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Gotti C, Clementi F, Zoli M. Auxiliary protein and chaperone regulation of neuronal nicotinic receptor subtype expression and function. Pharmacol Res 2024; 200:107067. [PMID: 38218358 DOI: 10.1016/j.phrs.2024.107067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/15/2024]
Abstract
Neuronal nicotinic acetylcholine receptors (nAChRs) are a family of pentameric, ligand-gated ion channels that are located on the surface of neurons and non-neuronal cells and have multiple physiological and pathophysiological functions. In order to reach the cell surface, many nAChR subtypes require the help of chaperone and/or auxiliary/accessory proteins for their assembly, trafficking, pharmacological modulation, and normal functioning in vivo. The use of powerful genome-wide cDNA screening has led to the identification and characterisation of the molecules and mechanisms that participate in the assembly and trafficking of receptor subtypes, including chaperone and auxiliary or accessory proteins. The aim of this review is to describe the latest findings concerning nAChR chaperones and auxiliary proteins and pharmacological chaperones, and how some of them control receptor biogenesis or regulate channel activation and pharmacology. Some auxiliary proteins are subtype selective, some regulate various subtypes, and some not only modulate nAChRs but also target other receptors and signalling pathways. We also discuss how changes in auxiliary proteins may be involved in nAChR dysfunctions.
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Affiliation(s)
- Cecilia Gotti
- CNR, Institute of Neuroscience, Milan, Italy; NeuroMi Milan Center for Neuroscience, University of Milano-Bicocca, Italy.
| | - Francesco Clementi
- CNR, Institute of Neuroscience, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Michele Zoli
- Department of Biomedical, Metabolic and Neural Sciences, Center for Neuroscience and Neurotechnology (CfNN), University of Modena and Reggio Emilia, Modena, Italy
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Lawson SC, Arif M, Hoopsick RA, Homish DL, Homish GG. Exploring Racial/Ethnic Disparities in Substance Dependence and Serious Psychological Distress among US Veterans. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01753-9. [PMID: 37603224 PMCID: PMC10879463 DOI: 10.1007/s40615-023-01753-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 08/03/2023] [Accepted: 08/06/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES There are substantial racial/ethnic disparities in substance use and mental health among civilian populations, but few studies have examined these disparities in veterans using a nationally representative sample. Thus, we examined differences in substance dependence and serious psychological distress (SPD) by race/ethnicity among a national sample of US veterans. METHODS We pooled cross-sectional data from the 2015-2019 waves of the National Survey on Drug Use and Health (N = 7,653 veterans aged 18-64 years). Regression models were utilized to examine racial/ethnic differences in DSM-IV substance dependence and SPD with a Benjamini-Hochberg correction applied. RESULTS Compared to non-Hispanic White veterans: American Indian/Alaska Native veterans had significantly higher odds of past-year alcohol dependence (AOR = 2.55, 95% CI: 1.28, 5.08); Asian American veterans had significantly lower odds of past-year alcohol dependence (AOR = 0.12, 95% CI: 0.02, 0.62); non-Hispanic Black (AOR = 0.60, 95% CI: 0.48, 0.77), Hispanic (AOR = 0.47, 95% CI: 0.34, 0.65), and veterans of more than one race (AOR = 0.55, 95% CI: 0.36, 0.83) had significantly lower odds of past-month nicotine dependence; Asian American veterans had significantly lower odds of past-year illicit drug dependence (AOR = 0.05, 95% CI: 0.01, 0.35); and non-Hispanic Black veterans had significantly lower odds of past-year SPD (AOR = 0.69, 95% CI: 0.55, 0.85) after correction for multiple comparisons. CONCLUSION Overall, racial/ethnic disparities in substance dependence and SPD among veterans are not as stark as in civilian populations, but some disparities remain.
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Affiliation(s)
- Schuyler C Lawson
- Graduate Research Assistant, Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA.
| | - Mehreen Arif
- Graduate Research Assistant, Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Rachel A Hoopsick
- Assistant Professor, Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Urbana-Champaign, Champaign, IL, USA
| | - D Lynn Homish
- Project Director, Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Gregory G Homish
- Professor and Chair, Department of Community Health and Health Behavior, University at Buffalo, The State University of New York, Buffalo, NY, USA
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Bautista M, Mogul AS, Fowler CD. Beyond the label: current evidence and future directions for the interrelationship between electronic cigarettes and mental health. Front Psychiatry 2023; 14:1134079. [PMID: 37645635 PMCID: PMC10460914 DOI: 10.3389/fpsyt.2023.1134079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Electronic cigarette use has dramatically increased over the last decade. With this recent technological development and wide range of constituents in various products, putative adverse effects on the brain and body have been largely unexplored. Here, we review current evidence linking electronic nicotine cigarette use with potential health consequences and provide evidence supporting an association between drug use and depression in humans. We also examine the biological effects of individual constituents in electronic cigarette aerosols, which include labeled ingredients, such as propylene glycol, vegetable glycerin, nicotine, and flavorants, as well as unlabeled ingredients found in the aerosols, such as carbonyls and heavy metals. Lastly, we examine the effects of electronic cigarette use on endogenous metabolism via changes in cytochrome P450 enzymes, which can thereby impact therapeutic outcomes. While the current evidence offers insight into the potential effects of electronic cigarette use on biological processes, further studies are necessary to determine the long-term clinical relevance of aerosol inhalation.
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Affiliation(s)
| | | | - Christie D. Fowler
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
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Horn K, Dearfield CT, Beth Johnson S, Krost K, Rincon Gallardo Patino S, Gray T, Crandell I, Bernat DH. Smoking cessation intentions and attempts one year after the federally mandated smoke-free housing rule. Prev Med Rep 2021; 24:101600. [PMID: 34976657 PMCID: PMC8683937 DOI: 10.1016/j.pmedr.2021.101600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 12/15/2022] Open
Abstract
The present study examines public housing residents' smoking cessation intentions, expectancies, and attempts one year after implementation of the Department of Housing and Urban Development's mandatory smoke-free rule in public housing. The sample includes 233 cigarette smokers, ages 18-80, who reside in the District of Columbia Housing Authority. Data collection occurred between March and August 2019. Descriptive statistics, chi-square, and Wilcoxon two-sample test analyses assessed smoking cessation intentions, expectancies, and attempts across resident demographics and characteristics. Findings showed 17.2% of residents reported not thinking about quitting, 39.1% reported thinking about quitting, and 48.6% reported thinking about quitting specifically because of the rule. Residents ages 60-80 were more likely to consider quitting because of the rule, compared to residents ages 18-59. Of those thinking of quitting, 58.6% were sure they could quit if they tried. Those thinking of quitting due to the rule (62.0%) were more likely to have made at least one quit attempt in the past 3 months than those i not attributinging thinking of quitting to the rule. Res Residents trying to quit reported an average of 2.7 attempts in the last 3 months;; most perceived evidence-based cessation supports as not helpful. A A majority reported thinking about quitting and attempting to quit but continuing to smoke, indicating a significant gap between intent to quit and successfully quitting. Results suggest that the rule positively influenced smoking behaviors. However, additional interventions are needed to assist public housing residents with successfully quitting smoking.
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Affiliation(s)
- Kimberly Horn
- Virginia Tech-Carilion Fralin Biomedical Research Institute, Blacksburg, VA, USA
| | - Craig T. Dearfield
- The George Washington University Milken Institute School of Public Health, Department of Epidemiology, Washington, DC, USA
| | - Sallie Beth Johnson
- Radford University Carilion, Department of Public Health and Healthcare Leadership, Roanoke, VA, USA
- Virginia Tech Carilion, Department of Family and Community Medicine, Roanoke, VA, USA
| | - Kevin Krost
- Virginia Tech-Carilion Fralin Biomedical Research Institute, Blacksburg, VA, USA
| | | | - Tiffany Gray
- Virginia Tech-Carilion Fralin Biomedical Research Institute, Blacksburg, VA, USA
| | - Ian Crandell
- Virginia Tech-Center for Biostatistics and Health Data Sciences, Roanoke, VA, USA
| | - Debra H. Bernat
- The George Washington University Milken Institute School of Public Health, Department of Epidemiology, Washington, DC, USA
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Kim MM, Curtin GM. Assessing the evidence on the differential impact of menthol versus non-menthol cigarette use on smoking cessation in the U.S. population: a systematic review and meta-analysis. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2021; 16:61. [PMID: 34380503 PMCID: PMC8359586 DOI: 10.1186/s13011-021-00397-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 12/12/2022]
Abstract
Background The potential impact of menthol versus non-menthol cigarette use on smoking behaviors is an intensely scrutinized topic in the public health arena. To date, several general literature reviews have been conducted, but findings and conclusions have been discordant. This systematic review followed PRISMA guidelines to examine the Key Question, “Does menthol cigarette use have a differential impact on smoking cessation compared with non-menthol cigarette use?” Methods Six databases—Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, MEDLINE, Embase and PsycInfo—were queried from inception to June 12, 2020. Articles comparing menthol versus non-menthol cigarette smokers in terms of at least one predefined smoking cessation outcome were included. Risk of bias was assessed using the Agency for Healthcare Research and Quality Evidence-Based Practice Center approach. A random-effects model utilizing the DerSimonian and Laird method to pool adjusted odds ratio was applied. Variations among pooled studies were assessed using Cochran’s Q statistic, and heterogeneity was quantified using the inconsistency index (I2). Results Forty-three demographically adjusted studies (22 rated “good”, 20 rated “fair”, and one study rated “poor” individual study quality) comparing menthol and non-menthol smokers were qualitatively synthesized across the following measures (study count; strength of evidence): duration of abstinence (2; low); quit attempts (15; insufficient); rate of abstinence/quitting (29; moderate); change in smoking quantity/frequency (5; insufficient); and, return to smoking/relapse (2; insufficient). Overall, the qualitative synthesis failed to show a consistent trend for an association between menthol cigarette use and smoking cessation across outcomes. Meta-analyses found no difference between menthol and non-menthol cigarette use and either quit attempts or abstinence. Conclusions Given the lack of consistency or statistical significance in the findings—combined with a “low” overall strength of evidence grade, based on deficiencies of indirectness and inconsistency—no consistent or significant associations between menthol cigarette use and smoking cessation were identified. Recommendations for future studies include increased focus on providing longitudinal, adjusted data collected from standardized outcome measures of cessation to better inform long-term smoking cessation and menthol cigarette use. Such improvements should also be further considered in more methodologically rigorous systematic reviews characterized by objectivity, comprehensiveness, and transparency with the ultimate objective of better informing public health and policy decision making. Supplementary Information The online version contains supplementary material available at 10.1186/s13011-021-00397-4.
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Affiliation(s)
- Mimi M Kim
- Scientific & Regulatory Affairs, RAI Services Company, 401 North Main Street, Winston-Salem, NC, 27101, USA.
| | - Geoffrey M Curtin
- Scientific & Regulatory Affairs, RAI Services Company, 401 North Main Street, Winston-Salem, NC, 27101, USA
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Mills SD, Hao Y, Ribisl KM, Wiesen CA, Hassmiller Lich K. The Relationship Between Menthol Cigarette Use, Smoking Cessation, and Relapse: Findings From Waves 1 to 4 of the Population Assessment of Tobacco and Health Study. Nicotine Tob Res 2021; 23:966-975. [PMID: 33063826 PMCID: PMC8248945 DOI: 10.1093/ntr/ntaa212] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Some, but not all, studies suggest that menthol cigarette smokers have more difficulty quitting than non-menthol cigarette smokers. Inconsistent findings may be a result of differences in smoker characteristics (eg, daily vs. non-daily smokers) across studies. This study examines the relationship between menthol cigarette use, cessation, and relapse in a longitudinal, nationally representative study of tobacco use in the United States. AIMS AND METHODS Data come from four waves of the Population Assessment of Tobacco and Health Study. Waves 1-4 were conducted approximately annually from September 2013 to January 2018. Generalized estimating equation models were used to prospectively examine the relationship between menthol cigarette use, cessation, and relapse in non-daily and daily adult (18+) smokers. Cessation was defined as smokers who had not used cigarettes within the past 30 days at their subsequent assessment. Relapse was defined as cessation followed by past 30-day smoking in the next assessment. RESULTS Among daily smokers (n = 13 710), 4.0% and 5.3% of menthol and non-menthol smokers quit after 1 year, respectively. In an adjusted model, menthol smokers were less likely to quit compared with non-menthol smokers (odds ratio [OR] = 0.76 [0.63, 0.91]). When the sample was stratified by race/ethnicity, African American (OR = 0.47 [0.24, 0.91]) and White (OR = 0.78 [0.63, 0.97]) daily menthol users were less likely to have quit. Among non-daily smokers (n = 3608), there were no significant differences in quit rates. Among daily and non-daily former smokers, there were also no differences in relapse rates between menthol and non-menthol smokers. CONCLUSIONS Menthol cigarette use is associated with lower odds of cessation. IMPLICATIONS Findings from this study suggest that menthol cigarette use is associated with lower odds of cessation, but not relapse. Removing menthol cigarettes from the market may improve cessation rates.
