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Pahlavanzadeh B, Kolagari S, Ebrahimi Kalan M, Taleb ZB, Ward KD, Zare S, Charkazi A. Psychometric properties of Fagerström Tolerance Questionnaire among Turkmen Nass (Naswar) users. Addict Sci Clin Pract 2023; 18:32. [PMID: 37217987 DOI: 10.1186/s13722-023-00390-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/08/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Smokeless tobacco (SLT) products are gaining popularity around the globe, particularly in Asia, Africa, and the Middle East. Among these products, Nass (aka Naswar) is popular among the Turkmen ethnicity in Iran. Although several studies reported nicotine dependence (ND) among SLT users, psychometric instruments have never been utilized to specifically measure ND among Nass users. Therefore, in this study, we aimed to evaluate the reliability and validity of the Fagerström Tolerance Questionnaire (FTQ) among Turkmen Nass users. METHODS A cross-sectional, descriptive study was conducted in June-December 2018 among 411 Turkmen adults who currently (past 30 days) used Nass. Two bilinguals (Persian English) individuals translated and back-translated the FTQ-SLT, which maintained both the questionnaire's accuracy and cultural sensitivity. Construct validity was assessed using exploratory and confirmatory factor analysis. RESULTS The mean age and standard deviation for initiating Nass were 22.5 ± 11.81 years. Exploratory and confirmatory factor analysis indicated a single-factor solution with 8-items that captured several important ND components. Using Nass frequently, soon after waking, when sick, and experiencing a craving were some of the main components. Subgroups comparison revealed that higher scores occurred among those who were married, had Nass user(s) in their immediate family, and consumed bulk form of Turkmen Nass directly without using a tissue. CONCLUSION Our findings show that the FTQ- SLT is a fairly reliable and valid scale to measure ND among Turkmen Nass users and warrants further testing to accommodate cross-cultural differences in other populations.
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Affiliation(s)
| | - Shohreh Kolagari
- Faculty of Nursing & Midwifery, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, 411 S. Nedderman Drive Box 19407, Arlington, TX, 76019-0407, USA
| | - Kenneth D Ward
- School of Public Health, University of Memphis, 3720 Alumni Ave, Memphis, TX, 38152, USA
| | - Samane Zare
- School of Medicine, Department of Social Medicine, Population, & Public Health, University of California Riverside, 3333 14th Street, Riverside, CA, 92501, USA
| | - Abdurrahman Charkazi
- Environmental Health Research Center, Faculty of Health, Golestan University of Medical Sciences, Late Falsefi University Complex, KM 5of Gorgan-Sari Road, Gorgan, Iran.
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Sami A, Elimairi I, Anthony Ryan C, Paul Ross R, Stanton C. Sudanese Toombak smokeless tobacco users harbour significantly altered long-term cortisol body production. Steroids 2023; 193:109189. [PMID: 36738817 DOI: 10.1016/j.steroids.2023.109189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
The Sudanese, in particular its male population, are known to utilise a smokeless tobacco product (Toombak) which is placed in the oral cavity and can be replaced several times a day. Toombak has been shown to harm human health and is highly addictive. The effect on body cortisol response over a retrospective period in users of this product has not been previously explored. In addition, psycho-dependency scores of Toombak users have not been analysed. In this study, 37 male subjects, age 18-45 years were recruited, of which 18 were non-users of Toombak and 19 were Toombak users. One hair sample was collected from each user and non-user of Toombak. Each hair sample (n=37) was placed in a pre-prepared long piece of foil with two labels on either side marked: 'scalp-side' and 'distant-side'. Cortisol was extracted by mincing 10 mg of 'scalp-side' hair, not exceeding 3 cm, with methanol addition, incubation, and sonication. Cortisol was measured using the enzyme-linked immunosorbent assay kit (Enzo Life Sciences, UK). The amount of hair cortisol in the samples was determined using spectrophotometry at wavelength 405 nm measured in pg/ml and visualised with a four parametric logistic curve. Toombak users were further asked to complete the Fagerstrom Test for Nicotine Dependence-Smokeless Tobacco questionnaire (FTND-ST) comprising of six questions. Scores of > 5 indicated a significant dependence, while a score of < 4 marked low to moderate dependence. The mean concentration of hair cortisol in Toombak users (9.7 pg/ml) was significantly lower (p=0.023) compared to non-users (19.4 pg/ml), with total concentrations ranging from 2.1 to 55.6 pg/ml. FTND-ST scores ranged from 4 to 9, with high levels of psycho-dependency (score > 5) and nicotine tolerance found in 85 % of Toombak users. Cortisol body release in Sudanese smokeless tobacco users was found to be significantly altered. While low cortisol levels do lead to anxiolytic effects, in the long-term, this can allow for increased susceptibility to low cortisol-associated diseases.
