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Sprenger S, Anderson JS. Dying to Quit: Understanding the Burden of Tobacco in Psychiatric Patients-A Clinical Review. J Psychiatr Pract 2024; 30:23-31. [PMID: 38227724 DOI: 10.1097/pra.0000000000000764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Smoking is the leading cause of preventable death worldwide and remains a critical public health challenge. The burden of disease caused by smoking is disproportionately borne by persons living with mental illness. Public health efforts to address smoking have not historically translated to a significant reduction in smoking prevalence among patients with mental illness. Smoking is a substantial cause of morbidity and mortality among psychiatric patients who smoke at 1.7 to 3.3 times the rate of the general population. Among those with serious mental illness, tobacco-related illness accounts for half of all deaths. Nicotine dependence also interferes with treatment and worsens many psychiatric symptoms. Interventions are underutilized due to persistent misunderstandings regarding tobacco cessation for patients who are mentally ill. Addressing these misunderstandings is crucial in targeting the disparate rates of smoking in this population. Therefore, it is incumbent on psychiatrists to address the outsized effect that smoking has on patients with mental illness.
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Affiliation(s)
- Steven Sprenger
- SPRENGER, ANDERSON: Deparment of Psychiatry, Tristar Centennial Medical Center, Nashville, TN
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Mousavi SL, Rezayof A, Alijanpour S, Delphi L, Hosseinzadeh Sahafi O. Activation of mediodorsal thalamic dopamine receptors inhibited nicotine-induced anxiety in rats: A possible role of corticolimbic NMDA neurotransmission and BDNF expression. Pharmacol Biochem Behav 2023; 232:173650. [PMID: 37778541 DOI: 10.1016/j.pbb.2023.173650] [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: 07/24/2023] [Revised: 09/11/2023] [Accepted: 09/28/2023] [Indexed: 10/03/2023]
Abstract
The present study aimed to evaluate the functional interaction between the dopaminergic and glutamatergic systems of the mediodorsal thalamus (MD), the ventral hippocampus (VH), and the prefrontal cortex (PFC) in nicotine-induced anxiogenic-like behaviors. Brain-derived neurotrophic factor (BDNF) level changes were measured in the targeted brain areas following the drug treatments. The percentage of time spent in the open arm (% OAT) and open arm entry (% OAE) were calculated in the elevated plus maze (EPM) to measure anxiety-related behaviors in adult male Wistar rats. Systemic administration of nicotine at a dose of 0.5 mg/kg induced an anxiogenic-like response associated with decreased BDNF levels in the hippocampus and the PFC. Intra-MD microinjection of apomorphine (0.1-0.3 μg/rat) induced an anxiogenic-like response, while apomorphine inhibited nicotine-induced anxiogenic-like behaviors associated with increased hippocampal and PFC BDNF expression levels. Interestingly, the blockade of the VH or the PFC NMDA receptors via the microinjection of D-AP5 (0.3-0.5 μg/rat) into the targeted sites reversed the inhibitory effect of apomorphine (0.5 μg/rat, intra-MD) on the nicotine response and led to the decrease of BDNF levels in the hippocampus and the PFC. Also, the microinjection of a higher dose of D-AP5 (0.5 μg/rat, intra-PFC) alone produced an anxiogenic effect. These findings suggest that the functional interaction between the MD dopaminergic D1/D2-like and the VH/PFC glutamatergic NMDA receptors may be partially involved in the anxiogenic-like effects of nicotine, likely via the alteration of BDNF levels in the hippocampus and the PFC.
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Affiliation(s)
- Seyedeh Leila Mousavi
- Department of Animal Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran; Department of Biobehavioral Health, Pennsylvania State University, University Park, PA 16802, USA
| | - Ameneh Rezayof
- Department of Animal Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran.