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Affiliation(s)
- Sarah D Mills
- Department of Health Behavior, Gillings School of Global
Public Health, University of North Carolina, Chapel Hill,
Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of
North Carolina, Chapel Hill, Chapel Hill,
NC
| | - Yajing Hao
- Department of Biostatistics, Gillings School of Global
Public Health, University of North Carolina, Chapel Hill,
Chapel Hill, NC
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global
Public Health, University of North Carolina, Chapel Hill,
Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of
North Carolina, Chapel Hill, Chapel Hill,
NC
| | | | - Kristen Hassmiller Lich
- Department of Health Policy and Management, University of
North Carolina, Chapel Hill, Chapel Hill,
NC
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Nollen NL, Ahluwalia JS, Sanderson Cox L, Okuyemi K, Lawrence D, Samuels L, Benowitz NL. Assessment of Racial Differences in Pharmacotherapy Efficacy for Smoking Cessation: Secondary Analysis of the EAGLES Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2032053. [PMID: 33464316 PMCID: PMC7816102 DOI: 10.1001/jamanetworkopen.2020.32053] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/04/2020] [Indexed: 01/02/2023] Open
Abstract
Importance Understanding Black vs White differences in pharmacotherapy efficacy and the underlying reasons is critically important to reducing tobacco-related health disparities. Objective To compare pharmacotherapy efficacy and examine variables to explain Black vs White differences in smoking abstinence. Design, Setting, and Participants This study is a secondary analysis of the Evaluating Adverse Events in a Global Smoking Cessation Study (EAGLES) double-blind, placebo-controlled, randomized clinical trial, which took place at clinical trial centers, academic centers, and outpatient clinics in 29 states in the US. US Black and White smokers who smoked 10 or more cigarettes per day with and without psychiatric comorbidity were enrolled between November 2011 and January 2015. Data analysis was performed from July 2019 to January 2020. Interventions Participants were randomized (1:1:1:1) in a double-blind, triple-dummy, placebo- and active-controlled (nicotine patch) trial of varenicline and bupropion for 12 weeks with follow-up through week 24. Main Outcomes and Measures Biochemically verified continuous cigarette abstinence rate (CAR) from weeks 9 to 24. Baseline, postbaseline treatment, and safety characteristics were examined as variables to explain race differences in abstinence. Results Of the 1065 Black smokers enrolled, 255 were randomized to receive varenicline, 259 received bupropion, 286 received nicotine replacement therapy (NRT [ie, nicotine patch]), and 265 received placebo. Among the 3044 White smokers enrolled, 778 were randomized to receive varenicline, 769 received bupropion, 738 received NRT, and 759 received placebo. Participants were predominantly female (614 Black [57.7%] and 1786 White [58.7%] women) and heavy smokers (mean [SD] cigarettes per day, 18.2 [7.9] for Black and 20.0 [7.5] for White smokers), with a mean (SD) age of 47.2 (11.2) years for Black and 46.5 (12.7) years for White participants. Treatment and race were associated with CAR for weeks 9 to 24. The CAR was 4.9% lower for Black vs White participants (odds ratio [OR], 0.53; 95% CI, 0.41-0.69; P < .001); differences were found across all treatments. Pooling psychiatric and nonpsychiatric cohorts, varenicline (OR, 2.63; 95% CI, 1.90-3.63; P < .001), bupropion (OR, 1.75; 95% CI, 1.25-2.46; P = .001), and NRT (OR, 1.52; 95% CI, 1.07-2.16; P = .02) had greater efficacy than placebo for White participants. Only varenicline (OR, 2.63; 95% CI, 1.26-5.48; P = .01) had greater efficacy than placebo for Black participants. Baseline, postbaseline, and safety characteristics differed by race, but these variables did not eliminate the association of race with CAR. Black participants had 49% reduced odds of CAR for weeks 9 to 24 compared with White participants in the adjusted model (OR, 0.51; 95% CI, 0.39-0.66; P < .001). Conclusions and Relevance Black and White smokers achieved the highest rate of abstinence while taking varenicline, suggesting that it is the best first-line therapy for these groups. However, Black smokers were less responsive to all therapies, including placebo. Understanding variables (eg, socioeconomic or biological) beyond those may lead to improved treatment outcomes for Black smokers. Trial Registration ClinicalTrials.gov Identifier: NCT01456936.
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Affiliation(s)
- Nicole L. Nollen
- Department of Population Health, University of Kansas School of Medicine, Kansas City
| | - Jasjit S. Ahluwalia
- Alpert Medical School, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island
- Alpert Medical School, Department of Medicine, Brown University School of Public Health, Providence, Rhode Island
| | - Lisa Sanderson Cox
- Department of Population Health, University of Kansas School of Medicine, Kansas City
| | - Kolawole Okuyemi
- Department of Family and Preventive Medicine, The University of Utah School of Medicine, Salt Lake City
| | | | | | - Neal L. Benowitz
- Department of Medicine, Bioengineering, and Therapeutic Sciences, University of California, San Francisco
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Kingsbury JH, Mehrotra K, D'Silva J, Nichols E, Tripp R, Johnson D. Perceptions of Menthol Cigarettes and Reasons for Unsuccessful Quits in an African American Community Sample. J Immigr Minor Health 2020; 23:137-144. [PMID: 32451691 DOI: 10.1007/s10903-020-01028-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study aimed to better understand African Americans' perceptions of menthol tobacco and reasons for unsuccessful quit attempts among menthol smokers. A cross-sectional survey of 407 U.S.-born African American adults from Minnesota assessed menthol perceptions and experiences trying to quit menthol cigarettes. A majority of the sample (59%) was either unsure of the relative harm of menthol cigarettes or perceived that menthol cigarettes are less harmful than non-menthol cigarettes. Menthol smokers were more likely than nonsmokers to perceive that menthol makes it easier to start smoking and harder to quit, and that menthol cigarettes are marketed to African Americans more than other groups (ps < .05). Nearly half (45%) of menthol smokers who reported a failed quit attempt identified cravings as a reason why they were unsuccessful. Media campaigns and educational interventions that highlight the dangers of menthol and promote cessation resources are needed to help reduce the pernicious effects of menthol in the African American community.
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Affiliation(s)
- John H Kingsbury
- Minnesota Department of Health, Office of Statewide Health Improvement Initiatives, 85 7th Pl E, Saint Paul, MN, USA.
| | - Komal Mehrotra
- Department of Public Health, Hennepin County, Minneapolis, MN, USA
| | | | | | - Ruth Tripp
- Department of Public Health, Hennepin County, Minneapolis, MN, USA
| | - David Johnson
- Department of Public Health, Hennepin County, Minneapolis, MN, USA
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Frost-Pineda K, Heck JD, Curtin GM. Measures of dependence in menthol and nonmenthol smokers - A comprehensive narrative review. J Addict Dis 2020; 38:122-142. [PMID: 32286199 DOI: 10.1080/10550887.2020.1727286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Introduction. More than a decade ago, concerns were raised that menthol in cigarettes might enhance addiction to smoking. This article provides a comprehensive review of published studies examining cigarette dependence among menthol and nonmenthol smokers. The purpose of the review is to evaluate the scientific evidence to determine if menthol increases cigarette dependence. Materials and Methods. The published literature was searched in 2019 for studies that provide evidence on cigarette dependence among menthol compared to nonmenthol smokers. Included in this review are published studies that compare menthol and nonmenthol smokers based on widely accepted and validated measures of dependence, or other established predictors of dependence (age of smoking initiation [first cigarette]/age of progression [regular/daily smoking]) and indicators of dependence (smoking frequency, cigarettes smoked per day, time to first cigarette after waking, night waking to smoke, smoking duration). Results and Conclusion. Based on a review of the available studies, including those with adjusted results and large representative samples, reliable and consistent empirical evidence supports a conclusion that menthol smokers are not more dependent than nonmenthol smokers and thus menthol in cigarettes does not increase dependence.
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Smith PH, Assefa B, Kainth S, Salas-Ramirez KY, McKee SA, Giovino GA. Use of Mentholated Cigarettes and Likelihood of Smoking Cessation in the United States: A Meta-Analysis. Nicotine Tob Res 2020; 22:307-316. [PMID: 31204787 PMCID: PMC7161928 DOI: 10.1093/ntr/ntz067] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/26/2019] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Previous qualitative reviews have summarized evidence of an association between menthol cigarette use and likelihood of smoking cessation. The objective of this meta-analysis was to provide a quantitative summary of effect sizes, their variability, and factors related to the variability in effect size for the association between menthol use and likelihood of smoking cessation. METHODS We systematically searched Medline, PsycINFO, and Embase for prospective and cross-sectional studies of the association between menthol use and smoking cessation. We analyzed data with random effects meta-analyses and meta-regression. RESULTS Our review identified 22 reports from 19 studies of the association between menthol use and cessation. All identified study samples included only US smokers, with one exception that included both Canadian and US smokers. Our overall model did not demonstrate a significant association between menthol use and cessation; however, menthol users were significantly less likely to quit among blacks/African American smokers (odds ratio = 0.88). CONCLUSIONS Among blacks/African Americans predominantly in the US menthol users have approximately 12% lower odds of smoking cessation compared to non-menthol users. This difference is likely the result of the tobacco industry's ongoing marketing influence on the black/African American Community, suggesting that a menthol ban may have a unique public health benefit for black/African American smokers by encouraging quitting behavior. IMPLICATIONS This study adds a quantitative summary of the association between menthol cigarette use and smoking cessation in the United States. Findings of an association with lower likelihood of cessation among black/African American smokers, likely resulting from the tobacco industry's marketing influence, support the ban of menthol flavoring as part of a comprehensive tobacco control effort to increase cessation among black/African American smokers.
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Affiliation(s)
- Philip H Smith
- Department of Kinesiology and Health, Miami University, Oxford, OH
- City University of New York School of Medicine, New York, NY
| | - Biruktawit Assefa
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | | | | | - Sherry A McKee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
| | - Gary A Giovino
- Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY
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Ruglass LM, Root JC, Dambreville N, Shevorykin A, Haque N, Sun V, Sheffer CE, Melara RD. Smoking policies in the home have less influence on cigarettes per day and nicotine dependence level among African American than White smokers: A cross-sectional analysis. J Natl Med Assoc 2019; 111:606-615. [PMID: 31375277 PMCID: PMC6925645 DOI: 10.1016/j.jnma.2019.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/30/2019] [Accepted: 07/09/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND African American smokers suffer disproportionately from tobacco-related disease caused, in part, by lower rates of smoking cessation. We examined whether smoke-free home policies and delay discounting were differentially associated with cigarettes smoked per day (CPD) and nicotine dependence (ND) among African Americans and Whites. METHODS Secondary data analysis was conducted using data from 65 African American (n = 40) and White (n = 25) smokers who completed measures of CPD, ND, tobacco craving, stress, depression, home smoking policy, and delay discounting. RESULTS A significant interaction was found between race and home smoking policy on CPD (B = -11.21, p = 0.002) and ND (B = -3.42, p = 0.004). Smoke-free policies in the home were associated with fewer CPD and lower ND levels among Whites, but not among African Americans. Whites who allowed smoking in their homes had significantly greater mean CPD and higher mean ND than their counterparts who did not allow smoking in the home. Among African American smokers, there were no differences in CPD and ND among those who allowed smoking in their home versus those who did not. CONCLUSIONS The findings extend the scientific literature by suggesting that a malleable environmental factor (home smoking policy) commonly associated with cessation among Whites does not have the same influence on cessation among African American.
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Affiliation(s)
- Lesia M Ruglass
- Department of Psychology, The City College of New York, CUNY, USA.
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Naomi Dambreville
- Department of Psychology, The City College of New York and the Graduate Center, CUNY, USA
| | - Alina Shevorykin
- Department of Psychology and Mental Health Counseling, Pace University, USA
| | - Noshin Haque
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Vicki Sun
- Sophie Davis School of Biomedical Education, CUNY School of Medicine, USA
| | | | - Robert D Melara
- Department of Psychology, The City College of New York, CUNY, USA
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Fowler CD, Gipson CD, Kleykamp BA, Rupprecht LE, Harrell PT, Rees VW, Gould TJ, Oliver J, Bagdas D, Damaj MI, Schmidt HD, Duncan A, De Biasi M. Basic Science and Public Policy: Informed Regulation for Nicotine and Tobacco Products. Nicotine Tob Res 2019; 20:789-799. [PMID: 29065200 DOI: 10.1093/ntr/ntx175] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 08/01/2017] [Indexed: 12/25/2022]
Abstract
Introduction Scientific discoveries over the past few decades have provided significant insight into the abuse liability and negative health consequences associated with tobacco and nicotine-containing products. While many of these advances have led to the development of policies and laws that regulate access to and formulations of these products, further research is critical to guide future regulatory efforts, especially as novel nicotine-containing products are introduced and selectively marketed to vulnerable populations. Discussion In this narrative review, we provide an overview of the scientific findings that have impacted regulatory policy and discuss considerations for further translation of science into policy decisions. We propose that open, bidirectional communication between scientists and policy makers is essential to develop transformative preventive- and intervention-focused policies and programs to reduce appeal, abuse liability, and toxicity of the products. Conclusions Through these types of interactions, collaborative efforts to inform and modify policy have the potential to significantly decrease the use of tobacco and alternative nicotine products and thus enhance health outcomes for individuals. Implications This work addresses current topics in the nicotine and tobacco research field to emphasize the importance of basic science research and provide examples of how it can be utilized to inform public policy. In addition to relaying current thoughts on the topic from experts in the field, the article encourages continued efforts and communication between basic scientists and policy officials.
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Affiliation(s)
- Christie D Fowler
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA
| | | | | | - Laura E Rupprecht
- Center for Neuroscience at the University of Pittsburgh, Pittsburgh, PA
| | - Paul T Harrell
- Division of Community Health & Research, Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA
| | - Vaughan W Rees
- Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Thomas J Gould
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA
| | - Jason Oliver
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC
| | - Deniz Bagdas
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, VA
| | - Heath D Schmidt
- Department of Biobehavioral Health Sciences, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Alexander Duncan
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mariella De Biasi
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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Weinberger AH, Giovenco DP, Zhu J, Lee J, Kashan RS, Goodwin RD. Racial/ethnic differences in daily, nondaily, and menthol cigarette use and smoking quit ratios in the United States: 2002 to 2016. Prev Med 2019; 125:32-39. [PMID: 31004620 DOI: 10.1016/j.ypmed.2019.04.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/01/2019] [Accepted: 04/14/2019] [Indexed: 10/27/2022]
Abstract
In the United States (US), racial/ethnic groups differ in cigarette smoking behaviors. We examined changes in cigarette prevalence and quit ratios over 15 years by racial/ethnic group (Non-Hispanic (NH) White, NH Black, Hispanic, NH Other). Data were drawn from the 2002-2016 National Survey on Drug Use and Health (NSDUH) public use data files and analyzed in 2018. Linear time trends of the prevalence of daily, nondaily, and menthol cigarette use and quit ratios (i.e., proportion of former smokers among lifetime smokers) were assessed using logistic regression models. 19.35% of NH White persons were daily smokers in 2016; this prevalence was significantly higher than all other groups (NH Black 10.99%, Hispanic 6.81%, NH Other 9.10%). Menthol use was significantly more common among NH Black individuals than all other groups in every year from 2002 to 2016 (2016: NH Black 23.38%, NH White 14.52%, Hispanic 10.49%, NH Other 8.97%). From 2002 to 2016, daily and nondaily smoking decreased significantly among all groups. The rate of decline of nondaily smoking was more rapid among Hispanic than NH White individuals while the rate of menthol smoking decline was more rapid among NH White than among Hispanic individuals. The quit ratio did not change significantly from 2002 to 2016 among NH Black individuals (31% to 35%) in contrast to a significant increase among NH White (2002, 45%; 2016, 50%) and Hispanic (2002, 33%; 2016, 41%) individuals. Further progress in tobacco control for vulnerable groups may need to include innovative strategies to address these concerning trends.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Daniel P Giovenco
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | - Jiaqi Zhu
- Institute for Implementation Science in Population Health, The City University of New York, New York, NY, USA.
