSIONS We found that PM10 and tobacco smoking affect ovarian hormones independently and do not interact with each other. Both exposures appear to have estrogenic effects even though women's susceptibility to these effects differs across the menstrual cycle. We propose that the hormonal mechanisms are involved in observed relationships between air pollution and smoking with women's reproductive health.
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Butler-Dawson J, Barnoya J, Brindley S, Krisher L, Fan W, Asensio C, Newman LS. Cross-sectional study examining the accuracy of self-reported smoking status as compared to urinary cotinine levels among workers at risk for chronic kidney disease of unknown origin in Guatemala. BMJ Open 2021; 11:e050374. [PMID: 34697113 PMCID: PMC8547360 DOI: 10.1136/bmjopen-2021-050374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 10/06/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES There is a lack of information on cotinine levels in rural populations in low-income and middle-income countries like Guatemala. Therefore, there is a need to explore smoking status and biomarkers of tobacco use in epidemiological research in rural, low-income populations, in particular those at-risk for chronic kidney disease of unknown origin (CKDu). DESIGN We evaluated self-reported smoking status against urinary cotinine levels, the gold standard biomarker of tobacco smoke exposure, among agricultural workers at four separate cross-sectional time points. SETTING Guatemala. PARTICIPANTS 283 sugarcane workers. PRIMARY OUTCOME MEASURES Compared self-reported smoking status and urinary cotinine levels in two agricultural worker studies. RESULTS Self-reported smoking prevalence was 12% among workers. According to cotinine levels (≥50 ng/mL), the smoking prevalence was 34%. Self-reported smoking status had 28% sensitivity and 96% specificity. Urinary cotinine levels show that smoking prevalence is underestimated in this worker population. CONCLUSIONS According to our findings, smoking status should be objectively measured with biomarkers rather than self-reported in CKDu epidemiological research. Self-reported smoking status is likely an underestimate of the true smoking prevalence among agricultural workers. Research on the CKDu epidemic in Central America and other parts of the world might be underestimating tobacco exposure as a potential contributor to the development of CKDu.
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Affiliation(s)
- Jaime Butler-Dawson
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
- Center for Health, Work and Environment, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Joaquin Barnoya
- Integra Cancer Institute, Guatemala City, Guatemala
- Unit for Cardiovascular Surgery, Unidad de Cirugía Cardiovascular de Guatemala, UNICAR, Guatemala City, Guatemala
| | - Stephen Brindley
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Lyndsay Krisher
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
- Center for Health, Work and Environment, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Wenyi Fan
- Center for Health, Work and Environment, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | | | - Lee S Newman
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
- Center for Health, Work and Environment, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, School of Medicine, and Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
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Gass JC, Funderburk JS, Shepardson R, Kosiba JD, Rodriguez L, Maisto SA. The use and impact of self-monitoring on substance use outcomes: A descriptive systematic review. Subst Abus 2021; 42:512-526. [PMID: 33617740 DOI: 10.1080/08897077.2021.1874595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Self-Monitoring (SM), the act of observing ones' own behavior, has been used in substance use treatment because SM may bring conscious awareness to automatized substance use behaviors. Empirical findings regarding SM's effectiveness are mixed. The aim of this study was to synthesize the literature for the efficacy of SM on substance use. Method: A literature search was conducted using MEDLINE/PubMed. Results: Out of 2,659 citations, 41 studies with 126 analyses were included. Among analyses from studies rated Moderate (n = 24) or Strong (n = 3) quality, SM was shown to have a helpful effect (e.g., reducing substance use) 29% of the time; to have no effect 63.0% of the time; and to be detrimental in 8.0% of analyses. SM's helpful effects were associated with methodological characteristics including longer monitoring and Phone/IVR and EMA/Computer methodologies compared to Paper/Pencil. SM was more helpful in non-treatment-seekers (35.0% of analyses showed SM to be helpful compared to 25.0% of analyses with treatment-seekers). Conclusions: Results of this study suggest that SM, under certain circumstances, as the potential to be a low-cost, low-risk research and early intervention strategy for substance users.
