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Kelpin S, Brockman TA, Decker PA, Young A, Boehmer K, Nguyen A, Kamath C, St Sauver J, Sinicrope PS, Sharma P, McCoy R, Allen S, Huang M, Pritchett J, Esterov D, Lampman M, Petersen C, Cheville A, Patten CA. Increasing digital equity to promote online smoking cessation program engagement among rural adults: a randomized controlled pilot trial. COMMUNICATIONS MEDICINE 2024; 4:194. [PMID: 39375517 DOI: 10.1038/s43856-024-00624-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 09/25/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND Cigarette smoking prevalence is higher for rural than urban adults, yet digital access to cessation programming is reduced. We aim to investigate digital access interventions to promote engagement with an online evidence-based cessation treatment (EBCT) program among rural adults. METHODS This pilot trial used a pragmatic, three-arm, randomized, parallel-group design (ClinicalTrials.gov: NCT05209451). Inclusion criteria included being aged ≥18, Mayo Clinic Midwest patient, rural residency, and currently smokes cigarettes. All participants received an online, 12-week EBCT program and were randomized to receive one of three digital access interventions: print materials (control, n = 30); print materials + loaner iPad device with data plan coverage (n = 30); or print materials + loaner device + up to six, 15-20-minute motivational interviewing-based coaching calls to support technology needs (n = 30). A composite score of trial engagement (primary outcome) and self-reported smoking abstinence and use of EBCT resources (secondary outcomes) were assessed online at 4 and 12 weeks. Qualitative interviews were used to assess patient experience. Neither participants nor outcome assessors were blinded to group assignment. RESULTS Results are reported for all 30 participants in each group. The average age of participants is 51.0 years and 61% are women. We show no significant arm differences for the trial engagement composite score (p = 0.30). We also find coaching support is significantly (p < 0.05) associated with enhanced smoking-related treatment response, including cigarette abstinence and use of EBCT resources, and participants reported positive experiences with the intervention. CONCLUSIONS The coaching intervention to support technology needs is acceptable and shows preliminary evidence of its efficacy in smoking-related treatment response. Further studies could refine and implement the coaching intervention for trial engagement and long-term cessation.
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Affiliation(s)
- Sydney Kelpin
- Department of Psychiatry & Psychology, Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Tabetha A Brockman
- Department of Psychiatry & Psychology, Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Paul A Decker
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Antonia Young
- Department of Psychiatry & Psychology, Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Kasey Boehmer
- Health Care Delivery Research, Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Aaron Nguyen
- Department of Psychiatry & Psychology, Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Celia Kamath
- Health Care Delivery Research, Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jennifer St Sauver
- Health Care Delivery Research, Knowledge and Evaluation Research (KER) Unit, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Pamela S Sinicrope
- Department of Psychiatry & Psychology, Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Pravesh Sharma
- Department of Psychiatry & Psychology, Mayo Clinic Health System, 1221 Whipple St., Eau Claire, WI, 54703, USA
| | - Rozalina McCoy
- Division of Community Internal Medicine, Geriatrics, and Palliative Care, Department of Medicine, Geriatrics, and Palliative Care, Department of Medicine, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Summer Allen
- Family Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Ming Huang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Joshua Pritchett
- Hematology/Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Dmitry Esterov
- Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Michelle Lampman
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Carolyn Petersen
- Division of HE&CS, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Andrea Cheville
- Physical Medicine and Rehabilitation & Palliative Medicine, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Christi A Patten
- Department of Psychiatry & Psychology, Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
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Sun J, Zhang M, Dang J, Niu X, Tao Q, Kang Y, Ma L, Mei B, Wei Y, Wang W, Han S, Cheng J, Zhang Y. Mapping brain activity and neurotransmitters pre-cigarette smoking evolution: A study of male subjects. J Psychiatr Res 2024; 180:39-46. [PMID: 39369637 DOI: 10.1016/j.jpsychires.2024.09.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 09/22/2024] [Accepted: 09/29/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND The impact of tobacco smoking on global health persists and it is essential to understand the progression of addiction and the involvement of neurotransmitters. METHODS This study assessed 47 participants with tobacco use disorder (TUD) categorized based on changes in Fagerström Test for Nicotine Dependence (FTND) scores over 6 years: progressive TUD (pTUD), regressive TUD (rTUD), and stable TUD (sTUD). Additionally, 35 healthy controls were included. Resting-state functional magnetic resonance imaging was used to evaluate brain regional homogeneity (ReHo) and correlations with neurotransmitter distributions using JuSpace. RESULTS Significant differences in ReHo were observed among pTUD, rTUD, sTUD, and controls. After strict Bonferroni correction, rTUD exhibited increased ReHo in the dorsolateral superior frontal gyrus compared to sTUD (p < 0.001) and controls (p < 0.001). Both pTUD (p < 0.001) and rTUD (p < 0.001) showed decreased ReHo in the superior temporal gyrus compared to sTUD. sTUD had increased ReHo in the supramarginal gyrus compared to all other groups (p < 0.001, p < 0.001, p = 0.002, separately). The strongest association, which survived rigorous Bonferroni correction, was between the ReHo changes in rTUD compared to sTUD and neurotransmitter distribution. This includes 5-hydroxytryptamine receptor 2A (p = 0.001), gamma-aminobutyric acid type A receptor (p < 0.001), norepinephrine transporter (p < 0.001), and N-Methyl-D-Aspartate (p = 0.002). CONCLUSIONS This study provides insights into how smoking behaviors correlate with alterations in brain activity and neurotransmitter function. By elucidating these neural links to tobacco use disorder progression, our findings contribute to a deeper understanding of smoking's neurological impact and potentially inform more targeted therapeutic strategies.
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Affiliation(s)
- Jieping Sun
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Mengzhe Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Jinghan Dang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Xiaoyu Niu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Qiuying Tao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Yimeng Kang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Longyao Ma
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Bohui Mei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Weijian Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China.
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China.
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Vrints C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J, Banning AP, Budaj A, Buechel RR, Chiariello GA, Chieffo A, Christodorescu RM, Deaton C, Doenst T, Jones HW, Kunadian V, Mehilli J, Milojevic M, Piek JJ, Pugliese F, Rubboli A, Semb AG, Senior R, Ten Berg JM, Van Belle E, Van Craenenbroeck EM, Vidal-Perez R, Winther S. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J 2024; 45:3415-3537. [PMID: 39210710 DOI: 10.1093/eurheartj/ehae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
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Martinelli S, Mazzotta A, Longaroni M, Petrucciani N. Potential role of glucagon-like peptide-1 (GLP-1) receptor agonists in substance use disorder: A systematic review of randomized trials. Drug Alcohol Depend 2024; 264:112424. [PMID: 39288591 DOI: 10.1016/j.drugalcdep.2024.112424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 08/17/2024] [Accepted: 08/18/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Increasing evidence suggests that GLP-1 receptor agonists (GLP-1RA) have a potential use in addiction treatment. Few studies have assessed the impact of GLP-1RA on substance use disorder (SUD), particularly in humans. The study aimed to do systematic review of clinical trials to assess GLP-1RA's effect on reducing SUD in patients. METHODS The scientific literature was reviewed using the MEDLINE, Scopus and Cochrane Library databases, following PRISMA guidelines. Studies including patients with a diagnosis of SU who were treated with GLP-1RA were selected. The primary outcome was GLP-1RA's therapeutic effect on SUD, and the secondary outcomes were therapeutic effects of GLP-1RA on weight, BMI and HbA1c. RESULTS 1218 studies were retrieved, resulting in 507 papers after title and abstract screening. Following full-text review, only 5 articles met inclusion criteria. We incorporated a total of 630 participants utilizing Exenatide (n=3) and Dulaglutide (n=2) as GLP-1RAs. Therapeutic effect of GLP-1RA on SUD was assessed in 5 studies, with 3 demonstrating a significant decrease in SUD (alcohol and nicotine). GLP-1RA's impact on body weight, BMI, and HbA1c, was reported in 3 studies. These revealed a notable reduction in these parameters among the GLP-1RA treated group. CONCLUSION This review will give an overview of current new findings in human studies; we suggest that the effects of GLP-1RA in SUD is a possible new option of therapy in addiction medicine.
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Affiliation(s)
- Silvia Martinelli
- Department of Life Sciences and Public Health, Catholic University of the Sacred Heart, Rome, Italy; Department of Mental Health, Local Health Authority Viterbo, Viterbo, Italy
| | - Alessandro Mazzotta
- Department of Surgery, M.G. General Vannini Hospital, Istituto Figlie Di San Camillo, Rome, Italy
| | - Mattia Longaroni
- Department of Surgery, Santa Maria della Misericordia Hospital, University of Perugia, Italy
| | - Niccolò Petrucciani
- Department of Medical and Surgical Sciences and Translational Medicine, Division of General and Hepatobiliary Surgery, St. Andrea Hospital, Sapienza University of Rome, Italy.
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5
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Pei D, Popova L, Chowdhury P, Shi J, Njie G. Exposure to anti- and pro-smoking messages among adults in China: Results from the Global Adult Tobacco Survey, 2018. PLoS One 2024; 19:e0304028. [PMID: 38870150 PMCID: PMC11175413 DOI: 10.1371/journal.pone.0304028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 05/05/2024] [Indexed: 06/15/2024] Open
Abstract
SIGNIFICANCE For decades, tobacco advertisements and promotions have been common in mass media and public places in China. In 2015, China amended the Advertising Law to prohibit the distribution of tobacco advertising, while also initiating waves of tobacco control media campaigns. This study investigates the associations between exposure to anti- and pro-smoking messages, smoking status, and people's smoking-related beliefs and willingness to support tobacco control policies. METHODS A secondary data analysis was performed with the 2018 Global Adult Tobacco Survey of 19,376 adults aged ≥15 years in China. Anti- and pro-smoking message exposures were measured as the sum of sources (media or places) where respondents have seen the messages. Multivariable logistic regression analyses were conducted to examine the relationships among smoking status, message exposure, and the outcome variables (health harm beliefs, support for increasing tax on cigarettes, support for using part of the increased tax on tobacco control) controlling for smoking status and demographic differences. RESULTS Overall, 63.3% of the respondents reported being exposed to anti-smoking messages from at least 1 source, while 18.1% were exposed to pro-smoking messages from at least 1 source. Adults who currently, formerly, and never smoked differed in their beliefs about smoking and willingness to support tobacco control policies. Greater reported exposure to anti-smoking messages was positively associated with belief that smoking is harmful, support for increased cigarette tax, and support for using increased tax revenue for tobacco control measures. Meanwhile, greater reported exposure to pro-smoking messages was negatively related to willingness to support cigarette tax increases. CONCLUSIONS While national and local tobacco control campaigns in China have reached a large proportion of the adult population, there is still room for improvement. China might consider expanding anti-tobacco campaigns, as reported exposure to these messages is associated with increased public awareness of the health hazards of smoking and support for increasing cigarette taxes.
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Affiliation(s)
- Di Pei
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Lucy Popova
- School of Public Health, Georgia State University, Atlanta, Georgia, United States of America
| | - Pranesh Chowdhury
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
| | - Jing Shi
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
- Noninfectious Disease Programs, CDC Foundation, Atlanta, Georgia, United States of America
| | - Gibril Njie
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America
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Xia X, Li YH, Liu Y, Su Z, Qin R, Liu Z, Xie Y, Huang ZX, Zhou XM, Cheng AQ, Li JX, Wei XW, Song QQ, Zhao L, Xiao D, Wang C. Prevalence of cigarette use and addiction among Chinese females by age and province: Findings from nationwide China Health Literacy Survey during 2018-19. Drug Alcohol Depend 2024; 258:111258. [PMID: 38503243 DOI: 10.1016/j.drugalcdep.2024.111258] [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: 12/13/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND The prevalence of cigarette smoking among women is significantly different from that of men, however, cigarette use by women is little known. The study aims to describe cigarette use prevalence and patterns among Chinese females by age and province. METHODS This study was based on the 2018 China Health Literacy Survey (2018 CHLS), a nationally representative cross-sectional study, and our analysis included 43,319 female participants aged 20-69 with valid data. The prevalence of cigarette use was estimated overall by sociodemographic factors and weighted based on the census population data. The logistic regression model was conducted to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the risk factors associated with cigarette use and dependency. RESULTS In China, the estimated female current cigarette use prevalence was 1.85%, with over half of the population suffering from tobacco dependence (7.34 million). Jilin Province has the highest cigarette prevalence among women (10.59%), while Fujian Province has the lowest (0.27%). Participants over 60 years old (aOR=1.61, 95%CI=1.20-2.14), single (aOR=1.54, 95%CI=1.07-2.21), with primary education (aOR=1.93, 95%CI=1.47-2.52) were more likely to smoke. The age of smoking initiation among women intergenerational advanced, and compared to the cigarette users without tobacco dependence, those who have tobacco dependence start smoking earlier in all age groups (25.69 years vs. 19.36 years, p<0.001). CONCLUSIONS The cigarette use prevalence among Chinese women was 1.85%, and there are significant differences among provinces. We noted a trend of women initiating smoking at increasingly younger ages, particularly among those with tobacco dependence.