| | - Joun Lee
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Clinical Psychology, Teachers College, Columbia University, New York, NY, USA.
| | - Rachel S Kashan
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA.
| | - Renee D Goodwin
- Institute for Implementation Science in Population Health, The City University of New York, New York, NY, USA; Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, The City University of New York, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
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14
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Lindson N, Thompson TP, Ferrey A, Lambert JD, Aveyard P. Motivational interviewing for smoking cessation. Cochrane Database Syst Rev 2019; 7:CD006936. [PMID: 31425622 PMCID: PMC6699669 DOI: 10.1002/14651858.cd006936.pub4] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Motivational Interviewing (MI) is a directive patient-centred style of counselling, designed to help people to explore and resolve ambivalence about behaviour change. It was developed as a treatment for alcohol abuse, but may help people to a make a successful attempt to stop smoking. OBJECTIVES To evaluate the efficacy of MI for smoking cessation compared with no treatment, in addition to another form of smoking cessation treatment, and compared with other types of smoking cessation treatment. We also investigated whether more intensive MI is more effective than less intensive MI for smoking cessation. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register for studies using the term motivat* NEAR2 (interview* OR enhanc* OR session* OR counsel* OR practi* OR behav*) in the title or abstract, or motivation* as a keyword. We also searched trial registries to identify unpublished studies. Date of the most recent search: August 2018. SELECTION CRITERIA Randomised controlled trials in which MI or its variants were offered to smokers to assist smoking cessation. We excluded trials that did not assess cessation as an outcome, with follow-up less than six months, and with additional non-MI intervention components not matched between arms. We excluded trials in pregnant women as these are covered elsewhere. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods. Smoking cessation was measured after at least six months, using the most rigorous definition available, on an intention-to-treat basis. We calculated risk ratios (RR) and 95% confidence intervals (CI) for smoking cessation for each study, where possible. We grouped eligible studies according to the type of comparison. We carried out meta-analyses where appropriate, using Mantel-Haenszel random-effects models. We extracted data on mental health outcomes and quality of life and summarised these narratively. MAIN RESULTS We identified 37 eligible studies involving over 15,000 participants who smoked tobacco. The majority of studies recruited participants with particular characteristics, often from groups of people who are less likely to seek support to stop smoking than the general population. Although a few studies recruited participants who intended to stop smoking soon or had no intentions to quit, most recruited a population without regard to their intention to quit. MI was conducted in one to 12 sessions, with the total duration of MI ranging from five to 315 minutes across studies. We judged four of the 37 studies to be at low risk of bias, and 11 to be at high risk, but restricting the analysis only to those studies at low or unclear risk did not significantly alter results, apart from in one case - our analysis comparing higher to lower intensity MI.We found low-certainty evidence, limited by risk of bias and imprecision, comparing the effect of MI to no treatment for smoking cessation (RR = 0.84, 95% CI 0.63 to 1.12; I2 = 0%; adjusted N = 684). One study was excluded from this analysis as the participants recruited (incarcerated men) were not comparable to the other participants included in the analysis, resulting in substantial statistical heterogeneity when all studies were pooled (I2 = 87%). Enhancing existing smoking cessation support with additional MI, compared with existing support alone, gave an RR of 1.07 (95% CI 0.85 to 1.36; adjusted N = 4167; I2 = 47%), and MI compared with other forms of smoking cessation support gave an RR of 1.24 (95% CI 0.91 to 1.69; I2 = 54%; N = 5192). We judged both of these estimates to be of low certainty due to heterogeneity and imprecision. Low-certainty evidence detected a benefit of higher intensity MI when compared with lower intensity MI (RR 1.23, 95% CI 1.11 to 1.37; adjusted N = 5620; I2 = 0%). The evidence was limited because three of the five studies in this comparison were at risk of bias. Excluding them gave an RR of 1.00 (95% CI 0.65 to 1.54; I2 = n/a; N = 482), changing the interpretation of the results.Mental health and quality of life outcomes were reported in only one study, providing little evidence on whether MI improves mental well-being. AUTHORS' CONCLUSIONS There is insufficient evidence to show whether or not MI helps people to stop smoking compared with no intervention, as an addition to other types of behavioural support for smoking cessation, or compared with other types of behavioural support for smoking cessation. It is also unclear whether more intensive MI is more effective than less intensive MI. All estimates of treatment effect were of low certainty because of concerns about bias in the trials, imprecision and inconsistency. Consequently, future trials are likely to change these conclusions. There is almost no evidence on whether MI for smoking cessation improves mental well-being.
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Affiliation(s)
- Nicola Lindson
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
| | - Tom P Thompson
- University of PlymouthFaculty of Medicine and DentistryPlymouthDevonUK
| | - Anne Ferrey
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
| | | | - Paul Aveyard
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordOxfordshireUKOX2 6GG
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15
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Jones MR, Joshu CE, Navas-Acien A, Platz EA. Racial/Ethnic Differences in Duration of Smoking Among Former Smokers in the National Health and Nutrition Examination Surveys. Nicotine Tob Res 2019; 20:303-311. [PMID: 28003510 DOI: 10.1093/ntr/ntw326] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 12/10/2016] [Indexed: 01/22/2023]
Abstract
Introduction The burden of tobacco-related disease is not uniformly distributed across racial/ethnic groups. Differences in smoking duration by race/ethnicity may contribute to this disparity. Previous studies have examined racial/ethnic differences in smoking duration among ever smokers (former and current smokers combined). It is unknown if racial/ethnic differences in smoking duration are evident among quitters. This study examined racial/ethnic differences in duration of smoking among former smokers in the United States. Methods We studied 6030 white, black, and Mexican-American former smokers (3647 men and 2383 women) aged 20-79 years who participated in the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2012. Mean differences in smoking duration by race/ethnicity were estimated using linear regression models. Results After adjustment for demographics, age at smoking initiation and smoking intensity, compared to white men, black men smoked for 2.3 (95% confidence interval [CI]: 1.3, 3.3) years longer before quitting and Mexican-American men for 0.2 (95% CI: -1.6, 1.2) years less before quitting. Compared to white women, black women smoked for 1.9 (95% CI: 0.7, 3.0) years longer before quitting and Mexican-American women for 0.9 (95% CI: -2.4, 0.5) years less before quitting. Conclusions In a representative sample of US adults, black former smokers continued smoking for longer periods before quitting compared to white former smokers. These findings support the need for smoking cessation efforts that address racial/ethnic differences in smoking behaviors. The longer time to quit among black former smokers should be investigated as an explanation for racial/ethnic disparities in smoking-associated diseases. Implications In a representative sample of US adults that successfully quit smoking, the timing of smoking cessation differed by race/ethnicity with blacks smoking for longer periods before quitting compared to whites. Racial/ethnic differences in duration of smoking among former smokers differed by participant age and age at smoking initiation. These findings support the need for smoking cessation efforts that address racial/ethnic differences in smoking behaviors.
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Affiliation(s)
- Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD
| | - Ana Navas-Acien
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Department of Environmental Health Sciences, Columbia University, Mailman School of Public Health, New York, NY
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.,Department of Urology and the James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD
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16
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Hartmann‐Boyce J, Hong B, Livingstone‐Banks J, Wheat H, Fanshawe TR. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database Syst Rev 2019; 6:CD009670. [PMID: 31166007 PMCID: PMC6549450 DOI: 10.1002/14651858.cd009670.pub4] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Pharmacotherapies for smoking cessation increase the likelihood of achieving abstinence in a quit attempt. It is plausible that providing support, or, if support is offered, offering more intensive support or support including particular components may increase abstinence further. OBJECTIVES To evaluate the effect of adding or increasing the intensity of behavioural support for people using smoking cessation medications, and to assess whether there are different effects depending on the type of pharmacotherapy, or the amount of support in each condition. We also looked at studies which directly compare behavioural interventions matched for contact time, where pharmacotherapy is provided to both groups (e.g. tests of different components or approaches to behavioural support as an adjunct to pharmacotherapy). SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register, clinicaltrials.gov, and the ICTRP in June 2018 for records with any mention of pharmacotherapy, including any type of nicotine replacement therapy (NRT), bupropion, nortriptyline or varenicline, that evaluated the addition of personal support or compared two or more intensities of behavioural support. SELECTION CRITERIA Randomised or quasi-randomised controlled trials in which all participants received pharmacotherapy for smoking cessation and conditions differed by the amount or type of behavioural support. The intervention condition had to involve person-to-person contact (defined as face-to-face or telephone). The control condition could receive less intensive personal contact, a different type of personal contact, written information, or no behavioural support at all. We excluded trials recruiting only pregnant women and trials which did not set out to assess smoking cessation at six months or longer. DATA COLLECTION AND ANALYSIS For this update, screening and data extraction followed standard Cochrane methods. The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically-validated rates, if available. We calculated the risk ratio (RR) and 95% confidence interval (CI) for each study. Where appropriate, we performed meta-analysis using a random-effects model. MAIN RESULTS Eighty-three studies, 36 of which were new to this update, met the inclusion criteria, representing 29,536 participants. Overall, we judged 16 studies to be at low risk of bias and 21 studies to be at high risk of bias. All other studies were judged to be at unclear risk of bias. Results were not sensitive to the exclusion of studies at high risk of bias. We pooled all studies comparing more versus less support in the main analysis. Findings demonstrated a benefit of behavioural support in addition to pharmacotherapy. When all studies of additional behavioural therapy were pooled, there was evidence of a statistically significant benefit from additional support (RR 1.15, 95% CI 1.08 to 1.22, I² = 8%, 65 studies, n = 23,331) for abstinence at longest follow-up, and this effect was not different when we compared subgroups by type of pharmacotherapy or intensity of contact. This effect was similar in the subgroup of eight studies in which the control group received no behavioural support (RR 1.20, 95% CI 1.02 to 1.43, I² = 20%, n = 4,018). Seventeen studies compared interventions matched for contact time but that differed in terms of the behavioural components or approaches employed. Of the 15 comparisons, all had small numbers of participants and events. Only one detected a statistically significant effect, favouring a health education approach (which the authors described as standard counselling containing information and advice) over motivational interviewing approach (RR 0.56, 95% CI 0.33 to 0.94, n = 378). AUTHORS' CONCLUSIONS There is high-certainty evidence that providing behavioural support in person or via telephone for people using pharmacotherapy to stop smoking increases quit rates. Increasing the amount of behavioural support is likely to increase the chance of success by about 10% to 20%, based on a pooled estimate from 65 trials. Subgroup analysis suggests that the incremental benefit from more support is similar over a range of levels of baseline support. More research is needed to assess the effectiveness of specific components that comprise behavioural support.
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Affiliation(s)
- Jamie Hartmann‐Boyce
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | - Bosun Hong
- Birmingham Dental HospitalOral Surgery Department5 Mill Pool WayBirminghamUKB5 7EG
| | - Jonathan Livingstone‐Banks
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | - Hannah Wheat
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | - Thomas R Fanshawe
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
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17
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St Helen G, Benowitz NL, Ahluwalia JS, Tyndale RF, Addo N, Gregorich SE, Pérez-Stable EJ, Cox LS. Black Light Smokers: How Nicotine Intake and Carcinogen Exposure Differ Across Various Biobehavioral Factors. J Natl Med Assoc 2019; 111:509-520. [PMID: 31084916 DOI: 10.1016/j.jnma.2019.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/07/2019] [Accepted: 04/11/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The study objective was to identify biobehavioral variables associated with greater intake of nicotine and a tobacco carcinogen among Black light smokers who smoke 1 to 10 cigarettes per day (CPD). METHODS We analyzed baseline data collected from 426 Black light smokers enrolled in Kick It at Swope III (KIS III), a smoking cessation trial for Black smokers. We examined differences in concentrations of tobacco biomarkers, including urinary total nicotine equivalents (TNE) and total 4-(methylnitrosamino)-1-(3)pyridyl-1-butanonol (NNAL; a human carcinogen), across gender, age, plasma nicotine metabolite ratio (NMR), CPD, and measures of tobacco dependence, including time to first cigarette (TFC), using ANOVA. RESULTS Tobacco biomarker levels were significantly higher among those who smoked more CPD (6-10 vs 1-5 CPD) and those with greater reported physical dependence on tobacco. Concurrently, those who smoked 1-5 CPD smoked each cigarette more intensely than those who smoked 6-10 CPD. While we found no gender differences overall, among those who smoked 1-5 CPD, women had higher NNAL levels compared to men. The rate of nicotine metabolism, measured by the nicotine metabolite ratio, was not significantly related to TNE or NNAL levels. CONCLUSION Among Black Light smokers, higher cigarette consumption and greater physical dependence-but not rate of nicotine metabolism, menthol use, or socioeconomic status-were associated with greater toxicant exposure and thus a likely increased risk of tobacco-related diseases. The lack of data on light smokers, and specifically on Blacks, make this observation important given the disproportionate burden of lung cancer in this population.
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Affiliation(s)
- Gideon St Helen
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA; Center for Tobacco Control Research and Education (CTCRE), University of California, San Francisco, CA, USA.
| | - Neal L Benowitz
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA; Center for Tobacco Control Research and Education (CTCRE), University of California, San Francisco, CA, USA; Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | - Jasjit S Ahluwalia
- Departments of Behavioral and Social Sciences and Medicine, Brown University School of Public Health and Alpert School of Medicine, Providence, RI, USA
| | - Rachel F Tyndale
- Campbell Family Mental Health Research Institute and Addictions Division, Centre for Addiction and Mental Health (CAMH), Department of Pharmacology and Toxicology, Department of Psychiatry, University of Toronto, ON, Canada
| | - Newton Addo
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine, Zuckerberg San Francisco General Hospital, University of California, San Francisco, CA, USA
| | - Steven E Gregorich
- Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Eliseo J Pérez-Stable
- Division of Intramural Research, National Heart, Lung and Blood Institute and Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, MD, USA
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, KS, USA
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18
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Fowler CD, Turner JR, Imad Damaj M. Molecular Mechanisms Associated with Nicotine Pharmacology and Dependence. Handb Exp Pharmacol 2019; 258:373-393. [PMID: 31267166 DOI: 10.1007/164_2019_252] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Tobacco dependence is a leading cause of preventable disease and death worldwide. Nicotine, the main psychoactive component in tobacco cigarettes, has also been garnering increased popularity in its vaporized form, as derived from e-cigarette devices. Thus, an understanding of the molecular mechanisms underlying nicotine pharmacology and dependence is required to ascertain novel approaches to treat drug dependence. In this chapter, we review the field's current understanding of nicotine's actions in the brain, the neurocircuitry underlying drug dependence, factors that modulate the function of nicotinic acetylcholine receptors, and the role of specific genes in mitigating the vulnerability to develop nicotine dependence. In addition to nicotine's direct actions in the brain, other constituents in nicotine and tobacco products have also been found to alter drug use, and thus, evidence is provided to highlight this issue. Finally, currently available pharmacotherapeutic strategies are discussed, along with an outlook for future therapeutic directions to achieve to the goal of long-term nicotine cessation.
