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Ozga JE, Bays C, Haliwa I, Felicione NJ, Ferguson SG, Dino G, Blank MD. Measurement of cigarette smoking: Comparisons of global self-report, returned cigarette filters, and ecological momentary assessment. Exp Clin Psychopharmacol 2022; 30:365-370. [PMID: 33630647 PMCID: PMC8384977 DOI: 10.1037/pha0000449] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Prior work suggests that prospective measurement of cigarette use may be more reliable and valid than retrospective self-reports. Despite several studies comparing retrospective and prospective methods, there are a myriad of prospective methods that have not been directly compared, including spent cigarette filters that are returned to the laboratory by participants and diary logs of cigarette use on an electronic device via ecological momentary assessment. The current secondary data analysis compared the reliability of retrospective global self-report, returned cigarette filters, and electronic diary logs among a sample of cigarette smokers that also use smokeless tobacco (SLT; N = 51) over two consecutive weeks. CPD values also were compared to salivary cotinine levels to determine whether any method was associated more strongly with nicotine/tobacco exposure. Results indicated that CPD values via global self-report were significantly larger than returned filter and diary log daily averages across both weeks (t(50) = 8.28 to 9.35; p < .001). Both prospective measures showed less digit bias and more variation in smoking behavior across days than global self-reports. Only returned CPD values were correlated significantly with salivary cotinine levels (r(593) = 0.09, p = .024). Importantly, most reliability outcomes for returned filters and logged CPD did not differ significantly, suggesting that they may be comparable prospective methods for measuring cigarette use. Because returned filters and diary logs did not differ from one another, researchers' selection of a prospective measurement method should rely on considerations of participant compliance, protocol burden, and specific research questions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Jenny E. Ozga
- Department of Behavioral Medicine and Psychiatry, West Virginia University
| | - Colleen Bays
- Department of Social Sciences and Public Administration, West Virginia University Institute of Technology
| | - Ilana Haliwa
- Department of Psychology, West Virginia University
| | - Nicholas J. Felicione
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | | | - Geri Dino
- WV Prevention Research Center, West Virginia University
- WV Clinical and Translational Sciences Institute, West Virginia University
| | - Melissa D. Blank
- Department of Behavioral Medicine and Psychiatry, West Virginia University
- WV Prevention Research Center, West Virginia University
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Andong FA, Okwuonu ES, Melefa TD, Okoye CO, Nkemakolam AO, Hinmikaiye FF, Nwankpo EO, Ozue CC. The Consequence of Aqueous Extract of Tobacco Leaves ( Nicotiana tabacum. L) on Feed Intake, Body Mass, and Hematological Indices of Male Wistar Rats fed under Equal Environmental Conditions. J Am Coll Nutr 2021; 40:429-442. [PMID: 32729775 DOI: 10.1080/07315724.2020.1788471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/19/2020] [Accepted: 06/23/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE While the dangers of consuming tobacco by smoking has been of concern, the hazardous effect of other forms of tobacco consumption (in smokeless form) on health indices are less well explored. In this paper, we explored the effect of different doses of aqueous extract of tobacco leaves on feed intake, body mass, and hematological indices of male Wistar rats under equal environmental conditions. METHOD Using an oral route of administration, the rats (n = 24; w = 65-85 g; 2-3 weeks old) were administered at different doses of 100, 200, 400, 0 mg/kg body weight (b.w.) per day to group A, B, C, and D for 42 days, after phytochemical and acute toxicity testing of the tobacco leaves. RESULTS Compared to the negative control group (D), packed cell volume, hemoglobin concentration, red blood cells, and lymphocytes reduced dose-dependently in contrast to the white blood cells, neutrophils, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and mean corpuscular volume. As body mass and feed intake in relation to the different doses of aqueous extract of tobacco leaves reduced significantly (p < 0.05), the reverse was observed for body mass and feed intake in relation to room temperature. CONCLUSIONS By influencing hematological indices, feed intake, and body mass, the extract of tobacco leaves can be hazardous to health. However, to assess safety and to come up with a conscious conclusion, future studies should explore the effect of the extract on organs histopathology, biochemical parameters, and lipid profile of the body.