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Affiliation(s)
- Xin Xia
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ying-Hua Li
- China Health Education Center, Beijing, China
| | - Yi Liu
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Su
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Rui Qin
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhao Liu
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
| | - Ying Xie
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhen-Xiao Huang
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin-Mei Zhou
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
| | - An-Qi Cheng
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
| | - Jin-Xuan Li
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Xiao-Wen Wei
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Qing-Qing Song
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Liang Zhao
- National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China
| | - Dan Xiao
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, China.
| | - Chen Wang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; National Center for Respiratory Medicine; State Key Laboratory of Respiratory Health and Multimorbidity; National Clinical Research Center for Respiratory Diseases; Institute of Respiratory Medicine, Chinese Academy of Medical Sciences; Department of Tobacco Control and Prevention of Respiratory Diseases, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China; Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China; Capital Medical University China-Japan Friendship School of Clinical Medicine, Beijing, China
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Abstract
Substance use disorders (SUD) present a worldwide challenge with few effective therapies except for the relative efficacy of opioid pharmacotherapies, despite limited treatment access. However, the proliferation of illicit fentanyl use initiated a dramatic and cascading epidemic of lethal overdoses. This rise in fentanyl overdoses regenerated an interest in vaccine immunotherapy, which, despite an optimistic start in animal models over the past 50 years, yielded disappointing results in human clinical trials of vaccines against nicotine, stimulants (cocaine and methamphetamine), and opioids. After a brief review of clinical and selected preclinical vaccine studies, the "lessons learned" from the previous vaccine clinical trials are summarized, and then the newest challenge of a vaccine against fentanyl and its analogs is explored. Animal studies have made significant advances in vaccine technology for SUD treatment over the past 50 years, and the resulting anti-fentanyl vaccines show remarkable promise for ending this epidemic of fentanyl deaths.
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Affiliation(s)
- Thomas R Kosten
- Waggoner Professor of Psychiatry, Pharmacology, Neuroscience, Immunology, Baylor College of Medicine, Houston
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8
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Abellán Alemán J, Sabaris RC, Pardo DE, García Donaire JA, Romanos FG, Iriso JI, Penagos LM, Iglesias LJN, de Salinas APM, Pérez-Monteoliva NRR, Lezcano PSR, Saborido MT, Roca FV. Documento de consenso sobre tabaquismo y riesgo vascular. HIPERTENSION Y RIESGO VASCULAR 2024; 41 Suppl 1:S1-S85. [PMID: 38729667 DOI: 10.1016/s1889-1837(24)00075-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Consensus statement on smoking and vascular risk About 22% of the Spanish population are daily smokers. Men are more likely to smoke than women. In Spain, women between 15-25 years of age smoke as much or more than men. Every smoker should be assessed for: physical dependence on nicotine (Fagerström test), social and psychological dependence (Glover Nilsson test), level of motivation to quit (Richmond test), probability of therapy success (Henri-Mondor and Michael-Fiore tests), and stage of behavioral change development (Prochaska and DiClementi). Advice on smoking cessation is highly cost-effective and should always be provided. Smoking is an enhancer of cardiovascular risk because it acts as a pathogen agent in the development of arteriosclerosis and is associated with ischemic heart disease, stroke, and peripheral artery disease. Smoking increases the risk of chronic lung diseases (COPD) and is related to cancers of the lung, female genitalia, larynx, oropharynx, bladder, mouth, esophagus, liver and biliary tract, and stomach, among others. Combined oral contraceptives should be avoided in women smokers older than 35 years of age due to the risk of thromboembolism. In smoking cessation, the involvement of physicians, nurses, psychologists, etc. is important, and their multidisciplinary collaboration is needed. Effective pharmacological treatments for smoking cessation are available. Combined treatments are recommended when smoker's dependence is high. For individuals who are unable to quit smoking, a strategy based on tobacco damage management with a total switch to smokeless products could be a less dangerous alternative for their health than continuing to smoke.
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Affiliation(s)
- José Abellán Alemán
- Sociedad Murciana de Hipertensión Arterial y Riesgo Cardiovascular, Cátedra de Riesgo Cardiovascular, Universidad Católica de Murcia, Murcia, España.
| | - Rafael Crespo Sabaris
- Sociedad Riojana de Hipertensión y Riesgo Vascular, Centro de Salud de Entrena, La Rioja, España
| | - Daniel Escribano Pardo
- Sociedad Aragonesa de Hipertensión y Riesgo Vascular, Centro de Salud Oliver, Zaragoza, España
| | - José Antonio García Donaire
- Sociedad Española de Hipertensión, Unidad de Hipertensión, Servicio de Medicina Interna, Hospital Clínico Universitario San Carlos, Madrid, España
| | - Fernando García Romanos
- Sociedad de Hipertensión y Riesgo Vascular de las Illes Balears, Centro de Salud Santa Catalina, Palma de Mallorca, España
| | - Jesús Iturralde Iriso
- Sociedad Vasca de Hipertensión y Riesgo Vascular, Centro de Salud la Habana-Cuba, Vitoria-Gasteiz, España
| | - Luis Martín Penagos
- Sociedad Cántabra de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - L Javier Nieto Iglesias
- Sociedad Castilla-La Mancha de Hipertensión y Riesgo Vascular, Unidad de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - Alfonso Pobes Martínez de Salinas
- Sociedad Asturiana de Hipertensión y Riesgo Vascular, Área de Gestión Clínica, Interáreas de Nefrología VII y VIII del SESPA, Asturias, España
| | | | - Pablo Sánchez-Rubio Lezcano
- Sociedad Aragonesa de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Hospital General Universitario San Jorge, Huesca, España
| | - Maribel Troya Saborido
- Sociedad Catalana de Hipertensión y Riesgo Vascular, Servicio de Nefrología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Francisco Valls Roca
- Sociedad Valenciana de Hipertensión y Riesgo Vascular, Centro de Salud de Beniganim, Valencia, España
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Apata J, Oladele A, Fahimi S, Atanda F, Barsha RAA, Crowley M, Redmond Y, Rose J, Assari S, Cohen JE, Sheikhattari P. Monday-Enhanced CEASE Program for Underserved Ethnic Minorities: a Mixed-Methods Study. J Racial Ethn Health Disparities 2024; 11:885-899. [PMID: 36995578 PMCID: PMC10062259 DOI: 10.1007/s40615-023-01570-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Due to the persistence of tobacco-related health disparities in the U.S., there is a need for innovative strategies to reach the underserved ethnic minority populations who are most at risk. As contemplations for health behavior modification tend to surge on Mondays, we explored the feasibility and effect of a Monday-enhanced smoking cessation program on quitting outcomes in a low-income ethnic minority community. AIMS To compare a Monday-enhanced with a standard Communities Engaged and Advocating for a Smoke-free Environment (CEASE) program and understand the overall experiences of participants in the program. METHODS In this mixed-methods study, affordable housing complexes (n = 4) and a church were randomly assigned either a Monday-enhanced (n = 3) or standard (n = 2) CEASE smoking cessation program. CEASE comprised twelve weekly group counseling sessions facilitated by trained peer motivators plus nicotine replacement products. Participants in the Monday-enhanced arm were encouraged to pick Mondays as a quitting day. Quantitative and qualitative data were collected during the program and at 3-month post-graduation. RESULTS Seventy-seven participants were enrolled in the study arms. In both groups combined, tobacco consumption reduced from 7.7 to 5.6 cig/day (mean reduction, 2.1; 95% CI: 0.9 to 5.1, p = 0.08). Although no significant difference in quit rate was observed between the two arms, more participants completed the follow-up survey in the Monday-enhanced than standard CEASE program [82.4% vs. 36.0%, p < 0.05]. While qualitative data suggested an overall satisfaction of participants with the program, motivation for quitting was higher in the Monday-enhanced CEASE program compared to the standard CEASE program. CONCLUSION The Monday-enhanced program is promising and may enhance participants' engagement and willingness to quit smoking, particularly in low-income ethnic minority communities. Further research should include larger sample sizes to better assess the efficacy of a Monday-enhanced program across diverse populations.
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Affiliation(s)
- Jummai Apata
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD USA
- The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD USA
| | - Adewumi Oladele
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD USA
| | - Saman Fahimi
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD USA
| | - Fiyinfolu Atanda
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD USA
| | - Rifath Ara Alam Barsha
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD USA
| | | | - Yvonne Redmond
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD USA
| | | | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA USA
- Department of Urban Public Health, Charles R Drew University of Medicine and Science, Los Angeles, CA USA
| | - Joanna E. Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - Payam Sheikhattari
- Center for Urban Health Disparities Research and Innovation, Morgan State University, Baltimore, MD USA
- The Prevention Sciences Research Center, School of Community Health and Policy, Morgan State University, Baltimore, MD USA
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10
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Panagopoulos VN, Bailey A, Kostopoulos GK, Ioannides AA. Changes in distinct brain systems identified with fMRI during smoking cessation treatment with varenicline: a review. Psychopharmacology (Berl) 2024; 241:653-685. [PMID: 38430396 DOI: 10.1007/s00213-024-06556-2] [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: 03/23/2023] [Accepted: 02/15/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Varenicline is considered one of the most effective treatment options for smoking cessation. Nonetheless, it is only modestly effective. A deeper comprehension of the effects of varenicline by means of the in-depth review of relevant fMRI studies may assist in paving the development of more targeted and effective treatments. METHODOLOGY A search of PubMed and Google Scholar databases was conducted with the keywords "functional magnetic resonance imaging" or "fMRI", and "varenicline". All peer-reviewed articles regarding the assessment of smokers with fMRI while undergoing treatment with varenicline and meeting the predefined criteria were included. RESULTS Several studies utilizing different methodologies and targeting different aspects of brain function were identified. During nicotine withdrawal, decreased mesocorticolimbic activity and increased amygdala activity, as well as elevated amygdala-insula and insula-default-mode-network functional connectivity are alleviated by varenicline under specific testing conditions. However, other nicotine withdrawal-induced changes, including the decreased reward responsivity of the ventral striatum, the bilateral dorsal striatum and the anterior cingulate cortex are not influenced by varenicline suggesting a task-dependent divergence in neurocircuitry activation. Under satiety, varenicline treatment is associated with diminished cue-induced activation of the ventral striatum and medial orbitofrontal cortex concomitant with reduced cravings; during the resting state, varenicline induces activation of the lateral orbitofrontal cortex and suppression of the right amygdala. CONCLUSIONS The current review provides important clues with regard to the neurobiological mechanism of action of varenicline and highlights promising research opportunities regarding the development of more selective and effective treatments and predictive biomarkers for treatment efficacy.
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Affiliation(s)
- Vassilis N Panagopoulos
- Laboratory for Human Brain Dynamics, AAI Scientific Cultural Services Ltd., Nicosia, Cyprus.