| | - Sakineh Alijanpour
- Department of Animal Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran; Department of Biology, Faculty of Science, Gonbad Kavous University, Gonbad Kavous, Iran
| | - Ladan Delphi
- Department of Animal Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Oveis Hosseinzadeh Sahafi
- Department of Neurophysiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
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Marler JD, Fujii CA, Utley MT, Balbierz DJ, Galanko JA, Utley DS. Long-Term Outcomes of a Comprehensive Mobile Smoking Cessation Program With Nicotine Replacement Therapy in Adult Smokers: Pilot Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e48157. [PMID: 37585282 PMCID: PMC10546267 DOI: 10.2196/48157] [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: 04/13/2023] [Revised: 06/07/2023] [Accepted: 08/15/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Increased smartphone ownership has led to the development of mobile smoking cessation programs. Although the related body of evidence, gathered through the conduct of randomized controlled trials (RCTs), has grown in quality and rigor, there is a need for longer-term data to assess associated smoking cessation durability. OBJECTIVE The primary aim was to compare smoking cessation outcomes at 52 weeks in adult smokers randomized to a mobile smoking cessation program, Pivot (intervention), versus QuitGuide (control). The secondary aims included comparison of other smoking-related behaviors, outcomes and participant feedback, and exploratory analyses of baseline factors associated with smoking cessation. METHODS In this remote pilot RCT, cigarette smokers in the United States were recruited on the web. Participants were offered 12 weeks of free nicotine replacement therapy (NRT). Data were self-reported via a web-based questionnaire with videoconference biovalidation in participants who reported 7-day point-prevalence abstinence (PPA). Outcomes focused on cessation rates with additional assessment of quit attempts, cigarettes per day (CPD), self-efficacy via the Smoking Abstinence Self-Efficacy Questionnaire, NRT use, and participant feedback. Cessation outcomes included self-reported 7- and 30-day PPA, abstinence from all tobacco products, and continuous abstinence. PPA and continuous abstinence were biovalidated using witnessed breath carbon monoxide samples. Exploratory post hoc regression analyses were performed to identify baseline variables associated with smoking cessation. RESULTS Participants comprised 188 smokers (n=94, 50% in the Pivot group and n=94, 50% in the QuitGuide group; mean age 46.4, SD 9.2 years; n=104, 55.3% women; n=128, 68.1% White individuals; mean CPD 17.6, SD 9.0). Several cessation rates were higher in the Pivot group (intention to treat): self-reported continuous abstinence was 20% (19/94) versus 9% (8/94; P=.03) for QuitGuide, biochemically confirmed abstinence was 31% (29/94) versus 18% (17/94; P=.04) for QuitGuide, and biochemically confirmed continuous abstinence was 19% (18/94) versus 9% (8/94; P=.046) for QuitGuide. More Pivot participants (93/94, 99% vs 80/94, 85% in the QuitGuide group; P<.001) placed NRT orders (mean 3.3, SD 2.0 vs 1.8, SD 1.6 for QuitGuide; P<.001). Pivot participants had increased self-efficacy via the Smoking Abstinence Self-Efficacy Questionnaire (mean point increase 3.2, SD 7.8, P<.001 vs 1.0, SD 8.5, P=.26 for QuitGuide). QuitGuide participants made more mean quit attempts (7.0, SD 6.3 for Pivot vs 9.5, SD 7.5 for QuitGuide; P=.01). Among those who did not achieve abstinence, QuitGuide participants reported greater CPD reduction (mean -34.6%, SD 35.5% for Pivot vs -46.1%, SD 32.3% for QuitGuide; P=.04). Among those who reported abstinence, 90% (35/39) of Pivot participants and 90% (26/29) of QuitGuide participants indicated that their cessation program helped them quit. CONCLUSIONS This pilot RCT supports the long-term effectiveness of the Pivot mobile smoking cessation program, with abstinence rates durable to 52 weeks. TRIAL REGISTRATION ClinicalTrials.gov NCT04955639; https://clinicaltrials.gov/ct2/show/NCT04955639.