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Affiliation(s)
- Felix Atawal Andong
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
- A.P. Leventis Ornithological Research Institute, Department of Zoology, University of Jos, Jos, Plateau, Nigeria
| | - Elijah Sunday Okwuonu
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Temitope Dadewura Melefa
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Charles Obinwanne Okoye
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Augustine Okorie Nkemakolam
- Department of Pharmacology and Toxicology, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Funmilayo Faith Hinmikaiye
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Emelda Obioma Nwankpo
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Chibike Chisom Ozue
- Department of Zoology and Environmental Biology, Faculty of Biological Sciences, University of Nigeria, Nsukka, Enugu State, Nigeria
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Solhi M, Fattahi E, Manzari ZS, Gupta PC, Kargar M, Kasmaei P, Barati H. The Reasons for Using Smokeless Tobacco: A Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2021; 50:492-501. [PMID: 34178796 PMCID: PMC8214603 DOI: 10.18502/ijph.v50i3.5589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Smokeless tobacco use is a public health problem in some parts of the world. The major objective of this study was to investigate the reasons and factors of consumption. Methods: A content analysis was conducted on articles for the past thirty years (1989–2019). We reviewed and selected 400 abstracts of original articles from PubMed databases by the search strategy, and reviewed one by one. Among these, 45 abstracts were selected, in which the patterns of use, the reasons for using, and the determinants and predictors were described. Eleven papers were selected based on the results and related to the research objectives. The results of these articles were evaluated precisely word by word and phrase by phrase with content analysis method and inductive approach. Results: The reasons for the use of smokeless tobacco fell in two main themes: socio-cultural structure; and, beliefs, each contained Sub-themes such as “culture and living conditions”, “laws”, “family and peer relationships”, “beliefs related to psychological” and “beliefs related to physical influences”, “beliefs”, “The role of harm perceptions “. Conclusion: There was a difference between beliefs, cultures and social conditions among the people about using of smokeless tobacco and the association of these factors is investigated in future studies. We also suggest for the prevention and control of smokeless tobacco use, cultural norms and beliefs will need to address adequately.
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Affiliation(s)
- Mahnaz Solhi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Fattahi
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Sadat Manzari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Prakash C Gupta
- Healis-Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
| | - Mehdi Kargar
- Department of Health Education & Promotion, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Kasmaei
- Health and Environment Research Center, Department of Health Education and Promotion, School of Health, Guilan University of Medical Sciences, Rasht, Iran
| | - Hadis Barati
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Maack B, Willborn R. Description of tobacco use and cessation among Bhutanese refugees participating in a tobacco cessation program. ETHNICITY & HEALTH 2018; 23:367-379. [PMID: 28110549 DOI: 10.1080/13557858.2017.1280134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVES To compare the tobacco use, exposure, and cessation differences between Bhutanese refugee and non-Hispanic Caucasian tobacco users in a US federally qualified health center tobacco cessation program. DESIGN A retrospective cohort study reviewing data from 374 patients counseled on tobacco cessation was performed. Demographic information, tobacco use history, exposure to tobacco, and type of tobacco used characterized baseline assessments. The patient record was followed forward in time to evaluate tobacco cessation outcomes as the dependent variable. Data were analyzed using odds ratios and the Mann-Whitney U-test. RESULTS Data analysis included 318 patients (211 non-Hispanic Caucasian patients and 107 Bhutanese refugee patients). Bhutanese refugees demonstrated a higher likelihood of smokeless tobacco product use than the non-Hispanic Caucasian population (67.3% vs 1%, OR = 214.971, 95% CI 50.429, 916.383), and a greater odds of having household tobacco users (OR = 2.533, 95% CI 1.532, 4.186). Likewise, the non-Hispanic Caucasian population exhibited larger odds of smoking cigarettes vs the Bhutanese population (97.2% vs 26.2%, OR = 96.399, 95% CI 38.449, 241.687), had a higher odds of passive smoke exposure (OR = 12.765, 95% CI 5.36, 30.393), and higher likelihood of a past quit attempt (OR = 9.037, 95% CI 5.180, 15.765). Significant gender differences with regard to type of tobacco used were noted among Bhutanese refugees. Bhutanese refugees demonstrated significantly higher likelihood of tobacco cessation, compared with the non-Hispanic Caucasian population, at all length cutpoints, while showing no difference in number of follow-up visits or median time followed. CONCLUSION These culture-specific findings, showing unique tobacco use characteristics and increased cessation among the Bhutanese refugee population, provide novel information helpful to professionals identifying and treating these individuals for tobacco cessation. More research is needed to confirm our results and findings.
