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Herman RJ, Schmidt HD. Targeting GLP-1 receptors to reduce nicotine use disorder: Preclinical and clinical evidence. Physiol Behav 2024; 281:114565. [PMID: 38663460 PMCID: PMC11128349 DOI: 10.1016/j.physbeh.2024.114565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/18/2024] [Accepted: 04/22/2024] [Indexed: 04/30/2024]
Abstract
Nicotine use disorder (NUD) remains a leading cause of preventable death in the U.S. Unfortunately, current FDA-approved pharmacotherapies for smoking cessation have limited efficacy and are associated with high rates of relapse. One major barrier to long-term smoking abstinence is body weight gain during withdrawal. Nicotine withdrawal-induced body weight gain can also lead to development of chronic disease states like obesity and type II diabetes mellitus. Therefore, it is critical to identify novel pharmacotherapies for NUD that decrease relapse and nicotine withdrawal symptoms including body weight gain. Recent studies demonstrate that glucagon-like peptide-1 receptor (GLP-1R) agonists attenuate voluntary nicotine taking and seeking and prevent withdrawal-induced hyperphagia and body weight gain. Emerging evidence also suggests that GLP-1R agonists improve cognitive deficits, as well as depressive- and anxiety-like behaviors, which contribute to smoking relapse during withdrawal. While further studies are necessary to fully characterize the effects of GLP-1R agonists on NUD and understand the mechanisms by which GLP-1R agonists decrease nicotine withdrawal-mediated behaviors, the current literature supports GLP-1R-based approaches to treating NUD.
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Affiliation(s)
- Rae J Herman
- Neuroscience Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Heath D Schmidt
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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2
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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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Nakajima M, Allen S, al'Absi M. Influences of the Menstrual Phase on Cortisol Response to Stress in Nicotine Dependent Women: A Preliminary Examination. Nicotine Tob Res 2020; 21:617-622. [PMID: 29648657 DOI: 10.1093/ntr/nty071] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/09/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Evidence indicates that menstrual cycle phase plays a role in smoking withdrawal symptoms and craving. Stress increases these symptoms. Whether the stress regulatory mechanism is associated with menstrual phase and withdrawal symptoms is not well understood. METHODS Thirty-seven female smokers and 16 female nonsmokers were asked to complete a laboratory session. In each group, approximately half of the participants were tested when they were in the follicular phase and the other half was tested in the luteal phase. The session included resting baseline, stress, and recovery periods. Saliva samples for the measurement of cortisol and subjective measures of craving and withdrawal symptoms were collected at the end of each period. RESULTS A series of repeated measures analysis of covariance found a significant smoking group × menstrual phase × sampling time interaction in cortisol levels (p < .05). Follow-up analyses indicated a reduced cortisol stress response in the luteal group relative to the follicular group in smokers (p < .02). This difference was not found in nonsmokers. CONCLUSIONS Menstrual cycle phase is related to hormonal stress response and smoking withdrawal symptomatology. IMPLICATIONS We show influences of the menstrual cycle phase on stress response among smokers. This is demonstrated by a reduced cortisol response to stress in the luteal group relative to the follicular group among smokers. This menstrual phase difference was not found in nonsmokers.
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Affiliation(s)
- Motohiro Nakajima
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN
| | - Sharon Allen
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Mustafa al'Absi
- Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School, Duluth, MN
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al'Absi M, Lemieux A, Hodges JS, Allen S. Circulating orexin changes during withdrawal are associated with nicotine craving and risk for smoking relapse. Addict Biol 2019; 24:743-753. [PMID: 30117237 DOI: 10.1111/adb.12643] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/11/2018] [Accepted: 05/17/2018] [Indexed: 01/09/2023]
Abstract
We examined the extent to which orexin measured during smoking and the early phase of abstinence was related to craving, withdrawal, stress hormones, and risk for smoking relapse in men and women. Considering its role in modulating nicotine-related reward, we predicted that a reduction in circulating orexin during withdrawal would be associated with increased craving and risk for smoking relapse. Two hundred and eighty five participants provided biological samples and self-report information to identify predictors of smoking relapse. All participants attended two laboratory sessions, which were before and after a period of required abstinence from smoking. After quitting, participants also attended four weekly sessions to track smoking relapse. Only smokers who relapsed within the follow-up period exhibited reduced orexin levels during the initial withdrawal period; ACTH, but not craving nor cortisol, increased across the abstinence period for successful abstainers but not for relapsers. Sex differences in orexin and craving or withdrawal associations also emerged. Adding sex, HPA hormones, and self-reported measures of craving and withdrawal as potential mediators had minimal effects on the above abstinence and orexin effects. These results provide the first evidence that circulating orexin may be a useful marker of risk for relapse; and sex, adrenal hormones, and self-reported craving and withdrawal were not mediators of this effect. The results point to a promising pathway to investigate objective biological markers for craving and smoking relapse and highlight the complexity of the neurobiology of relapse.