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Affiliation(s)
| | - Craig A Fujii
- Pivot Health Technologies, Inc, San Carlos, CA, United States
| | | | | | - Joseph A Galanko
- Department of Pediatrics, University of North Carolina, Chapel Hill, NC, United States
| | - David S Utley
- Pivot Health Technologies, Inc, San Carlos, CA, United States
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Tran DD, Davis JP, Tucker JS, Bricker JB, Lee DS, Fitzke RE, Pedersen ER. Cigarette Smoking and Depression Among U.S. Veterans: Longitudinal Associations With Posttraumatic Stress Disorder. Nicotine Tob Res 2023; 25:1496-1504. [PMID: 37094359 PMCID: PMC10347971 DOI: 10.1093/ntr/ntad064] [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: 06/17/2022] [Revised: 03/09/2023] [Accepted: 04/21/2023] [Indexed: 04/26/2023]
Abstract
INTRODUCTION Cigarette smoking and depression are associated with morbidity and mortality. Among veterans, approximately 22% are current smokers and 11%-15% have been diagnosed with depression. Although prior research suggests a strong association between smoking and depression among veterans, little research has examined trajectories of smoking and depressive symptoms and their correlates over time in this population. AIMS AND METHODS Using parallel process growth curve modeling, we examined the longitudinal relationship between smoking and depression and tested whether posttraumatic stress disorder (PTSD) symptoms predict smoking and depression trajectories over 18 months (February 2020-August 2021). Veterans were recruited for an online, longitudinal study and responded to surveys across five-time points (baseline N = 1230; retention = 79.3%-83.3% across waves). RESULTS Associations indicated that more frequent smoking at baseline was associated with steeper increases in depression symptom severity, and greater depression severity at baseline was associated with a less steep decrease in smoking frequency over time. PTSD was associated with less smoking at time 1 but more frequent smoking at times 3-5 as well as greater depression across all time points. CONCLUSIONS Findings provide support that the growth trajectories of smoking and depression are linked, and PTSD symptoms are associated with these trajectories among veterans. Addressing these factors simultaneously in veteran treatment centers or through tobacco cessation efforts may be beneficial. IMPLICATIONS This study offers strong evidence that the growth trajectories of smoking and depression are linked, and PTSD symptoms affect these trajectories among veterans, who represent a largely understudied population despite high rates of substance use and mental health problems. Results of this study strengthen the case for a more integrated treatment approach in which both smoking and mental health concerns are simultaneously addressed, which may yield more beneficial physical health and clinical outcomes for post-9/11 veterans.
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Affiliation(s)
- Denise D Tran
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CAUSA
| | - Jordan P Davis
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CAUSA
| | | | - Jonathan B Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA USA
- Department of Psychology, University of Washington, Seattle, WA USA
| | - Daniel S Lee
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CAUSA
| | - Reagan E Fitzke
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CAUSA
| | - Eric R Pedersen
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CAUSA
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Guo Y, Liu DY, Wang YJ, Huang MJ, Jiang N, Hou Q, Feng B, Wu WY, Wu YB, Qi F, Sun XY. Family functioning and nicotine dependence among smoking fathers: a cross-sectional study. BMC Public Health 2023; 23:658. [PMID: 37024859 PMCID: PMC10080741 DOI: 10.1186/s12889-023-15475-4] [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: 11/18/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Nicotine dependence is a significant public health issue, and understanding the factors associated with nicotine dependence in this population is crucial for developing effective interventions. This study examined the association between family functioning and nicotine dependence levels of smoking fathers based on the McMaster model of family functioning (MMFF), providing evidence for future interventions. METHODS In this study, we selected fathers of first- to fifth-grade students from 10 pilot elementary schools in Qingdao whose families smoked. We used the Fagerstrom test to assess nicotine dependence and the Family Assessment Device to evaluate family functioning. We performed univariate analysis to compare differences among those with different levels of nicotine dependence, and we used an ordinal logistic regression analysis to investigate the influences related to nicotine dependence. RESULTS This study included 874 smokers, with 78.5% having mild nicotine dependence, 11.7% having moderate dependence, and 9.84% having severe dependence. Univariate analysis showed that smokers with severe dependence had lower education levels, higher prevalence of chronic diseases, more frequent alcohol consumption, and poorer family functioning compared to those with mild to moderate dependence. Ordinal logistic regression analysis showed that poorer general functioning scores (OR = 1.087, 95% CI: 1.008-1.173, P = 0.030), poorer behavioral control (OR = 1.124, 95% CI: 1.026-1.232, P = 0.012), more quit attempts, frequent alcohol consumption, and longer smoking duration may be associated with a higher likelihood of developing severe nicotine dependence. The older age of starting smoking and higher education level may be associated with a lower likelihood of developing severe nicotine dependence. However, it is important to note that the cross-sectional nature of this study precludes the determination of causal relationships. CONCLUSIONS This study finds that heavy nicotine dependence in smoking fathers is associated with risky behaviors and demographics such as longer smoking duration and frequent alcohol consumption. Targeted smoking cessation interventions are crucial for this group, taking these specific factors into consideration. Family functioning, particularly general functioning and behavioral control, may also be linked to nicotine dependence, indicating the need for further research in this area.