- Department of Physiology, Medical School, University of Patras, Patras, Greece.
| | - Alexis Bailey
- Pharmacology Section, St. George's University of London, London, UK
| | | | - Andreas A Ioannides
- Laboratory for Human Brain Dynamics, AAI Scientific Cultural Services Ltd., Nicosia, Cyprus
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11
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Shao J, Fei Y, Xiao J, Wang L, Zou S, Yang J. The role of miRNA-144-3p/Oprk1/KOR in nicotine dependence and nicotine withdrawal in male rats. Nicotine Tob Res 2023; 25:1856-1864. [PMID: 37455648 PMCID: PMC10664084 DOI: 10.1093/ntr/ntad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/31/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION The kappa-opioid receptor (KOR) has been implicated in mediating the behavioral and biochemical effects associated with nicotine reward and withdrawal; however, its underlying mechanisms remain to be further explored. METHODS Adult male Sprague-Dawley rats were used to establish a nicotine dependence and withdrawal model by injecting nicotine (3 mg/kg/day, s.c.) or vehicle for 14 days, followed by the termination of nicotine for 7 days. Body weight gain, pain behaviors, and withdrawal scores were assessed in succession. MicroRNA (miRNA) sequencing was performed, and quantitative real-time PCR was used to detect the expression of candidate miRNAs and Oprk1. Western blotting was performed to examine KOR protein expression of KOR. Luciferase assay was conducted to validate the relationship of certain miRNAs/Oprk1. RESULTS The behavioral results showed that nicotine dependence and withdrawal induced behavioral changes. Biochemical analyses demonstrated that miR-144-3p expression decreased and Oprk1/KOR expression increased in the prefrontal cortex, nucleus accumben, and hippocampus. Further investigation suggested that miR-144-3p exerted an inhibitory effect on Oprk1 expression in PC12 cells. CONCLUSIONS This study revealed that miR-144-3p/Oprk1/KOR might be a potential pathway underlying the adverse effects induced by nicotine dependence and withdrawal, and might provide a novel therapeutic target for smoking cessation. IMPLICATIONS This study demonstrates an impact of nicotine dependence and nicotine withdrawal on behavioral outcomes and the expressions of miR-144-3p/Oprk1/KOR in male rats. These findings have important translational implications given the continued use of nicotine and the difficulty in smoking cessation worldwide, which can be applied to alleviated the adverse effects induced by nicotine dependence and withdrawal, thus assist smokers to quit smoking.
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Affiliation(s)
- Jiali Shao
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
| | - Yanxia Fei
- Department of Anesthesiology, Women’s Hospital, School of Medicine Zhejiang University, Zhejiang, China
| | - Ji Xiao
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
| | - Lijuan Wang
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
| | - Shuangfa Zou
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
| | - Jinfeng Yang
- Department of Anesthesiology, Hunan Cancer Hospital, School of Xiangya Medicine, Central South University, Hunan, China
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Sansone L, Milani F, Fabrizi R, Belli M, Cristina M, Zagà V, de Iure A, Cicconi L, Bonassi S, Russo P. Nicotine: From Discovery to Biological Effects. Int J Mol Sci 2023; 24:14570. [PMID: 37834017 PMCID: PMC10572882 DOI: 10.3390/ijms241914570] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 10/15/2023] Open
Abstract
Nicotine, the primary psychoactive agent in tobacco leaves, has led to the widespread use of tobacco, with over one billion smokers globally. This article provides a historical overview of tobacco and discusses tobacco dependence, as well as the biological effects induced by nicotine on mammalian cells. Nicotine induces various biological effects, such as neoangiogenesis, cell division, and proliferation, and it affects neural and non-neural cells through specific pathways downstream of nicotinic receptors (nAChRs). Specific effects mediated by α7 nAChRs are highlighted. Nicotine is highly addictive and hazardous. Public health initiatives should prioritize combating smoking and its associated risks. Understanding nicotine's complex biological effects is essential for comprehensive research and informed health policies. While potential links between nicotine and COVID-19 severity warrant further investigation, smoking remains a significant cause of morbidity and mortality globally. Effective public health strategies are vital to promote healthier lifestyles.
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Affiliation(s)
- Luigi Sansone
- Department of Human Sciences and Quality, Life Promotion San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (L.S.); (M.B.); (M.C.); (A.d.I.); (S.B.)
- MEBIC Consortium, San Raffaele University, 00166 Rome, Italy
| | - Francesca Milani
- Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy; (F.M.); (R.F.); (L.C.)
| | - Riccardo Fabrizi
- Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy; (F.M.); (R.F.); (L.C.)
| | - Manuel Belli
- Department of Human Sciences and Quality, Life Promotion San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (L.S.); (M.B.); (M.C.); (A.d.I.); (S.B.)
- MEBIC Consortium, San Raffaele University, 00166 Rome, Italy
| | - Mario Cristina
- Department of Human Sciences and Quality, Life Promotion San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (L.S.); (M.B.); (M.C.); (A.d.I.); (S.B.)
- Department of Molecular Medicine, University La Sapienza, Viale del Policlinico 155, 00161 Rome, Italy
| | - Vincenzo Zagà
- Italian Society of Tabaccology (SITAB), 00136 Bologna, Italy;
| | - Antonio de Iure
- Department of Human Sciences and Quality, Life Promotion San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (L.S.); (M.B.); (M.C.); (A.d.I.); (S.B.)
- Experimental Neurophysiology IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy
| | - Luca Cicconi
- Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy; (F.M.); (R.F.); (L.C.)
| | - Stefano Bonassi
- Department of Human Sciences and Quality, Life Promotion San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (L.S.); (M.B.); (M.C.); (A.d.I.); (S.B.)
- Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma, Via di Val Cannuta 247, 00166 Rome, Italy; (F.M.); (R.F.); (L.C.)
| | - Patrizia Russo
- Department of Human Sciences and Quality, Life Promotion San Raffaele University, Via di Val Cannuta 247, 00166 Rome, Italy; (L.S.); (M.B.); (M.C.); (A.d.I.); (S.B.)
- MEBIC Consortium, San Raffaele University, 00166 Rome, Italy
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13
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Oates GR, Schechter MS. Aiming to Improve Equity in Pulmonary Health: Cystic Fibrosis. Clin Chest Med 2023; 44:555-573. [PMID: 37517835 PMCID: PMC10458995 DOI: 10.1016/j.ccm.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
This review summarizes the evidence of health disparities in cystic fibrosis (CF), an autosomal recessive genetic disorder with substantial variation in disease progression and outcomes. We review disparities by race, ethnicity, socioeconomic status, geographic location, gender identity, or sexual orientation documented in the literature. We outline the mechanisms that generate and perpetuate such disparities across levels and domains of influence and assess the implications of this evidence. We then recommend strategies for improving equity in CF outcomes, drawing on recommendations for the general population and considering approaches specific to people living with CF.
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Affiliation(s)
- Gabriela R Oates
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Michael S Schechter
- Division of Pulmonary Medicine, Department of Pediatrics, Virginia Commonwealth University and Children's Hospital of Richmond at VCU, Richmond, VA, USA
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Ashour AM. Use of Vaping as a Smoking Cessation Aid: A Review of Clinical Trials. J Multidiscip Healthc 2023; 16:2137-2144. [PMID: 37529148 PMCID: PMC10389080 DOI: 10.2147/jmdh.s419945] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/21/2023] [Indexed: 08/03/2023] Open
Abstract
Purpose Smoking is a global public health concern, with a significant negative impact on human health and healthcare spending. Vaping, or the use of electronic cigarettes (e-cigarettes), has emerged as a popular alternative to traditional nicotine replacement therapies (NRTs) for smoking cessation. While considered less harmful than combustible cigarettes, the long-term health effects of e-cigarettes (vaping) are unknown. Therefore, this study aimed to identify and provide a comprehensive overview of the performance of vaping in clinical trials. Patients and Methods A search was conducted in the ClinicalTrials.gov database on April 14th, 2023, using the search term "smoking cessation, e-cigarettes, NRTs, and vaping". Inclusion and exclusion criteria were defined to identify relevant clinical trials. Randomized controlled trials (RCTs) and non-randomized clinical trials that evaluated vaping as a therapeutic approach to smoking cessation were included. Results A total of 87 clinical trials were identified, of which only seven were related to smoking cessation through vaping as a form of treatment. The primary endpoint was the effect of vaping as smoking cessation, and the secondary endpoints were patients' abstinence rate, withdrawal symptoms, and adverse events of e-cigarettes. Most of the trials used e-cigarettes as an intervention, with some trials including a combination of e-cigarettes and other NRTs. The trials lasted from 4 weeks to 12 months. The overall results of the trials indicated that vaping was effective in helping smokers to quit. It was also associated with a lower risk of adverse events than combustible cigarettes. Conclusion Vaping appears to be an effective method for smoking cessation, and it is associated with a lower risk of adverse events than combustible cigarettes.
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Affiliation(s)
- Ahmed M Ashour
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
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15
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Harmelech T, Hanlon CA, Tendler A. Transcranial Magnetic Stimulation as a Tool to Promote Smoking Cessation and Decrease Drug and Alcohol Use. Brain Sci 2023; 13:1072. [PMID: 37509004 PMCID: PMC10377606 DOI: 10.3390/brainsci13071072] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive, drug-free, neural-circuit-based therapeutic tool that was recently cleared by the United States Food and Drug Associate for the treatment of smoking cessation. TMS has been investigated as a tool to reduce consumption and craving for many other substance use disorders (SUDs). This review starts with a discussion of neural networks involved in the addiction process. It then provides a framework for the therapeutic efficacy of TMS describing the role of executive control circuits, default mode, and salience circuits as putative targets for neuromodulation (via targeting the DLPFC, MPFC, cingulate, and insula bilaterally). A series of the largest studies of TMS in SUDs are listed and discussed in the context of this framework. Our review concludes with an assessment of the current state of knowledge regarding the use of rTMS as a therapeutic tool in reducing drug, alcohol, and nicotine use and identifies gaps in the literature that need to be addressed in future studies. Namely, while the presumed mechanism through which TMS exerts its effects is by modulating the functional connectivity circuits involved in executive control and salience of drug-related cues, it is also possible that TMS has direct effects on subcortical dopamine, a hypothesis that could be explored in greater detail with PET imaging.
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Affiliation(s)
| | - Colleen A Hanlon
- BrainsWay Ltd., Winston-Salem, NC 27106, USA
- Wake Forest School of Medicine, Winston-Salem, NC 27106, USA
| | - Aron Tendler
- BrainsWay Ltd., Winston-Salem, NC 27106, USA
- Department of Life Sciences, Ben Gurion University of the Negev, Beer-Sheva 84105, Israel
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16
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Ramsey AT, Cavazos-Rehg PA, Chen LS, Bierut LJ. Leveraging Implementation Science in the Treatment of Tobacco Use Disorder. MISSOURI MEDICINE 2023; 120:285-291. [PMID: 37609466 PMCID: PMC10441270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
The tobacco use disorder field has an armamentarium of approaches to help people quit smoking: medication-based treatment for tobacco use, digital therapeutics for just-intime behavioral interventions, genetic and metabolic biomarkers to guide tobacco treatment, to name a few. Whether the treatment approach is old or new, an underlying truth remains: the benefit is only as great as the extent to which these treatment approaches reach individuals who need them most and prove effective and feasible to implement in real-world settings. Further, certain treatments tend to be used more robustly in practice, namely, those that address a great need yet are low in cost, burden, and risk of clinical harms. This is where implementation science comes in, providing guidance on how best to get effective treatments adopted and used in clinical and community settings. Implementation science holds the keys to the uptake and routine use of evidence-based treatments and should be more fully leveraged in the tobacco use disorder field. At the same time, disruptive technologies in treatment are breaking new ground, pushing the field of implementation science to build a bigger "toolbox" of ways to improve access and quality of treatment in an ever-evolving landscape. In this paper, we underscore this synergy between tobacco treatment and implementation science. We spotlight emerging trends in tobacco use, effective and emerging treatment approaches for tobacco use, and ways that implementation science intersects with the current and evolving landscape of tobacco use and substance use disorder more broadly.
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Affiliation(s)
- Alex T Ramsey
- Associate Professor, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Patricia A Cavazos-Rehg
- Professor, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Li-Shiun Chen
- Professor, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Laura J Bierut
- Alumni Endowed Professor, Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
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Rahmadi M, Nurhan AD, Rahmawati RIA, Damayanti TF, Purwanto DA, Khotib J. Epigallocatechin Gallate Ameliorates Nicotine Withdrawal Conditions-Induced Somatic and Affective Behavior Changes in Mice and Its Molecular Mechanism. Behav Neurol 2023; 2023:5581893. [PMID: 37346971 PMCID: PMC10281828 DOI: 10.1155/2023/5581893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 04/10/2023] [Accepted: 05/20/2023] [Indexed: 06/23/2023] Open
Abstract
In nicotine withdrawal (NW) conditions, molecular changes, such as increasing corticotropin-releasing factor (CRF) in the amygdala, and melanocortin signaling in the hypothalamus, can occur in the brain, leading to increased feeding behavior and body weight as somatic changes as well as high anxiety-like behavior as an affective changes. Therefore, this research aimed to investigate the effect of epigallocatechin gallate (EGCG), the largest component in green tea, on CRF, pro-opiomelanocortin (POMC), and melanocortin four receptor gene expression in the brain under NW conditions. The 24 Balb/c male mice used were randomly divided into four groups. The doses used included normal saline 1.0 mL/kg as a control group, and nicotine 3.35 mg/kg that was administered subcutaneously three times a day. After NW conditions, EGCG 50 mg/kg was administered intraperitoneally two times a day. Behavior evaluation was performed to measure somatic and affective changes, and the animal was sacrificed for molecular analysis. The results showed that NW conditions significantly increased food intake, body weight, and anxiety-like behavior compared with the normal group. Meanwhile, EGCG significantly decreased food intake, body weight, and anxiety-like behavior compared with NW conditions in mice without EGCG. The polymerase chain reaction results also showed that EGCG decreased the CRF mRNA expression in the amygdala and increased the POMC. This indicated that EGCG improved somatic and affective behavior in NW conditions by decreasing CRF mRNA expression in the amygdala and increasing POMC mRNA expression in the hypothalamus.