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Affiliation(s)
- Mustafa al'Absi
- Department of Family Medicine and Biobehavioral HealthUniversity of Minnesota Medical School Duluth MN USA
- PsychiatryUniversity of Minnesota, Twin Cities Minneapolis MN USA
| | - Andrine Lemieux
- Department of Family Medicine and Biobehavioral HealthUniversity of Minnesota Medical School Duluth MN USA
| | - James S. Hodges
- Division of BiostatisticsUniversity of Minnesota, Twin Cities Minneapolis MN USA
| | - Sharon Allen
- Department of Family Medicine and Community HealthUniversity of Minnesota, Twin Cities Minneapolis MN USA
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Allen AM, Jung AM, Lemieux AM, Alexander AC, Allen SS, Ward KD, al'Absi M. Stressful life events are associated with perinatal cigarette smoking. Prev Med 2019; 118:264-271. [PMID: 30468790 PMCID: PMC6322958 DOI: 10.1016/j.ypmed.2018.11.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/08/2018] [Accepted: 11/17/2018] [Indexed: 12/01/2022]
Abstract
Perinatal smoking, including smoking during pregnancy and postpartum smoking relapse, is a persistent public health problem. While childhood trauma has been linked to perinatal smoking, less is known about the association with more proximal stressful life events (SLEs). The objective of this study was to examine the association between SLEs that occurred during the year prior to childbirth with perinatal smoking. Using the Pregnancy Risk Assessment Monitoring System 2009-2011, perinatal smoking was assessed at three time points: (1) three months prior to pregnancy, (2) the last three months of pregnancy, and (3) two to six months postpartum. Survey respondents endorsed up to 13 SLEs (i.e., death of someone close). SLEs were analyzed individually, as well as using a cumulative score (range 0-13). Weighted analyses included unadjusted and adjusted logistic regression. Among those who smoked prior to pregnancy (n = 15,316), 48% (n = 7308) reported quitting smoking during pregnancy. Of those, 44% (n = 3126) reported postpartum smoking relapse. A total of 11 SLEs were associated with smoking during pregnancy and 2 SLEs were associated with postpartum smoking relapse. The odds of continued smoking during pregnancy was 12% higher for each SLE endorsed (adjusted odds ratio [aOR] = 1.12, 95% confidence interval [CI]: 1.09, 1.15) and this association was attenuated in relation to the odds of postpartum smoking relapse (aOR = 1.03, 95% CI: 0.99, 1.08). SLEs are associated with perinatal smoking. Additional research is needed to elucidate the mechanisms of action and to develop interventions specific to the needs of women who experience SLEs.
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Affiliation(s)
- Alicia M Allen
- Department of Family & Community Medicine, College of Medicine, University of Arizona, 3950 South Country Club Road, Suite 330, Tucson, AZ 85714-2238, United States of America.
| | - Alesia M Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, PO Box 245211, Tucson, AZ 85724-5211, United States of America
| | - Andrine M Lemieux
- Department of Family Medicine & Biobehavioral Health, Medical School, University of Minnesota, Duluth, 1035 University Drive, 291 SMed, Duluth, MN 55812-3031, United States of America
| | - Adam C Alexander
- Department of Social and Behavioral Sciences, School of Public Health, University of Memphis, 3825 DeSoto Avenue, Room 207, Memphis, TN 38152, United States of America
| | - Sharon S Allen
- Department of Family Medicine and Community Health, Medical School, University of Minnesota, 420 Delaware Street SE, Room A682, Minneapolis, MN 55455-0341, United States of America
| | - Kenneth D Ward
- School of Public Health, University of Memphis, 201 Robison Hall, Memphis, TN 38152-3420, United States of America
| | - Mustafa al'Absi
- Department of Family Medicine & Biobehavioral Health, Medical School, University of Minnesota, Duluth, 1035 University Drive, Duluth, MN, 55812-3031, United States of America
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6
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Carlson SC, Allen AM, Allen SS, al’Absi M. Differences in mood and cortisol by menstrual phase during acute smoking abstinence: A within-subject comparison. Exp Clin Psychopharmacol 2017; 25:338-345. [PMID: 29048182 PMCID: PMC5687826 DOI: 10.1037/pha0000142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There is evidence that smoking-cessation success differs by menstrual phase and sex hormone levels; however, the biological mechanisms underlying these differences are not clear. One possibility is that variation in cortisol throughout the menstrual cycle and early smoking abstinence may be partly responsible. The goal of this secondary-data analysis was to conduct a within-subject examination of the effects of menstrual phase and smoking abstinence on salivary cortisol and mood. Data are from a controlled crossover trial, in which participants completed 2 testing weeks during their follicular and luteal phases. During each testing week, they smoked ad libitum during the first 2 days and then abstained from smoking during the next 4 days. Salivary cortisol and self-reported mood were collected 5 times on the day before abstinence (D0) and the first (D1) and third (D3) days of abstinence. Participants (n = 125) were, on average (mean ± SE), 29.4 ± 0.6 years old and smoked 12.6 ± 0.5 cigarettes/day. Whereas salivary cortisol varied significantly by time of day (p < .0001) and smoking abstinence (D0 to D1: β = -0.06 ± 0.02 log[ng/ml], p = .0074 and D3: β = -0.05 ± 0.02 log[ng/ml], p = .0117). no significant differences by menstrual phase were observed. Craving increased from D0 to D1 during the follicular phase but decreased in the luteal phase (+0.31 vs. -0.15, β = 0.46 ± 0.19, p = .0162). This work builds on prior observations in demonstrating a decrease in cortisol in acute smoking abstinence and menstrual phase differences in craving. The results provide further evidence that cortisol levels do not vary by menstrual phase in the first few days of abstinence. (PsycINFO Database Record