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Affiliation(s)
- Yi Guo
- School of Public Health, Peking University, Beijing, China
| | - Di-Yue Liu
- International School of Public Health and One Health, Hainan Medical University, Haikou, China
| | - Yu-Jia Wang
- College of Humanities and Social Sciences, Harbin Medical University, Heilongjiang, China
| | - Meng-Jie Huang
- School of Public Health, Shandong University, Jinan, China
| | - Nan Jiang
- School of Public Health, Qingdao University, Qingdao, China
| | - Qiang Hou
- College of Medical Sciences, Shanxi Medical University, Shanxi, China
| | - Bojunhao Feng
- School of Medicine, Macau University of Science and Technology, Macao, China
| | - Wen-Yu Wu
- School of Health Management, Harbin Medical University, Heilongjiang, China
| | - Yi-Bo Wu
- School of Public Health, Peking University, Beijing, China
| | - Fei Qi
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
| | - Xin-Ying Sun
- School of Public Health, Peking University, Beijing, China.
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Hammad AM, Alhusban AA, Alzaghari LF, Alasmari F, Sari Y. Effect of Cigarette Smoke Exposure and Aspirin Treatment on Neurotransmitters’ Tissue Content in Rats’ Hippocampus and Amygdala. Metabolites 2023; 13:metabo13040515. [PMID: 37110173 PMCID: PMC10145483 DOI: 10.3390/metabo13040515] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/26/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
Cigarette smoke withdrawal can cause anxiety-like behavior and modulate neurotransmitter-related proteins in the brain. We examined the effects of cigarette smoke with and without aspirin treatment on the concentrations of neurotransmitters, including dopamine, serotonin, glutamate, glutamine, and GABA in the amygdala and hippocampus. Sprague-Dawley rats were randomly assigned to four different groups: (1) control group exposed only to standard room air, (2) cigarette smoke exposed group treated with saline vehicle, (3) cigarette smoke exposed group treated with aspirin (30 mg/kg), and (4) control group treated only with aspirin (30 mg/kg). Cigarette smoke exposure was performed for 2 h/day, 5 days/week, for 31 days. Behavioral testing was carried out weekly, 24 h after cigarette smoke exposure, during acute withdrawal. At the end of week 4, rats were given either distilled water (1 mL) or aspirin 45 min before cigarette exposure for 11 days. Dopamine, serotonin, glutamate, glutamine, and GABA were extracted from both the amygdala and hippocampus and were separated and quantified using a developed and validated HPLC-MS/MS method. Cigarette smoke withdrawal induced anxiety behaviors, and aspirin treatment reduced this effect. Cigarette smoke exposure increased tissue content of dopamine, serotonin, glutamate, glutamine, and GABA, and aspirin treatment reversed this effect. Cigarette smoke caused an increase in tissue content of several neurotransmitters as well as anxiety-like behavior, and these effects were normalized by aspirin treatment.
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Affiliation(s)
- Alaa M. Hammad
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan
| | - Ala A. Alhusban
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan
| | - Lujain F. Alzaghari
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan
| | - Fawaz Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia
| | - Youssef Sari
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, OH 43606, USA
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Suárez-Castro D, Barroso-Hurtado M, Martínez-Vispo C, Becoña E, López-Durán A. Boredom Susceptibility and Quit Smoking: The Role of Anxiety Symptoms. THE JOURNAL OF PSYCHOLOGY 2023; 157:242-251. [PMID: 36944190 DOI: 10.1080/00223980.2023.2183933] [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: 03/23/2023] Open
Abstract
Boredom is one of the main reported motives for smoking. However, scarce research has examined the relationship between boredom susceptibility and abstinence achievement in treatment-seeking smokers. The aim of this study is to examine the mediating effect of anxiety symptoms in the relationship between boredom susceptibility and abstinence at the end of a smoking cessation treatment. The sample was composed of 481 Spanish smokers who received a cognitive-behavioral treatment to quit (Mage= 45.51, SD = 11.16; 60.6% female). The Boredom Susceptibility subscale of the Sensation Seeking Scale Form-V and the Beck Anxiety Inventory were used. Pearson correlations and mediation analyses were conducted to examine the relationships between the study variables. Boredom susceptibility was significantly and positively correlated to anxiety symptoms, but not to abstinence. Anxiety symptoms were significantly and negatively correlated to abstinence. A significant indirect effect of boredom susceptibility on abstinence at the end of treatment through anxiety symptoms was found. There was no direct relation between boredom susceptibility and abstinence. These findings extend previous literature by showing that higher boredom susceptibility is associated with less likelihood to be abstinent at the end of the treatment through higher anxiety symptoms. These results highlight the relevance of considering the inclusion of boredom and anxiety management techniques in smoking cessation interventions.