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Affiliation(s)
- Mahardian Rahmadi
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Biomedical Pharmacy Research Group, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Ahmad D. Nurhan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Biomedical Pharmacy Research Group, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Retno I. A. Rahmawati
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Theresia F. Damayanti
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Djoko A. Purwanto
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Pharmaceutical Analysis Research Group, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Junaidi Khotib
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
- Biomaterial Translational Research Group, Faculty of Pharmacy, Universitas Airlangga, Surabaya 60115, Indonesia
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Patten CA, Koller KR, Sinicrope PS, Prochaska JJ, Young C, Resnicow K, Decker PA, Hughes CA, Merritt ZT, McConnell CR, Huang M, Thomas TK. Facebook Intervention to Connect Alaska Native People With Resources and Support to Quit Smoking: CAN Quit Pilot Randomized Controlled Trial. Nicotine Tob Res 2023; 25:803-813. [PMID: 36130170 PMCID: PMC10032195 DOI: 10.1093/ntr/ntac221] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/22/2022] [Accepted: 09/19/2022] [Indexed: 11/14/2022]
Abstract
INTRODUCTION There is some evidence that social media interventions can promote smoking cessation. This randomized controlled pilot study is the first to evaluate the feasibility and potential efficacy of a Facebook smoking cessation intervention among Alaska Native (AN) adults. AIMS AND METHODS Recruitment and data collection occurred from December 2019 to March 2021. Participants were recruited statewide in Alaska using Facebook advertisements with a targeted sample of 60 enrolled. Participants were stratified by gender, age, and rural or urban residence and randomly assigned to receive referral resources on evidence-based cessation treatments (EBCTs) (control, n = 30) or these resources plus a 3-month, closed (private), culturally tailored, Facebook group (intervention, n = 31) that connected participants to EBCT resources and was moderated by two Alaska Native Trained Tobacco Specialists. Assessments were conducted online post-randomization at 1, 3, and 6 months. Outcomes were feasibility (recruitment, retention, and intervention engagement), self-reported use of EBCTs, and biochemically confirmed seven-day point-prevalence smoking abstinence. RESULTS Of intervention participants, 90% engaged (eg posted, commented) more than once. Study retention was 57% at 6 months (no group differences). The proportion utilizing EBCTs was about double for intervention compared with the control group participants at 3 and 6 months. Smoking abstinence was higher for intervention than control participants at 3 months (6.5% vs. 0%, p = .16) but comparable at 6 months (6.4% vs. 6.7%, p = .97). CONCLUSIONS While additional research is needed to promote long-term cessation, this pilot trial supports recruitment feasibility during the Coronavirus Disease 2019 (COVID-19) pandemic, consumer uptake, and a signal for intervention efficacy on the uptake of cessation treatment and short-term smoking abstinence. IMPLICATIONS This study is the first evaluation of a social media intervention for smoking cessation among Indigenous people. We learned that statewide Facebook recruitment of AN adults who smoke was feasible and there was a signal for the efficacy of a Facebook intervention on the uptake of EBCT and short-term (3 months) biochemically verified smoking abstinence. Clinically, social media platforms may complement current care models by connecting AN individuals and others living in hard-to-reach communities to cessation treatment resources.
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Affiliation(s)
- Christi A Patten
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Kathryn R Koller
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Pamela S Sinicrope
- Department of Psychiatry and Psychology and Behavioral Health Research Program, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Judith J Prochaska
- Department of Medicine, Stanford Prevention Research Center, Stanford University, 1265 Welch Road, Stanford, CA, 94305-5411, USA
| | - Colleen Young
- Division of Consumer Communications, Social and Digital Innovation, Mayo Clinic Connect, 200 First St SW, Rochester, MN, 55905, USA
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, 109 S. Observatory, 3867 SPH1, Ann Arbor, MI, 48109, USA
| | - Paul A Decker
- Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Christine A Hughes
- Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Zoe T Merritt
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Clara R McConnell
- Wellness and Prevention, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
| | - Ming Huang
- Department of Artificial Intelligence and Informatics, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Timothy K Thomas
- Research Services, Division of Community Health Services, Alaska Native Tribal Health Consortium, 4000 Ambassador Dr, Anchorage, AK, 99508, USA
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Lile JA, Turner BW, Cox DH, Bonn-Miller MO, Katz NR, Shellenberg TP, Stoops WW, Strickland JC. Cannabis Use Disorder Treatment Preferences: A Pilot Survey in Current Users of Cannabis. J Addict Med 2023; 17:e87-e93. [PMID: 36731101 PMCID: PMC9950290 DOI: 10.1097/adm.0000000000001059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Highly effective treatments for cannabis use disorder (CUD) are lacking, and patient preferences have not been considered during treatment development. We therefore conducted an exploratory crowdsourced survey of individuals reporting current cannabis use and a willingness to cut down or quit their cannabis use, to determine their interest in various treatment aspects. METHODS Subjects (n = 63) were queried about their willingness to take medications as a function of type, route, and regimen and to participate in adherence monitoring. Subjects were also asked about their willingness to engage in behavioral/psychosocial interventions as a function of type, setting, and duration. Measures theorized to be associated with treatment preferences were also collected, including cannabis use variables, readiness to change, reduction or cessation goal, perceived cessation barriers, and medication use beliefs and behaviors. RESULTS Survey responses indicated that efforts to develop CUD medications should focus on nonsynthetic compounds administered orally or by mouth spray no more than once per day to maximize patient acceptance. Remote adherence monitoring and one-on-one outpatient behavioral treatment approaches, especially contingency management, are also anticipated to enhance participation. Most subjects indicated a preference to reduce their cannabis use rather than quit. CONCLUSIONS These data provide guidance for the development of CUD interventions based on the preferences of individuals interested in treatment for their cannabis use. Additional research is needed to confirm these results in a larger sample and determine if matching CUD patients with their preferred treatments improves success rates.
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Affiliation(s)
- Joshua A. Lile
- Department of Behavioral Science, University of Kentucky College of Medicine, College of Medicine Office Building, Lexington, KY 40536-0086, USA
- Department of Psychology, University of Kentucky College of Arts and Sciences, 106-B Kastle Hall, Lexington, KY 40506-0044, USA
- Department of Psychiatry, University of Kentucky College of Medicine, 3470 Blazer Pkwy, Lexington, KY 40509-1810, USA
| | - Brian W. Turner
- Center for Innovation in Population Health, University of Kentucky College of Public Health, Lexington, KY 40506, USA
| | - David H. Cox
- Department of Behavioral Science, University of Kentucky College of Medicine, College of Medicine Office Building, Lexington, KY 40536-0086, USA
| | | | - Ned R. Katz
- Department of Behavioral Science, University of Kentucky College of Medicine, College of Medicine Office Building, Lexington, KY 40536-0086, USA
| | - Thomas P. Shellenberg
- Department of Behavioral Science, University of Kentucky College of Medicine, College of Medicine Office Building, Lexington, KY 40536-0086, USA
| | - William W. Stoops
- Department of Behavioral Science, University of Kentucky College of Medicine, College of Medicine Office Building, Lexington, KY 40536-0086, USA
- Department of Psychology, University of Kentucky College of Arts and Sciences, 106-B Kastle Hall, Lexington, KY 40506-0044, USA
- Department of Psychiatry, University of Kentucky College of Medicine, 3470 Blazer Pkwy, Lexington, KY 40509-1810, USA
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21037, USA
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20
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Gao X, Zhang M, Yang Z, Niu X, Zhou B, Chen J, Wang W, Wei Y, Han S, Cheng J, Zhang Y. Nicotine addiction and overweight affect intrinsic neural activity and neurotransmitter activity: A fMRI study of interaction effects. Psychiatry Clin Neurosci 2023; 77:178-185. [PMID: 36468828 DOI: 10.1111/pcn.13516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/11/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Nicotine addiction and overweight often co-exist, but the neurobiological mechanism of their co-morbidity remains to be clarified. In this study, we explore how nicotine addiction and overweight affect intrinsic neural activity and neurotransmitter activity. METHODS This study included 54 overweight people and 54 age-, sex-, and handedness-matched normal-weight individuals, who were further divided into four groups based on nicotine addiction. We used a two-way factorial design to compare intrinsic neural activity (calculated by the fALFF method) in four groups based on resting-state functional magnetic resonance images (rs-fMRI). Furthermore, the correlation between fALFF values and PET- and SPECT-derived maps to examine specific neurotransmitter system changes underlying nicotine addiction and overweight. RESULTS Nicotine addiction and overweight affect intrinsic neural activity by themselves. In combination, they showed antagonistic effects in the interactive brain regions (left insula and right precuneus). Cross-modal correlations displayed that intrinsic neural activity changes in the interactive brain regions were related to the noradrenaline system (NAT). CONCLUSION Due to the existence of interaction, nicotine partially restored the changes of spontaneous activity in the interactive brain regions of overweight people. Therefore, when studying one factor alone, the other should be used as a control variable. Besides, this work links the noradrenaline system with intrinsic neural activity in overweight nicotine addicts. By examining the interactions between nicotine addiction and overweight from neuroimaging and molecular perspectives, this study provides some ideas for the treatment of both co-morbidities.
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Affiliation(s)
- Xinyu Gao
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Mengzhe Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Zhengui Yang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Xiaoyu Niu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Bingqian Zhou
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Jingli Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Weijian Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Key Laboratory for Functional Magnetic Resonance Imaging and Molecular imaging of Henan Province, Henan, China.,Engineering Technology Research Center for detection and application of brain function of Henan Province, Henan, China.,Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan, China.,Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan, China.,Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Zhengzhou, China.,Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan, China.,Engineering Research Center of Brain Function Development and Application of Henan Province, Henan, China
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21
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Non-Pharmacologic Approaches to Tobacco Cessation. Respir Med 2023. [DOI: 10.1007/978-3-031-24914-3_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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22
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Debbaneh P, Dhir S, Anderson M, Rivero A. Electronic Cigarettes: A Narrative Review and Cohort Study of Electronic Cigarette Users in the Otolaryngology Clinic. Perm J 2022; 26:85-93. [PMID: 36184759 PMCID: PMC9761286 DOI: 10.7812/tpp/22.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Electronic nicotine delivery systems (ENDSs) are growing in popularity, particularly in young adults. While in vitro and murine models have demonstrated potentially harmful health effects of ENDSs, long-term health effects and clinical outcomes are generally unknown. Use as a smoking cessation aid is propagated by studies of potential harm reduction compared to conventional cigarette smoking. We present a review of the current controversies of ENDS use and present a novel cohort of patients visiting the otolaryngology clinic with known ENDS use to understand their clinical and demographic characteristics and the prevalence of otolaryngologic inflammatory diagnoses. Eighty-eight patients had 105 diagnoses. Forty-three (48.9%) ENDS users had at least 1 inflammatory diagnosis. ENDS use was more common in White, male patients between the ages of 18 and 35 years. The most common inflammatory diagnoses were chronic otitis media (17.4%) and allergic rhinitis (13.0%). While the rate of inflammatory disease was significantly higher in male than in female patients (60.7% vs 28.1% p = 0.003), no significant association was seen between inflammatory disease and age, race/ethnicity, or length of ENDS use. The identification and description of patients with ENDS use will help clinicians' better risk-stratify otolaryngologic diagnoses associated with this novel health behavior. Additionally, further clinical research is necessary to elucidate long-term health outcomes of ENDS use.