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Affiliation(s)
- Brody Maack
- a College of Health Professions , North Dakota State University , Fargo , ND , USA
| | - Robert Willborn
- b Pharmacy Service , VA Eastern Colorado Health Care System , Denver , CO , USA
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Sinha DN, Rizwan SA, Aryal KK, Karki KB, Zaman MM, Gupta PC. Trends of Smokeless Tobacco use among Adults (Aged 15-49 Years) in Bangladesh, India and Nepal. Asian Pac J Cancer Prev 2016; 16:6561-8. [PMID: 26434875 DOI: 10.7314/apjcp.2015.16.15.6561] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smokeless tobacco (SLT) has long been realized as an important component of the fight for global tobacco control. It still remains a major problem in countries like India, Bangladesh and Nepal. The objective of this study was to estimate the trends of SLT use in three countries of the SEARO WHO office. MATERIALS AND METHODS We used data from national surveys in three countries (Bangladesh, India and Nepal) to estimate trends in prevalence of current SLT use. All available nationally representative data sources were used. Estimates were weighted, age standardized and given along with 95% confidence intervals. Significance of linear trend in prevalence over time was tested using the Cochrane-Armitage test for trend. A p value of less than 0.05 was considered statistically significant. RESULTS We identified three surveys for Bangladesh, three for India and four for Nepal that met the selection criteria (such as Demographic and Health Surveys, WHO-STEPwise approach to Surveillance and Global Adult Tobacco Surveys). A significantly increasing trend was noticed in the prevalence of current SLT use among Bangladeshi men (20.2% to 23%, p=0.03). In India, a similar significantly increasing trend was seen among men (27.1% to 33.4%, p<0.001) and women (10.1% to 15.7%, p<0.001). In Nepal, there was a no significant trend among both men (39.1% to 31.6%, p=0.11) and women (5.6% to 4.7%, p=0.49). CONCLUSIONS In the study countries SLT use has remained at alarmingly high levels. Usage trends do not show any signs of decline in spite of control efforts. Tobacco control measures should focus more on controlling SLT use.
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Affiliation(s)
- Dhirendra N Sinha
- Regional Adviser, Surveillance, (Tobacco Control), Tobacco Free Initiative Unit, Regional Office for South-East Asia, World Health Organization, New Delhi, India E-mail :
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Jhanjee S, Jain R, Jain V, Gupta T, Mittal S, Goelz P, Schnoll RA. Evaluating the Effects of Varenicline on Craving, Withdrawal, and Affect in a Randomized, Double-Blind, Placebo-Controlled Clinical Trial of Varenicline for Smokeless Tobacco Dependence in India. J Psychoactive Drugs 2015; 47:325-30. [PMID: 26317176 PMCID: PMC4699413 DOI: 10.1080/02791072.2015.1075092] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study examined changes in tobacco craving, withdrawal, and affect as correlates of efficacy in a phase-2 clinical trial of varenicline for smokeless tobacco dependence in India. Smokeless tobacco users (N = 237) at the All India Institute of Medical Sciences were randomized to placebo or varenicline. Abstinence was defined as cotinine-verified seven-day point prevalence cessation at end of treatment (EOT). General Linear Model repeated measures assessed the effects of treatment condition, time, abstinence state, and interaction effects on changes in craving, withdrawal, positive (PA) and negative affect (NA) from baseline to EOT. All participants showed a significant reduction in withdrawal (p < .001), total craving (p < .001), positive reinforcement (PR) craving (p < .001), and NA (p = .02), and an increase in PA (p = .04) from baseline to EOT. However, there were no differences between placebo and varenicline participants in measures of withdrawal, craving, or affect from baseline to week 3 or at EOT. Significant interactions between time and abstinence state were found for total craving (p = .008), PR craving (p < .001), and withdrawal (p = .001), indicating reductions in these processes among those abstinent vs. those still chewing smokeless tobacco. Additional research is needed concerning the effects of varenicline on craving, withdrawal, and affect among smokeless tobacco users.