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Affiliation(s)
- Samantha C. Carlson
- Department of Family Medicine & Community Health, Medical
School, University of Minnesota, 717 Delaware Street SE, Suite 454,
Minneapolis, MN 55414
| | - Alicia M. Allen
- Department of Family & Community Medicine, College of
Medicine, University of Arizona, 3950 South Country Club Drive, Suite 330,
Tucson, AZ 85742
| | - Sharon S. Allen
- Department of Family Medicine & Community Health, Medical
School, University of Minnesota, 420 Delaware Street SE, Room A682,
Minneapolis, MN 55455
| | - Mustafa al’Absi
- Department of Behavioral Sciences, Medical School, University of
Minnesota, Duluth, 1035 University Drive, 236 SMed, D601A, Duluth, MN
55812
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Kysil EV, Meshalkina DA, Frick EE, Echevarria DJ, Rosemberg DB, Maximino C, Lima MG, Abreu MS, Giacomini AC, Barcellos LJG, Song C, Kalueff AV. Comparative Analyses of Zebrafish Anxiety-Like Behavior Using Conflict-Based Novelty Tests. Zebrafish 2017; 14:197-208. [DOI: 10.1089/zeb.2016.1415] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Elana V. Kysil
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Darya A. Meshalkina
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
| | - Erin E. Frick
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi
| | - David J. Echevarria
- Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, Louisiana
| | - Denis B. Rosemberg
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, Louisiana
- Graduate Program in Biological Sciences: Toxicological Biochemistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Caio Maximino
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, Louisiana
- Laboratory of Neurosciences and Behavior “Frederico Guilherme Graeff,” Center for Biological and Health Sciences, Institute of Health and Biological Studies, Federal University of Southern and Southeastern Pará (UNIFESSPA), Marabá, Brazil
| | - Monica Gomes Lima
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, Louisiana
- University of the State of Pará (UEPA), Marabá, Brazil
| | - Murilo S. Abreu
- Postgraduate Program in Bio-Experimentation, University of Passo Fundo (UPF), Passo Fundo, Brazil
| | - Ana C. Giacomini
- Postgraduate Program in Bio-Experimentation, University of Passo Fundo (UPF), Passo Fundo, Brazil
| | - Leonardo J. G. Barcellos
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, Louisiana
- Postgraduate Program in Bio-Experimentation, University of Passo Fundo (UPF), Passo Fundo, Brazil
- Postgraduate Program in Pharmacology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Cai Song
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
- Graduate Institute of Neural and Cognitive Sciences, China Medical University Hospital, Taichung, Taiwan
| | - Allan V. Kalueff
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg, Russia
- The International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, Louisiana
- Research Institute for Marine Drugs and Nutrition, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang, China
- Ural Federal University, Ekaterinburg, Russia
- ZENEREI Research Center, Slidell, Louisiana
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Goldberg SB, Manley AR, Smith SS, Greeson JM, Russell E, Van Uum S, Koren G, Davis JM. Hair cortisol as a biomarker of stress in mindfulness training for smokers. J Altern Complement Med 2014; 20:630-4. [PMID: 24963659 DOI: 10.1089/acm.2014.0080] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Stress is a well-known predictor of smoking relapse, and cortisol is a primary biomarker of stress. The current pilot study examined changes in levels of cortisol in hair within the context of two time-intensity matched behavioral smoking cessation treatments: mindfulness training for smokers and a cognitive-behavioral comparison group. PARTICIPANTS Eighteen participants were recruited from a larger randomized controlled trial of smoking cessation. OUTCOME MEASURES Hair samples (3 cm) were obtained 1 month after quit attempt, allowing for a retrospective analysis of hair cortisol at preintervention and post-quit attempt time periods. Self-reported negative affect was also assessed before and after treatment. INTERVENTION Both groups received a 7-week intensive intervention using mindfulness or cognitive-behavioral strategies. RESULTS Cortisol significantly decreased from baseline to 1 month after quit attempt in the entire sample (d=-0.35; p=.005). In subsequent repeated-measures analysis of variance models, time by group and time by quit status interaction effects were not significant. However, post hoc paired t tests yielded significant pre-post effects among those randomly assigned to the mindfulness condition (d=-0.48; p=.018) and in those abstinent at post-test (d=-0.41; p=.004). Decreased hair cortisol correlated with reduced negative affect (r=.60; p=.011). CONCLUSIONS These preliminary findings suggest that smoking cessation intervention is associated with decreased hair cortisol levels and that reduced hair cortisol may be specifically associated with mindfulness training and smoking abstinence. RESULTS support the use of hair cortisol as a novel objective biomarker in future research.