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Affiliation(s)
- Peter Debbaneh
- 1Department of Otolaryngology—Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA,Peter Debbaneh, MD
| | - Sanidhya Dhir
- 2Chicago Medical School–Rosalind Franklin University, North Chicago, IL, USA
| | | | - Alexander Rivero
- 1Department of Otolaryngology—Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
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23
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Sha L, Yang X, Deng R, Wang W, Tao Y, Cao H, Ma Q, Wang H, Nie Y, Leng S, Lv Q, Li X, Wang H, Meng Y, Xu J, Greenshaw AJ, Li T, Guo WJ. Automated Digital Interventions and Smoking Cessation: Systematic Review and Meta-analysis Relating Efficiency to a Psychological Theory of Intervention Perspective. J Med Internet Res 2022; 24:e38206. [PMID: 36383408 PMCID: PMC9713619 DOI: 10.2196/38206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/13/2022] [Accepted: 11/01/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Smoking remains a highly significant preventable global public health problem. In this context, digital interventions offer great advantages in terms of a lack of biological side effects, possibility of automatic delivery, and consequent human resource savings relative to traditional interventions. Such interventions have been studied in randomized controlled trials (RCTs) but have not been systematically reviewed with the inclusion of text-based and multiplatform-based interventions. In addition, this area has not been evaluated from the perspective of the psychological theoretical basis of intervention. OBJECTIVE The aim of this paper is to assess the efficiency of digital interventions in RCT studies of smoking cessation and to evaluate the effectiveness of the strategies used for digital interventions. METHODS An electronic search of RCTs was conducted using PubMed, Embase, and the Cochrane Library by June 30, 2021. Eligible studies had to compare automated digital intervention (ADI) to the use of a self-help guideline or no intervention. Participants were current smokers (aged 16 years or older). As the main outcome, abstinence after endpoint was extracted from the studies. Systematic review and meta-analysis were conducted to assess the efficiency of ADIs. Metaregressions were conducted to assess the relationship between intervention theory and effectiveness. RESULTS A total of 19 trials (15,472 participants) were included in the analysis. The overall abstinence rate (95% CI) at the endpoint was 17.8% (17.0-18.7). The overall risk ratio of the intervention group compared to the controls at the endpoint was 17.8% (17.0-18.7). Cochrane risk-of-bias tool for randomized trials (ROB 2) suggested that most of the studies had a low risk of bias (56.3%). Psychological theory-related constructs or predictors, which refer to other theory-based concepts (rather than only behavioral theory) such as craving or anxiety, are associated with effectiveness. CONCLUSIONS This study found that ADI had a clear positive effect compared to self-help guidelines or to no intervention, and effectiveness was associated with theory-related constructs or predictors. ADIs should be promoted by policy makers and clinical practitioners to address the huge gap between the need for smoking cessation and availability of traditional treatment resources. Possible increases in ADI efficiency may be achieved by optimally integrating psychotherapeutic theories and techniques. TRIAL REGISTRATION PROSPERO CRD42021256593; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=256593.
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Affiliation(s)
- Leihao Sha
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Xia Yang
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Renhao Deng
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Wen Wang
- Chinese Evidence-Based Medicine Center, West China Hospital of Sichuan University, Chengdu, China
| | - YuJie Tao
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - HaiLing Cao
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Qianshu Ma
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Hao Wang
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Yirou Nie
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Siqi Leng
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Qiuyue Lv
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaojing Li
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Huiyao Wang
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Yajing Meng
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | - Jiajun Xu
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
| | | | - Tao Li
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
- Mental Health Center and Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Wan-Jun Guo
- Mental Health Center and Sichuan Clinical Medical Research Center for Mental Disorders, West China Hospital of Sichuan University, Chengdu, China
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24
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Lucchiari C, Masiero M, Mazzocco K, Veronesi G, Maisonneuve P, Jemos C, Salè EO, Spina S, Bertolotti R, Busacchio D, Pravettoni G. Nicotine-Free E-Cigarettes Might Promote Tobacco Smoking Reduction Better Than Nicotine Delivery Devices: Results of a Double-Blind Randomized Controlled Trial at 1 Year. Curr Oncol 2022; 29:8579-8590. [PMID: 36421329 PMCID: PMC9717729 DOI: 10.3390/curroncol29110676] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/28/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of the present study was to determine whether the use of e-cigarettes to aid in quitting contributed to the increase in the pulmonary health of chronic smokers. The efficacy of e-cigarettes to support a successful smoking cessation attempt was also investigated. A total of 210 smokers (78 women) were enrolled in a screening program for the early detection of lung cancer and distributed in three arms: nicotine e-cigarette plus support, nicotine-free e-cigarette plus support, and support. Results showed that participants in the nicotine e-cigarette arm had a significant and fast decrease in daily cigarettes, but that later they resume smoking more than the other two groups. Conversely, participants in the other two arms showed similar daily consumption at the two evaluation points. Among abstinent participants, only 12.5% reported cough, while 48% of current smokers had pulmonary symptoms. Our study suggests that, in the long run, the use of a nicotine-free liquid may favor reducing smoking and could be considered a good option in a clinical setting.
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Affiliation(s)
| | - Marianna Masiero
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.M.); (G.P.)
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
- Correspondence: ; Tel.: +39-02-9437-2099
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.M.); (G.P.)
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Giulia Veronesi
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy;
- Division of Thoracic Surgery, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Costantino Jemos
- Division of Pharmacy, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy; (C.J.); (E.O.S.)
| | - Emanuela Omodeo Salè
- Division of Pharmacy, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy; (C.J.); (E.O.S.)
| | - Stefania Spina
- Division of Thoracic and General Surgery, Humanitas Research Hospital, 20089 Milan, Italy;
| | - Raffaella Bertolotti
- Division of Thoracic Surgery, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Derna Busacchio
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy; (K.M.); (G.P.)
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology, IRCCS, 20141 Milan, Italy;
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Abstract
Relapse is a defining feature of smoking and a significant challenge in cessation management. Elucidation of novel factors underlying relapse may inform future treatments. Cotinine, the major metabolite of nicotine, has been shown to support intravenous self-administration in rats, implicating it as one potential factor contributing to nicotine reinforcement. However, it remains unknown whether cotinine would induce relapse-like behaviors. The current study investigated relapse to cotinine seeking in two relapse models, the reinstatement of drug seeking and incubation of drug craving models. In the reinstatement model, rats were trained to self-administer cotinine, underwent extinction of cotinine-associated responses, and were tested for cue-, drug-, or stress-induced reinstatement. Conditioned cues associated with cotinine self-administration, cotinine (1-2 mg/kg), or the pharmacological stressor yohimbine (1.25-2.5 mg/kg) induced reinstatement of cotinine seeking. Female rats displayed more pronounced cue-induced, but not drug- or stress-induced reinstatement than male rats. In the incubation of the craving model, rats were trained to self-administer cotinine and underwent forced withdrawal in home cages. Rats were tested for cue-induced cotinine-seeking on both withdrawal day 1 and withdrawal day 18. Rats exhibited greater cue-induced cotinine-seeking on withdrawal day 18 compared to withdrawal day 1, with no difference between male and female rats. These findings indicate that cotinine induces sex-specific relapse to drug seeking in rats, suggesting that cotinine may contribute to relapse.
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Affiliation(s)
- Xiaoying Tan
- Department of Anesthesiology & Perioperative Medicine
| | | | - Zheng-Ming Ding
- Department of Anesthesiology & Perioperative Medicine
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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26
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Parker HP, Dawson A, Jones MJ, Yan R, Ouyang J, Hong R, Hunter WN. Delineating the activity of the potent nicotinic acetylcholine receptor agonists (+)-anatoxin-a and (−)-hosieine-A. Acta Crystallogr F Struct Biol Commun 2022; 78:313-323. [PMID: 36048081 PMCID: PMC9435674 DOI: 10.1107/s2053230x22007762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
The affinity and thermodynamic parameters for the interactions of two naturally occurring neurotoxins, (+)-anatoxin-a and (−)-hosieine-A, with acetylcholine-binding protein were investigated using a fluorescence-quenching assay and isothermal titration calorimetry. The crystal structures of their complexes with acetylcholine-binding protein from Aplysia californica (AcAChBP) were determined and reveal details of molecular recognition in the orthosteric binding site. Comparisons treating AcAChBP as a surrogate for human α4β2 and α7 nicotinic acetylcholine receptors (nAChRs) suggest that the molecular features involved in ligand recognition and affinity for the protein targets are conserved. The ligands exploit interactions with similar residues as the archetypal nAChR agonist nicotine, but with greater affinity. (−)-Hosieine-A in particular has a high affinity for AcAChBP driven by a favorable entropic contribution to binding. The ligand affinities help to rationalize the potent biological activity of these alkaloids. The structural data, together with comparisons with related molecules, suggest that there may be opportunities to extend the hosieine-A scaffold to incorporate new interactions with the complementary side of the orthosteric binding site. Such a strategy may guide the design of new entities to target human α4β2 nAChR that may have therapeutic benefit.
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Zorrilla JG, Evidente A. Structures and Biological Activities of Alkaloids Produced by Mushrooms, a Fungal Subgroup. Biomolecules 2022; 12:biom12081025. [PMID: 35892335 PMCID: PMC9332295 DOI: 10.3390/biom12081025] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/11/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
Alkaloids are a wide family of basic N-containing natural products, whose research has revealed bioactive compounds of pharmacological interest. Studies on these compounds have focused more attention on those produced by plants, although other types of organisms have also been proven to synthesize bioactive alkaloids, such as animals, marine organisms, bacteria, and fungi. This review covers the findings of the last 20 years (2002–2022) related to the isolation, structures, and biological activities of the alkaloids produced by mushrooms, a fungal subgroup, and their potential to develop drugs and agrochemicals. In some cases, the synthesis of the reviewed compounds and structure−activity relationship studies have been described.
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Affiliation(s)
- Jesús G. Zorrilla
- Allelopathy Group, Department of Organic Chemistry, Institute of Biomolecules (INBIO), School of Science, University of Cadiz, C/Republica Saharaui, s/n, 11510 Puerto Real, Spain
- Department of Chemical Sciences, University of Naples “Federico II”, Complesso Universitario Monte Sant’Angelo, Via Cintia 4, 80126 Napoli, Italy;
- Correspondence:
| | - Antonio Evidente
- Department of Chemical Sciences, University of Naples “Federico II”, Complesso Universitario Monte Sant’Angelo, Via Cintia 4, 80126 Napoli, Italy;
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Interventions for Increasing Digital Equity and Access (IDEA) among rural patients who smoke: Study protocol for a pragmatic randomized pilot trial. Contemp Clin Trials 2022; 119:106838. [PMID: 35760340 DOI: 10.1016/j.cct.2022.106838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Cigarette smoking prevalence is higher among rural compared with urban adults, yet access to cessation programming is reduced. The Increasing Digital Equity and Access (IDEA) study aims to evaluate three digital access and literacy interventions for promoting engagement with an online evidence-based smoking cessation treatment (EBCT) program among rural adults. METHODS The pilot trial will use a pragmatic, three-arm, randomized, parallel-group design with participants recruited from a Midwest community-based health system in Minnesota, Wisconsin, and Iowa. All participants will receive an online, 12-week, EBCT program, and written materials on digital access resources. Participants will be stratified based on state of residence and randomly assigned with 1:1:1 allocation to one of three study groups: (1) Control Condition-no additional study intervention (n = 30); (2) Loaner Digital Device-Bluetooth enabled iPad with data plan coverage loaned for the study duration (n = 30); (3) Loaner Digital Device + Coaching Support-loaner device plus up to six, 15-20 min motivational interviewing-based coaching calls to enhance participants' digital access and literacy (n = 30). All participants will complete study assessments at baseline and 4- and 12-weeks post-randomization. Outcomes are cessation program and trial engagement, biochemically confirmed smoking abstinence, and patient experience. RESULTS A rural community advisory committee was formed that fostered co-design of the study protocol for relevance to rural populations, including the trial design and interventions. CONCLUSION Study findings, processes, and resources may have relevance to other health systems aiming to foster digital inclusion in smoking cessation and chronic disease management programs and clinical trials in rural communities.
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Oates GR, Schechter MS. Socioeconomic determinants of respiratory health in patients with cystic fibrosis: implications for treatment strategies. Expert Rev Respir Med 2022; 16:637-650. [PMID: 35705523 DOI: 10.1080/17476348.2022.2090928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Great variation exists in the progression and outcomes of cystic fibrosis (CF) lung disease, due to both genetic and environmental influences. Social determinants mediate environmental exposures and treatment success; people with CF from socioeconomically disadvantaged backgrounds have worse health and die younger than those in more advantaged positions. AREAS COVERED This paper reviews the literature on the mechanisms that are responsible for generating and sustaining disparities in CF health, and the ways by which social determinants translate into health advantages or disadvantages in people with CF. The authors make recommendations for addressing social risk factors in CF clinical practice. EXPERT OPINION Socioeconomic factors are not dichotomous and their impact is felt at every step of the social ladder. CF care programs need to adopt a systematic protocol to screen for health-related social risk factors, and then connect patients to available resources to meet individual needs. Considerations such as daycare, schooling options, living and working conditions, and opportunities for physical exercise and recreation as well as promotion of self-efficacy are often overlooked. In addition, advocacy for changes in public policies on health insurance, environmental regulations, social welfare, and education would all help address the root causes of CF health inequities.