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Barandon S, Castel L, Galera C, van der Waerden J, Sutter-Dallay AL. Women's quality of life and mental health in the first year after birth: Associated factors and effects of antenatal preventive measures among mothers in the ELFE cohort. J Affect Disord 2023; 321:16-27. [PMID: 36272461 DOI: 10.1016/j.jad.2022.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 10/11/2022] [Accepted: 10/16/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND During the perinatal period, women's perceived quality of life (QOL) may be altered due to physiological, psychological, and bodily changes, as well as changes in family functioning. OBJECTIVES to explore in a sample of women from the general population, the associations between physical and mental QOL at 1 year post-partum and i) pregnancy social support, demographic, socioeconomic, medical and child health-related factors, paternal and maternal psychological characteristics at 2 months and 1 year post-partum, ii) antenatal preventive measures (early prenatal interview/antenatal classes). METHODS We used data from the "French Longitudinal Study since Childhood" (ELFE), a representative cohort of children and their parents followed from birth to adulthood. Data were collected from mothers in the maternity ward, at 2 months and 1-year post-partum. QOL was assessed using the SF12 physical (PCS-12) and mental (MCS-12) subscales. RESULTS Women with both low PCS-12 and MCS-12 scores were more likely to have high maternal age and to experience psychological difficulties during pregnancy. They also had more frequent PNDS, quarrels with insults within the couple, low sleep time at 2 months postpartum, and more frequently received psychological, social and child caregiver support, and were more often housewives or students at 1-year post-partum. Others factors are specific for low PCS-12 or MCS-12. There was no association with antenatal preventive measure and QOL at 1-year post-partum. CONCLUSION Factors influencing maternal QOL are multiple and multidimensional and can mostly be identified during the ante or early postnatal period. A graduated and coordinated preventive and curative pathway would improve women's health. An ecosystemic approach to pregnancy and the perinatal period could help preventing the negative effects of environment on mothers and thus infants during the "1000-day period".
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Affiliation(s)
- S Barandon
- Bordeaux University, INSERM, Bordeaux Population Health Research Center, U 1219, F-33000 Bordeaux, France; Bordeaux Hospital University Center, Bordeaux School of Midwives, F-33076 Bordeaux, France.
| | - L Castel
- Bordeaux University, INSERM, Bordeaux Population Health Research Center, U 1219, F-33000 Bordeaux, France; Bordeaux University, F-33000 Bordeaux, France
| | - C Galera
- Bordeaux University, INSERM, Bordeaux Population Health Research Center, U 1219, F-33000 Bordeaux, France; Bordeaux University, F-33000 Bordeaux, France; University Department of Child and Adolescent Psychiatry, Charles-Perrens Hospital, F-33000 Bordeaux, France
| | - J van der Waerden
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique 5IPLESP, Department of Social Epidemiology, 27 rue Chaligny, 75012 Paris, France
| | - A-L Sutter-Dallay
- Bordeaux University, INSERM, Bordeaux Population Health Research Center, U 1219, F-33000 Bordeaux, France; Bordeaux University, F-33000 Bordeaux, France; University Department of Child and Adolescent Psychiatry, Charles-Perrens Hospital, F-33000 Bordeaux, France
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9
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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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Abascal L, Vela A, Sugden S, Kohlenberg S, Hirschberg A, Young A, Lane K, Merlo G. Incorporating Mental Health Into Lifestyle Medicine. Am J Lifestyle Med 2022; 16:570-576. [PMID: 36072684 PMCID: PMC9442472 DOI: 10.1177/15598276221084250] [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: 09/04/2024] Open
Abstract
The evidence-based interconnection between mental health with lifestyle medicine practice is discussed. The extent to which physical health, and mental and behavioral health overlap are significant, and their interaction is seen in many ways. These bidirectional influences form a continuous thread through all lifestyle medicine pillars. The intersection of mental health and lifestyle should be considered and applied to provide optimal evidence-based lifestyle medicine for all patient populations who will benefit from the specific attention to diet, physical activity, relationships, stress, sleep, and substance use. Lifestyle medicine can be utilized to directly address and treat a range of mental health symptoms and disorders, and physical illnesses. In addition, behavior change skills and addressing the psychological factors contributing to barriers are crucial to helping patients reach their lifestyle medicine goals. Approaches to practice that attend to, and address, mental and behavioral health are relevant to and necessary for all types of providers who work within the lifestyle medicine framework.