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Affiliation(s)
- Amel Sami
- APC Microbiome Ireland, School of Microbiology, University College Cork, Cork T12 YN60, Europe; Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Dentistry, National Ribat University, Nile Street, Khartoum 1111, Sudan
| | - Imad Elimairi
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Dentistry, National Ribat University, Nile Street, Khartoum 1111, Sudan.
| | - C Anthony Ryan
- Department of Paediatrics and Child Health, University College Cork, Cork T12 DFK4, Europe
| | - R Paul Ross
- APC Microbiome Ireland, School of Microbiology, University College Cork, Cork T12 YN60, Europe
| | - Catherine Stanton
- APC Microbiome Ireland, School of Microbiology, University College Cork, Cork T12 YN60, Europe; Teagasc Food Research Centre, Moorepark, Fermoy, Cork P61 C996, Ireland.
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Thawal VP, Tzelepis F, Bagade T, Paul C. Psychometric properties of smokeless tobacco dependence measures: A COSMIN systematic review. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 147:208978. [PMID: 36889219 DOI: 10.1016/j.josat.2023.208978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/19/2022] [Accepted: 02/05/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND A comprehensive assessment of the quality of the psychometric properties of smokeless tobacco (SLT) dependence measures is necessary to help researchers and health professionals decide on the most appropriate measure to use when assessing dependence and planning cessation treatment. The aim of this systematic review was to identify and critically appraise measures for assessing dependence on SLT products. METHODS The study team searched MEDLINE, CINAHL, PsycINFO, EMBASE and SCOPUS databases. We included English-language studies describing the development or psychometric properties of an SLT dependence measure. Two reviewers independently extracted data and appraised risk of bias using the rigorous Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. RESULTS Sixteen studies assessing 16 unique measures were eligible for assessment. Eleven studies were conducted in the United States; two in Taiwan and one each in Sweden, Bangladesh, and Guam. Of the sixteen measures, none of the measures was rated as "A" (can be recommended for use) as per COSMIN standards primarily due to limitations in structural validity and internal consistency. Nine measures (FTND-ST, FTQ-ST-9, FTQ-ST-10, OSSTD, BQDS, BQDI, HONC, AUTOS and STDS) were rated as "B": having potential for assessing dependence, although further assessment of psychometric properties is needed. Four measures, MFTND-ST, TDS, GN-STBQ and SSTDS having high quality evidence for an insufficient measurement property were rated as "C" and were not supported for use as per COSMIN standards. The remaining three brief measures HSTI, ST-QFI and STDI (consisting of <3 items) were rated inconclusive due to the inability of assessment of structural validity (minimum 3 items required for factor analysis), which is a prerequisite for assessment of internal consistency per the recommendations by the COSMIN framework. CONCLUSION Further validation is required for the current tools that assess dependence on SLT products. Given the concerns related to the structural validity of these tools, a need may also exist to develop new measures for use by clinicians and researchers for assessing dependence on SLT products. PROSPERO CRD42018105878.