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Affiliation(s)
- Gabriela R Oates
- Division of Pulmonary and Sleep Medicine, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Michael S Schechter
- Division of Pulmonary Medicine, Department of Pediatrics, Virginia Commonwealth University and Children's Hospital of Richmond at VCU, USA
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The effect of aerobic exercises of different intensities on anxiety, cigarette addiction, sleep quality, and quality of life in former smokers. Ir J Med Sci 2022:10.1007/s11845-022-03065-z. [PMID: 35723855 DOI: 10.1007/s11845-022-03065-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/09/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND There is a worldwide struggle to quit smoking and prevent relapsing. Aerobic exercises are frequently utilized to aid in smoking cessation and prevent relapse. AIMS This study aimed to investigate the effects of aerobic exercises of different intensity on the level of anxiety, smoking addiction, and quality of sleep and life in former smokers. METHODS The study included 60 people aged 18 to 45 who had quit smoking within the previous month. Individuals were randomly assigned to control (CON), mild-intensity aerobic activity (MIA), and moderate-intensity aerobic activity (MoIA) groups. The MIA group did submaximal aerobic exercises at 40% of maximum heart rate (MHR), while the MoIA group did them at 60% of MHR for 8 weeks/3 days. Participants' anxiety levels were assessed using the Beck Anxiety Scale (BAS), smoking addiction was assessed using the Fagerström Test for Nicotine Dependence and Substance Craving Scale (SCS), sleep quality was assessed using the Pittsburgh Sleep Quality Index, and quality of life was assessed using the SF-36 Short Form Scale (SF-36). RESULTS The SCS score of the MoIA group declined more than the MIA and CON groups, and the MIA group had a lower sleep disturbance score than other groups when the influence of exercise training was assessed over time (p < 0.05). Aerobic exercise had no influence on SF-36 or BAS scores (p > 0.05). CONCLUSIONS The benefits of mild and moderate aerobic exercise on quality of life and anxiety are similar. However, mild-intensity aerobic exercises may be suitable for sleep difficulties while moderate-intensity aerobic exercises may be preferred for reducing smoking addiction.
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Ye X, Zhang Y, Song X, Liu Q. Research Progress in the Pharmacological Effects and Synthesis of Nicotine. ChemistrySelect 2022. [DOI: 10.1002/slct.202104425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Xiaoping Ye
- Department of Pharmaceutical Engineering College of Chemical Engineering Northwest University Taibai North Road 229 Xi'an 710069 Shaanxi P.R. China
| | - Yanxin Zhang
- Department of Pharmaceutical Engineering College of Chemical Engineering Northwest University Taibai North Road 229 Xi'an 710069 Shaanxi P.R. China
- Glycobiology and Glycotechnology Research center College of Food Science and Technology Northwest University Taibai North Road 229 Xi'an 710069 Shaanxi P.R. China
- College of Life Sciences Northwest University Taibai North Road 229 Xi'an 710069 Shaanxi P.R. China
| | - Xiaoping Song
- Department of Pharmaceutical Engineering College of Chemical Engineering Northwest University Taibai North Road 229 Xi'an 710069 Shaanxi P.R. China
- Shaanxi Key Laboratory of Degradable Biomedical Materials College of Chemical Engineering Northwest University Taibai North Road 229 Xi'an 710069 Shaanxi P.R. China
- Shaanxi R&D Center of Biomaterials and Fermentation Engineering College of Chemical Engineering Northwest University Taibai North Road 229 Xi'an 710069 Shaanxi P.R. China
| | - Qingchao Liu
- Department of Pharmaceutical Engineering College of Chemical Engineering Northwest University Taibai North Road 229 Xi'an 710069 Shaanxi P.R. China
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32
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Defining the Role of the Physical Therapist in Addressing Vaping and Smoking Cessation. Cardiopulm Phys Ther J 2022. [DOI: 10.1097/cpt.0000000000000199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Davis S, Zhu J. Substance abuse and neurotransmission. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2022; 93:403-441. [PMID: 35341573 PMCID: PMC9759822 DOI: 10.1016/bs.apha.2021.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The number of people who suffer from a substance abuse disorder has continued to rise over the last decade; particularly, the number of drug-related overdose deaths has sharply increased during the COVID-19 pandemic. Converging lines of clinical observations, supported by imaging and neuropsychological performance testing, have demonstrated that substance abuse-induced dysregulation of neurotransmissions in the brain is critical for development and expression of the addictive properties of abused substances. Recent scientific advances have allowed for better understanding of the neurobiological processes that mediates drugs of abuse and addiction. This chapter presents the past classic concepts and the recent advances in our knowledge about how cocaine, amphetamines, opioids, alcohol, and nicotine alter multiple neurotransmitter systems, which contribute to the behaviors associated with each drug. Additionally, we discuss the interactive effects of HIV-1 or COVID-19 and substance abuse on neurotransmission and neurobiological pathways. Finally, we introduce therapeutic strategies for development of pharmacotherapies for substance abuse disorders.
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Affiliation(s)
- Sarah Davis
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, United States
| | - Jun Zhu
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, United States.
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Ock M, Shin JS, Ra SW. Safety and Effectiveness of Varenicline in Korean Smokers: A Nationwide Post-Marketing Surveillance Study. Patient Prefer Adherence 2022; 16:413-426. [PMID: 35210758 PMCID: PMC8858022 DOI: 10.2147/ppa.s344757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 01/20/2022] [Indexed: 12/04/2022] Open
Abstract
PURPOSE Varenicline has demonstrated its safety and efficacy in Western studies including <3% of Asian participants. This prospective multi-center observational study investigated the safety and effectiveness of varenicline in Korean smokers. PATIENTS AND METHODS Smokers prescribed varenicline for the first time were enrolled from 252 medical institutions. Investigators recorded and graded all adverse events (AEs). To assess the effectiveness of varenicline, the 7-day point prevalence (PP) of smoking cessation was evaluated at the four visits during the 12-week treatment course. Rates of AE incidence and smoking cessation were analyzed using Chi-squared test or Fisher's exact test. This study is registered with ClinicalTrials.gov, number NCT00483002. RESULTS A total of 3719 and 3700 study subjects were included in the safety and effectiveness analyses, respectively. Overall, 346 (9.3%) subjects experienced 471 AEs: 358 mild, 97 moderate, 9 severe, and 7 serious. The most frequent AEs were nausea (5.1%), dyspepsia (0.8%), abnormal dreams (0.8%), insomnia (0.8%), and headache (0.7%). Among the subjects with AEs, 73 subjects discontinued treatment, of which 68 were due to AE occurrence. The 7-day PP of smoking cessation at weeks 1-2, 3-6, 7-10, and ≥ week 11 were 51.7% (387/749), 59.6% (1740/2922), 73.3% (1114/1520), and 77.0% (1116/1449), respectively (p for trend = 0.023). Comorbidities and allergies were associated with a higher incidence of AEs and lower smoking cessation rate (p < 0.05). Younger subjects, infrequent alcohol drinkers, and lighter smokers showed a higher smoking cessation rate (p < 0.05). CONCLUSION Varenicline in adult Korean smokers was well tolerated and effective as a smoking cessation aid in routine clinical practice.
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Affiliation(s)
- Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Ji Soo Shin
- Medical Affairs, Pfizer Korea, Seoul, South Korea
| | - Seung Won Ra
- Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
- Correspondence: Seung Won Ra, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 44033, South Korea, Tel +82 52 250 8857, Fax +82 52 250 7048, Email
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Truong TT, Kosten TR. Current status of vaccines for substance use disorders: A brief review of human studies. J Neurol Sci 2021; 434:120098. [PMID: 34952345 DOI: 10.1016/j.jns.2021.120098] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 12/12/2021] [Accepted: 12/14/2021] [Indexed: 01/20/2023]
Abstract
Substance use is a major public health concern worldwide. In the United States, drug-related deaths have increased many-fold in the past two decades due to the infiltration of more potent and lethal drugs such as fentanyl. Despite significant advancement in medicine, the management of substance use disorders (SUD) continues to be fraught with high attrition, relapse, morbidity, and mortality. The conceptual transition of a SUD from a moral failing to a chronic disease caused by substances facilitated the expansion of biological treatments, including pharmacotherapy, neurostimulation, and immunotherapy. While the quest for vaccines against drugs of abuse had an optimistic start in animal models, clinical trials in humans have yielded disappointing results. This paper provides a brief review on the current progress of vaccines against nicotine, stimulants (cocaine and methamphetamine), opioids including fentanyl, novel psychoactive substances (synthetic cathinones and synthetic cannabis), and discusses prospects for vaccine technology in the treatment of SUD.
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Affiliation(s)
- Thanh Thuy Truong
- Baylor College of Medicine, Menninger Department of Psychiatry and Behavioral Sciences, 1 Baylor plaza, Houston, TX 77030, USA.
| | - Thomas R Kosten
- Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, BLDG 110, Rm 229, Houston, TX 77030, USA.
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Thayer LS, Tiffany EM, Carreira DS. Addressing Smoking in Musculoskeletal Specialty Care. J Bone Joint Surg Am 2021; 103:2145-2152. [PMID: 34546983 DOI: 10.2106/jbjs.21.00108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
➤ Physicians who advise patients to quit smoking substantially improve cessation rates, but cessation counseling is currently underperformed. ➤ Counseling, pharmacotherapy, and additional interventions can improve the chance of successful smoking cessation. Most patients require multiple attempts at quitting to be successful. ➤ A list of referral contacts and resources should be developed and routinely offered to these patients. The national Quitline (1-800-QUIT-NOW) provides free access to trained counselors and "quit coaches" for each state program in the United States. ➤ Government and private insurance plans in the United States are required (in most cases) to cover the cost of 2 quitting attempts per year including counseling referrals and medications. ➤ Several biopsychosocial factors that affect orthopaedic outcomes (weight, anxiety, depression, etc.) are also relevant to smoking cessation; management of these factors is thus potentially aggregately advantageous.
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Affiliation(s)
| | - Elizabeth M Tiffany
- Department of Psychiatry, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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Tan X, Vrana K, Ding ZM. Cotinine: Pharmacologically Active Metabolite of Nicotine and Neural Mechanisms for Its Actions. Front Behav Neurosci 2021; 15:758252. [PMID: 34744656 PMCID: PMC8568040 DOI: 10.3389/fnbeh.2021.758252] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
Tobacco use disorder continues to be a leading public health issue and cause of premature death in the United States. Nicotine is considered as the major tobacco alkaloid causing addiction through its actions on nicotinic acetylcholine receptors (nAChRs). Current pharmacotherapies targeting nicotine's effects produce only modest effectiveness in promoting cessation, highlighting the critical need for a better understanding of mechanisms of nicotine addiction to inform future treatments. There is growing interest in identifying potential contributions of non-nicotine components to tobacco reinforcement. Cotinine is a minor alkaloid, but the major metabolite of nicotine that can act as a weak agonist of nAChRs. Accumulating evidence indicates that cotinine produces diverse effects and may contribute to effects of nicotine. In this review, we summarize findings implicating cotinine as a neuroactive metabolite of nicotine and discuss available evidence regarding potential mechanisms underlying its effects. Preclinical findings reveal that cotinine crosses the blood brain barrier and interacts with both nAChRs and non-nAChRs in the nervous system, and produces neuropharmacological and behavioral effects. Clinical studies suggest that cotinine is psychoactive in humans. However, reviewing evidence regarding mechanisms underlying effects of cotinine provides a mixed picture with a lack of consensus. Therefore, more research is warranted in order to provide better insight into the actions of cotinine and its contribution to tobacco addiction.