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Affiliation(s)
- Sonali Jhanjee
- a National Drug Dependence Treatment Centre , All India Institute of Medical Sciences , New Delhi , India
| | - Raka Jain
- a National Drug Dependence Treatment Centre , All India Institute of Medical Sciences , New Delhi , India
| | - Veena Jain
- b Centre for Dental Education and Research , All India Institute of Medical Sciences , New Delhi , India
| | - Tina Gupta
- a National Drug Dependence Treatment Centre , All India Institute of Medical Sciences , New Delhi , India
| | - Swati Mittal
- a National Drug Dependence Treatment Centre , All India Institute of Medical Sciences , New Delhi , India
| | - Patricia Goelz
- c Department of Psychiatry and Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA
| | - Robert A Schnoll
- c Department of Psychiatry and Abramson Cancer Center , University of Pennsylvania , Philadelphia , PA
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Jitnarin N, Haddock CK, Poston WSC, Jahnke S. Smokeless tobacco and dual use among firefighters in the central United States. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:675426. [PMID: 23533451 PMCID: PMC3606806 DOI: 10.1155/2013/675426] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 02/18/2013] [Accepted: 02/18/2013] [Indexed: 11/17/2022]
Abstract
Little is known about smokeless tobacco (SLT) use in the fire service, whose personnel need to maintain high levels of health and fitness given the rigorous physical and mental job requirements. We examined the relationships among variables associated with SLT use and dual tobacco use (SLT and smoking) among 353 male career firefighters. Around 13% of male career firefighters reported being current exclusive SLT users, and 2.6% used both cigarettes and SLT. Age-adjusted models revealed that race, binge drinking, and dietary fat consumption were positively associated with exclusive SLT use when compared to nontobacco users. SLT users were much more likely to binge drink (OR = 3.98, P < .01) and consume high fat foods (OR = 1.94, P < .05). Only high dietary fat consumption was a strong correlate (OR = 8.41, P < .05) of dual use when compared to nontobacco users. SLT and dual tobacco use are associated with significant health risks. Detailed information on the predictors of SLT use among firefighters will aid in developing more effective tobacco prevention and cessation intervention in fire service.
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Affiliation(s)
- Nattinee Jitnarin
- Center for Fire Rescue and EMS Health Research, Institute for Biobehavioral Health Research, National Development and Research Institutes, 1920 West 143rd Street, Leawood, KS 66224, USA.
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Croucher R, Haque MF, Kassim S. Oral pain before and after smokeless tobacco cessation in U.K.-resident Bangladeshi women: cross-sectional analyses. Nicotine Tob Res 2012; 15:896-903. [PMID: 23042981 DOI: 10.1093/ntr/nts203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Paan quid with tobacco (PQT) use is common in South Asian populations. Oral pain following a PQT cessation attempt is commonly reported. Factors determining this await full exploration. METHODS This prospective study of PQT chewers used a prepiloted interview and clinical examination. Oral pain, socioeconomic position, oral status, health service use, tobacco use and dependency, and psychological distress measures were collected from U.K.-resident Bangladeshi women before and after their quit attempts. Analysis included descriptive and analytic modeling of oral pain determinants, using multiple logistic regressions and a significance value p ≤ .05. RESULTS A total of 150 females (mean age 51.2 [SD = 13.7, range = 24-84] years) completed the study. Baseline oral pain prevalence was 39% and 73% at follow-up. Completed education level predicted baseline oral pain (OR = 3.43, 95% CI [1.66, 7.11], p = .001). Follow-up oral pain was predicted by completed education level (OR = 3.74, 95% CI [1.43, 9.79], p = .007), anxiety (OR = 3.52, 95% CI [1.23, 10.07], p = .019), choosing behavioral support alone in the cessation attempt (OR = 3.12, 95% CI [1.26, 8.70], p = .015), failure to stop tobacco chewing during the cessation attempt (OR = 4.16, 95% CI [1.44, 12.04], p = .009), and tooth wear (attrition) (OR = 5.71, 95% CI [1.84, 17.79], p = .003). Lower dependency level (OR = 0.79, 95% CI [0.64, 0.97], p = .023) was protective. CONCLUSION Dental care access, nicotine replacement therapy, and anxiety management should be incorporated into cessation service delivery protocols to manage oral pain onset and facilitate successful cessation.
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Affiliation(s)
- Ray Croucher
- Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, London, United Kingdom.
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Basharat S, Kassim S, Croucher RE. Availability and use of Naswar: an exploratory study. J Public Health (Oxf) 2011; 34:60-4. [PMID: 21676923 DOI: 10.1093/pubmed/fdr044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Naswar is a niche smokeless tobacco product from Pakistan. There is little information about its availability and user characteristics. METHODS This cross-sectional survey identified outlets selling Naswar in two wards of one London borough and interviewed a purposively recruited sample of 73 Naswar purchasers. Data were analysed using descriptive and chi-square tests (significance, P ≤ 0.05). RESULTS Of 65 outlets identified 15 sold Naswar. The purchasers' mean (SD) age was 32 (± 10) years and 63% had completed only secondary education. Naswar consumption was significantly associated with tobacco dependency, whilst starting Naswar use at a younger age, having lower education levels, using Naswar more frequently and being of Pakhtunkhwa origin was associated with high monthly consumption (P ≤ 0.05). CONCLUSIONS Naswar was widely available. Naswar purchasers of Pakistani origin were employed and young, but with limited education and little knowledge of Naswar's health impacts. Naswar dependency and consumption was linked to behavioural and socio-demographic factors. Further evidence is needed to support policy development.