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Affiliation(s)
- Julie C Gass
- VA Center for Integrated Healthcare, Western New York VA Healthcare System, Buffalo, NY, USA.,Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Jennifer S Funderburk
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.,Department of Psychology, Syracuse University, Syracuse, NY, USA.,Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Robyn Shepardson
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.,Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Jesse D Kosiba
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.,Department of Psychiatry, University of Rochester, Rochester, NY, USA
| | - Lauren Rodriguez
- VA Center for Integrated Healthcare, Western New York VA Healthcare System, Buffalo, NY, USA.,Department of Psychology, University at Buffalo, State University of New York, Buffalo, NY, USA
| | - Stephen A Maisto
- VA Center for Integrated Healthcare, Syracuse VA Medical Center, Syracuse, NY, USA.,Department of Psychology, Syracuse University, Syracuse, NY, USA
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Nollen NL, Cox LS, Mayo MS, Ellerbeck EF, Ahluwalia JS. Counseling alone or in combination with nicotine replacement therapy for treatment of black non-daily smokers: a randomized trial. Addiction 2020; 115:1547-1560. [PMID: 31899564 DOI: 10.1111/add.14948] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/01/2019] [Accepted: 12/20/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS One-third of US tobacco users are non-daily smokers (NDS). Black NDS have strikingly high levels of nicotine and carcinogen exposure. No smoking cessation studies have been conducted with this high-risk group. This study compared the effectiveness in black NDS of smoking cessation counseling alone or in combination with the participant's choice of nicotine replacement therapy. DESIGN Two-arm parallel-group individually randomized clinical trial (allocation ratio of 2 : 1 intervention to control) SETTING: Academic medical and federally qualified health centers in three US cities. PARTICIPANTS Non-Hispanic black adult NDS receiving counseling with nicotine replacement therapy (C + NRT, n = 185) or counseling alone (C, n = 93). INTERVENTIONS Twelve weeks of in-person and telephone smoking cessation counseling in combination with nicotine replacement therapy (NRT; C + NRT) or counseling alone (C). All participants received five sessions of counseling; those randomized to C + NRT received their choice of nicotine gum, patch and/or lozenge after a 9-day product trial period. The target quit day was set at 2 weeks post-baseline for both groups. MEASUREMENTS Primary outcome was biochemically verified 30-day abstinence at week 12. Secondary outcomes were change in nicotine and carcinogen exposure [4-(methynitrosamino)-1-(3) pyridyle-1-butanol; NNAL] and tobacco consumption patterns. FINDINGS Abstinence was 11.4% in C + NRT and 8.6% in C [odds ratio (OR) = 1.4, 95% confidence interval (CI) = 0.6, 3.2, P = 0.48]. Both groups experienced significant reduction in NNAL (C + NRT: 53% reduction, C: 50% reduction, within-group P < 0.0001) but non-significant changes in cotinine (P = 0.69). C + NRT reported more days abstinent (P < 0.001) and fewer total cigarettes (P = 0.002) compared with C. There was no evidence of compensation with other tobacco products. CONCLUSIONS Among black non-daily smokers in the United States, there was no difference in abstinence between nicotine replacement therapy (NRT) and counseling alone. NRT led to greater increase in days abstinent and reduction in cigarettes, with no evidence of compensation from other sources of nicotine.
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Affiliation(s)
- Nicole L Nollen
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Matthew S Mayo
- Department of Biostatistics and Data Science, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Edward F Ellerbeck
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Jasjit S Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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Doran N, Correa JB, Myers MG, Tully L. Associations Between Self-Reported and Biological Measures of Nicotine Consumption Among Young Adult Nondaily Cigarette Smokers. Am J Addict 2020; 29:471-475. [PMID: 32358904 DOI: 10.1111/ajad.13052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/31/2020] [Accepted: 04/23/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Intermittent, dual use of cigarettes and e-cigarettes is a common pattern among youth and young adults. However, little is known about the validity of self-report measures of nicotine consumption in these populations. The goal of the present study was to examine associations between self-reported frequency of cigarette and e-cigarette use and nicotine levels in hair samples at two assessments 1 year apart. METHODS Participants (n = 90; 65% female) were 19- to 25-year-old intermittent cigarette smokers recruited from the community for a longitudinal study of tobacco use. They submitted hair samples via mail, 1 and 2 years after enrollment in the parent study. RESULTS Findings indicated that days of use of both cigarettes and e-cigarettes in the past 30 days independently predicted hair nicotine in the full sample, and when examining only timepoints at which any cigarette use was reported. Timepoints when any e-cigarette use was reported, hair nicotine was positively associated with e-cigarette but not cigarette frequency. DISCUSSION AND CONCLUSIONS Data suggest that self-report measures are valid methods of assessing intermittent use of both cigarettes and e-cigarettes. Findings also suggest that dual users may tend to consume more nicotine and thus be at greater risk for dependence than single product users. SCIENTIFIC SIGNIFICANCE These results are among the first to indicate that hair analysis can be used to detect intermittent nicotine exposure via both cigarettes and e-cigarettes. (Am J Addict 2020;29:471-475).