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Affiliation(s)
- Christie D Fowler
- Department of Neurobiology and Behavior, University of California Irvine, Irvine, CA, USA
| | - Jill R Turner
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Kentucky, Lexington, KY, USA
| | - M Imad Damaj
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA. .,Translational Research Initiative for Pain and Neuropathy at VCU, Richmond, VA, USA.
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Weinberger AH, Pacek LR, Giovenco D, Galea S, Zvolensky MJ, Gbedemah M, Goodwin RD. Cigarette Use Among Individuals with Alcohol Use Disorders in the United States, 2002 to 2016: Trends Overall and by Race/Ethnicity. Alcohol Clin Exp Res 2018; 43:79-90. [PMID: 30408209 DOI: 10.1111/acer.13922] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 10/12/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Individuals with alcohol use disorders (AUDs) who smoke cigarettes experience greater health risks than those using either substance alone. Further, disparities exist in AUDs and smoking by race/ethnicity. Although smoking has declined in the general population, it is not known whether the smoking prevalence has changed over time for individuals with AUDs. The current study used representative U.S. data to estimate the prevalence of current cigarette use from 2002 to 2016 by AUD status and severity overall and by race/ethnicity. METHODS Data were drawn from the National Survey on Drug Use and Health, an annual cross-sectional study of U.S. individuals, from 2002 to 2016 (total analytic sample n = 837,326). Cigarette smoking prevalence was calculated annually among those with and without past-year AUD and by AUD severity level (mild, moderate, severe AUD). Time trends in smoking prevalence by AUD status and severity were tested using logistic regression for the overall sample and significant interactions were subsequently stratified by race/ethnicity (non-Hispanic [NH] White, NH Black, Hispanic, NH Other). RESULTS Cigarette use was persistently over twice as common among those with AUDs compared to without AUDs (2016: 37.84% vs. 16.29%). Cigarette use was also more common among those at each level of AUD severity criteria (2016: mild AUD 34.59%; moderate AUD 35.35%; severe AUD 52.23%). Approximately half of NH Black respondents with AUDs, and three-quarters of NH Black respondents with severe AUDs, reported smoking in 2016. The prevalence of smoking decreased significantly over time among respondents with and without AUDs; however, there were differences by race. There was no decline in smoking prevalence among NH Black respondents with AUDs over time in contrast to a significant decrease for every other racial/ethnic group with and without AUDs. CONCLUSIONS Individuals with AUDs may need additional resources and interventions to quit smoking, especially NH Black individuals.
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Affiliation(s)
- Andrea H Weinberger
- Ferkauf Graduate School of Psychology , Yeshiva University, Bronx, New York.,Department of Epidemiology & Population Health , Albert Einstein College of Medicine, Bronx, New York
| | - Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences , Duke University School of Medicine, Durham, North Carolina
| | - Daniel Giovenco
- Department of Sociomedical Sciences , Mailman School of Public Health, Columbia University, New York, New York
| | - Sandro Galea
- Department of Epidemiology , Boston University School of Public Health, Boston, Massachusetts
| | | | - Misato Gbedemah
- Department of Epidemiology and Biostatistics , Graduate School of Public Health and Health Policy, The City University of New York, New York, New York.,Institute for Implementation Science in Population Health , The City University of New York, New York, New York
| | - Renee D Goodwin
- Department of Epidemiology and Biostatistics , Graduate School of Public Health and Health Policy, The City University of New York, New York, New York.,Institute for Implementation Science in Population Health , The City University of New York, New York, New York.,Department of Epidemiology , Mailman School of Public Health, Columbia University, New York, New York
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20
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Effect of overnight smoking abstinence on a marker for microglial activation: a [ 11C]DAA1106 positron emission tomography study. Psychopharmacology (Berl) 2018; 235:3525-3534. [PMID: 30343364 PMCID: PMC6497451 DOI: 10.1007/s00213-018-5077-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 10/10/2018] [Indexed: 12/27/2022]
Abstract
RATIONALE Microglia are the main immune cells in the central nervous system and participate in neuroinflammation. When activated, microglia express increased levels of the translocator protein 18 kDa (TSPO), thereby making TSPO availability a marker for neuroinflammation. Using positron emission tomography (PET) scanning, our group recently demonstrated that smokers in the satiated state had 16.8% less binding of the radiotracer [11C]DAA1106 (a radioligand for TSPO) in the brain than nonsmokers. OBJECTIVES We sought to determine the effect of overnight smoking abstinence on [11C]DAA1106 binding in the brain. METHODS Forty participants (22 smokers and 18 nonsmokers) completed the study (at one of two sites) and had usable data, which included images from a dynamic [11C]DAA1106 PET scanning session (with smokers having been abstinent for 17.9 ± 2.3 h) and a blood sample for TSPO genotyping. Whole brain standardized uptake values (SUVs) were determined, and analysis of variance was performed, with group (overnight abstinent smoker vs. nonsmoker), site, and TSPO genotype as factors, thereby controlling for site and genotype. RESULTS Overnight abstinent smokers had lower whole brain SUVs (by 15.5 and 17.0% for the two study sites) than nonsmokers (ANCOVA, P = 0.004). The groups did not significantly differ in injected radiotracer dose or body weight, which were used to calculate SUV. CONCLUSIONS These results in overnight abstinent smokers are similar to those in satiated smokers, indicating that chronic cigarette smoking leads to global impairment of microglial activation which persists into early abstinence. Other explanations for study results, such as smoking leading to reduced numbers of microglia or smokers having more rapid metabolism of the radiotracer than nonsmokers, are also possible.
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Hartmann‐Boyce J, Chepkin SC, Ye W, Bullen C, Lancaster T. Nicotine replacement therapy versus control for smoking cessation. Cochrane Database Syst Rev 2018; 5:CD000146. [PMID: 29852054 PMCID: PMC6353172 DOI: 10.1002/14651858.cd000146.pub5] [Citation(s) in RCA: 242] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Nicotine replacement therapy (NRT) aims to temporarily replace much of the nicotine from cigarettes to reduce motivation to smoke and nicotine withdrawal symptoms, thus easing the transition from cigarette smoking to complete abstinence. OBJECTIVES To determine the effectiveness and safety of nicotine replacement therapy (NRT), including gum, transdermal patch, intranasal spray and inhaled and oral preparations, for achieving long-term smoking cessation, compared to placebo or 'no NRT' interventions. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group trials register for papers mentioning 'NRT' or any type of nicotine replacement therapy in the title, abstract or keywords. Date of most recent search is July 2017. SELECTION CRITERIA Randomized trials in people motivated to quit which compared NRT to placebo or to no treatment. We excluded trials that did not report cessation rates, and those with follow-up of less than six months, except for those in pregnancy (where less than six months, these were excluded from the main analysis). We recorded adverse events from included and excluded studies that compared NRT with placebo. Studies comparing different types, durations, and doses of NRT, and studies comparing NRT to other pharmacotherapies, are covered in separate reviews. DATA COLLECTION AND ANALYSIS Screening, data extraction and 'Risk of bias' assessment followed standard Cochrane methods. The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. We calculated the risk ratio (RR) for each study. Where appropriate, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. MAIN RESULTS We identified 136 studies; 133 with 64,640 participants contributed to the primary comparison between any type of NRT and a placebo or non-NRT control group. The majority of studies were conducted in adults and had similar numbers of men and women. People enrolled in the studies typically smoked at least 15 cigarettes a day at the start of the studies. We judged the evidence to be of high quality; we judged most studies to be at high or unclear risk of bias but restricting the analysis to only those studies at low risk of bias did not significantly alter the result. The RR of abstinence for any form of NRT relative to control was 1.55 (95% confidence interval (CI) 1.49 to 1.61). The pooled RRs for each type were 1.49 (95% CI 1.40 to 1.60, 56 trials, 22,581 participants) for nicotine gum; 1.64 (95% CI 1.53 to 1.75, 51 trials, 25,754 participants) for nicotine patch; 1.52 (95% CI 1.32 to 1.74, 8 trials, 4439 participants) for oral tablets/lozenges; 1.90 (95% CI 1.36 to 2.67, 4 trials, 976 participants) for nicotine inhalator; and 2.02 (95% CI 1.49 to 2.73, 4 trials, 887 participants) for nicotine nasal spray. The effects were largely independent of the definition of abstinence, the intensity of additional support provided or the setting in which the NRT was offered. A subset of six trials conducted in pregnant women found a statistically significant benefit of NRT on abstinence close to the time of delivery (RR 1.32, 95% CI 1.04 to 1.69; 2129 participants); in the four trials that followed up participants post-partum the result was no longer statistically significant (RR 1.29, 95% CI 0.90 to 1.86; 1675 participants). Adverse events from using NRT were related to the type of product, and include skin irritation from patches and irritation to the inside of the mouth from gum and tablets. Attempts to quantitatively synthesize the incidence of various adverse effects were hindered by extensive variation in reporting the nature, timing and duration of symptoms. The odds ratio (OR) of chest pains or palpitations for any form of NRT relative to control was 1.88 (95% CI 1.37 to 2.57, 15 included and excluded trials, 11,074 participants). However, chest pains and palpitations were rare in both groups and serious adverse events were extremely rare. AUTHORS' CONCLUSIONS There is high-quality evidence that all of the licensed forms of NRT (gum, transdermal patch, nasal spray, inhalator and sublingual tablets/lozenges) can help people who make a quit attempt to increase their chances of successfully stopping smoking. NRTs increase the rate of quitting by 50% to 60%, regardless of setting, and further research is very unlikely to change our confidence in the estimate of the effect. The relative effectiveness of NRT appears to be largely independent of the intensity of additional support provided to the individual. Provision of more intense levels of support, although beneficial in facilitating the likelihood of quitting, is not essential to the success of NRT. NRT often causes minor irritation of the site through which it is administered, and in rare cases can cause non-ischaemic chest pain and palpitations.
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Affiliation(s)
- Jamie Hartmann‐Boyce
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | | | - Weiyu Ye
- University of OxfordOxford University Clinical Academic Graduate SchoolOxfordUK
| | - Chris Bullen
- University of AucklandNational Institute for Health InnovationPrivate Bag 92019Auckland Mail CentreAucklandNew Zealand1142
| | - Tim Lancaster
- King’s College LondonGKT School of Medical EducationLondonUK
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Smiley SL. Sociodemographic correlates of intention to quit smoking for good among U.S. adult menthol and non-menthol smokers: Evidence from the 2013-2014 National Adult Tobacco Survey. Tob Prev Cessat 2018; 4:22. [PMID: 32411848 PMCID: PMC7205077 DOI: 10.18332/tpc/90968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/23/2018] [Accepted: 05/11/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION In the U.S. significant progress has been made to reduce cigarette use, yet menthol cigarette use is a continuing public health problem, especially among young adults and Black/African Americans. Smoking cessation is warranted to reduce smoking-related diseases and premature death. Ample evidence has demonstrated that having an intention to quit smoking is strongly associated with attaining cessation. The objective of this study was to identify and compare the sociodemographic correlates of intention to quit smoking for good between menthol and non-menthol adult smokers in the U.S.. METHODS A cross-sectional secondary data analysis was conducted on the 2013- 2014 National Adult Tobacco Survey. Multivariable logistic regression was used to analyze individual factors and their relation to intention to quit smoking for good. The total sample was nationally representative of the U.S. population and included 10 121 adult smokers aged ≥18 years. RESULTS Among menthol smokers, non-Hispanic Blacks (adjusted odds ratio, AOR=1.31, 95% confidence interval, CI: 1.03-1.67) were significantly (p=0.03) more likely to have an intention to quit smoking for good compared to non-Hispanic Whites. Young adults aged 18-25 years (AOR=0.70, 95% CI: 0.58-0.85) were significantly (p=0.01) less likely to have an intention to quit compared to adults aged 50 years and older, and sexual minorities (i.e. lesbian, gay, bisexual) (AOR=0.69, 95% CI: 0.49-0.93) were significantly (p=0.03) less likely to have the intention to quit compared to heterosexuals. Among non-menthol smokers, adults aged 26-34 years (AOR=1.46, 95% CI: 1.13-1.88) and 35-49 years (AOR=1.71, 95% CI: 1.34-2.20) were significantly (p=0.01; p< 0.001, respectively) more likely to have an intention to quit smoking for good compared to those aged 50 years and older. CONCLUSIONS Study findings provide insight into the association of menthol cigarette consumption with intention to quit smoking for good, notably among Black Americans, young adults and sexual minorities. Smoking cessation efforts should consider demographics and menthol smoking status.