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Affiliation(s)
- Simon B Goldberg
- 1 Department of Counseling Psychology, University of Wisconsin , Madison, WI
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9
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Differences between 1-month quitters and relapsers in biospsychosocial characteristics among male smokers in Korea. J Addict Nurs 2014; 24:187-94. [PMID: 24621549 DOI: 10.1097/jan.0b013e3182a4cc2b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to compare and contrast biopsychosocial characteristics and processes of change (POC) between 1-month quitters and relapsers among male smokers in Korea. METHODS This study employed a prospective study design. Forty-one male smokers were recruited on one university campus. The instruments used in this study included blood pressure (BP), body mass index, salivary cortisol, perceived stress, self-efficacy, and POC. After collection of baseline data, participants were encouraged to adopt smoking cessation, either by obtaining smoking cessation counseling or self-abstinence. Baseline data and data collected after 1 month from smoking cessation were compared. RESULTS The mean age of the participants was 24.9 years (SD = 1.90 years), and 51.2% were overweight or obese. According to results of the study, SBP, DBP, and perceived stress were significantly lower, whereas self-efficacy was significantly higher among quitters, compared with relapsers, after 1 month (p < .05). Results of within-group comparison indicated that, among POC, self-liberation, helping relationship, and reinforcement management showed a significant decrease among 1-month relapsers (p < .05), whereas, counter conditioning showed a significant increase among 1-month quitters (p < .05). CONCLUSIONS According to the results of this study, BP and perceived stress showed a significant decrease among 1-month quitters, whereas those less likely to utilize behavioral processes were more likely to have relapsed after 1 month.
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Ho JY, Kraemer WJ, Volek JS, Vingren JL, Fragala MS, Flanagan SD, Maladouangdock J, Szivak TK, Hatfield DL, Comstock BA, Dunn-Lewis C, Ciccolo JT, Maresh CM. Effects of resistance exercise on the HPA axis response to psychological stress during short-term smoking abstinence in men. Addict Behav 2014; 39:695-8. [PMID: 24290878 DOI: 10.1016/j.addbeh.2013.10.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 10/02/2013] [Accepted: 10/22/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to examine the effects of resistance exercise on the hypothalamic-pituitary-adrenal axis (HPA) response to mental challenge, withdrawal symptoms, urge to smoke, and cognitive stress during 24-hour smoking abstinence. METHODS 8 sedentary smokers (mean±SD age: 20.1±1.7y; height: 171.6±10.8cm; body mass: 70.4±12.0kg; smoking history: 2.9±0.8y) completed a 24-hour ad libitum smoking trial (SMO) followed by two 24-hour smoking abstinence trials. During abstinence trials, participants performed six whole body resistance exercises (EX) or a control condition (CON) in the morning, followed by mental challenge tasks in the afternoon. Plasma adrenocorticotropin hormone (ACTH), and salivary and serum cortisol were measured during each visit at rest (REST), and then before (PRE-EX), immediately after (IP-EX), and 30min after exercise (30-EX); and before (PRE-MC), immediately after (IP-MC), and 30min after mental challenge (30-MC). RESULTS Resistance exercise significantly (p≤0.05) elevated plasma ACTH and serum cortisol at IP-EX during EX compared with SMO and CON trials. Resting ACTH, salivary and serum cortisol concentrations at Pre-MC did not differ between EX and CON trials. The HPA axis response to mental challenge was similar after EX and CON trials. Finally, resistance exercise did not reduce withdrawal symptoms, urge to smoke, or stress. CONCLUSION Resistance exercise did not substantially alter resting HPA hormones or the HPA response to mental challenge tasks during 24h of smoking abstinence.
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Affiliation(s)
- Jen-Yu Ho
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA; Department of Athletic Performance, National Taiwan Normal University Taipei, Taiwan
| | - William J Kraemer
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA.
| | - Jeff S Volek
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Jakob L Vingren
- Department of Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, TX, USA
| | - Maren S Fragala
- Department of Child, Family and Community Sciences, University of Central Florida, Orlando, FL, USA
| | - Shawn D Flanagan
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Jesse Maladouangdock
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Tunde K Szivak
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Disa L Hatfield
- Department of Kinesiology, University of Rhode Island, Kingston, RI, USA
| | - Brett A Comstock
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Courtenay Dunn-Lewis
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
| | - Joseph T Ciccolo
- Department of Biobehavioral Sciences (Program in Movement Sciences) Teachers College, Columbia University, New York, NY 10027, USA
| | - Carl M Maresh
- Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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Dutra LM, Williams DR, Gupta J, Kawachi I, Okechukwu CA. Human rights violations and smoking status among South African adults enrolled in the South Africa Stress and Health (SASH) study. Soc Sci Med 2014; 105:103-11. [PMID: 24509050 DOI: 10.1016/j.socscimed.2014.01.018] [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: 05/14/2013] [Revised: 09/26/2013] [Accepted: 01/12/2014] [Indexed: 10/25/2022]
Abstract
Despite South Africa's history of violent political conflict, and the link between stressful experiences and smoking in the literature, no public health study has examined South Africans' experiences of human rights violations and smoking. Using data from participants in the nationally representative cross-sectional South Africa Stress and Health study (SASH), this analysis examined the association between respondent smoking status and both human rights violations experienced by the respondent and violations experienced by the respondents' close friends and family members. SAS-Callable SUDAAN was used to construct separate log-binomial models by political affiliation during apartheid (government or liberation supporters). In comparison to those who reported no violations, in adjusted analyses, government supporters who reported violations of themselves but not others (RR = 1.76, 95% CI: 1.25-2.46) had a significantly higher smoking prevalence. In comparison to liberation supporters who reported no violations, those who reported violations of self only (RR = 1.56, 95%CI: 1.07-2.29), close others only (RR = 1.97, 95%CI: 1.12-3.47), or violations of self and close others due to close others' political beliefs and the respondent's political beliefs (RR = 2.86, 95%CI: 1.70-4.82) had a significantly higher prevalence of smoking. The results of this analysis suggest that a relationship may exist between human rights violations and smoking among South Africa adults. Future research should use longitudinal data to assess causality, test the generalizability of these findings, and consider how to apply these findings to smoking cessation interventions.