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Affiliation(s)
- S Basharat
- Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, 4 Newark Street, London E1 4AT, UK
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Ebbert JO, Severson HH, Croghan IT, Danaher BG, Schroeder DR. A randomized clinical trial of nicotine lozenge for smokeless tobacco use. Nicotine Tob Res 2009; 11:1415-23. [PMID: 19880578 PMCID: PMC2784490 DOI: 10.1093/ntr/ntp154] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Accepted: 08/21/2009] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Smokeless tobacco (ST) use is associated with adverse health consequences, and effective treatments are needed. Pilot data suggest that 4-mg nicotine lozenge decreases tobacco craving and nicotine withdrawal symptoms among ST users. METHODS We conducted a randomized, placebo-controlled multicenter clinical trial to evaluate the efficacy of 12 weeks of 4-mg nicotine lozenge for ST use. RESULTS We randomized 270 participants (136 active lozenge, 134 placebo). No significant differences were observed between the groups in biochemically confirmed all tobacco abstinence rates at Week 12 (36% lozenge vs. 27.6% placebo; odds ratio [OR] 1.5, 95% CI 0.7-2.1; p = .138). However, the 4-mg nicotine lozenge increased self-reported all tobacco abstinence (44.1% vs. 29.1%; OR 1.9, 95% CI 1.2-3.2; p = .011) and self-reported ST abstinence (50.7% vs. 34.3%; OR 2.0, 95% CI 1.2-3.2; p = .013) compared with placebo at the end of treatment (Week 12). Following target quit date (TQD), nicotine withdrawal symptoms decreased significantly with time (time effect = -.022 per day, SE = .003; p < .001) and was significantly lower for the active lozenge (treatment effect = -.213, SE = .071; p = .003). Tobacco craving also decreased significantly following TQD (time effect = -.071, SE = .006; p < .001) and was lower for the active nicotine lozenge (treatment effect = -.452, SE = .164; p = .006). DISCUSSION The 4-mg nicotine lozenge increased self-reported but not biochemically confirmed tobacco abstinence rates at 3 months. The use of the 4-mg nicotine lozenge is associated with decreased nicotine withdrawal symptoms and tobacco craving.
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Affiliation(s)
- Jon O Ebbert
- Mayo Clinic College of Medicine; Rochester, MN 55905, USA.
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Abstract
The US Public Health Service Guideline for Treating Tobacco Use and Dependence 2008 Update emphasizes tobacco use as a chronic medical disorder; highlights both behavioral counseling and the use of 1 or more of the 7 approved medications; and points out the utility, efficacy, and reach of telephone quitlines. The treatment of users of smokeless tobacco continues to be less than optimal. Although providing evidence-based treatment for tobacco- dependent patients is a challenge for busy physicians, a team approach including trained and certified tobacco treatment specialists (TTS) provides an efficient treatment model. TTS represent a new and growing part of the health care team and hold great potential for expanding the collective tobacco treatment expertise in the medical setting. The effective treatment of tobacco dependence frequently requires tailoring, and often intensifying, interventions (both counseling and pharmacotherapy) to meet the needs of the individual patient.
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Affiliation(s)
- Richard D Hurt
- Nicotine Dependence Center, Mayo Clinic, Rochester, MN 55905, USA.
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Severson HH, Peterson AL, Andrews JA, Gordon JS, Cigrang JA, Danaher BG, Hunter CM, Barckley M. Smokeless tobacco cessation in military personnel: A randomized controlled trial. Nicotine Tob Res 2009; 11:730-8. [DOI: 10.1093/ntr/ntp057] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Gansky SA, Ellison JA, Kavanagh C, Isong U, Walsh MM. Patterns and correlates of spit tobacco use among high school males in rural California. J Public Health Dent 2009; 69:116-24. [PMID: 19054309 PMCID: PMC3145454 DOI: 10.1111/j.1752-7325.2008.00109.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess patterns and correlates of spit [smokeless tobacco (ST)] use among high school males in rural California. METHODS An 18-item, self-administered questionnaire was used to assess ST use among young males in 41 randomly selected high schools in 21 rural counties in California. To ensure confidentiality, students were instructed to seal their completed questionnaire in an attached envelope prior to returning it to the questionnaire administrator. RESULTS Overall prevalence of ST use was 9.8 percent, significantly increasing with year in school from 5 percent among freshmen to 15 percent among seniors. ST use was highest among rodeo athletes at 42 percent compared with <6 percent among nonathletes; ST use was significantly higher among smokers (32 percent) who were 2.5-30 times more likely to use ST compared with nonsmokers, depending on race/ethnicity as a result of a significant race/ethnicity x smoking interaction of degree/magnitude. In addition, students who believed there was no, or slight risk of, harm from ST use were significantly more likely to use ST than students perceiving moderate or great risk, depending on race/ethnicity (odds ratios 3.6-13). Among all ST users, 40 percent used ST on at least 5 days in the previous week, 80 percent of those reporting a brand used the brand Copenhagen, and 41 percent (189) used ST within 30 minutes of waking. CONCLUSION Dental public health practitioners, scholars, and policy-makers need to promote dental health through organized community efforts targeting high school male subgroups in rural areas that are at risk for ST-associated adverse health effects.