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Affiliation(s)
- Vaibhav P Thawal
- School of Medicine and Public Health (SMPH), University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia.
| | - Flora Tzelepis
- School of Medicine and Public Health (SMPH), University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia; Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.
| | - Tanmay Bagade
- School of Medicine and Public Health (SMPH), University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia.
| | - Christine Paul
- School of Medicine and Public Health (SMPH), University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, New Lambton Heights, Newcastle, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, Australia; Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Newcastle, Australia.
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Onmaz M, Demirbas N, Eryavuz Onmaz D, Kutlu R, Unlu A. Effect of cigarette smoking on serum methylarginine and α-klotho levels. Nutr Metab Cardiovasc Dis 2023; 33:602-609. [PMID: 36710115 DOI: 10.1016/j.numecd.2022.12.020] [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] [Received: 06/07/2022] [Revised: 10/19/2022] [Accepted: 12/24/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Smoking causes many diseases such as cardiovascular, lung diseases, stroke and premature aging. However, the role of smoking in the pathogenesis of these diseases is unclear. Increasing evidence suggests that methylarginine pathway metabolites and α-klotho may be strong markers for pathologies such as premature aging, endothelial dysfunction, and oxidant damage. Therefore, the study aimed to measure the serum levels of arginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), N-monomethyl-l-arginine (L-NMMA), and α-klotho levels in smokers. METHODS AND RESULTS This case-control analytical study included 65 smokers and 71 non-smokers. Sociodemographic characteristics, routine biochemistry parameters, Framingham risk scores and Fagerström Nicotine Dependence Test (FTND) were recorded. Serum methylarginine and α-klotho levels were analyzed by tandem mass spectrometry and enzyme-linked immunosorbent assay (ELISA), respectively. Serum ADMA (p < 0.001), L-NMMA (p = 0.024), SDMA (p < 0.001) levels of smokers were higher than non-smokers, and serum α-klotho (p < 0.001) and arginine levels (p < 0.001) were lower. There was a positive correlation between serum ADMA levels with FNDT, age and pack/year in smokers, while there was a negative correlation between klotho levels and age. A positive correlation was found between serum ADMA levels, Framingham risk score and age in non-smokers. CONCLUSION Smoking is related to premature aging and is a strong risk factor for various diseases such as cardiovascular, inflammatory, and renal diseases. Elevated serum methylarginine and decreased serum klotho levels were found in smokers. Therefore, our findings suggest that smoking may be involved in the pathogenesis of these diseases by affecting α-klotho and methylarginine-related pathways.
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Affiliation(s)
- Mustafa Onmaz
- Necmettin Erbakan University Faculty of Medicine, Department of Family Medicine, Konya, Turkey.
| | - Nur Demirbas
- Necmettin Erbakan University Faculty of Medicine, Department of Family Medicine, Konya, Turkey
| | - Duygu Eryavuz Onmaz
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Ruhusen Kutlu
- Necmettin Erbakan University Faculty of Medicine, Department of Family Medicine, Konya, Turkey
| | - Ali Unlu
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