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Affiliation(s)
- Lauren M Dutra
- Harvard University, USA; University of California San Francisco, USA.
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12
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Brief psycho-education affects circadian variability in nicotine craving during cessation. Drug Alcohol Depend 2013; 132:283-9. [PMID: 23478153 DOI: 10.1016/j.drugalcdep.2013.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 02/12/2013] [Accepted: 02/14/2013] [Indexed: 11/23/2022]
Abstract
BACKGROUND Nicotine cravings are a key target of smoking cessation interventions. Cravings demonstrate circadian variation during abstinence, often peaking during the morning and evening hours. Although some research has also shown diurnal variation in the efficacy of nicotine replacement medications, little research has examined how brief psychosocial interventions affect temporal patterns of craving during abstinence. The present study examined the impact of two brief psycho-education interventions on circadian variations in cravings during a 24-h period. METHOD 176 adult smokers interested in quitting participated in two lab sessions. During the first session, participants received (a) mindfulness psycho-education that encouraged acceptance of cravings as a normal, tolerable part of quitting that people should not expect to perfectly control, (b) standard cessation psycho-education, or (c) no psycho-education. Half the sample initiated a cessation attempt the following day. Dependent variables were assessed using ecological momentary assessment (24-h of monitoring, immediately after first lab session) and questionnaires four days later. RESULTS Partially consistent with hypotheses, both forms of psycho-education were associated with differential diurnal variation in cravings during cessation. Relative to those receiving no psycho-education, standard smoking cessation psycho-education decreased morning cravings. Psycho-education encouraging acceptance of cravings was associated with lower craving in both the morning and evening, albeit only among successfully abstinent smokers. CONCLUSIONS Results demonstrate that brief non-pharmacological interventions can affect circadian craving patterns during smoking cessation. Further investigation of mechanisms of change and of the impact of psycho-education on cessation outcomes is warranted.
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Bruijnzeel AW. Tobacco addiction and the dysregulation of brain stress systems. Neurosci Biobehav Rev 2012; 36:1418-41. [PMID: 22405889 PMCID: PMC3340450 DOI: 10.1016/j.neubiorev.2012.02.015] [Citation(s) in RCA: 116] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 02/01/2012] [Accepted: 02/23/2012] [Indexed: 11/15/2022]
Abstract
Tobacco is a highly addictive drug and is one of the most widely abused drugs in the world. The first part of this review explores the role of stressors and stress-associated psychiatric disorders in the initiation of smoking, the maintenance of smoking, and relapse after a period of abstinence. The reviewed studies indicate that stressors facilitate the initiation of smoking, decrease the motivation to quit, and increase the risk for relapse. Furthermore, people with depression or an anxiety disorder are more likely to smoke than people without these disorders. The second part of this review describes animal studies that investigated the role of brain stress systems in nicotine addiction. These studies indicate that corticotropin-releasing factor, Neuropeptide Y, the hypocretins, and norepinephrine play a pivotal role in nicotine addiction. In conclusion, the reviewed studies indicate that smoking briefly decreases subjective stress levels but also leads to a further dysregulation of brain stress systems. Drugs that decrease the activity of brain stress systems may diminish nicotine withdrawal and improve smoking cessation rates.
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Affiliation(s)
- Adrie W Bruijnzeel
- Department of Psychiatry, McKnight Brain Institute, University of Florida, 1149 S. Newell Dr., Gainesville, FL 32611, USA.
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14
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Allostasis model facilitates understanding race differences in the diurnal cortisol rhythm. Dev Psychopathol 2012; 23:1167-86. [PMID: 22018088 DOI: 10.1017/s095457941100054x] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The concept of allostasis suggests that greater cumulative stress burden can influence stress-responsive physiology. Dysregulation of allostatic mediators, including the hypothalamic-pituitary-adrenal (HPA) axis, is thought to precede many other signs of age-related pathology as the persistent burden of stressors accumulates over the individual's life span. We predicted that even in young adulthood, HPA regulation would differ between Blacks and Whites, reflecting, in part, higher rates of stressor exposure and greater potential for stressors to "get under the skin." We examined whether stressor exposure, including experiences with racism and discrimination, explained race differences in waking cortisol and the diurnal rhythm. We also examined whether HPA functioning was associated with mental health outcomes previously linked to cortisol. Salivary cortisol was assayed in 275 young adults (127 Blacks, 148 Whites, 19 to 22 years old), four times a day across 3 days. Hierarchical linear models revealed flatter slopes for Blacks, reflecting significantly lower waking and higher bedtime cortisol levels compared to Whites. Associations of HPA functioning with stressors were typically more robust for Whites such that more stress exposure created an HPA profile that resembled that of Black young adults. For Blacks, greater stressor exposure did not further impact HPA functioning, or, when significant, was often associated with higher cortisol levels. Across both races, flatter slopes generally indicated greater HPA dysregulation and were associated with poor mental health outcomes. These differential effects were more robust for Whites. These findings support an allostatic model in which social contextual factors influence normal biorhythms, even as early as young adulthood.