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Affiliation(s)
- Stuart A Gansky
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, CA 94143-1361, USA
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Ebbert JO, Glover E, Shinozaki E, Schroeder DR, Dale LC. Predictors of smokeless tobacco abstinence. Am J Health Behav 2008; 32:735-40. [PMID: 18442352 PMCID: PMC2947084 DOI: 10.5555/ajhb.2008.32.6.735] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
OBJECTIVES To investigate predictors of tobacco abstinence among smokeless tobacco (ST) users. METHODS Logistic regression analyses assessed characteristics associated with tobacco abstinence among ST users receiving bupropion SR. RESULTS Older age was associated with increased tobacco abstinence in both placebo and bupropion SR groups at end of treatment and one year. Abstinence was lower at one year for subjects with a history of major depression. At end-of-treatment, a 2-way interaction was detected suggesting bupropion SR may be efficacious for subjects with other household tobacco users. CONCLUSIONS Younger ST users and those with a history of depression are less likely to quit ST use.
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Affiliation(s)
- Jon O. Ebbert
- Assistant Professor of Medicine, Mayo Clinic College of Medicine; Mayo Clinic, 200 1 Street Southwest, Rochester, MN 55905; ; Telephone: (507) 266-1944; Fax: (507) 266-7900
| | - Elbert Glover
- Professor & Chair Department of Public & Community Health (PCH) Director, Center for Health Behavior Research (CHBR); University of Maryland School of Public Health, 2387 HHP Building, College Park, MD 20742; ; Telephone: (301) 405-2029; Fax: (301) 314-9167(PCH)
| | - Eri Shinozaki
- Mayo Clinic, 200 1 Street Southwest, Rochester, MN 55905; ; Telephone: (507) 266-1944; Fax: (507) 266-7900
| | - Darrell R. Schroeder
- Professor of Biostatistics; Mayo Clinic College of Medicine; Mayo Clinic, 200 1 Street Southwest, Rochester, MN 55905; ; Telephone: (507) 284-3437; Fax: (507) 266-7900
| | - Lowell C. Dale
- Associate Professor of Medicine, Mayo Clinic College of Medicine; Mayo Clinic, 200 1 Street Southwest, Rochester, MN 55905; ; Telephone: (507) 266-1948; Fax: (507) 266-7900
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Kauffman RM, Ferketich AK, Wee AG, Shultz JM, Kuun P, Wewers ME. Factors associated with smokeless tobacco cessation in an Appalachian population. Addict Behav 2008; 33:821-30. [PMID: 18261859 DOI: 10.1016/j.addbeh.2008.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2007] [Revised: 11/28/2007] [Accepted: 01/07/2008] [Indexed: 11/24/2022]
Abstract
Identifying factors associated with successful tobacco quit attempts may help in the development and targeting of effective cessation strategies. This paper aims to describe factors associated with smokeless tobacco (ST) cessation and compares the results to findings in the smoking cessation literature. Prospective data on 116 men aged 19 to 70 and participating in a ST cessation program were used to examine correlates of successful ST cessation at 1-year post-intervention. Controlling for age, level of education (p=0.002) and daily coffee consumption (p=0.005) had significant independent associations with successful cessation. No ST use variables were significant predictors of cessation success. In a multivariable logistic regression model three factors were significantly associated with cessation: education (p=0.010), coffee consumption (p=0.019), and age (p=0.029). Factors associated with successful ST cessation in this sample are consistent with predictors of smoking cessation reported in the literature. Based on its widespread use and the strength of its association with successful quitting, the role of caffeine consumption in ST cessation merits further study.