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Lim KH, Yun YX, Cheong YL, Sulaiman N, Mahadzir ME, Lim JH, Hashim MHM, Lim HL. Construct validity and reliability of the Malay version of the Fagerström test for nicotine dependence (FTND): A confirmatory factor analysis. Tob Induc Dis 2023; 21:36. [PMID: 36909814 PMCID: PMC9993235 DOI: 10.18332/tid/159624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/11/2022] [Accepted: 01/21/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION The Fagerström test for nicotine dependence (FTND) was forward-backwards translated into the Malay language (FTND-M) and administered to 152 daily smokers who sought treatment for smoking cessation in government health clinics in Selangor state, Malaysia. METHODS Using confirmatory factor analysis (CFA), four measurement models with the best relative fit were compared, one uni-dimensional model, and three different two-domain (morning and daytime smoking) models. RESULTS The findings indicate that the best model of the FTND-M was a two-domain model, wherein domain one represented morning smoking (time to first cigarette of the day, smoking more in the morning, and which cigarette would you hate to give up) and domain two represented daytime smoking (cigarettes per day, difficulty refraining from smoking, and smoking when ill) which showed good model fit [χ2/df=1.932, goodness of fit (GFI) of 0.967, comparative fix index (CFI) of 0.945, incremental fit index (IFI) of 0.98, Tucker-Lewis index (TLI) of 0.95 and a real mean square end of approximation (RMSEA) of 0.079, and substantial reliability >0.70]. CONCLUSIONS This study indicates that the FTND-M can be used to assess these two dimensions of nicotine addiction among daily smokers in a clinical setting.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Yah Xin Yun
- Selangor Pharmacy Enforcement Branch, Selangor State Health Department, Selangor, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Mas Eliana Mahadzir
- Pharmacy Department, Shah Alam Hospital, Shah Alam, Malaysia.,Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Putrajaya Hospital, Putrajaya, Malaysia
| | | | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
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Giovacchini CX, Crotty Alexander LE, Que LG. Electronic Cigarettes: A Pro-Con Review of the Current Literature. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:2843-2851. [PMID: 35872217 DOI: 10.1016/j.jaip.2022.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 05/11/2023]
Abstract
Electronic cigarettes (e-cigarettes, e-cigs, or electronic nicotine delivery systems) are battery-operated devices typically containing glycerol and/or propylene glycol-based solutions with varying nicotine content, known as e-liquids. Although e-cigarettes were originally developed as a potentially less harmful alternative to traditional combustible tobacco cigarette smokers, several factors have driven their popularity among smokers and nonsmokers alike, including their sleek product designs, innumerable appealing flavors, lack of combustible smoke and odor, and high potential nicotine concentrations. Furthermore, many advocates have promoted the idea that e-cigarettes are safe to use, or at least safer than conventional tobacco, despite limited longitudinal data to support these claims. Here, we examine what is known about the impacts of e-cigarette use on traditional cigarette smoking cessation, lung health, and youth and young adult tobacco product exposure. Upon review of the currently available literature, the negative effects of e-cigarette use seem to outweigh any potential benefit, because the available evidence does not confirm the use of e-cigarettes as an effective strategy for supporting traditional combustible tobacco cigarette smoking cessation, particularly given the emerging adverse effects on lung health and the potential future public health effects of e-cigarette adoption among a burgeoning new generation of tobacco product users.
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Affiliation(s)
- Coral X Giovacchini
- Division of Pulmonary, Allergy, and Critical Care, Duke University Health System, Durham, NC
| | - Laura E Crotty Alexander
- Pulmonary Critical Care Section, VA San Diego Healthcare System, San Diego, Calif; Division of Pulmonary, Critical Care, Sleep, and Physiology, University of California San Diego, San Diego, Calif.
| | - Loretta G Que
- Division of Pulmonary, Allergy, and Critical Care, Duke University Health System, Durham, NC.