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Nakajima M, al'Absi M. Enhanced pain perception prior to smoking cessation is associated with early relapse. Biol Psychol 2011; 88:141-6. [PMID: 21816208 DOI: 10.1016/j.biopsycho.2011.07.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 07/05/2011] [Accepted: 07/19/2011] [Indexed: 11/26/2022]
Abstract
Accumulated evidence suggests that nicotine induces analgesia, and endogenous pain regulatory mechanisms may be altered by chronic smoking. The extent to which individual differences in pain perception are related to smokers' ability to abstain from smoking has not been directly examined. Seventy-one smokers who were interested in quitting completed a pre-cessation laboratory session which included the cold pressor test (CPT). Pain ratings were collected during and after CPT. Also, mood changes, cardiovascular measures, and salivary cortisol samples were evaluated prior to, during, and after CPT. Participants attended 4 weekly follow-up assessment sessions after their quit day. Cox regression analysis revealed that higher pain ratings during and after CPT predicted greater risk for smoking relapse. These results remained significant after affective and physiological responses to CPT were controlled, suggesting that pain ratings prior to smoking cessation are potentially useful in identifying smokers who are at greater risk of early smoking relapse and may reflect underlying putative risk for nicotine dependence and relapse.
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Affiliation(s)
- Motohiro Nakajima
- University of Minnesota Medical School, 1035 University Drive, Duluth, MN 55812, USA
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Ussher M, Aveyard P, Reid F, West R, Evans P, Clow A, Hucklebridge F, Fuller J, Ibison J, Steptoe A. A randomised placebo-controlled trial of oral hydrocortisone for treating tobacco withdrawal symptoms. Psychopharmacology (Berl) 2011; 216:43-51. [PMID: 21301812 DOI: 10.1007/s00213-011-2191-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Accepted: 01/17/2011] [Indexed: 11/25/2022]
Abstract
RATIONALE Many smokers experience a decline in cortisol to sub-normal levels during the first days of smoking cessation. A greater decline in cortisol is associated with more intense cigarette withdrawal symptoms, urge to smoke and relapse to smoking. Findings from an uncontrolled study suggest that glucocorticoids could ameliorate cigarette withdrawal. OBJECTIVES We investigated whether taking oral hydrocortisone would reduce withdrawal symptoms and the desire to smoke on the first day of temporary smoking abstinence compared with placebo. METHODS Using a double-blind within-subject randomised crossover design, 48 smokers took a single dose of 40 mg hydrocortisone, 20 mg hydrocortisone or placebo following overnight smoking abstinence. Abstinence was maintained through the afternoon, and withdrawal symptoms and the desire to smoke were rated across the morning. Salivary cortisol was assessed in the afternoon prior to abstinence (baseline) and while abstinent after each treatment. RESULTS There was a significant dose-response relation between dose of hydrocortisone and reduction in depression and anxiety ratings while abstinent, but there were no other statistically significant associations with dose. Overall, the decline in cortisol following smoking cessation (placebo only) was not significant. Cortisol level on the afternoon of smoking abstinence was not significantly associated with symptom ratings. CONCLUSIONS Supplements of hydrocortisone do not reduce the desire to smoke but may ameliorate withdrawal-related depression and anxiety, although the clinical benefit is slight.
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Affiliation(s)
- Michael Ussher
- Division of Population Health Sciences and Education, St George's, University of London, Cranmer Terrace, London, SW17 ORE, UK.
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Ćalušić AL, Varnai VM, Macan J. Acute effects of smoking and food consumption on breath condensate pH in healthy adults. Exp Lung Res 2010; 37:92-100. [DOI: 10.3109/01902148.2010.521616] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Veda M. Varnai
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Jelena Macan
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
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18
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Xue Y, Morris M, Ni L, Guthrie SK, Zubieta JK, Gonzalez K, McConnell DS, Domino EF. Venous plasma nicotine correlates of hormonal effects of tobacco smoking. Pharmacol Biochem Behav 2010; 95:209-15. [PMID: 20100507 PMCID: PMC2832319 DOI: 10.1016/j.pbb.2010.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 01/13/2010] [Accepted: 01/18/2010] [Indexed: 11/28/2022]
Abstract
The present study resolves some of the discrepancies in the literature by correlating the effects of tobacco smoking on hormone release with venous plasma nicotine levels. Cortisol, prolactin, and beta-endorphin concentrations were measured. Habitual male tobacco users smoked denicotinized (very low nicotine) and average nicotine cigarettes in the morning after overnight tobacco abstinence. Several venous blood samples were withdrawn before and during the smoking sessions for subsequent analyses. The increases in plasma nicotine correlated well with plasma cortisol and prolactin levels (correlation coefficients r=0.66 and 0.53, respectively, p<0.05). This study quantifies the well known increase in plasma cortisol and prolactin after nicotine postsmoking for about 1h with peak plasma levels up to 35 ng/ml. Contrary to most abused drugs which release dopamine and decrease prolactin, nicotine concentration correlated with increased prolactin release. Increases in maximal plasma beta-endorphin levels following tobacco smoking were barely statistically significant with insufficient data to obtain a correlation coefficient.