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Affiliation(s)
- Sabrina L Smiley
- Institute for Health Promotion and Disease Prevention Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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23
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Keeler C, Max W, Yerger V, Yao T, Ong MK, Sung HY. The Association of Menthol Cigarette Use With Quit Attempts, Successful Cessation, and Intention to Quit Across Racial/Ethnic Groups in the United States. Nicotine Tob Res 2018; 19:1450-1464. [PMID: 27613927 DOI: 10.1093/ntr/ntw215] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 08/16/2016] [Indexed: 11/13/2022]
Abstract
Introduction Few studies have examined the relationship between menthol use and smoking cessation across various racial/ethnic groups; the findings were mixed. This study explored the association of menthol cigarette use with quit attempts, smoking cessation, and intention-to-quit among US adults and by race/ethnicity. Methods Using the 2006/2007 and 2010/2011 Tobacco Use Supplements to the Current Population Survey data, this study analyzed 54 448 recent active smokers, defined as current smokers or former smokers who quit less than 12 months ago. Three behaviors were examined: any quit attempts in the past 12 months, successful cessation for ≥3 months, and intention-to-quit smoking in the next 6 months. For each cessation behavior, multiple logistic regression models were estimated separately for the full-sample and stratified racial/ethnic subsamples. Results While 72.3% of African American recent active smokers typically smoked menthol cigarettes, this proportion was 21.7%, 21.5%, and 28.0% for whites, Asians, and Hispanics, respectively. African American menthol smokers had higher odds of quit attempts compared to non-African American, non-menthol smokers (full-sample analysis), as well as African American non-menthol smokers (subsample analysis). Menthol use was not significantly associated with quit attempts in other racial/ethnic subsamples. There was no significant difference in either successful cessation or intention-to-quit between menthol and non-menthol smokers. Conclusions African American menthol smokers were more likely to attempt to quit smoking than non-menthol smokers but these quit attempts did not translate into successful cessation. This study revealed no association of menthol use with quit attempts, successful cessation, and intention-to-quit among other racial/ethnic groups. Implications The findings suggested that African American menthol smokers were more motivated to quit smoking; yet, the results also indicated no significant differences in successful cessation between African American menthol and non-menthol smokers. Interventions targeting menthol smokers within the African American community may help bridge this gap. While more local sales restrictions are beginning to occur (eg, Tobacco 21 efforts), additional policies restricting price discounting as well as the regulation of access to and the time, place, and/or manner of menthol tobacco advertising could also improve cessation rates. Further evaluation is needed to determine the viability of these policies.
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Affiliation(s)
- Courtney Keeler
- Department of Population Health Sciences, School of Nursing, University of San Francisco, San Francisco, CA
| | - Wendy Max
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
| | - Valerie Yerger
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, CA
| | - Tingting Yao
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
| | - Michael K Ong
- Department of Medicine, University of California, Los Angeles, CA.,Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Hai-Yen Sung
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
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Villanti AC, Collins LK, Niaura RS, Gagosian SY, Abrams DB. Menthol cigarettes and the public health standard: a systematic review. BMC Public Health 2017; 17:983. [PMID: 29284458 PMCID: PMC5747135 DOI: 10.1186/s12889-017-4987-z] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 12/10/2017] [Indexed: 11/22/2022] Open
Abstract
Background Although menthol was not banned under the Tobacco Control Act, the law made it clear that this did not prevent the Food and Drug Administration from issuing a product standard to ban menthol to protect public health. The purpose of this review was to update the evidence synthesis regarding the role of menthol in initiation, dependence and cessation. Methods A systematic review of the peer-reviewed literature on menthol cigarettes via a PubMed search through May 9, 2017. The National Cancer Institute’s Bibliography of Literature on Menthol and Tobacco and the FDA’s 2011 report and 2013 addendum were reviewed for additional publications. Included articles addressing initiation, dependence, and cessation were synthesized based on study design and quality, consistency of evidence across populations and over time, coherence of findings across studies, and plausibility of the findings. Results Eighty-two studies on menthol cigarette initiation (n = 46), dependence (n = 14), and cessation (n = 34) were included. Large, representative studies show an association between menthol and youth smoking that is consistent in magnitude and direction. One longitudinal and eight cross-sectional studies demonstrate that menthol smokers report increased nicotine dependence compared to non-menthol smokers. Ten studies support the temporal relationship between menthol and reduced smoking cessation, as they measure cessation success at follow-up. Conclusions The strength and consistency of the associations in these studies support that the removal of menthol from cigarettes is likely to reduce youth smoking initiation, improve smoking cessation outcomes in adult smokers, and in turn, benefit public health. Electronic supplementary material The online version of this article (10.1186/s12889-017-4987-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea C Villanti
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA. .,Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT, USA. .,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Lauren K Collins
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA
| | - Raymond S Niaura
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | | | - David B Abrams
- The Schroeder Institute for Tobacco Research and Policy Studies at Truth Initiative, Washington, DC, USA.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Oncology, Georgetown University Medical Center, Lombardi Comprehensive Cancer Center, Washington, DC, USA
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Effect of Cigarette Smoking on a Marker for Neuroinflammation: A [ 11C]DAA1106 Positron Emission Tomography Study. Neuropsychopharmacology 2017; 42:1630-1639. [PMID: 28262740 PMCID: PMC5518907 DOI: 10.1038/npp.2017.48] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/01/2017] [Accepted: 02/23/2017] [Indexed: 01/21/2023]
Abstract
In the brain, microglia continuously scan the surrounding extracellular space in order to respond to damage or infection by becoming activated and participating in neuroinflammation. When activated, microglia increase the expression of translocator protein (TSPO) 18 kDa, thereby making the TSPO expression a marker for neuroinflammation. We used the radiotracer [11C]DAA1106 (a ligand for TSPO) and positron emission tomography (PET) to determine the effect of smoking on availability of this marker for neuroinflammation. Forty-five participants (30 smokers and 15 non-smokers) completed the study and had usable data. Participants underwent a dynamic PET scanning session with bolus injection of [11C]DAA1106 (with smokers in the satiated state) and blood draws during PET scanning to determine TSPO affinity genotype and plasma nicotine levels. Whole-brain standardized uptake values (SUVs) were determined, and analysis of variance was performed, with group (smoker vs non-smoker) and genotype as factors, thereby controlling for genotype. Smokers and non-smokers differed in whole-brain SUVs (P=0.006) owing to smokers having 16.8% lower values than non-smokers. The groups did not differ in injected radiotracer dose or body weight, which were used to calculate SUV. An inverse association was found between whole-brain SUV and reported cigarettes per day (P<0.05), but no significant relationship was found for plasma nicotine. Thus, smokers have less [11C]DAA1106 binding globally than non-smokers, indicating less microglial activation. Study findings are consistent with much prior research demonstrating that smokers have impaired inflammatory functioning compared with non-smokers and that constituents of tobacco smoke other than nicotine affect inflammatory processes.
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26
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Watson CV, Richter P, de Castro BR, Sosnoff C, Potts J, Clark P, McCraw J, Yan X, Chambers D, Watson C. Smoking Behavior and Exposure: Results of a Menthol Cigarette Cross-over Study. Am J Health Behav 2017; 41:309-319. [PMID: 28376975 DOI: 10.5993/ajhb.41.3.10] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Our objective was to improve understanding of the differences in use behavior and exposure when smoking menthol and non-menthol cigarettes using a 2-part cross-over design. METHODS Adult daily smokers were assigned randomly to alternate between 2 weeks of exclusively smoking a menthol test cigarette or a non-menthol test cigarette. Urine and saliva were collected for biomarker measurements; carbon monoxide (CO) was measured, and participants smoked test cigarettes through a CreSS® smoking topography device during 3 clinic visits. Participants turned in their cigarette butts from the test periods for determination of mouth level nicotine and completed subjective questionnaires related to the test cigarettes. RESULTS Regardless of cigarette preference, participants had higher salivary cotinine when smoking the non-menthol test cigarette, but there were no significant differences detected in urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol between the 2 test cigarettes. Mouth level nicotine, puff volume, and puff duration were significantly higher when smoking the menthol brand. Both menthol and non-menthol smokers reported significantly lower enjoyment and satisfaction scores for test cigarettes compared with their brand of choice. CONCLUSIONS Our results suggest that mentholation has an effect on measures of smoking behavior and that mouth level nicotine is a useful indicator of between-brand smoke exposure.
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Affiliation(s)
| | | | | | | | | | | | - Joan McCraw
- Centers for Disease Control and Prevention, Atlanta, GA
| | - Xizheng Yan
- Centers for Disease Control and Prevention, Atlanta, GA
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Abstract
BACKGROUND Individual counselling from a smoking cessation specialist may help smokers to make a successful attempt to stop smoking. OBJECTIVES The review addresses the following hypotheses:1. Individual counselling is more effective than no treatment or brief advice in promoting smoking cessation.2. Individual counselling is more effective than self-help materials in promoting smoking cessation.3. A more intensive counselling intervention is more effective than a less intensive intervention. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialized Register for studies with counsel* in any field in May 2016. SELECTION CRITERIA Randomized or quasi-randomized trials with at least one treatment arm consisting of face-to-face individual counselling from a healthcare worker not involved in routine clinical care. The outcome was smoking cessation at follow-up at least six months after the start of counselling. DATA COLLECTION AND ANALYSIS Both authors extracted data in duplicate. We recorded characteristics of the intervention and the target population, method of randomization and completeness of follow-up. We used the most rigorous definition of abstinence in each trial, and biochemically-validated rates where available. In analysis, we assumed that participants lost to follow-up continued to smoke. We expressed effects as a risk ratio (RR) for cessation. Where possible, we performed meta-analysis using a fixed-effect (Mantel-Haenszel) model. We assessed the quality of evidence within each study using the Cochrane 'Risk of bias' tool and the GRADE approach. MAIN RESULTS We identified 49 trials with around 19,000 participants. Thirty-three trials compared individual counselling to a minimal behavioural intervention. There was high-quality evidence that individual counselling was more effective than a minimal contact control (brief advice, usual care, or provision of self-help materials) when pharmacotherapy was not offered to any participants (RR 1.57, 95% confidence interval (CI) 1.40 to 1.77; 27 studies, 11,100 participants; I2 = 50%). There was moderate-quality evidence (downgraded due to imprecision) of a benefit of counselling when all participants received pharmacotherapy (nicotine replacement therapy) (RR 1.24, 95% CI 1.01 to 1.51; 6 studies, 2662 participants; I2 = 0%). There was moderate-quality evidence (downgraded due to imprecision) for a small benefit of more intensive counselling compared to brief counselling (RR 1.29, 95% CI 1.09 to 1.53; 11 studies, 2920 participants; I2 = 48%). None of the five other trials that compared different counselling models of similar intensity detected significant differences. AUTHORS' CONCLUSIONS There is high-quality evidence that individually-delivered smoking cessation counselling can assist smokers to quit. There is moderate-quality evidence of a smaller relative benefit when counselling is used in addition to pharmacotherapy, and of more intensive counselling compared to a brief counselling intervention.
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Affiliation(s)
- Tim Lancaster
- King’s College LondonGKT School of Medical EducationLondonUK
| | - Lindsay F Stead
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
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28
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Vijayaraghavan M, Schroeder SA, Kushel M. The effectiveness of tobacco control policies on vulnerable populations in the USA: a review. Postgrad Med J 2016; 92:670-676. [DOI: 10.1136/postgradmedj-2014-133193] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/24/2016] [Accepted: 08/27/2016] [Indexed: 11/04/2022]
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Alexander LA, Trinidad DR, Sakuma KLK, Pokhrel P, Herzog TA, Clanton MS, Moolchan ET, Fagan P. Why We Must Continue to Investigate Menthol's Role in the African American Smoking Paradox. Nicotine Tob Res 2016; 18 Suppl 1:S91-101. [PMID: 26980870 PMCID: PMC6367903 DOI: 10.1093/ntr/ntv209] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 09/09/2015] [Indexed: 11/14/2022]
Abstract
BACKGROUND The disproportionate burden of tobacco use among African Americans is largely unexplained. The unexplained disparities, referred to as the African American smoking paradox, includes several phenomena. Despite their social disadvantage, African American youth have lower smoking prevalence rates, initiate smoking at older ages, and during adulthood, smoking rates are comparable to whites. Smoking frequency and intensity among African American youth and adults are lower compared to whites and American Indian and Alaska Natives, but tobacco-caused morbidity and mortality rates are disproportionately higher. Disease prediction models have not explained disease causal pathways in African Americans. It has been hypothesized that menthol cigarette smoking, which is disproportionately high among African Americans, may help to explain several components of the African American smoking paradox. PURPOSE This article provides an overview of the potential role that menthol plays in the African American smoking paradox. We also discuss the research needed to better understand this unresolved puzzle. METHODS We examined prior synthesis reports and reviewed the literature in PubMed on the menthol compound and menthol cigarette smoking in African Americans. RESULTS The pharmacological and physiological effects of menthol and their interaction with biological and genetic factors may indirectly contribute to the disproportionate burden of cigarette use and diseases among African Americans. CONCLUSIONS Future studies that examine taste sensitivity, the menthol compound, and their effects on smoking and chronic disease would provide valuable information on how to reduce the tobacco burden among African Americans. IMPLICATIONS Our study highlights four counterintuitive observations related to the smoking risk profiles and chronic disease outcomes among African Americans. The extant literature provides strong evidence of their existence and shows that long-standing paradoxes have been largely unaffected by changes in the social environment. African Americans smoke menthols disproportionately, and menthol's role in the African American smoking paradox has not been thoroughly explored. We propose discrete hypotheses that will help to explain the phenomena and encourage researchers to empirically test menthol's role in smoking initiation, transitions to regular smoking and chronic disease outcomes in African Americans.
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Affiliation(s)
- Linda A Alexander
- College of Public Health, University of Kentucky College of Public Health, Lexington, KY
| | - Dennis R Trinidad
- Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA
| | - Kari-Lyn K Sakuma
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Pallav Pokhrel
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Thaddeus A Herzog
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | | | | | - Pebbles Fagan
- University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI;
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Ross KC, Dempsey DA, St Helen G, Delucchi K, Benowitz NL. The Influence of Puff Characteristics, Nicotine Dependence, and Rate of Nicotine Metabolism on Daily Nicotine Exposure in African American Smokers. Cancer Epidemiol Biomarkers Prev 2016; 25:936-43. [PMID: 27030603 DOI: 10.1158/1055-9965.epi-15-1034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 03/16/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND African American (AA) smokers experience greater tobacco-related disease burden than Whites, despite smoking fewer cigarettes per day (CPD). Understanding factors that influence daily nicotine intake in AA smokers is an important step toward decreasing tobacco-related health disparities. One factor of interest is smoking topography, or the study of puffing behavior. AIMS (i) to create a model using puff characteristics, nicotine dependence, and nicotine metabolism to predict daily nicotine exposure, and (ii) to compare puff characteristics and nicotine intake from two cigarettes smoked at different times to ensure the reliability of the puff characteristics included in our model. METHODS Sixty AA smokers smoked their preferred brand of cigarette at two time points through a topography device. Plasma nicotine, expired CO, and changes in subjective measures were measured before and after each cigarette. Total nicotine equivalents (TNE) was measured from 24-hour urine collected during ad libitum smoking. RESULTS In a model predicting daily nicotine exposure, total puff volume, CPD, sex, and menthol status were significant predictors (R(2) = 0.44, P < 0.001). Total puff volume was significantly greater and inter-puff intervals were significantly shorter after ad lib smoking compared with the first cigarette of the day, but puffing behaviors for both cigarettes were highly correlated (r range = 0.69-0.89, P < 0.001) within-subjects. CONCLUSION This is the first study, to our knowledge, to show that puff characteristics of individual cigarettes are predictive of daily nicotine intake. IMPACT These findings enhance our understanding of the relationship between smoking behavior and nicotine intake in AA smokers. Cancer Epidemiol Biomarkers Prev; 25(6); 936-43. ©2016 AACR.