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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: 19] [Impact Index Per Article: 6.3] [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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Mushtaq N, Beebe LA. Evaluating the Psychometric Properties of the Severson 7-Item Smokeless Tobacco Dependence Scale (SSTDS). Nicotine Tob Res 2021; 23:1224-1229. [PMID: 33367922 DOI: 10.1093/ntr/ntaa269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/17/2020] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The objective of the study was to assess the psychometric properties of the Severson 7-item Smokeless Tobacco Dependence Scale (SSTDS). METHODS Data from 95 male exclusive smokeless tobacco (ST) users were obtained through a self-administered mail survey to evaluate the reliability and validity of the SSTDS. Reliability of the scale was assessed by measures of internal consistency including Cronbach's coefficient alpha and item-total correlation. Other ST dependence scales and salivary cotinine concentration were used to evaluate concurrent validity. Structure model of the scale was ascertained by exploratory factor analysis. Overall accuracy and optimal cutoff score were obtained to evaluate SSTDS as a screening tool for ST dependence. RESULTS The SSTDS had high reliability as assessed by the internal consistency coefficient (ordinal α = 0.83). SSTDS total score was significantly correlated with Fagerström Test for Nicotine Dependence for ST users-FTND-ST (r = 0.42) and modified Tobacco Dependence Screener-TDS (r = 0.58). Exploratory factor analysis of the SSTDS identified two underlying factors measuring distinct dimensions of dependence. With reference to TDS based dependence diagnosis, SSTDS demonstrated good diagnostic accuracy (area under the curve: 0.82, 95% confidence interval: 0.74-0.90). Salivary cotinine concentration was not associated with the total score of the SSTDS; however, at an optimal cutoff score of SSTDS >9, everyday ST users classified as dependent had significantly higher cotinine concentration. CONCLUSIONS SSTDS is a reliable measure of dependence that has higher concurrent validity and reliability as compared with other commonly used ST dependence scales. Further research is needed using a larger and more diverse sample of ST users to unequivocally establish the validity of the scale. IMPLICATIONS ST dependence has multiple aspects that can be best studied by multidimensional dependence scales. The study findings validate that the SSTDS measures not only the physical dependence but also the behavioral and psychological dimensions of dependence. Good psychometric properties, diagnostic accuracy, and multidimensional structure of SSTDS indicate that it may serve as an effective tool in assessing ST dependence in clinical and research settings.
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Affiliation(s)
- Nasir Mushtaq
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa, OK
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK
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Determining Optimal Cutoffs for Exhaled Carbon Monoxide and Salivary Cotinine to Identify Smokers among Korean Americans in a Smoking Cessation Clinical Trial. J Smok Cessat 2021; 2021:6678237. [PMID: 34306232 PMCID: PMC8279201 DOI: 10.1155/2021/6678237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/11/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction It is critical to accurately identify individuals who continue to smoke even after treatment, as this may prompt the use of more intensive and effective treatment strategies to help them attain complete abstinence. Aims This study examined optimal cutoffs for exhaled carbon monoxide (CO) and salivary cotinine to identify smokers among Korean Americans in a smoking cessation clinical trial. Methods CO and cotinine were measured three to four times over 12 months from the quit day. Statistical analysis was conducted using Receiver Operating Characteristic (ROC) curves. Results A CO cutoff of 5 parts per million provided robust sensitivity (80.8-98.3%) and perfect specificity (100%), and a salivary cotinine cutoff of level 2 (30-100 ng/ml) provided the best sensitivity (91.2-95.6%) and perfect specificity (100%). Using these cutoffs, the agreement between self-reports and the two biomarkers ranged from 88.6% to 97.7%. The areas under ROC curves (AUCs) of exhaled CO ranged from 0.90 to 0.99, all of which were significant (all p values < 0.001), and the AUCs of salivary cotinine ranged from 0.96 to 0.98 (all p values < 0.001). Conclusion Exhaled CO and salivary cotinine are complementary, and they should be used together to verify smoking abstinence for smokers in a clinical trial.
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Khobragade B, Sharma V, Deshpande SN. A study on tobacco use in women with major mental illnesses- schizophrenia, bipolar disorder and recurrent depression. Psychiatry Res 2020; 290:113121. [PMID: 32505927 DOI: 10.1016/j.psychres.2020.113121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 11/29/2022]
Abstract
About 14.2% of women in the general Indian population and 4.8% in Delhi use tobacco but its use among women with Major Mental Illness (MMI) in developing countries has not been adequately studied. We assessed tobacco use in women with MMI in a tertiary care psychiatry outpatient department through a cross-sectional, observational study, with sample size of at least n= 77 each for schizophrenia-SZ, bipolar disorder-BD and Recurrent Depressive Disorder-RDD. Fagerstrom Test for Nicotine Dependence (FTND) both for smoke and smokeless tobacco were applied along with a subset of questions from Global Adult Tobacco Survey 2016. After diagnosis and referral by the treating psychiatrist and written informed consent, in our total sample of 321 women participants, lifetime use of tobacco was reported by 14.64%. Of all those who had ever used tobacco, 12.14% used it currently as well. As for diagnosis, those with BD (16.25%) used tobacco most frequently followed by SZ (14.18%) and RDD (6%). The FTND score was higher for schizophrenia indicating greater dependence. Tobacco use among women with MMI was thrice as common as women in general population of Delhi State, with smoke and smokeless tobacco use being equally prevalent, a grave cause for concern and intervention.