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Affiliation(s)
- Neal Doran
- Department of Psychiatry, University of California, San Diego, San Diego, California.,Psychology Service, VA San Diego Healthcare System, San Diego, California
| | - John B Correa
- Department of Psychiatry, University of California, San Diego, San Diego, California.,Psychology Service, VA San Diego Healthcare System, San Diego, California
| | - Mark G Myers
- Department of Psychiatry, University of California, San Diego, San Diego, California.,Psychology Service, VA San Diego Healthcare System, San Diego, California
| | - Lyric Tully
- Department of Psychiatry, University of California, San Diego, San Diego, California
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Socio-demographic and motivational correlates
of smoking status at term and postpartum. HEALTH PSYCHOLOGY REPORT 2020. [DOI: 10.5114/hpr.2020.102135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Petersen A, Myers MG, Tully L, Brikmanis K, Doran N. Polytobacco use among young adult smokers: prospective association with cigarette consumption. Tob Control 2018; 29:43-48. [PMID: 30385650 DOI: 10.1136/tobaccocontrol-2018-054625] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/02/2018] [Accepted: 10/10/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The risks of polytobacco use among young adults are unclear because we know relatively little about the consistency of multiproduct patterns over time and how these patterns impact cigarette smoking. The purpose of this study was to examine changes in multiple tobacco product use over time and associations with cigarette smoking quantity. METHODS Participants (n=335; 55% male) were 18-24 years old non-daily cigarette smokers living in California. Polytobacco use patterns were assessed quarterly for 2 years. RESULTS Transition analyses showed that while the number of products that had been used recently was volatile, the most common pattern was stability between timepoints. A longitudinal negative binomial regression model indicated that those who used more non-cigarette products also reported greater cigarette quantity. The strength of this relationship increased over time. CONCLUSIONS Findings suggest that individuals who use more tobacco products are at greater risk for increased cigarette smoking and maintaining a multiple product use pattern.
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Affiliation(s)
- Angela Petersen
- Department of Psychiatry, University of California, San Diego, California, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Mark G Myers
- Department of Psychiatry, University of California, San Diego, California, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Lyric Tully
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Kristin Brikmanis
- Department of Psychology, University of Illinois, Chicago, Illinois, USA
| | - Neal Doran
- Department of Psychiatry, University of California, San Diego, California, USA.,Psychology Service, VA San Diego Healthcare System, San Diego, California, USA
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11
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Cifu G, Arem H. Adherence to lifestyle-related cancer prevention guidelines and breast cancer incidence and mortality. Ann Epidemiol 2018; 28:767-773.e1. [DOI: 10.1016/j.annepidem.2018.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/02/2018] [Accepted: 09/10/2018] [Indexed: 10/28/2022]
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12
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Shiffman S, Kurland BF, Scholl SM, Mao JM. Nondaily Smokers' Changes in Cigarette Consumption With Very Low-Nicotine-Content Cigarettes: A Randomized Double-blind Clinical Trial. JAMA Psychiatry 2018; 75:995-1002. [PMID: 29902305 PMCID: PMC6233810 DOI: 10.1001/jamapsychiatry.2018.1831] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE The US Food and Drug Administration is considering limiting cigarettes to very low nicotine levels. Cigarette consumption of nondaily intermittent smokers (ITS), who compose one-third of US adult smokers, could feasibly increase or could be unaffected if their smoking is not motivated by nicotine seeking. OBJECTIVE To compare cigarette consumption in ITS receiving very low-nicotine-content cigarettes (VLNCCs) or identical normal-nicotine-content cigarettes (NNCCs). DESIGN, SETTING, AND PARTICIPANTS This randomized double-blind clinical trial was conducted from June 2015 to July 2017 at a single US site. Volunteer ITS not planning to quit were recruited via media. Overall, 297 individuals enrolled, and 238 were randomized. Analyses were intent-to-treat. INTERVENTIONS After a 2-week baseline of smoking their