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Affiliation(s)
- Yue Xue
- Department of Pharmacology, University of Michigan, Ann Arbor, MI 48109-5632, USA
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19
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Buchmann AF, Laucht M, Schmid B, Wiedemann K, Mann K, Zimmermann US. Cigarette craving increases after a psychosocial stress test and is related to cortisol stress response but not to dependence scores in daily smokers. J Psychopharmacol 2010; 24:247-55. [PMID: 18957475 DOI: 10.1177/0269881108095716] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Stress is known to induce cigarette craving in smokers, but the underlying mechanisms are widely unknown. We investigated how dependence severity, smoking habits and stress-induced cortisol secretion are associated with increased cigarette craving after a standardised laboratory stressor. Hundred and six healthy participants (50 men, age 18-19 years) underwent a standardised public speaking stress task. In all, 35 smoked daily (DS), 13 smoked occasionally (OS), and 58 never smoked (NS). Smoking was unrestricted until 2 h before stress onset. Plasma cortisol was measured before and up to 95 min after the stressor. All current smokers rated intensity of cigarette craving immediately before and immediately after the stressor using the Brief Questionnaire of Smoking Urges (BQSU). Cortisol levels significantly increased in response to stress in all groups. The magnitude of this stress response was significantly lower in DS compared with OS and NS but did not differ between OS and NS. Baseline BQSU scores were significantly higher in DS than OS. BQSU scores increased significantly during the stress period and were positively correlated to the cortisol response in the DS but were unrelated to their nicotine dependence scores. In OS, no change in cigarette craving could be observed. In daily smokers, cigarette craving is increased after compared with before stress exposure and is related to the magnitude of cortisol stress response rather than to severity of nicotine dependence. This result supports, but does not prove, the concept that hypothalamus-pituitary-adrenal stimulation is one of the mechanisms how stress can elicit cigarette craving.
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Affiliation(s)
- A F Buchmann
- Department of Addictive Behavior and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
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20
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Scerbo F, Faulkner G, Taylor A, Thomas S. Effects of exercise on cravings to smoke: The role of exercise intensity and cortisol. J Sports Sci 2010; 28:11-9. [DOI: 10.1080/02640410903390089] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Allen AM, Allen SS, Widenmier J, al'Absi M. Patterns of cortisol and craving by menstrual phase in women attempting to quit smoking. Addict Behav 2009; 34:632-5. [PMID: 19409710 DOI: 10.1016/j.addbeh.2009.03.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Revised: 01/09/2009] [Accepted: 03/17/2009] [Indexed: 12/13/2022]
Abstract
Research indicates stress, craving and menstrual phase may play a role in relapse to smoking. It remains unknown how these factors may interact during cessation. This study describes the relationship between craving and cortisol concentrations by menstrual phase during ad libitum smoking and investigates the impact of this relationship on time to relapse. Five assessments of cortisol concentrations and craving levels were collected the day before smoking cessation in female smokers (n=38) during either the follicular (n=21; F) or luteal (n=17; L) phase. Craving at wake-up was significantly greater in the F phase than the L phase (2.5+/-1.9 vs. 1.1+/-1.4; p=0.018; respectively). Decreased levels of morning cortisol concentrations and a greater decline from morning to the nadir levels in cortisol were associated with increased craving at bedtime in the L (r=-0.68, p=0.002; r=-0.67, p=0.003; respectively), but not in the F phase. Craving at wake-up was a significant predictor of time to relapse (p=0.008). Our results indicate that menstrual phase may play a role in the relationship among craving, cortisol concentrations, and risk for relapse.
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Abstract
OBJECTIVE To examine the extent to which nicotine dependence alters endogenous opioid regulation of the hypothalamic-pituitary-adrenocortical (HPA) axis functions. Endogenous opiates play an important role in regulating mood, pain, and drug reward. They also regulate the HPA functions. Previous work has demonstrated an abnormal HPA response to psychological stress among dependent smokers. METHODS Smokers and nonsmokers (total n = 48 participants) completed two sessions during which a placebo or 50 mg of naltrexone was administered, using a double-blind design. Blood and saliva samples, cardiovascular and mood measures were obtained during a resting absorption period, after exposure to two noxious stimuli, and during an extended recovery period. Thermal pain threshold and tolerance were assessed in both sessions. Participants also rated pain during a 90-second cold pressor test. RESULTS Opioid blockade increased adrenocorticotropin, plasma cortisol, and salivary cortisol levels; these increases were enhanced by exposure to the noxious stimuli. These responses were blunted in smokers relative to nonsmokers. Smokers tended to report less pain than nonsmokers, and women reported more pain during both pain procedures, although sex differences in pain were significant only among nonsmokers. CONCLUSIONS We conclude that nicotine dependence is associated with attenuated opioid modulation of the HPA. This dysregulation may play a role in the previously observed blunted responses to stress among dependent smokers.