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Affiliation(s)
- Xiaoying Tan
- Department of Anesthesiology & Perioperative Medicine, and Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Kent Vrana
- Department of Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Zheng-Ming Ding
- Department of Anesthesiology & Perioperative Medicine, and Pharmacology, Pennsylvania State University College of Medicine, Hershey, PA, United States
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Chaffee BW, Couch ET, Vora MV, Holliday RS. Oral and periodontal implications of tobacco and nicotine products. Periodontol 2000 2021; 87:241-253. [PMID: 34463989 PMCID: PMC8444622 DOI: 10.1111/prd.12395] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tobacco use contributes to more mortality and morbidity globally than any other behavioral risk factor. Adverse effects do not spare the oral cavity, with many oral diseases more common, and treatments less successful, in the tobacco-using patient. Many of the oral health effects of cigarette smoking are well established, but other forms of tobacco, including cigars and smokeless tobacco, merit dental professionals' attention. Recently, an expanding variety of new or emerging tobacco and/or nicotine products has been brought to market, most prominently electronic cigarettes, but also including heated tobacco and other noncombustible nicotine products. The use of cannabis (marijuana) is increasing and also has risks for oral health and dental treatment. For the practicing periodontist, and all dental professionals, providing sound patient recommendations requires knowledge of the general and oral health implications associated with this wide range of tobacco and nicotine products and cannabis. This review provides an overview of selected tobacco and nicotine products with an emphasis on their implications for periodontal disease risk and clinical management. Also presented are strategies for tobacco use counselling and cessation support that dental professionals can implement in practice.
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Affiliation(s)
- Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Elizabeth T. Couch
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Manali V. Vora
- Division of Periodontology, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Richard S. Holliday
- NIHR Clinical Lecturer in Restorative Dentistry, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Abstract
BACKGROUND Animal models are critical to improve our understanding of the neuronal mechanisms underlying nicotine withdrawal. Nicotine dependence in rodents can be established by repeated nicotine injections, chronic nicotine infusion via osmotic minipumps, oral nicotine intake, tobacco smoke exposure, nicotine vapor exposure, and e-cigarette aerosol exposure. The time course of nicotine withdrawal symptoms associated with these methods has not been reviewed in the literature. AIM The goal of this review is to discuss nicotine withdrawal symptoms associated with the cessation of nicotine, tobacco smoke, nicotine vapor, and e-cigarette aerosol exposure in rats and mice. Furthermore, age and sex differences in nicotine withdrawal symptoms are reviewed. RESULTS Cessation of nicotine, tobacco smoke, nicotine vapor, and e-cigarette aerosol exposure leads to nicotine withdrawal symptoms such as somatic withdrawal signs, changes in locomotor activity, anxiety- and depressive-like behavior, learning and memory deficits, attention deficits, hyperalgesia, and dysphoria. These withdrawal symptoms are most pronounced within the first week after cessation of nicotine exposure. Anxiety- and depressive-like behavior, and deficits in learning and memory may persist for several months. Adolescent (4-6 weeks old) rats and mice display fewer nicotine withdrawal symptoms than adults (>8 weeks old). In adult rats and mice, females show fewer nicotine withdrawal symptoms than males. The smoking cessation drugs bupropion and varenicline reduce nicotine withdrawal symptoms in rodents. CONCLUSION The nicotine withdrawal symptoms that are observed in rodents are similar to those observed in humans. Tobacco smoke and e-cigarette aerosol contain chemicals and added flavors that enhance the reinforcing properties of nicotine. Therefore, more valid animal models of tobacco and e-cigarette use need to be developed by using tobacco smoke and e-cigarette aerosol exposure methods to induce dependence.
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Affiliation(s)
| | - Azin Behnood-Rod
- Department of Psychiatry, University of Florida, Gainesville, USA
| | | | - Ryann Wilson
- Department of Psychiatry, University of Florida, Gainesville, USA
| | - Vijayapandi Pandy
- Department of Pharmacology, Chalapathi Institute of Pharmaceutical Sciences, Guntur, India
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Electrically controlled nicotine delivery through Carbon nanotube membranes via electrochemical oxidation and nanofluidically enhanced electroosmotic flow. Biomed Microdevices 2021; 23:48. [PMID: 34562167 DOI: 10.1007/s10544-021-00580-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
A promising tool for nicotine addiction treatment is a programmable nicotine delivery device coupled to smart phone-assisted behavioral therapies. Key metrics for such a device are delivery of adjustable nicotine doses tailored to individual needs, compact size and power efficiency. Reported here is a detailed optimization of carbon nanotube (CNT) membrane fabrication based on electrochemical oxidation, to improve its electrically driven performance for nicotine fluxes and switching ON (-1.5 V)-OFF (0 V) flux ratio. ON- state nicotine flux of ~ 6 µmoles/cm2/h at -1.5 V applied bias was achieved allowing ~ 6-folds decrease in the size of device (4 cm2) to attain flux equivalent to high dose nicotine gum (1.1 µmoles/cm2/h). Application of + 1.5 V bias in OFF state reduced diffusional background flux, giving an ON (-1.5 V)/OFF (+ 1.5 V) flux ratio of 68 that enabled device to deliver between the highest nicotine gum (1.1 µmoles/cm2/h) and lowest nicotine patch (0.08 µmoles/cm2/h) doses, as well as taper off nicotine doses for long term addiction treatment. The nicotine transport mechanism was studied as a function of pH and applied bias, using neutral tracer molecule, showing a mechanism of both electroosmosis and electrophoresis in the atomically smooth nanofluidic pores of CNTs. Optimal power consumption/flux efficiency of 111(µW/cm2)/µmoles/cm2/h was achieved allowing watch-battery lifetimes of 7-62 days for conventional treatment dosing regimens. Bluetooth-enabled, remotely controlled CNT membrane system has potential for treatments of nicotine, opioid and alcohol addictions that needs dose adjustment with precise temporal control.
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Klausen MK, Thomsen M, Wortwein G, Fink-Jensen A. The role of glucagon-like peptide 1 (GLP-1) in addictive disorders. Br J Pharmacol 2021; 179:625-641. [PMID: 34532853 DOI: 10.1111/bph.15677] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/21/2021] [Accepted: 06/19/2021] [Indexed: 11/29/2022] Open
Abstract
Drug-, alcohol- and tobacco use disorders are a global burden affecting millions of people. Despite decades of research, treatment options are sparse or missing, and relapse rates are high. Glucagon-like peptide-1 (GLP-1) is released in the small intestines, promotes blood glucose homeostasis, slows gastric emptying, and reduces appetite. GLP-1 receptor agonists approved for treating type 2 diabetes mellitus and obesity, have received attention as a potential anti-addiction treatment. Studies in rodents and non-human primates have demonstrated a reduction in intake of alcohol and drugs of abuse, and clinical trials have been initiated to investigate whether the preclinical findings can be translated to patients. This review will give an overview of current findings and discuss the possible mechanisms of action. We suggest that effects of GLP-1 in alcohol- and substance use disorder is mediated centrally, at least partly through dopamine signalling, but precise mechanisms are still to be uncovered.
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Affiliation(s)
- Mette Kruse Klausen
- Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Morgane Thomsen
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Gitta Wortwein
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
| | - Anders Fink-Jensen
- Laboratory of Neuropsychiatry, Psychiatric Centre Copenhagen and University Hospital of Copenhagen, Copenhagen, Denmark
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Eleftheriou C, Zacharia LC. Ginkgo biloba L. flavonoids inhibit CYP 2A5; potential dietary supplement for nicotine replacement therapy enhancement. Nat Prod Res 2021; 36:4210-4214. [PMID: 34498955 DOI: 10.1080/14786419.2021.1972419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Smoking is a public health concern, and even though smoking cessation methods exist, nicotine replacement therapy (NRT) is often ineffective. Smoking behavior is related to the nicotine metabolizing enzyme (NME) P450 2A6 (mouse 2A5) polymorphisms. Accordingly, fast metabolizers are nicotine dependent, and have low quitting rates compared to slow metabolizers. In this study we examined the ability of Ginkgo biloba L (GB) and its constituents to inhibit the NME, using mouse liver microsomes containing the 2A5 enzyme. Our results indicate that GB can inhibit 2A5 (25% inhibition at 5%v/v), with the flavonoids quercetin, isorhamnetin, and kaempferol being responsible for this inhibition (23.5%, 10.7%, 25.2% inhibition at 60 ng/μL, respectively). Importantly, the flavonoids inhibited 2A5 via mechanism based inhibition (for quercetin 30 ng/μl inhibition increased from 20.8% to 26.9% within 15 minutes). Our results suggest that GB if consumed on a regular basis can help NRT enhancement particularly in fast nicotine metabolizers.
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Affiliation(s)
- Constantina Eleftheriou
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Lefteris C Zacharia
- Department of Life and Health Sciences, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
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Schnitzer K, AhnAllen C, Beck S, Oliveira Y, Fromson J, Evins A. Multidisciplinary barriers to addressing tobacco cessation during an inpatient psychiatric hospitalization. Addict Behav 2021; 120:106988. [PMID: 34051645 DOI: 10.1016/j.addbeh.2021.106988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/03/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
Tobacco use and resultant health complications disproportionately impact individuals with psychiatric disorders. Inpatient psychiatric hospitalizations provide an opportunity to initiate tobacco treatment. In this study, electronic medical record review identified demographic and clinical information, smoking status, and tobacco cessation treatment offered for adults hospitalized on two acute, non-smoking psychiatric units in Massachusetts from January 2016 to March 2018. We additionally conducted semi-structured interviews with 15 inpatient nursing, psychiatry, psychology and social work providers regarding their tobacco cessation treatment practices and perceived facilitators and barriers to addressing tobacco use on psychiatric inpatient units. Chart review identified 1099 of 3140 (35%) people admitted reporting daily tobacco smoking. On discharge, 5 (0.005%) of inpatient smokers received a prescription for varenicline, 43 (0.04%) for dual-nicotine replacement therapy, 211 (19.2%) for nicotine patch, and 5 (0.005%) for bupropion. Barriers to inpatient smoking cessation treatment initiation identified in qualitative interviews included: 1) smoking cessation as low priority, 2) smoking cessation as the responsibility of outpatient providers, 3) lack of education about tobacco treatment, and 4) treatment discussions framed as preventing withdrawal. Given the potential to impact a large percentage of psychiatric tobacco users, future interventions should investigate provision of tobacco cessation counseling and pharmacotherapy in inpatient settings, with interventions that take into account the barriers and opportunities presented in this study.
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Mohamed R, Bullen C, Hairi FM, Nordin ASA. A systematic review of group therapy programs for smoking cessation in Asian countries. Tob Induc Dis 2021; 19:63. [PMID: 34413718 PMCID: PMC8336625 DOI: 10.18332/tid/140089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/26/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco causes more than 8 million deaths each year. Behavioral interventions such as group therapy, which provides counselling for smoking cessation, can be delivered in group form and smokers who receive cessation counselling are more likely to quit smoking compared to no assistance. We review the evidence of group-based counselling for smoking cessation for smokers in Asian countries. METHODS The review aims to determine the availability of group-based therapy for smoking cessation in Asian countries. The outcome measured was abstinence from smoking following group therapy. Electronic database searches in PubMed, OVID Medline, SCOPUS, Google Scholar, and PsycINFO, using keywords such as: ‘smoking’, ‘cigarette’, ‘tobacco’, ‘nicotine’, ‘group therapy’ and ‘cessation’ (smok*, *cigarette*, tobacco, nicotine, group therap*, cessation) were used. The results were reported following PRISMA and PROSPERO guidelines. Review Manager was used for data analysis. RESULTS A total of 21251 records were retrieved for screening the abstracts. In all, 300 articles for review were identified and assessed for eligibility. Nine articles, including Cochrane reviews, randomized control trials, cohort, observational and cross-sectional studies, were included in the final review. There were three observational qualitative studies, two prospective cohort studies, two crosssectional studies, one non-randomized quasi-experimental study and a single cluster-randomized, controlled trial. Group therapy was found to significantly increase the abstinence rate. Group therapy provided at the workplace, smoking cessation services, availability of pharmacotherapy, and socioeconomic status, appear to be key factors determining success. CONCLUSIONS Evidence of the use of group therapy for smoking cessation in Asian countries is still lacking despite publications in the Western population showed that group therapy was effective. Further research on group-based interventions for smoking cessation in Asian countries is required and direct one-to-one comparisons between group therapy and individual therapy for smokers who want to quit smoking, are needed.