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Affiliation(s)
- Bhupendra Khobragade
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001
| | - Vikas Sharma
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001
| | - Smita N Deshpande
- Dept. of Psychiatry, De-addiction Services & Resource Center for Tobacco Control, Centre of Excellence in Mental Health, ABVIMS Dr. Ram Manohar Lohia Hospital, Bangabandhu Sheikh Mujib Road, New Delhi, India 110001.
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Mushtaq N, Huque R, Beebe LA, Shah S, Siddiqi K. Evaluation of tobacco dependence measures in South Asian smokeless tobacco users. Drug Alcohol Depend 2019; 203:66-71. [PMID: 31404851 DOI: 10.1016/j.drugalcdep.2019.05.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite the high prevalence of smokeless tobacco (ST) use in South Asia, ST dependence in this population has not been studied. Therefore, it is of interest to explore if ST dependence measures developed and validated in the western countries are of similar relevance to ST users who are culturally different and use distinct ST products. The aim of this study is to assess ST dependence among its users in Bangladesh by employing ST dependence scales based on three different approaches to measure tobacco dependence. METHODS Data collected from a community-based sample of exclusive ST users living in Dhaka, Bangladesh (n = 200) were used for this study. Three ST dependence measures, Tobacco Dependence Screener (TDS), Fagerström Test for Nicotine Dependence for ST users (FTND-ST), and Oklahoma Scale for Smokeless Tobacco Dependence (OSSTD), were translated in Bangla and administered to the study participants. Saliva samples were collected for cotinine measurement. Reliability and concurrent and construct validity of FTND-ST and OSSTD were examined. RESULTS Median cotinine concentration of the study participants was 440.2 (min = 2.9, max = 1874) ng/ml and 47% of them had TDS-based dependence diagnosis. Women had higher mean OSSTD, FTND-ST, and TDS scores as compared to men (p < 0.001). OSSTD demonstrated better reliability (α = 0.93) than FTND-ST, and TDS (α = 0.64 and 0.86, respectively). Concurrent validity of FTND-ST as evaluated by TDS, OSSTD, and cotinine concentration was affirmative. CONCLUSION The FTND-ST is a valid and reliable tool to measure physical dependence among ST users in Bangladesh. The study was unable to replicate the structure of OSSTD.
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Affiliation(s)
- Nasir Mushtaq
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, 4502 East 41st Street, SAC 1G06, Tulsa, OK 74135, United States.