own brand of cigarettes provided gratis, ITS were randomized to VLNCCs or NNCCs for 10 weeks. MAIN OUTCOMES AND MEASURES The number of cigarettes per day (CPD) was assessed by real-time reporting, timeline follow-back reports, and cigarette butt counts. The primary outcome was change in CPD from baseline to weeks 9 to 10 of intervention, adjusting for baseline CPD. RESULTS The mean (SD) age of the 238 randomized participants was 37.9 (13.8) years. Of 238 participants, 108 (45%) were men. At baseline, the mean (SD) CPD was 3.1 (2.9). In intent-to-treat analyses using multiple imputation to address missing data, the VLNCC group had a mean decrease of 1.6 CPD (95% CI, 1.1-2.0; 51% of baseline) vs 0.05 decrease with NNCCs (95% CI, -0.5 to 0.4; 2% of baseline). Treatment group differences were not materially moderated by sex, race/ethnicity, or history of daily smoking. Cheating with conventional cigarettes, inferred from cotinine assays, was more common in the VLNCC group (OR, 2.95; 95% CI, 1.54-5.66), but sensitivity analyses showed significant VLNCC effects among the compliant participants as well. In longitudinal analysis of CPD over time with random intercept and slope, the VLNCC and NNCC groups differed significantly in both linear (-0.15; 95% CI, -0.22 to -0.08; P < .001) and quadratic (0.0026; 95% CI, 0.0010-0.0042; P = .002) trends: CPD dropped by 43.8% in the VLNCC group over 4 weeks, then leveled off thereafter. Abstinence (intent-to-treat, biochemically verified) in weeks 9 to 10 postrandomization did not differ significantly by treatment group (VLNCC, 10.2% vs NNNC, 5.0%; P = .28). CONCLUSIONS AND RELEVANCE Switching to VLNCCs caused substantial smoking reduction among ITS but did not significantly increase abstinence. Response to a VLNCC intervention suggests that nicotine-seeking motivates ITS' smoking. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02228824.
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Affiliation(s)
- Saul Shiffman
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania,UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania
| | - Brenda F. Kurland
- UPMC Hillman Cancer Center, Pittsburgh, Pennsylvania,Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sarah M. Scholl
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jason M. Mao
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania
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Chen X, Wang Y, Leeman RF, Li F, Zhao J, Bruijnzeel AW. Video-assisted topographical measurement of cigarette smoking: Exploration of an objective approach to evaluate nicotine dependence. Tob Prev Cessat 2018; 4:21. [PMID: 32411847 PMCID: PMC7205159 DOI: 10.18332/tpc/90821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Addressing nicotine dependence is key to effective smoking cessation. While self-report measures of nicotine dependence are often challenged for their reliability and validity, there is a lack of non-invasive and inexpensive objective measures of nicotine dependence. In this study, we aimed to explore the potential of using video-assisted smoking topography to derive objective measures indicative of nicotine dependence with the guidance of nicotine-receptor-based self-titration theory. METHODS Videotaped topography data were collected for one episode of smoking a whole cigarette the first time of the day from 10 cigarette smokers with diverse racial backgrounds (4 males and 6 females, mean age = 27 years, SD = 7.2). Temporal patterns of individual topographic measures (i.e. puff interval, puff speed, puff duration, inhalation duration, and rest duration) were measured and plotted against time. Levels of nicotine dependence were evaluated using three standard scales, including the 14-item DSM-IV scale, the 6-item ICD-10 scale, and the 6-item Fagerström Test of Nicotine Dependence. Both linear and non-linear fold catastrophe dynamic models were used to fit the data. RESULTS Compared with a linear model (R2 from 0.003 to 0.74), the non-linear model more adequately captured the temporal pattern of topographic measures (R2 from 0.11 to 0.99), especially puff speed. The indicators derived from the fitted fold catastrophe curve (e.g. average puff speed) were significantly associated with nicotine dependence scores, especially DSM-IV scale scores (r from 0.64 to 0.93). CONCLUSIONS Study findings suggest the potential to objectively and non-invasively measure nicotine dependence using video-assisted smoking topography.
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Affiliation(s)
| | - Yan Wang
- University of Florida, Florida, United States
| | | | - Fang Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
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