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Affiliation(s)
- Liana Abascal
- California School of Professional Psychology - San Diego Campus
| | - Alyssa Vela
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steve Sugden
- Huntsman Mental Health Institute, University of Utah, Salt Lake City, UT, USA
| | | | | | - Allison Young
- NYU Grossman School of Medicine, Palm Beach Gardens, FL, USA
| | - Karen Lane
- Life Ideals Private Practice, Windham, ME, USA
| | - Gia Merlo
- New York University, New York, NY, USA
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Weld-Blundell I, Grech L, Borland R, White SL, das Nair R, Marck CH. Smoking habits, awareness and support needs for cessation among people with multiple sclerosis in Australia: findings from an online survey. BMJ Open 2022; 12:e059637. [PMID: 35906060 PMCID: PMC9345070 DOI: 10.1136/bmjopen-2021-059637] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To assess smoking habits, nicotine use, exposure to passive smoking, awareness of associated harms, and experiences with and preferences for smoking cessation support among people with multiple sclerosis (MS). DESIGN Online survey, convenience sampling. SETTING Community setting, Australia. PARTICIPANTS Adults living in Australia with probable or diagnosed MS were recruited via social media and newsletters to participate in 2020. RESULTS Of the 284 participants in our convenience sample, 25.7% were current smokers (n=73) and 38.0% were former smokers (n=108). Awareness of the harms of smoking on MS onset (n=68, 24.3%) and progression (n=116, 41.6%) was low. Almost a quarter (n=67, 23.8%) of participants were regularly exposed to passive smoke, and awareness of associated harm was also low (n=47, 16.8%). Among current smokers, 76.1% (n=54) had tried quitting and 73.2% considered quitting within 6 months (n=52). Many participants reported perceived short-term benefits of smoking, and long-term benefits of quitting, on MS symptoms and general well-being (short-term n=28, 40.0%; long-term n=28, 82.4%). While most participants reported that their neurologist (n=126, 75.4%) or other healthcare providers (n=125, 74.9%) had assessed smoking status, very few neurologists (n=3, 1.8%) or other healthcare providers (n=14, 8.4%) had provided help with quitting. Most current smokers preferred speaking about smoking to a neurologist (n=36, 52.2%) or general practitioner (n=41, 59.4%). Almost 60% of the current smokers wanted additional cessation information specific to MS (n=41, 59.4%), and 45.5% said this information would motivate them to quit smoking (n=30). CONCLUSIONS Our convenience sample, which may not be representative, indicated an urgent need for regular evidence-based smoking cessation supports for people with MS. Most participants felt they would benefit from smoking cessation advice. MS clinicians, in collaboration with patient organisations, smoking cessation services and general practitioners, should make smoking cessation promotion with people with MS a priority.
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Affiliation(s)
- Isabelle Weld-Blundell
- Disability and Health Unit, Centre for Health Equity, the Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Grech
- Medicine Monash Health, Monash University, Clayton, Victoria, Australia
| | - Ron Borland
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sarah L White
- Quit, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Roshan das Nair
- Mental Health & Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Institute of Mental Health, Nottingham, UK
- Health Services Research, SINTEF, Trondheim, Norway
| | - Claudia H Marck
- Disability and Health Unit, Centre for Health Equity, the Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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12
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Substance use, microbiome and psychiatric disorders. Pharmacol Biochem Behav 2022; 219:173432. [PMID: 35905802 DOI: 10.1016/j.pbb.2022.173432] [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: 11/26/2021] [Revised: 04/29/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
Accumulating evidence from several studies has shown association between substance use, dysregulation of the microbiome and psychiatric disorders such as depression, anxiety, and psychosis. Many of the abused substances such as cocaine and alcohol have been shown to alter immune signaling pathways and cause inflammation in both the periphery and the central nervous system (CNS). In addition, these substances of abuse also alter the composition and function of the gut microbiome which is known to play important roles such as the synthesis of neurotransmitters and metabolites, that affect the CNS homeostasis and consequent behavioral outcomes. The emerging interactions between substance use, microbiome and CNS neurochemical alterations could contribute to the development of psychiatric disorders. This review provides an overview of the associative effects of substance use such as alcohol, cocaine, methamphetamine, nicotine and opioids on the gut microbiome and psychiatric disorders involving anxiety, depression and psychosis. Understanding the relationship between substance use, microbiome and psychiatric disorders will provide insights for potential therapeutic targets, aimed at mitigating these adverse outcomes.