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23
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Back SE, Waldrop AE, Saladin ME, Yeatts SD, Simpson A, McRae AL, Upadhyaya HP, Sisson RC, Spratt EG, Allen J, Kreek MJ, Brady KT. Effects of gender and cigarette smoking on reactivity to psychological and pharmacological stress provocation. Psychoneuroendocrinology 2008; 33:560-8. [PMID: 18321653 PMCID: PMC2446474 DOI: 10.1016/j.psyneuen.2008.01.012] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2007] [Revised: 11/26/2007] [Accepted: 01/28/2008] [Indexed: 10/22/2022]
Abstract
We examined the influence of gender and smoking status on reactivity in two human laboratory stress paradigms. Participants were 46 (21 men, 25 women) healthy individuals who completed the Trier Social Stress Task (i.e., performed speech and math calculations in front of an audience) and a pharmacological stress provocation (i.e., administration of corticotrophin releasing hormone (CRH)) after an overnight hospital stay. Approximately half (53%) of the participants were smokers. Cortisol, adrenocorticotrophin hormone (ACTH), physiologic measures (heart rate, blood pressure), and subjective stress were assessed at baseline and at several time points post-task. Men demonstrated higher baseline ACTH and blood pressure as compared to women; however, ACTH and blood pressure responses were more pronounced in women. Women smokers evidenced a more blunted cortisol response as compared to non-smoking women, whereas smoking status did not affect the cortisol response in men. Finally, there was a more robust cardiovascular and subjective response to the Trier as compared to the CRH. Although preliminary, the findings suggest that women may be more sensitive than men to the impact of cigarette smoking on cortisol response. In addition, there is some evidence for a more robust neuroendocrine and physiologic response to acute laboratory stress in women as compared to men.
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Affiliation(s)
- Sudie E. Back
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC.,Corresponding Author: Sudie E. Back, PhD, Department of Psychiatry and Behavioral Sciences, Clinical Neuroscience Division, Medical University of South Carolina, 67 President St., P.O. Box 250861, Charleston, SC 29425. Telephone (843)792-5215, Fax (843)792-0528. E-mail:
| | - Angela E. Waldrop
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
| | - Michael E. Saladin
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
| | - Sharon D. Yeatts
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
| | - Annie Simpson
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
| | - Aimee L. McRae
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
| | - Himanshu P. Upadhyaya
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
| | - Regana Contini Sisson
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
| | - Eve G. Spratt
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
| | - Julia Allen
- The Rockefeller University, Laboratory on the Biology of Addictive Diseases, 1230 York Avenue, New York, NY 10021
| | - Mary Jeanne Kreek
- The Rockefeller University, Laboratory on the Biology of Addictive Diseases, 1230 York Avenue, New York, NY 10021
| | - Kathleen T. Brady
- Medical University of South Carolina, Department of Psychiatry, Clinical Neuroscience Division, 67 President St, P.O. Box 250861, Charleston, SC
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Cleck JN, Blendy JA. Making a bad thing worse: adverse effects of stress on drug addiction. J Clin Invest 2008; 118:454-61. [PMID: 18246196 DOI: 10.1172/jci33946] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Sustained exposure to various psychological stressors can exacerbate neuropsychiatric disorders, including drug addiction. Addiction is a chronic brain disease in which individuals cannot control their need for drugs, despite negative health and social consequences. The brains of addicted individuals are altered and respond very differently to stress than those of individuals who are not addicted. In this Review, we highlight some of the common effects of stress and drugs of abuse throughout the addiction cycle. We also discuss both animal and human studies that suggest treating the stress-related aspects of drug addiction is likely to be an important contributing factor to a long-lasting recovery from this disorder.
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Affiliation(s)
- Jessica N Cleck
- Department of Pharmacology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6055, USA
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Abstract
CONTEXT Evidence for an association of smoking status with cortisol secretion is mixed. OBJECTIVE The objective of the study was to assess the relationship between smoking status and salivary cortisol. DESIGN This was a cross-sectional study of smoking status and cortisol secretion from phase 7 (2002-2004) of the Whitehall II study. SETTING An occupational cohort was originally recruited in 1985-1987. PARTICIPANTS The study population consisted of 3103 men (1514 never-smokers, 1278 ex-smokers, and 311 smokers) and 1128 women (674 never-smokers, 347 ex-smokers, and 107 smokers). Information was collected on smoking status, average number of cigarettes smoked, and additional covariates. OUTCOME MEASURES Saliva samples were taken on waking; waking + 0.5, 2.5, 8, and 12 h; and bedtime for the assessment of cortisol. RESULTS Smoking status was significantly associated with increased salivary cortisol release throughout the day (P < 0.001) adjusted for covariates; this was apparent for the cortisol awakening response (P < 0.001) when examined separately. Compared with never-smokers, smokers had higher release of total cortisol (P = 0.002), whereas no difference was observed between never-smokers and ex-smokers (P = 0.594): mean release per hour (nanomoles per liter), never-smokers, 4.13 [confidence interval (CI) 4.02-4.24]; ex-smokers, 4.21 (CI 4.08-4.35); smokers, 4.63 (CI 4.35-4.93). There was no significant relationship between number of cigarettes smoked and total cortisol release. However, a difference was observed for the cortisol awakening response: mean release by tertiles of cigarettes smoked (nanomoles per liter): high, 13.49 (CI 10.74-16.23); medium, 9.58 (CI 7.40-11.76); low, 8.49 (CI 5.99-10.99), P = 0.029. CONCLUSION Salivary cortisol is increased in current smokers, compared with nonsmokers; no differences were observed between ex-smokers and never-smokers, suggesting that smoking has a short-term effect on the neuroendocrine system.
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Affiliation(s)
- Ellena Badrick
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, United Kingdom.
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