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Affiliation(s)
- Kathryn C Ross
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Delia A Dempsey
- Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California. Departments of Pediatrics and Medicine, University of California, San Francisco, San Francisco, California
| | - Gideon St Helen
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Kevin Delucchi
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
| | - Neal L Benowitz
- Center for Tobacco Control, Research, and Education, University of California, San Francisco, San Francisco, California. Division of Clinical Pharmacology and Experimental Therapeutics, Department of Medicine, University of California, San Francisco, San Francisco, California. Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California.
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31
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Stead LF, Koilpillai P, Fanshawe TR, Lancaster T. Combined pharmacotherapy and behavioural interventions for smoking cessation. Cochrane Database Syst Rev 2016; 3:CD008286. [PMID: 27009521 PMCID: PMC10042551 DOI: 10.1002/14651858.cd008286.pub3] [Citation(s) in RCA: 232] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Both behavioural support (including brief advice and counselling) and pharmacotherapies (including nicotine replacement therapy (NRT), varenicline and bupropion) are effective in helping people to stop smoking. Combining both treatment approaches is recommended where possible, but the size of the treatment effect with different combinations and in different settings and populations is unclear. OBJECTIVES To assess the effect of combining behavioural support and medication to aid smoking cessation, compared to a minimal intervention or usual care, and to identify whether there are different effects depending on characteristics of the treatment setting, intervention, population treated, or take-up of treatment. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register in July 2015 for records with any mention of pharmacotherapy, including any type of NRT, bupropion, nortriptyline or varenicline. SELECTION CRITERIA Randomized or quasi-randomized controlled trials evaluating combinations of pharmacotherapy and behavioural support for smoking cessation, compared to a control receiving usual care or brief advice or less intensive behavioural support. We excluded trials recruiting only pregnant women, trials recruiting only adolescents, and trials with less than six months follow-up. DATA COLLECTION AND ANALYSIS Search results were prescreened by one author and inclusion or exclusion of potentially relevant trials was agreed by two authors. Data was extracted by one author and checked by another.The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically validated rates if available. We calculated the risk ratio (RR) and 95% confidence interval (CI) for each study. Where appropriate, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. MAIN RESULTS Fifty-three studies with a total of more than 25,000 participants met the inclusion criteria. A large proportion of studies recruited people in healthcare settings or with specific health needs. Most studies provided NRT. Behavioural support was typically provided by specialists in cessation counselling, who offered between four and eight contact sessions. The planned maximum duration of contact was typically more than 30 minutes but less than 300 minutes. Overall, studies were at low or unclear risk of bias, and findings were not sensitive to the exclusion of any of the six studies rated at high risk of bias in one domain. One large study (the Lung Health Study) contributed heterogeneity due to a substantially larger treatment effect than seen in other studies (RR 3.88, 95% CI 3.35 to 4.50). Since this study used a particularly intensive intervention which included extended availability of nicotine gum, multiple group sessions and long term maintenance and recycling contacts, the results may not be comparable with the interventions used in other studies, and hence it was not pooled in other analyses. Based on the remaining 52 studies (19,488 participants) there was high quality evidence (using GRADE) for a benefit of combined pharmacotherapy and behavioural treatment compared to usual care, brief advice or less intensive behavioural support (RR 1.83, 95% CI 1.68 to 1.98) with moderate statistical heterogeneity (I² = 36%).The pooled estimate for 43 trials that recruited participants in healthcare settings (RR 1.97, 95% CI 1.79 to 2.18) was higher than for eight trials with community-based recruitment (RR 1.53, 95% CI 1.33 to 1.76). Compared to the first version of the review, previous weak evidence of differences in other subgroup analyses has disappeared. We did not detect differences between subgroups defined by motivation to quit, treatment provider, number or duration of support sessions, or take-up of treatment. AUTHORS' CONCLUSIONS Interventions that combine pharmacotherapy and behavioural support increase smoking cessation success compared to a minimal intervention or usual care. Updating this review with an additional 12 studies (5,000 participants) did not materially change the effect estimate. Although trials differed in the details of their populations and interventions, we did not detect any factors that modified treatment effects apart from the recruitment setting. We did not find evidence from indirect comparisons that offering more intensive behavioural support was associated with larger treatment effects.
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Affiliation(s)
- Lindsay F Stead
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | | | - Thomas R Fanshawe
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
| | - Tim Lancaster
- University of OxfordNuffield Department of Primary Care Health SciencesRadcliffe Observatory QuarterWoodstock RoadOxfordUKOX2 6GG
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van de Nobelen S, Kienhuis AS, Talhout R. An Inventory of Methods for the Assessment of Additive Increased Addictiveness of Tobacco Products. Nicotine Tob Res 2016; 18:1546-55. [PMID: 26817491 PMCID: PMC4902882 DOI: 10.1093/ntr/ntw002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/30/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cigarettes and other forms of tobacco contain the addictive drug nicotine. Other components, either naturally occurring in tobacco or additives that are intentionally added during the manufacturing process, may add to the addictiveness of tobacco products. As such, these components can make cigarette smokers more easily and heavily dependent.Efforts to regulate tobacco product dependence are emerging globally. Additives that increase tobacco dependence will be prohibited under the new European Tobacco Product Directive. OBJECTIVE This article provides guidelines and recommendations for developing a regulatory strategy for assessment of increase in tobacco dependence due to additives. Relevant scientific literature is summarized and criteria and experimental studies that can define increased dependence of tobacco products are described. CONCLUSIONS Natural tobacco smoke is a very complex matrix of components, therefore analysis of the contribution of an additive or a combination of additives to the level of dependence on this product is challenging. We propose to combine different type of studies analyzing overall tobacco product dependence potential and the functioning of additives in relation to nicotine. By using a combination of techniques, changes associated with nicotine dependence such as behavioral, physiological, and neurochemical alterations can be examined to provide sufficient information.Research needs and knowledge gaps will be discussed and recommendations will be made to translate current knowledge into legislation. As such, this article aids in implementation of the Tobacco Product Directive, as well as help enable regulators and researchers worldwide to develop standards to reduce dependence on tobacco products. IMPLICATIONS This article provides an overall view on how to assess tobacco product constituents for their potential contribution to use and dependence. It provides guidelines that help enable regulators worldwide to develop standards to reduce dependence on tobacco products and guide researches to set research priorities on this topic.
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Affiliation(s)
- Suzanne van de Nobelen
- Center for Health Protection (GZB), National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Anne S Kienhuis
- Center for Health Protection (GZB), National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands
| | - Reinskje Talhout
- Center for Health Protection (GZB), National Institute of Public Health and Environment (RIVM), Bilthoven, The Netherlands
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Sakuma KLK, Felicitas J, Fagan P, Gruder CL, Blanco L, Cappelli C, Trinidad DR. Smoking Trends and Disparities Among Black and Non-Hispanic Whites in California. Nicotine Tob Res 2015; 17:1491-8. [PMID: 25666813 PMCID: PMC5967264 DOI: 10.1093/ntr/ntv032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 01/26/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The current study examined disparities in smoking trends across Blacks and non-Hispanic Whites in California. METHODS Data from the 1996 to 2008 California Tobacco Survey were analyzed to examine trends in smoking behaviors and cessation across Blacks and non-Hispanic Whites. RESULTS A decrease in overall ever and current smoking was observed for both Black and non-Hispanic Whites across the 12-year time period. A striking decrease in proportions of heavy daily smokers for both Black and non-Hispanic Whites were observed. Proportions of light and intermittent smokers and moderate daily smokers displayed modest increases for Blacks, but large increases for non-Hispanic Whites. Increases in successful cessation were also observed for Blacks and, to a lesser extent, for non-Hispanic Whites. DISCUSSION Smoking behavior and cessation trends across Blacks and non-Hispanic Whites were revealing. The decline in heavy daily and former smokers may demonstrate the success and effectiveness of tobacco control efforts in California. However, the increase in proportions of light and intermittent smokers and moderate daily smokers for both Blacks and non-Hispanic Whites demonstrates a need for tobacco cessation efforts focused on lighter smokers.
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Affiliation(s)
- Kari-Lyn Kobayakawa Sakuma
- College of Public Health and Human Sciences, School of Social and Behavioral Health Sciences, Oregon State University, Corvallis, OR;
| | - Jamie Felicitas
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | | | | | - Lyzette Blanco
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Christopher Cappelli
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Dennis R Trinidad
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
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Bello MS, Pang RD, Cropsey KL, Zvolensky MJ, Reitzel LR, Huh J, Leventhal AM. Tobacco Withdrawal Amongst African American, Hispanic, and White Smokers. Nicotine Tob Res 2015; 18:1479-87. [PMID: 26482061 DOI: 10.1093/ntr/ntv231] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 10/01/2015] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Persistent tobacco use among racial and ethnic minority populations in the United States is a critical public health concern. Yet, potential sources of racial/ethnic disparities in tobacco use remain unclear. The present study examined racial/ethnic differences in tobacco withdrawal-a clinically-relevant underpinning of tobacco use that has received sparse attention in the disparities literature-utilizing a controlled laboratory design. METHODS Daily smokers (non-Hispanic African American [n = 178], non-Hispanic white [n = 118], and Hispanic [n = 28]) attended two counterbalanced sessions (non-abstinent vs. 16-hour abstinent). At both sessions, self-report measures of urge, nicotine withdrawal, and affect were administered and performance on an objective behavioral task that assessed motivation to reinstate smoking was recorded. Abstinence-induced changes (abstinent scores vs. non-abstinent scores) were analyzed as a function of race/ethnicity. RESULTS Non-Hispanic African American smokers reported greater abstinence-induced declines in several positive affect states in comparison to other racial/ethnic groups. Relative to Hispanic smokers, non-Hispanic African American and non-Hispanic white smokers displayed larger abstinence-provoked increases in urges to smoke. No racial/ethnic differences were detected for a composite measure of nicotine withdrawal symptomatology, negative affect states, and motivation to reinstate smoking behavior. CONCLUSIONS These results suggest qualitative differences in the expression of some components of tobacco withdrawal across three racial/ethnic groups. This research helps shed light on bio-behavioral sources of tobacco-related health disparities, informs the application of smoking cessation interventions across racial/ethnic groups, and may ultimately aid the overall effort towards reducing the public health burden of tobacco addiction in minority populations. IMPLICATIONS The current study provides some initial evidence that there may be qualitative differences in the types of tobacco withdrawal symptoms experienced among non-Hispanic African American, Hispanic, and non-Hispanic white smokers. Extending this line of inquiry may elucidate mechanisms involved in tobacco-related health disparities and ultimately aid in reducing the public health burden of smoking in racial/ethnic minority populations.
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Affiliation(s)
- Mariel S Bello
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Raina D Pang
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Karen L Cropsey
- Department of Psychiatry, University of Alabama at Birmingham School of Medicine, Birmingham, AL
| | | | - Lorraine R Reitzel
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX
| | - Jimi Huh
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA; Department of Psychology, University of Southern California, Los Angeles, CA;
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Stead LF, Koilpillai P, Lancaster T. Additional behavioural support as an adjunct to pharmacotherapy for smoking cessation. Cochrane Database Syst Rev 2015:CD009670. [PMID: 26457723 DOI: 10.1002/14651858.cd009670.pub3] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Effective pharmacotherapies are available to help people who are trying to stop smoking, but quitting can still be difficult and providing higher levels of behavioural support may increase success rates further. OBJECTIVES To evaluate the effect of increasing the intensity of behavioural support for people using smoking cessation medications, and to assess whether there are different effects depending on the type of pharmacotherapy, or the amount of support in each condition. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group Specialised Register in May 2015 for records with any mention of pharmacotherapy, including any type of nicotine replacement therapy (NRT), bupropion, nortriptyline or varenicline that evaluated the addition of personal support or compared two or more intensities of behavioural support. SELECTION CRITERIA Randomized or quasi-randomized controlled trials in which all participants received pharmacotherapy for smoking cessation and conditions differed by the amount of behavioural support. The intervention condition had to involve person-to-person contact. The control condition could receive less intensive personal contact, or just written information. We did not include studies that used a contact-matched control to evaluate differences between types or components of support. We excluded trials recruiting only pregnant women, trials recruiting only adolescents, and trials with less than six months follow-up. DATA COLLECTION AND ANALYSIS One author prescreened search results and two authors agreed inclusion or exclusion of potentially relevant trials. One author extracted data and another checked them.The main outcome measure was abstinence from smoking after at least six months of follow-up. We used the most rigorous definition of abstinence for each trial, and biochemically-validated rates if available. We calculated the risk ratio (RR) and 95% confidence interval (CI) for each study. Where appropriate, we performed meta-analysis using a Mantel-Haenszel fixed-effect model. MAIN RESULTS Forty-seven studies met the inclusion criteria with over 18,000 participants in the relevant arms. There was little evidence of statistical heterogeneity (I² = 18%) so we pooled all studies in the main analysis. There was evidence of a small but statistically significant benefit from more intensive support (RR 1.17, 95% CI 1.11 to 1.24) for abstinence at longest follow-up. All but four of the included studies provided four or more sessions of support to the intervention group. Most trials used NRT. We did not detect significant effects for studies where the pharmacotherapy was nortriptyline (two trials) or varenicline (one trial), but this reflects the absence of evidence.In subgroup analyses, studies that provided at least four sessions of personal contact for the intervention and no personal contact for the control had slightly larger estimated effects (RR 1.25, 95% CI 1.08 to 1.45; 6 trials, 3762 participants), although a formal test for subgroup differences was not significant. Studies where all intervention counselling was via telephone (RR 1.28, 95% CI 1.17 to 1.41; 6 trials, 5311 participants) also had slightly larger effects, and the test for subgroup differences was significant, but this subgroup analysis was not prespecified. In this update, the benefit of providing additional behavioural support was similar for the subgroup of trials in which all participants, including controls, had at least 30 minutes of personal contact (RR 1.18, 95% CI 1.06 to 1.32; 21 trials, 5166 participants); previously the evidence of benefit in this subgroup had been weaker. This subgroup was not prespecified and a test for subgroup differences was not significant. We judged the quality of the evidence to be high, using the GRADE approach. We judged a small number of trials to be at high risk of bias on one or more domains, but findings were not sensitive to their exclusion. AUTHORS' CONCLUSIONS Providing behavioural support in person or via telephone for people using pharmacotherapy to stop smoking has a small but important effect. Increasing the amount of behavioural support is likely to increase the chance of success by about 10% to 25%, based on a pooled estimate from 47 trials. Subgroup analysis suggests that the incremental benefit from more support is similar over a range of levels of baseline support.