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Lee B, Levy DE, Macy JT, Elam KK, Bidulescu A, Seo DC. Smoking trajectories from adolescence to early adulthood as a longitudinal predictor of mental health in adulthood: evidence from 21 years of a nationally representative cohort. Addiction 2022; 117:1727-1736. [PMID: 34817100 DOI: 10.1111/add.15758] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 11/01/2021] [Indexed: 01/19/2023]
Abstract
AIMS To measure the prospective relationship between smoking trajectories from adolescence to young adulthood and mental health in later adulthood and test whether this relationship was mediated by concurrent co-use of alcohol and marijuana. DESIGN Longitudinal study using data drawn from rounds 1 to 18 of the National Longitudinal Survey of Youth 1997 (NLSY97), a nationally representative cohort study spanning 21 years. SETTING United States. PARTICIPANTS The analytical sample included those who completed survey items about smoking behaviors on at least half the data collection opportunities in adolescence and young adulthood (n = 8570, 48.9% female, 66.2% white). MEASUREMENTS Mental health in adulthood was measured using the five-item Mental Health Inventory (MHI-5; range = 0-100) at round 18. Seven trajectories of smoking from adolescence to young adulthood were identified by group-based multi-trajectory modeling, using data over 11 years from rounds 1 to 11. FINDINGS Late-onset moderate smokers [β = -1.95, 95% confidence interval (CI) = -3.61 to -0.29], late-onset accelerated smokers (β = -2.53, 95% CI = -4.28 to -0.78), early-onset heavy smokers (β = -3.72, 95% CI = -5.59 to -1.85) and early-onset moderate smokers (β = -2.66, 95% CI = -4.48 to -0.84) showed poorer regression-adjusted mean MHI-5 scores in later adulthood than stable abstainers, even after controlling for baseline mental health and covariates. Whether or not a difference in MHI-5 scores was present between quitters and stable abstainers was inconclusive. The concurrent co-use of alcohol and marijuana in young adulthood significantly mediated the relationship between smoking trajectory and mental health. CONCLUSIONS Continued smoking, especially early-onset and heavy smoking from adolescence to young adulthood, appears to increase the risk of poor mental health later in mid-adulthood, and quitting smoking in young adulthood may mitigate such risk even among early-onset smokers. Mediation analyses underscore the role of using multiple substances in this pathway.
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Affiliation(s)
- Boram Lee
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.,Tobacco Treatment and Research Center, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Douglas E Levy
- Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA.,Tobacco Treatment and Research Center, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jonathan T Macy
- Indiana University School of Public Health, Bloomington, IN, USA
| | - Kit K Elam
- Indiana University School of Public Health, Bloomington, IN, USA
| | | | - Dong-Chul Seo
- Indiana University School of Public Health, Bloomington, IN, USA
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14
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Kim B, Cho J, Park JY, Kim HE, Oh J. Delirium and Anxiety Outcomes Related to Visiting Policy Changes in the Intensive Care Unit During the COVID-19 Pandemic. Front Aging Neurosci 2022; 14:845105. [PMID: 35309896 PMCID: PMC8926309 DOI: 10.3389/fnagi.2022.845105] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/10/2022] [Indexed: 11/16/2022] Open
Abstract
Objective To evaluate the effect of intensive care unit (ICU) visit on the incidence of delirium, delirium subtype, and anxiety level in ICU patients. Methods Trained psychiatrists and nurses evaluated ICU patients for delirium, delirium subtypes, and anxiety. Propensity score matching (PSM) was used to retrospectively analyze the data. Then, we compared the differences in the incidence of delirium, delirium subtypes, and anxiety level before and after the ICU visit ban. Logistic regression was conducted to identify the risk factors for delirium subtypes and high anxiety levels. Results After PSM, there was no statistically significant difference in the incidence of delirium between the non-visiting and restrictive visiting groups (non-visiting 27.4% versus restrictive visiting 30.9%, p = 0.162). The proportion of hyperactive and mixed subtypes was higher in the non-visiting than in the restrictive visiting group (non-visiting 35.3 and 30.1% versus restrictive visiting 27.7 and 20.1%, p = 0.002). The anxiety level was higher in the non-visiting than in the restrictive visiting group (state-trait anxiety inventory score: non-visiting 53.46 ± 4.58 versus restrictive visiting 52.22 ± 6.50, p = 0.009). Patients who stayed in the ICU during the visit ban were more likely to have hyperactive (p = 0.005) and mixed subtype (p = 0.001) than those who did not. Moreover, patients who stayed in the ICU during the visit ban were more likely to experience high anxiety levels than those who did not (p < 0.001). Conclusion Prohibition of ICU visits during COVID-19 pandemic did not affect the incidence of delirium during COVID-19 but could change the delirium subtype and raise anxiety level. Moreover, visiting prohibition was a risk factor for non-hypoactive delirium subtype and high anxiety levels. Therefore, ICU visits are important in dealing with delirium subtypes and anxiety in ICU patients.