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Dale LC, Ebbert JO, Glover ED, Croghan IT, Schroeder DR, Severson HH, Hurt RD. Bupropion SR for the treatment of smokeless tobacco use. Drug Alcohol Depend 2007; 90:56-63. [PMID: 17353101 PMCID: PMC1994655 DOI: 10.1016/j.drugalcdep.2007.02.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2007] [Revised: 02/09/2007] [Accepted: 02/09/2007] [Indexed: 02/02/2023]
Abstract
BACKGROUND No pharmacotherapies have been shown to increase long-term (> or = 6 months) tobacco abstinence rates among smokeless tobacco (ST) users. Bupropion SR has demonstrated potential efficacy for ST users in pilot studies. We conducted a multicenter, randomized, double-blind, placebo-controlled, clinical trial to assess the efficacy and safety of bupropion SR for tobacco abstinence among ST users. METHODS Adult ST users were randomized to bupropion SR titrated to 150 mg twice daily (N=113) or placebo (N=112) for 12 weeks plus behavioral intervention. The primary endpoint was the 7-day point-prevalence tobacco abstinence rate at week 12. Secondary outcomes included prolonged and continuous tobacco abstinence rates, craving and nicotine withdrawal, and weight gain. RESULTS The 7-day point-prevalence tobacco abstinence rates did not differ between bupropion SR and placebo at the end treatment (53.1% versus 46.4%; odds ratio (OR) 1.3; p=0.301). The 7-day point-prevalence abstinence did not differ at weeks 24 and 52. The prolonged and continuous tobacco abstinence rates did not differ at weeks 12, 24, and 52. A time-by-treatment interaction was observed in craving over time with greater decreases in the bupropion SR group. At 12 weeks, the mean (+/-S.D.) weight change from baseline among abstinent subjects was an increase of 1.7 (+/-2.9)kg for the bupropion SR group compared to 3.2 (+/-2.7)kg for placebo (p=0.005). CONCLUSIONS Bupropion SR did not significantly increase tobacco abstinence rates among ST users, but it significantly decreased craving and weight gain over the treatment period.
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Affiliation(s)
- Lowell C Dale
- Mayo Clinic College of Medicine, Rochester, MN 55905, USA
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Croucher R, Choudhury SR. Tobacco control policy initiatives and UK resident Bangladeshi male smokers: community-based, qualitative study. ETHNICITY & HEALTH 2007; 12:321-37. [PMID: 17701760 DOI: 10.1080/13557850701300731] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To reflect on recent proposed tobacco control initiatives in the socio-cultural context of the smoking behaviours of UK resident Bangladeshi men. DESIGN Cross-sectional study using focus groups and one-to-one interviews conducted in English and Sylheti. Eighty-one men, aged 18-64 years, were recruited from the Bangladeshi community of Tower Hamlets, London, during 2002. Participants were purposively selected to reflect their age, place of birth and tobacco-use status. The discussions were tape-recorded and subsequently transcribed. The transcripts were analysed using 'framework' principles. Three of the current themes for tobacco control -- smoke-free workplace environments, access to alternative sources of tobacco, and use and availability of nicotine replacement therapy -- were used to organise the data. RESULTS Smoking initiation and use was confirmed as linked to gender, age, religion and tradition. Continued smoking was supported by anxieties about harassment in younger respondents, the migration experience of older respondents, and the unskilled employment opportunities available in the restaurant trade. These employment opportunities, whilst providing social support, did not support smoking regulations, in contrast to the practices observed in the general employment market. Levels of knowledge about the health risks of smoking varied by age. Three cheaper alternative tobacco types were readily accessible for use: contraband, roll-ups and traditional chewing tobacco in paan (chewing tobacco mixed with areca nut rolled in a betel leaf). Despite the latter's associations with use by women, younger respondents described the transition to chewing tobacco in paan as a smoking cessation aid instead of nicotine replacement therapy. There was confusion about the purpose, availability and efficacy of nicotine replacement therapy. Respondents reported isolation and marginalisation from current tobacco control initiatives, including much NHS Stop Smoking Service provision. CONCLUSION The socio-cultural context of the smoking behaviours of this group of Bangladeshi men was linked to a reported isolation and exclusion from current tobacco control initiatives. These initiatives should be inclusive and address the reported needs of this community. The findings have implications for service development. Addressing these findings will help to inform the implementation of relevant public health policy initiatives for tobacco control to meet the needs of this community.