| | - Rumana Huque
- Department of Economics, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Laura A Beebe
- Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, United States
| | - Sarwat Shah
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, United Kingdom
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, United Kingdom
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Faílde Garrido JM, Ruiz Soriano L, Pérez Fernández MR, Lameiras Fernández M, Rodríguez Castro Y. Evolution of quality of life and health‐related behaviors among Spanish university students. Int J Health Plann Manage 2018; 34:e789-e801. [DOI: 10.1002/hpm.2692] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
| | - Laura Ruiz Soriano
- Faculty of Education ScienceUniversity of Vigo (Ourense Campus) Pontevedra Spain
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Fagerstrom K. A Comparison of Dependence across Different Types of Nicotine Containing Products and Coffee. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1609. [PMID: 30061507 PMCID: PMC6121467 DOI: 10.3390/ijerph15081609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 07/28/2018] [Accepted: 07/30/2018] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Few studies have compared the dependence to different tobacco and nicotine products. Even less is known about how it relates to dependence on other common drugs, e.g., caffeine. In this study degree of dependence was compared between snus, cigarettes, nicotine replacement (NR), electronic cigarettes and coffee. METHODS A random sample of Swedish citizens belonging to an internet panel were contacted from September to October 2017. The responders were asked among other related things about their use of snus, NR, traditional cigarette or e-cigarette use and coffee consumption. The indicators of dependence used were: (A) the Heavy Smoking Index, (B) The proportions that used within 30 min after raising in the morning, (C) rating the first use in the morning as the most important and (D) Stating that it would be very hard to give up entirely. RESULTS Significantly fewer coffee drinkers started use within 30 min of awakening compared with all other products. The first use of the day was found to be more important for snus users compared with other products. On HSI there was no difference between snus and cigarettes. Snus and cigarettes were rated as being more difficult to give up than NR and coffee. CONCLUSION Dependence to traditional cigarettes and snus seem to be relatively similar while NR was rated lower and coffee lowest. Since the prevalence of caffeine use in all forms is so much more prevalent than nicotine there might be more persons in the society heavily dependent on caffeine. IMPLICATION Tobacco products are likely more dependence forming than NR products and coffee although there might be more people dependent on caffeine. The addiction to coffee or caffeine is seldom discussed in the society probably because of the little or no harm it causes. FUNDING The Snus Commission in Sweden (snuskommissionen) funded the data collection. No funding used for the analysis and writing of manuscript.
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Abstract
BACKGROUND It is accepted that smoking often triggers migraine. However, studies evaluating the relationship between the use of smokeless tobacco and migraine are limited, and there is no clear consensus on the subject. In this study, it was aimed to evaluate the relationship between migraine and Maras powder, which is the most common smokeless tobacco in Turkey. SUBJECTS AND METHODS The study included a total of 600 subjects, consisting of 300 patients (aged >18 years) diagnosed with a migraine according to the International Headache Society (IHS-ICHD-3 Beta) criteria after presenting at Sütçü Imam University Medical Faculty Neurology Policlinic with the complaint of headache between July 2016 and December 2016 and a control group of 300 individuals with similar features of age, gender, and educational level. A questionnaire was administered to each patient to record the status of smoking or using Maras powder. RESULTS In the migraine patient group, 16.4% smoked and 9.7% used Maras powder. In the control group, the rate of smoking was 8.5% and the rate of Maras powder use was 11.86%. In males diagnosed with a migraine, the use of Maras powder was found to be at a higher rate than smoking (p<0.001). The Visual Pain Score and the headache frequency values were higher in those who smoked or used Maras powder than in non-users (p<0.001). The Fagerström Test for Nicotine Dependence Smokeless Tobacco results of the patients diagnosed with migraine and who used Maras powder were found to be higher than of those who smoked (Fagerström Test for Nicotine Dependence; p<0.001). When patients were evaluated according to the Migraine Disability Assessment Scale, the majority of migraine patients were seen to be at stages 1 and 2, and one in every three patients who used Maras powder cigarette and one in every two patients who smoked had headaches of a severity which affected their daily activities (p<0.001). CONCLUSION Smoking or the use of Maras powder increases the frequency and severity of migraines in a similar way. Therefore, Maras powder must be included in the scope of the fight against tobacco and people should be warned about this issue.
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Affiliation(s)
- Yılmaz İnanç
- Department of Neurology, Kahramanmaraş Sütçüimam University School of Medicine, Kahramanmaraş, Turkey
| | - Fatma Özlem Orhan
- Department of Psychiatry, Kahramanmaraş Sütçüimam University School of Medicine, Kahramanmaraş, Turkey
| | - Yusuf İnanç
- Department of Neurology, Gaziantep University School of Medicine, Kahramanmaraş, Turkey
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