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Affiliation(s)
- Rashidi Mohamed
- Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Bangi, Malaysia
| | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Farizah Mohd Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.,University of Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
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Smith LC, Tieu L, Suhandynata RT, Boomhower B, Hoffman M, Sepulveda Y, Carrette LLG, Momper JD, Fitzgerald RL, Hanham K, Dowling J, Kallupi M, George O. Cannabidiol reduces withdrawal symptoms in nicotine-dependent rats. Psychopharmacology (Berl) 2021; 238:2201-2211. [PMID: 33909102 PMCID: PMC8295227 DOI: 10.1007/s00213-021-05845-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE Cannabidiol (CBD) reduces craving in animal models of alcohol and cocaine use and is known to modulate nicotinic receptor function, suggesting that it may alleviate symptoms of nicotine withdrawal. However, preclinical evaluation of its efficacy is still lacking. OBJECTIVES The goal of this study was to test the preclinical efficacy of a chronic CBD treatment in reducing nicotine dependence using measures of withdrawal symptoms including somatic signs, hyperalgesia, and weight gain during acute and protracted abstinence. METHODS Male and female Wistar rats were made dependent on nicotine using osmotic minipumps (3.15 mg/kg/day) for 2 weeks, after which minipumps were removed to induce spontaneous withdrawal. Three groups received CBD injections at doses of 7.5, 15, and 30 mg/kg/day for 2 weeks, starting 1 week into chronic nicotine infusion. The control groups included rats with nicotine minipumps that received vehicle injections of sesame oil instead of CBD; rats implanted with saline minipumps received sesame oil injections (double vehicle) or the highest dose of CBD 30 mg/kg/day. Throughout the experiment, serum was collected for determination of CBD and nicotine concentrations, mechanical sensitivity threshold and withdrawal scores were measured, and body weight was recorded. RESULTS CBD prevented rats from exhibiting somatic signs of withdrawal and hyperalgesia during acute and protracted abstinence. There was no dose-response observed for CBD, suggesting a ceiling effect at the doses used and the potential for lower effective doses of CBD. The saline minipump group did not show either somatic signs of withdrawal or hyperalgesia during acute and protracted abstinence, and the highest dose of CBD used (30 mg/kg/day) did not alter these results. CONCLUSIONS This preclinical study suggests that using CBD as a strategy to alleviate the withdrawal symptoms upon nicotine cessation may be beneficial.
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Affiliation(s)
- Lauren C Smith
- Department of Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd., La Jolla, CA, 92037, USA
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA,, 92093, USA
| | - Lani Tieu
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA,, 92093, USA
| | - Raymond T Suhandynata
- Department of Pathology, University of California, San Diego School of Medicine, San Diego, CA, 92093, USA
| | - Brent Boomhower
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA,, 92093, USA
| | - Melissa Hoffman
- Department of Pathology, University of California, San Diego School of Medicine, San Diego, CA, 92093, USA
| | - Yadira Sepulveda
- Division of Pharmaceutical Sciences, University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, 92093, USA
| | - Lieselot L G Carrette
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA,, 92093, USA
| | - Jeremiah D Momper
- Division of Pharmaceutical Sciences, University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CA, 92093, USA
| | - Robert L Fitzgerald
- Department of Pathology, University of California, San Diego School of Medicine, San Diego, CA, 92093, USA
| | - Kate Hanham
- CV Sciences, Inc., 10070 Barnes Canyon Road, San Diego, CA, 92121, USA
| | - Joseph Dowling
- CV Sciences, Inc., 10070 Barnes Canyon Road, San Diego, CA, 92121, USA
| | - Marsida Kallupi
- Department of Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd., La Jolla, CA, 92037, USA.
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA,, 92093, USA.
| | - Olivier George
- Department of Neuroscience, The Scripps Research Institute, 10550 N. Torrey Pines Rd., La Jolla, CA, 92037, USA.
- Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA,, 92093, USA.
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Cessation of smoke exposure improves pediatric CF outcomes: Longitudinal analysis of CF Foundation Patient Registry data. J Cyst Fibros 2021; 20:618-624. [PMID: 34281808 DOI: 10.1016/j.jcf.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 05/20/2021] [Accepted: 06/29/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Tobacco smoke exposure is a major risk factor for the health of children and adolescents with CF. In this study, we assess whether cessation of smoke exposure is associated with improved outcomes in this population. METHODS We used annualized and encounter-based data from the U.S. CF Foundation Patient Registry (2006-2018) on all individuals born 1998-2010. The analytical sample included those who ever reported second-hand smoke exposure (daily or weekly), ever lived with a smoker, or ever reported smoking themselves. We used non-linear mixed models for pulmonary exacerbations and linear mixed models for ppFEV1 and BMI as a function of ceased exposure. RESULTS The sample included 3,633 individuals contributing 19,629 person-years. Cessation of smoke exposure reduced the odds of a pulmonary exacerbation in 12 months by 17% (OR 0.83, p < 0.001) in the first year of cessation, with an additional 6% decrease (OR 0.94, p = 0.003) for each additional year of cessation. Cessation was associated with improvements in ppFEV1 and BMI: 0.7% ppFEV1 increase (p < 0.001) in the first year of cessation and 0.4% increase (p = 0.001) for each additional year of cessation; 1% increase in BMI percentile (p < 0.001) in the first year of cessation plus 0.4% increase (p = 0.009) for each additional year. Three years of cessation reduce the predicted probability of a pulmonary exacerbation in 12 months by 8% and improve ppFEV1 and BMI by 2%. CONCLUSION Eliminating smoke exposure may reduce pulmonary exacerbations and improve respiratory and nutritional outcomes in children and adolescents with CF. Both smoking cessation and exposure prevention should be prioritized in pediatric CF care.
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Kara HG, Erdal ME, Yılmaz SG, Şengül C, Şengül CB, Karakülah K. Association of NRG3 and ERBB4 gene polymorphism with nicotine dependence in Turkish population. Mol Biol Rep 2021; 48:5319-5326. [PMID: 34247340 DOI: 10.1007/s11033-021-06548-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/06/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Nicotine dependence (ND) is characterized by regular smoking, anxiety, irritation, difficulty concentrating, impatience, restlessness, tremor, dizziness, hunger, nicotine demand, and the individual's reluctance to quit despite knowing the health risks of smoking. Recently, it has been reported that the Neuregulin 3 (NRG3)/Erb-B2 receptor tyrosine kinase 4 (ERBB4) signaling pathway plays a role in ND. NRG3, which is activated after nicotine intake, binds to ERBB4 and causes GABA release. GABA reduces anxiety and tension, which are one of the nicotine withdrawal symptoms. Therefore we aimed to investigate the relationship between NRG3 and ERBB4 gene polymorphisms and ND. MATERIALS AND METHODS The study population was comprised of patients with ND (n = 200) and healthy non-smoker control subjects (n = 200) who were matched for age, sex, and compared for comorbidity factors such as alcohol, smoking, duration, and education (age range 18-60). Genotypes were detected by Real-Time PCR using TaqMan technology. The Fagerström Nicotine Dependence Test (FTND) score was 5 and above for the patient group and 0 for the control group. DNA was obtained from whole peripheral blood and six polymorphisms of Neuregulin 3 (NRG3) (rs1836724, rs7562566, and rs10048757) and Erb-B2 Receptor Tyrosine Kinase 4 (ERBB4) (rs1764072, rs6584400, and rs10883934) genes were analyzed by real-time PCR method. RESULTS Our findings show that the six selected SNPs are not significantly associated with ND in the Turkish population and no correlation with dependence levels (p > 0.05). CONCLUSION Although our findings do not show a relationship between ND and these polymorphisms, it is the first study to investigate these single nucleotide polymorphisms (SNPs) for the first time in ND and to find some genotypes in the Turkish population when compared to other populations. Also, our findings are important in terms of their contribution to the literature and forensic genetics.
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Affiliation(s)
- Hale Güler Kara
- Department of Medical Biology, Faculty of Medicine, Ege University, 35100, Izmir, Turkey.
- Unye State Hospital, Ordu, Turkey.
| | - Mehmet Emin Erdal
- Department of Medical Biology, Faculty of Medicine, Mersin University, 33343, Mersin, Turkey
- Unye State Hospital, Ordu, Turkey
| | - Senay Görücü Yılmaz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey
- Unye State Hospital, Ordu, Turkey
| | - Cem Şengül
- Psychiatry Clinic, Denizli, Turkey
- Unye State Hospital, Ordu, Turkey
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Devi AR, Sengupta M, Barman DM, Choudhury Y. Oral Nicotine Induces Oxidative Stress and Inflammation but Does Not Subvert Tumor Suppressor and DNA Repair Responses in Mice. Indian J Clin Biochem 2021; 36:296-303. [PMID: 34220004 PMCID: PMC8215012 DOI: 10.1007/s12291-020-00903-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/08/2020] [Indexed: 01/03/2023]
Abstract
Nicotine, responsible for the addictive properties of tobacco, is widely used in nicotine replacement therapy for tobacco use cessation. We investigated the time-dependent effect of treatment with nicotine on the tumor suppressor, DNA repair and immune responses. Swiss Albino mice (laca strain) of both sexes received nicotine dissolved at a dose of 100 µg/ml in 2% sucrose for 24 weeks, by oral gavage, while age- and gender-matched controls received only 2% sucrose for the same period. Nicotine-treated and control mice were sacrificed 6, 16 and 24 weeks post-treatment, and their tissues evaluated for alterations in histology, oxidative stress, TNF-α levels, nitric oxide (NO) and myeloperoxidase (MPO) release, tumor suppressor response and DNA repair response. Statistical significance of results was determined using Students' t test. The tissues of nicotine treated mice exhibited a large number of multinucleated and binucleated cells, enlarged nuclei and non-uniform distribution of cells, significant increase in expression of TNF-α gene and serum TNF-α, and time-dependent significant increase in lipid peroxidation, protein carbonylation, NO and MPO release when compared to age-and gender-matched controls. The mRNA expression of the tumor suppressor gene p53, its primary regulator Mdm2, and the DNA repair genes Brca2 and Ape1 were significantly elevated, but the corresponding protein levels remained largely unaltered. In conclusion, treatment with nicotine caused oxidative stress and inflammation which can cause widespread cellular damage from the very onset of treatment, without subverting the tumor suppressor and DNA repair responses.
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Affiliation(s)
| | - Mahuya Sengupta
- Department of Biotechnology, Assam University, Silchar, 788011 India
| | - Dipu Mani Barman
- Department of Biotechnology, Assam University, Silchar, 788011 India
| | - Yashmin Choudhury
- Department of Biotechnology, Assam University, Silchar, 788011 India
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Cytisine and cytisine derivatives. More than smoking cessation aids. Pharmacol Res 2021; 170:105700. [PMID: 34087351 DOI: 10.1016/j.phrs.2021.105700] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/29/2021] [Accepted: 05/29/2021] [Indexed: 12/12/2022]
Abstract
Cytisine, a natural bioactive compound that is mainly isolated from plants of the Leguminosae family (especially the seeds of Laburnum anagyroides), has been marketed in central and eastern Europe as an aid in the clinical management of smoking cessation for more than 50 years. Its main targets are neuronal nicotinic acetylcholine receptors (nAChRs), and pre-clinical studies have shown that its interactions with various nAChR subtypes located in different areas of the central and peripheral nervous systems are neuroprotective, have a wide range of biological effects on nicotine and alcohol addiction, regulate mood, food intake and motor activity, and influence the autonomic and cardiovascular systems. Its relatively rigid conformation makes it an attractive template for research of new derivatives. Recent studies of structurally modified cytisine have led to the development of new compounds and for some of them the biological activities are mediated by still unidentified targets other than nAChRs, whose mechanisms of action are still being investigated. The aim of this review is to describe and discuss: 1) the most recent pre-clinical results obtained with cytisine in the fields of neurological and non-neurological diseases; 2) the effects and possible mechanisms of action of the most recent cytisine derivatives; and 3) the main areas warranting further research.
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Fahrizal Y, Risdiana N, Rustyawati F. The Correlation between Nicotine Dependence Level and Anxiety in Indonesian Adolescent Smokers. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.5862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Smoking behavior in Indonesia increases from year to year. The adverse effects of smoking do not appear directly after the cigarette use, but they will be seen in a few months or even in several years. The adverse effects of smoking include nicotine dependence, and anxiety disorder felt as a part of withdrawal symptoms.
AIM: This research aims to identify if there is a correlation between nicotine dependence level and anxiety level in adolescents.
METHODS: This study is non-experiment research with a quantitative method and a cross-sectional approach. The sample of the study was 44 people. Fagerstrom Test for Nicotine Dependence was used as the instrument to measure the nicotine dependence level, while the instrument for anxiety level was carried out using the Taylor Manifest Anxiety Scale.
RESULTS: The correlation analysis between the level of nicotine dependence and anxiety conducted using Spearman rho non-parametric correlation analysis obtained a significant value of 0.0001 (p > 0.05). The value of r = 0.979 showed a positive and robust correlation between nicotine dependence and anxiety level.
CONCLUSION: It is concluded that there is a strong and positive correlation between the nicotine dependence level and the anxiety level in adolescents.
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