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Affiliation(s)
- Ray Croucher
- Institute of Dentistry, Queen Mary's School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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Croucher RE, Islam SS, Pau AK. Concurrent tobacco use in a random sample of UK-resident Bangladeshi men. J Public Health Dent 2007; 67:83-8. [PMID: 17557678 DOI: 10.1111/j.1752-7325.2007.00019.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED The literature on concurrent tobacco (CCT) use, i.e., regularly using both smoked and chewed tobacco, is sparse. OBJECTIVES This study aims to establish the point prevalence of CCT use in a randomly selected sample of UK-resident Bangladeshi males, compare CCT users with other tobacco users (smokers alone and chewers alone), and model the factors for CCT use and chewing tobacco use alone. METHODS A cross-sectional bilingual interview survey collecting data on age, marital status, social class, employment status, home ownership and overcrowding, self-assessed health and chronic illness episodes, social capital, nicotine dependence, and oral pain was used. Carbon monoxide readings validated smoked tobacco use. Logistic regressions were used for data analysis. RESULTS The initial response rate was 59 percent. Sample mean age was 40.7 years. CCT prevalence was estimated at 22 percent, practiced by older respondents of limited educational status. CCT users more likely had only average or poor self-rated health and more likely reported current oral pain compared with tobacco smokers. A wife chewing tobacco distinguished CCT users, as compared with tobacco smokers alone. CONCLUSIONS In this sample of adult Bangladeshi males, CCT use was prevalent. CCT users more likely had a partner who was also a tobacco chewer, as compared with tobacco smokers.
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Affiliation(s)
- Raymond E Croucher
- Institute of Dentistry, Barts & The London (QMUL), Turner Street, London UK El 2AD.
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Danaher BG, Boles SM, Akers L, Gordon JS, Severson HH. Defining participant exposure measures in Web-based health behavior change programs. J Med Internet Res 2006; 8:e15. [PMID: 16954125 PMCID: PMC1761946 DOI: 10.2196/jmir.8.3.e15] [Citation(s) in RCA: 111] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2006] [Revised: 05/16/2006] [Accepted: 08/06/2006] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Published research on the use of Web-based behavior change programs is growing rapidly. One of the observations characterized as problematic in these studies is that participants often make relatively few website visits and spend only a brief time accessing the program. Properly structured websites permit the unobtrusive measurement of the ways in which participants access (are exposed to) program content. Research on participant exposure to Web-based programs is not merely of interest to technologists, but represents an important opportunity to better understand the broader theme of program engagement and to guide the development of more effective interventions. OBJECTIVES The current paper seeks to provide working definitions and describe initial patterns of various measures of participant exposure to ChewFree.com, a large randomized controlled trial of a Web-based program for smokeless tobacco cessation. METHODS We examined measures of participant exposure to either an Enhanced condition Web-based program (interactive, tailored, and rich-media program) or a Basic condition control website (static, text-based material). Specific measures focused on email prompting, participant visits (number, duration, and pattern of use over time), and Web page viewing (number of views, types of pages viewed, and Web forum postings). RESULTS Participants in the ChewFree.com Enhanced condition made more visits and spent more time accessing their assigned website than did participants assigned to the Basic condition website. In addition, exposure data demonstrated that Basic condition users thoroughly accessed program content, indicating that the condition provided a meaningful, face-valid control to the Enhanced condition. CONCLUSIONS We recommend that researchers conducting evaluations of Web-based interventions consider the collection and analysis of exposure measures in the broader context of program engagement in order to assess whether participants obtain sufficient exposure to relevant program content.
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Affiliation(s)
- Brian G Danaher
- Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR 97403, USA.
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Abstract
Athletes use substances to produce pleasure, relieve pain and stress, improve socialization, recover from injury, and enhance performance. Therefore, they use some substances in substantially higher rates that nonathletes. Despite these higher rates of use, rates of addiction may in fact be lower in athletes. This article reviews the prevalence and patterns of use, health and performance effects, and preventive and treatment interventions for alcohol, tobacco, stimulants, and steroids. Each substance is considered from the differing perspectives of abuse/addiction and performance enhancement models. Similarities and differences between college and professional athletes are discussed. Finally, suggestions for future research are made.
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Affiliation(s)
- David R McDuff
- Division of Alcohol and Drug Abuse, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
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Abstract
Smokeless tobacco (ST) use is an important health issue in the United States, and chronic use leads to significant morbidity. ST users are exposed to levels of nicotine comparable with smokers and experience symptoms of nicotine withdrawal when attempting to stop. Clinical treatment of ST users requires an understanding of the unique characteristics of ST. This article reviews ST products, epidemiology, pharmacology, health risks, and treatment approaches.
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Affiliation(s)
- Jon O Ebbert
- Department of Medicine, Mayo Clinic College of Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905, USA.
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