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Affiliation(s)
- Lindsay F Stead
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Woodstock Road, Oxford, UK, OX2 6GG
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Alsharari SD, King JR, Nordman JC, Muldoon PP, Jackson A, Zhu AZX, Tyndale RF, Kabbani N, Damaj MI. Effects of Menthol on Nicotine Pharmacokinetic, Pharmacology and Dependence in Mice. PLoS One 2015; 10:e0137070. [PMID: 26355604 PMCID: PMC4565647 DOI: 10.1371/journal.pone.0137070] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 08/12/2015] [Indexed: 11/25/2022] Open
Abstract
Although menthol, a common flavoring additive to cigarettes, has been found to impact the addictive properties of nicotine cigarettes in smokers little is known about its pharmacological and molecular actions in the brain. Studies were undertaken to examine whether the systemic administration of menthol would modulate nicotine pharmacokinetics, acute pharmacological effects (antinociception and hypothermia) and withdrawal in male ICR mice. In addition, we examined changes in the brain levels of nicotinic receptors of rodents exposed to nicotine and menthol. Administration of i.p. menthol significantly decreased nicotine’s clearance (2-fold decrease) and increased its AUC compared to i.p. vehicle treatment. In addition, menthol pretreatment prolonged the duration of nicotine-induced antinociception and hypothermia (2.5 mg/kg, s.c.) for periods up to 180 min post-nicotine administration. Repeated administration of menthol with nicotine increased the intensity of mecamylamine-precipitated withdrawal signs in mice exposed chronically to nicotine. The potentiation of withdrawal intensity by menthol was accompanied by a significant increase in nicotine plasma levels in these mice. Western blot analyses of α4 and β2 nAChR subunit expression suggests that chronic menthol impacts the levels and distribution of these nicotinic subunits in various brain regions. In particular, co-administration of menthol and nicotine appears to promote significant increase in β2 and α4 nAChR subunit expression in the hippocampus, prefrontal cortex and striatum of mice. Surprisingly, chronic injections of menthol alone to mice caused an upregulation of β2 and α4 nAChR subunit levels in these brain regions. Because the addition of menthol to tobacco products has been suggested to augment their addictive potential, the current findings reveal several new pharmacological molecular adaptations that may contribute to its unique addictive profile.
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Affiliation(s)
- Shakir D. Alsharari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Justin R. King
- Department of Molecular Neuroscience, Krasnow Institute for Advanced Study, George Mason University, Fairfax, Virginia, United States of America
| | - Jacob C. Nordman
- Department of Molecular Neuroscience, Krasnow Institute for Advanced Study, George Mason University, Fairfax, Virginia, United States of America
| | - Pretal P. Muldoon
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Asti Jackson
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Andy Z. X. Zhu
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Department of Pharmacology and Toxicology, and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Rachel F. Tyndale
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Department of Pharmacology and Toxicology, and Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Nadine Kabbani
- Department of Molecular Neuroscience, Krasnow Institute for Advanced Study, George Mason University, Fairfax, Virginia, United States of America
- * E-mail:
| | - M. Imad. Damaj
- Department of Pharmacology and Toxicology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia, United States of America
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Cropsey KL, Clark CB, Zhang X, Hendricks PS, Jardin BF, Lahti AC. Race and Medication Adherence Moderate Cessation Outcomes in Criminal Justice Smokers. Am J Prev Med 2015; 49:335-44. [PMID: 26091924 PMCID: PMC4546875 DOI: 10.1016/j.amepre.2015.03.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 03/06/2015] [Accepted: 03/13/2015] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Smokers in the criminal justice system represent some of the most disadvantaged smokers in the U.S., as they have high rates of smoking (70%-80%) and are primarily uninsured, with low access to medical interventions. Few studies have examined smoking-cessation interventions in racially diverse smokers, and none have examined these characteristics among individuals supervised in the community. The purpose of this study is to determine if four sessions of standard behavioral counseling for smoking cessation would differentially aid smoking cessation for African American versus non-Hispanic white smokers under community corrections supervision. DESIGN An RCT. SETTING/PARTICIPANTS Five hundred smokers under community corrections supervision were recruited between 2009 and 2013 via flyers posted at the community corrections offices. INTERVENTION All participants received 12 weeks of bupropion plus brief physician advice to quit smoking. Half of the participants received four sessions of 20-30 minutes of smoking-cessation counseling following tobacco treatment guidelines, whereas half received no additional counseling. MAIN OUTCOME MEASURES Generalized estimating equations were used to determine factors associated with smoking abstinence across time. Analyses were conducted in 2014. RESULTS The end-of-treatment abstinence rate across groups was 9.4%, with no significant main effects indicating group differences. However, behavioral counseling had a differential effect on cessation: whites who received counseling had higher quit rates than whites who did not receive counseling. Conversely, African Americans who did not receive counseling had higher average cessation rates than African Americans who received counseling. Overall, medication-adherent African American smokers had higher abstinence rates relative to other smokers. CONCLUSIONS Racial disparities in smoking cessation are not evident among those who are adherent to medication. More research is needed to better understand the differential effect that behavioral counseling might have on treatment outcomes between white and African American smokers under community corrections supervision.
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Affiliation(s)
| | | | - Xiao Zhang
- Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai, West Hollywood, California
| | - Peter S Hendricks
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Bianca F Jardin
- Division of Psychiatry, Roper St. Francis Hospital, Charleston, South Carolina
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Fagan P, Pokhrel P, Herzog TA, Pagano IS, Franke AA, Clanton MS, Alexander LA, Trinidad DR, Sakuma KLK, Johnson CA, Moolchan ET. Nicotine Metabolism in Young Adult Daily Menthol and Nonmenthol Smokers. Nicotine Tob Res 2015; 18:437-46. [PMID: 25995160 DOI: 10.1093/ntr/ntv109] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 05/12/2015] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Menthol cigarette smoking may increase the risk for tobacco smoke exposure and inhibit nicotine metabolism in the liver. Nicotine metabolism is primarily mediated by the enzyme CYP2A6 and the nicotine metabolite ratio (NMR = trans 3' hydroxycotinine/cotinine) is a phenotypic proxy for CYP2A6 activity. No studies have examined differences in this biomarker among young adult daily menthol and nonmenthol smokers. This study compares biomarkers of tobacco smoke exposure among young adult daily menthol and nonmenthol smokers. METHODS Saliva cotinine and carbon monoxide were measured in a multiethnic sample of daily smokers aged 18-35 (n = 186). Nicotine, cotinine, the cotinine/cigarette per day ratio, trans 3' hydroxycotinine, the NMR, and expired carbon monoxide were compared. RESULTS The geometric means for nicotine, cotinine, and the cotinine/cigarette per day ratio did not significantly differ between menthol and nonmenthol smokers. The NMR was significantly lower among menthol compared with nonmenthol smokers after adjusting for race/ethnicity, gender, body mass index, and cigarette smoked per day (0.19 vs. 0.24, P = .03). White menthol smokers had significantly higher cotinine/cigarettes per day ratio than white nonmenthol smokers in the adjusted model. White menthol smokers had a lower NMR in the unadjusted model (0.24 vs. 0.31, P = .05) and the differences remained marginally significant in the adjusted model (0.28 vs. 0.34, P = .06). We did not observe these differences in Native Hawaiians and Filipinos. CONCLUSIONS Young adult daily menthol smokers have slower rates of nicotine metabolism than nonmenthol smokers. Studies are needed to determine the utility of this biomarker for smoking cessation treatment assignments.
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Affiliation(s)
- Pebbles Fagan
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI;
| | - Pallav Pokhrel
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Thaddeus A Herzog
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Ian S Pagano
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | - Adrian A Franke
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu, HI
| | | | | | - Dennis R Trinidad
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
| | - Kari-Lyn K Sakuma
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Carl A Johnson
- School of Community and Global Health, Claremont Graduate University, Claremont, CA
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Fagan P, Pohkrel P, Herzog T, Pagano I, Vallone D, Trinidad DR, Sakuma KL, Sterling K, Fryer CS, Moolchan E. Comparisons of three nicotine dependence scales in a multiethnic sample of young adult menthol and non-menthol smokers. Drug Alcohol Depend 2015; 149:203-11. [PMID: 25744873 PMCID: PMC4865397 DOI: 10.1016/j.drugalcdep.2015.02.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 01/14/2015] [Accepted: 02/03/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Few studies have compared nicotine dependence among menthol and non-menthol cigarette smokers in a multiethnic sample of young adult daily cigarette smokers. This study examines differences in nicotine dependence among menthol and non-menthol daily smokers and the associations of nicotine dependence with quitting behaviors among Native Hawaiian, Filipino, and White cigarette smokers aged 18-35. METHODS Craigslist.org, newspaper advertisements, and peer-to-peer referrals were used to recruit daily smokers (n = 186) into a lab-based study. Nicotine dependence was assessed using the Fagerstrom Test of Nicotine Dependence (FTND), the Nicotine Dependence Syndrome Scale (NDSS), and the brief Wisconsin Inventory for Smoking Dependence Motives (WISDM). Multiple regression analyses were used to examine differences in nicotine dependence between menthol and non-menthol smokers and the relationship between each nicotine dependence scale with self-efficacy to quit, quit attempt in the past 12 months, and number of attempts. RESULTS Menthol smokers were more likely to report difficulty refraining from smoking in places where forbidden (p = .04) and had higher scores on social/environmental goads subscale of the WISDM (p = .0005). Two-way interaction models of the FTND and menthol status showed that menthol smokers with higher levels of dependence were more likely to have tried to quit smoking in the past 12 months (p = .02), but were less likely to have had multiple quit attempts (p = .01). CONCLUSIONS Components of the FTND and WISDM distinguish levels of dependence between menthol and non-menthol smokers. Higher FTND scores were associated with having a quit attempt, but fewer quit attempts among menthol smokers.
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Affiliation(s)
- Pebbles Fagan
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Pallav Pohkrel
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Thaddeus Herzog
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Ian Pagano
- Cancer Prevention and Control Program, University of Hawaii Cancer Center, University of Hawaii at Manoa, 701 Ilalo Street, Honolulu, HI 96813, USA.
| | - Donna Vallone
- American Legacy Foundation, 1724 Massachusetts Avenue N.W., Washington, DC 20036, USA.
| | - Dennis R. Trinidad
- School of Community and Global Health, Claremont Graduate University, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711-3475, USA
| | - Kari-Lyn Sakuma
- Oregon State University, College of Public Health and Human Sciences, 412 Waldo, Corvallis, OR 97331, USA.
| | - Kymberle Sterling
- School of Public Health, Georgia State University, One Park Place, Suite 662, Atlanta, GA 30303, USA.
| | - Craig S. Fryer
- Department of Behavioral and Community Health, School of Public Health, Maryland Center for Health Equity, University of Maryland, 2324 SPH Building #255, College Park, MD 20742, USA
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Frost-Pineda K, Muhammad-Kah R, Rimmer L, Liang Q. Predictors, indicators, and validated measures of dependence in menthol smokers. J Addict Dis 2015; 33:94-113. [PMID: 24738914 PMCID: PMC4104824 DOI: 10.1080/10550887.2014.909696] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This article presents a comprehensive review of the menthol cigarette dependence-related literature and results from an original analysis of the Total Exposure Study (TES), which included 1,100 menthol and 2,400 nonmenthol adult smokers. The substantial scientific evidence available related to age of first cigarette, age of regular use, single-item dependence indicators (smoking frequency, cigarettes per day, time to first cigarette, night waking to smoke), smoking duration, numerous validated and widely accepted measures of nicotine/cigarette dependence, and our analysis of the TES do not support that menthol smokers are more dependent than nonmenthol smokers or that menthol increases dependence.
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Affiliation(s)
- Kimberly Frost-Pineda
- a Altria Client Services Inc., Center for Research and Technology , Richmond , Virginia , USA
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Besaratinia A, Tommasi S. The lingering question of menthol in cigarettes. Cancer Causes Control 2015; 26:165-169. [PMID: 25416451 DOI: 10.1007/s10552-014-0499-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 11/13/2014] [Indexed: 10/24/2022]
Abstract
Tobacco use is the single most important preventable cause of cancer-related deaths in the USA and many parts of the world. There is growing evidence that menthol cigarettes are starter tobacco products for children, adolescents, and young adults. Accumulating research also suggests that smoking menthol cigarettes reinforces nicotine dependence, impedes cessation, and promotes relapse. However, menthol cigarettes are exempt from the US Food and Drug Administration ban on flavored cigarettes due, in part, to the lack of empirical evidence describing the health consequences of smoking menthol cigarettes relative to regular cigarettes. Determining the biological effects of menthol cigarette smoke relative to regular cigarette smoke can clarify the health risks associated with the use of respective products and assist regulatory agencies in making scientifically based decisions on the development and evaluation of regulations on tobacco products to protect public health and to reduce tobacco use by minors. We highlight the inherent shortcomings of the conventional epidemiologic, clinical, and laboratory research on menthol cigarettes that have contributed to the ongoing debate on the public health impact of menthol in cigarettes. In addition, we provide perspectives on how future investigations exploiting state-of-the-art biomarkers of exposure and disease states can help answer the lingering question of menthol in cigarettes.
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Affiliation(s)
- Ahmad Besaratinia
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA, 90033, USA.
| | - Stella Tommasi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, M/C 9603, Los Angeles, CA, 90033, USA
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Wang T, Wang B, Chen H. Menthol facilitates the intravenous self-administration of nicotine in rats. Front Behav Neurosci 2014; 8:437. [PMID: 25566005 PMCID: PMC4267270 DOI: 10.3389/fnbeh.2014.00437] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 12/01/2014] [Indexed: 11/17/2022] Open
Abstract
Menthol is preferred by ~25% of smokers and is the most common flavoring additive in tobacco and electronic cigarettes. Although some clinical studies have suggested that menthol facilitates the initiation of smoking and enhances the dependence on nicotine, many controversies remain. Using licking as the operant behavior, we found that adolescent rats self-administering nicotine (30μg/kg/infusion, free base, i.v.) with contingent oral menthol (60μl, 0.01% w/v) obtained significantly more infusions than rats receiving a vehicle cue or rats self-administering i.v. saline with a menthol cue. Rats yoked to their menthol-nicotine masters emitted significantly fewer licks on the active spouts, indicating that contingent pairing between nicotine and menthol is required for sustained nicotine intake. Rats that self-administered nicotine with a menthol cue also exhibited a long-lasting extinction burst and robust reinstatement behavior, neither of which were observed in rats that self-administered saline with a menthol cue. The cooling sensation of menthol is induced by activating the transient receptor potential M8 (TRPM8) channel. When WS-23, an odorless agonist of the TRPM8 channel, was used as a contingent cue for nicotine, the rats obtained a similar number of nicotine infusions as the rats that were provided a menthol cue and exhibited a strong preference for the active spout. In contrast, highly appetitive taste and odor cues failed to support nicotine self-administration. These data indicated that menthol, likely by inducing a cooling sensation, becomes a potent conditioned reinforcer when it is contingently delivered with nicotine. Together, these results provide a key behavioral mechanism by which menthol promotes the use of tobacco products or electronic cigarettes.
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Affiliation(s)
- Tengfei Wang
- Department of Pharmacology, University of Tennessee Health Science Center Memphis, TN, USA
| | - Bin Wang
- College of Pharmacy, Shaanxi University of Chinese Medicine Xian Yang, Shaanxi, China
| | - Hao Chen
- Department of Pharmacology, University of Tennessee Health Science Center Memphis, TN, USA
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Smith SS, Fiore MC, Baker TB. Smoking cessation in smokers who smoke menthol and non-menthol cigarettes. Addiction 2014; 109:2107-17. [PMID: 24938369 PMCID: PMC4443703 DOI: 10.1111/add.12661] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 04/29/2014] [Accepted: 06/06/2014] [Indexed: 11/30/2022]
Abstract
AIMS To assess the relations of menthol cigarette use with measures of cessation success in a large comparative effectiveness trial (CET). DESIGN Participants were randomized to one of six medication treatment conditions in a randomized double-blind, placebo-controlled clinical trial. All participants received six individual counseling sessions. SETTING Community-based smokers in two communities in Wisconsin, USA. PARTICIPANTS A total of 1504 adult smokers who smoked at least 10 cigarettes per day during the past 6 months and reported being motivated to quit smoking. The analysis sample comprised 1439 participants: 814 white non-menthol smokers, 439 white menthol smokers and 186 African American (AA) menthol smokers. There were too few AA non-menthol smokers (n = 16) to be included in the analyses. INTERVENTIONS Nicotine lozenge, nicotine patch, bupropion sustained release, nicotine patch + nicotine lozenge, bupropion + nicotine lozenge and placebo. MEASUREMENTS Biochemically confirmed 7-day point-prevalence abstinence assessed at 4, 8 and 26 weeks post-quit. FINDINGS In longitudinal abstinence analyses (generalized estimating equations) controlling for cessation treatment, menthol smoking was associated with reduced likelihood of smoking cessation success relative to non-menthol smoking [model-based estimates of abstinence = 31 versus 38%, respectively; odds ratio (OR) = 0.71, 95% confidence interval (CI) = 0.59, 0.86]. In addition, among menthol smokers, AA women were at especially high risk of cessation failure relative to white women (estimated abstinence = 17 versus 35%, respectively; OR = 2.63, 95% CI = 1.75, 3.96; estimated abstinence rates for AA males and white males were both 30%, OR = 1.06, 95% CI = 0.60, 1.66). CONCLUSION In the United States, smoking menthol cigarettes appears to be associated with reduced cessation success compared with non-menthol smoking, especially in African American females.
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Affiliation(s)
- Stevens S. Smith
- Department of Medicine, University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, WI,Center for Tobacco Research and Intervention, UWSMPH
| | - Michael C. Fiore
- Department of Medicine, University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, WI,Center for Tobacco Research and Intervention, UWSMPH
| | - Timothy B. Baker
- Department of Medicine, University of Wisconsin School of Medicine and Public Health (UWSMPH), Madison, WI,Center for Tobacco Research and Intervention, UWSMPH
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Tobacco control environment in the United States and individual consumer characteristics in relation to continued smoking: differential responses among menthol smokers? Prev Med 2014; 65:47-51. [PMID: 24780527 PMCID: PMC4101025 DOI: 10.1016/j.ypmed.2014.04.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 04/15/2014] [Accepted: 04/18/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We used a consumer panel augmented with state-specific measures of tobacco control activities to examine the main effects and interactions among consumer behaviors, particularly menthol cigarette smoking, and tobacco control environment on cessation over a six-year period. METHODS We used the Nielson Homescan Panel, which tracks consumer purchasing behaviors, and tobacco control information matched to panelist zip code. We focused on 1582 households purchasing ≥20 packs from 2004 to 2009. Our analysis included demographics; purchasing behavior including menthol versus nonmenthol use (≥80% of cigarettes purchased being menthol), quality preferences (average price/pack), purchase recency, and nicotine intake (nicotine levels of cigarettes purchased); and tobacco control metrics (taxation, anti-tobacco advertising, smoke-free policies). RESULTS Menthol smoking (Hazard Ratio [HR]=0.79, 95% Confidence Interval [CI] 0.64, 0.99), being African American (HR=0.67, CI 0.46, 0.98), being male (HR=0.46, CI 0.28, 0.74), higher quality premium preferences (HR=0.80, CI 0.77, 0.91), lower recency (HR=1.04, CI 1.02, 1.05), and higher nicotine intake rates (HR=0.99, CI 0.99, 0.99) were related to continued smoking. No significant interactions were found. CONCLUSION While there were no interactions between menthol use and effects of tobacco control activities, we did find additional support for the decreased cessation rates among menthol cigarette smokers, particularly in the African American population.
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Azagba S, Minaker LM, Sharaf MF, Hammond D, Manske S. Smoking intensity and intent to continue smoking among menthol and non-menthol adolescent smokers in Canada. Cancer Causes Control 2014; 25:1093-9. [PMID: 24913782 DOI: 10.1007/s10552-014-0410-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 05/30/2014] [Indexed: 11/25/2022]
Abstract
PURPOSE Research suggests that menthol cigarette use is associated with nicotine dependence. However, findings on the relationship between menthol smoking status and quantity of cigarettes smoked are less clear. The objective of this paper was to examine whether menthol cigarette smoking is associated with higher smoking intensity and intention to continue smoking among adolescents. METHODS A nationally representative sample of 4,736 Canadian students in grades 9-12 was drawn from the 2010-2011 Canadian Youth Smoking Survey. Associations between smoking intensity and menthol smoking were examined using linear regression. A logistic regression was used to examine whether menthol smoking increased the odds that a student reported intention to continue smoking. RESULTS Thirty-two percentage of smokers in grades 9-12 smoked menthol cigarettes in the last 30 days. Unadjusted average number of cigarettes reported by menthol smokers was 6.86 compared with 4.59 among non-menthol smokers (p < 0.001). Multivariable results showed that the average number of cigarettes smoked by menthol smokers was greater than non-menthol smokers (β = 1.92; 95 % CI = 1.16-2.68). Similar results were found using the total number of cigarettes smoked in the past week. Additionally, menthol smokers had greater odds of reporting intent to continue smoking compared with non-menthol smokers (OR = 2.95; 95 % CI = 2.24-3.90). These results were similar when separate analyses were conducted for established smokers and experimental smokers. CONCLUSIONS The findings of this study along with existing evidence suggest the need for banning mentholated tobacco products in Canada, in part because of its significant effect on adolescent smoking.
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Affiliation(s)
- Sunday Azagba
- Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada,
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Liu JJ, Wabnitz C, Davidson E, Bhopal RS, White M, Johnson MRD, Netto G, Sheikh A. Smoking cessation interventions for ethnic minority groups--a systematic review of adapted interventions. Prev Med 2013; 57:765-75. [PMID: 24076130 DOI: 10.1016/j.ypmed.2013.09.014] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Revised: 08/22/2013] [Accepted: 09/18/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Existing smoking cessation interventions tend to be under utilized by ethnic minority groups. We sought to identify smoking cessation interventions that have been adapted to meet the needs of African-, Chinese- and South Asian-origin populations, to increase understanding of the approaches used to promote behavior change, to assess their acceptability to the target populations, and to evaluate their effectiveness. METHODS Two reviewers independently searched for, identified, critically appraised and extracted data from studies identified from 11 databases (January 1950-April 2013). Study quality was assessed using validated instruments (EPHPP and STROBE). Adaptations were independently coded using an established typology, and findings descriptively summarized and thematically synthesized. RESULTS 23 studies described interventions adapted for African-Americans, and five for Chinese-origin populations. No intervention adapted for South-Asian populations was identified. Six studies directly compared a culturally adapted versus a non-adapted intervention. Adapted interventions were more acceptable to ethnic minority groups, but this did not translate into improvements in smoking cessation outcomes. CONCLUSIONS Given the evidence of greater acceptability of adapted interventions, it may be ethically preferable to use these. There is, however, no clear evidence of the effectiveness of adapted interventions in promoting smoking cessation in ethnic minority groups.
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Affiliation(s)
- Jing Jing Liu
- Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
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Smoking, menthol cigarettes and all-cause, cancer and cardiovascular mortality: evidence from the National Health and Nutrition Examination Survey (NHANES) and a meta-analysis. PLoS One 2013; 8:e77941. [PMID: 24205038 PMCID: PMC3808303 DOI: 10.1371/journal.pone.0077941] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Accepted: 09/06/2013] [Indexed: 12/04/2022] Open
Abstract
Background The U.S. Food and Drug Administration has the authority to regulate tobacco product constituents, including menthol, if the scientific evidence indicates harm. Few studies, however, have evaluated the health effects of menthol cigarette use. Objective To investigate associations of cigarette smoking and menthol cigarette use with all-cause, cancer and cardiovascular risk in U.S. adults. Methods We studied 10,289 adults ≥ 20 years of age who participated in the National Health and Nutrition Examination Survey from 1999-2004 and were followed through December 2006. We also identified studies comparing risk of all-cause mortality, cardiovascular disease and cancer for menthol and nonmenthol cigarette smokers and estimates were pooled using random-effects models. Results Fifty-five percent of participants were never smokers compared to 23%, 17% and 5% of former, current nonmenthol and current menthol cigarette smokers, respectively. The adjusted hazard ratios (95% CI) for former, current nonmenthol and current menthol cigarette smokers compared to never smokers were 1.24 (0.96, 1.62), 2.40 (1.56, 3.71) and 2.07 (1.20, 3.58), respectively, for all-cause mortality; 0.92 (0.62, 1.37), 2.10 (1.02, 4.31) and 3.48 (1.52, 7.99) for cardiovascular mortality; and 1.91 (1.21, 3.00), 3.82 (2.19, 6.68) and 2.03 (1.00, 4.13) for cancer mortality. Using data from 3 studies of all-cause mortality, 5 of cardiovascular disease and 13 of cancer, the pooled relative risks (95% CI) comparing menthol cigarette smokers to nonmenthol cigarette smokers was 0.94 (0.85, 1.05) for all-cause mortality, 1.28 (0.91, 1.80) for cardiovascular disease and 0.84 (0.76, 0.92) for any cancer. Conclusions In a representative sample of U.S. adults, menthol cigarette smoking was associated with increased all-cause, cardiovascular and cancer mortality with no differences compared to nonmenthol cigarettes. In the systematic review, menthol cigarette use was associated with inverse risk of cancer compared to nonmenthol cigarette use with some evidence of an increased risk for cardiovascular disease.
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Rojewski AM, Toll BA, O'Malley SS. Menthol cigarette use predicts treatment outcomes of weight-concerned smokers. Nicotine Tob Res 2013; 16:115-9. [PMID: 24113927 DOI: 10.1093/ntr/ntt137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Studies have shown that individuals who smoke menthol cigarettes are less likely to quit smoking and more likely to relapse during a quit attempt. The current study investigated menthol cigarette use as a potential predictor of smoking cessation outcomes in a sample of treatment-seeking smokers. METHODS This is a secondary analysis of data from a randomized controlled trial of low-dose naltrexone augmentation of nicotine replacement designed to examine smoking cessation and postcessation weight gain in weight-concerned smokers. RESULTS Analyses revealed that menthol use predicted lower quit rates. Among menthol smokers (N = 61), 13% were abstinent at week 26, and among nonmenthol smokers (N = 105), 30% were abstinent (Wald = 4.15, p = .04; odds ratio [OR] = 2.47; 95% CI = 1.04-5.90). Further, menthol smokers who quit smoking gained significantly more weight at week 26 (M = 14.87 lbs, SD = 9.08; t(37) = -2.22, p = .03) than nonmenthol smokers who quit (M = 7.95 lbs, SD = 7.53). CONCLUSIONS Menthol cigarette use has not typically been evaluated as a predictor of smoking cessation outcomes, but emerging evidence suggests that consumption of menthol may make cessation more difficult. This study adds to the literature supporting the claim that smoking menthol cigarettes can have adverse effects on smoking cessation efforts and on other cessation-related outcomes, such as postcessation weight gain.
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Affiliation(s)
- Alana M Rojewski
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT
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Stahre MA, Toomey TL, Erickson DJ, Forster JL, Okuyemi KS, Ahluwalia JS. The Effects of a Tobacco Intervention on Binge Drinking Among African American Light Smokers. J Addict Dis 2013; 32:377-86. [DOI: 10.1080/10550887.2013.849972] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Reitzel LR, Etzel CJ, Cao Y, Okuyemi KS, Ahluwalia JS. Associations of menthol use with motivation and confidence to quit smoking. Am J Health Behav 2013; 37:629-34. [PMID: 23985285 DOI: 10.5993/ajhb.37.5.6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine associations of menthol cigarette use with motivation and confidence to quit smoking, and potential moderation by race, among adult current smokers (N = 1067; 85% White, 15% Black). METHODS Regression analyses, adjusted for sociodemographics and tobacco dependence, examined associations of menthol use with motivation and confidence to quit smoking with and without an interaction term for race. RESULTS Main effects were not significant; however, there was a significant interaction for confidence to quit smoking (p = .02). Stratified analyses indicated that Black menthol users were more confident about quitting than Black non-menthol users (p = .01). CONCLUSIONS Given their relatively lower quit rates as cited in previous literature, Black menthol users appear overly confident about their ability to quit smoking.
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Affiliation(s)
- Lorraine R Reitzel
- Department of Health Disparities Research, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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