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Affiliation(s)
- Bomi Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jaehwa Cho
- Department of Pulmonary and Critical Care Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Park
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea
| | - Hesun Erin Kim
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jooyoung Oh
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, South Korea
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- *Correspondence: Jooyoung Oh,
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15
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Prevalence of Anxiety in Smoking Cessation: A Worldwide Systematic Review and Meta-analysis. ADDICTIVE DISORDERS & THEIR TREATMENT 2021. [DOI: 10.1097/adt.0000000000000263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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16
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Middleton R, Loveday C, Hobbs C, Almasi E, Moxham L, Green H, Halcomb E, Fernandez R. The COVID-19 pandemic - A focus on nurse managers' mental health, coping behaviours and organisational commitment. Collegian 2021; 28:703-708. [PMID: 34744479 PMCID: PMC8556582 DOI: 10.1016/j.colegn.2021.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/22/2021] [Accepted: 10/19/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The emergence of COVID-19 has substantially impacted frontline health care workers, including nurse managers. To date, no studies have been conducted to examine the impact COVID-19 has had on Nurse Managers' mental health, coping strategies and organisational commitment. AIM To investigate the mental health, coping behaviours, and organisational commitment among Nurse Managers during the COVID-19 pandemic. METHODS Cross-sectional study involving 59 Nursing Managers from one Local Health District in Sydney Australia during the first wave of the COVID-19 pandemic. Data were collected relating to demographics, anxiety, coping strategies and organisational commitment. RESULTS Overall, approximately three quarters of the Nurse Managers had high anxiety scores. Managers who had worked longer as a nurse had higher scores for adaptive coping strategies and 41% of Nurse Managers considered leaving their jobs. CONCLUSIONS Strategies to minimise anxiety and enable coping as part of organisational disaster, emergency or crisis planning for Nurse Managers may result in decreased anxiety and stress levels, increased use of adaptive coping strategies and lower intent to leave the organisation and the nursing profession.
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Affiliation(s)
- Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Clare Loveday
- St. George Hospital, Gray St, Kogarah NSW 2217, Australia
| | - Cassandra Hobbs
- Sutherland Hospital, Kingsway & Kareena Rd, Caringbah NSW 2229, Australia
| | - Elham Almasi
- Sutherland Hospital, Kingsway & Kareena Rd, Caringbah NSW 2229, Australia
| | - Lorna Moxham
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Heidi Green
- St. George Hospital, Gray St, Kogarah NSW 2217, Australia
| | - Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
| | - Ritin Fernandez
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- Illawarra Health and Medical Research Institute (IHMRI), University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia
- St. George Hospital, Gray St, Kogarah NSW 2217, Australia
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17
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Stea TH, Alvsvåg L, Kleppang AL. The Association between Dietary Habits, Substance Use, and Mental Distress among Adults in Southern Norway: A Cross-Sectional Study among 28,047 Adults from the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189731. [PMID: 34574654 PMCID: PMC8468906 DOI: 10.3390/ijerph18189731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to examine associations between dietary habits, substance use, and mental distress among adults. This cross-sectional study was conducted in 2019 using an online questionnaire and included 28,047 adults (≥18 years) from Southern Norway. Multivariable logistic regression models stratified by gender were used to examine the associations between different lifestyle behaviors and mental distress. The results showed increased odds of mental distress among males and females with low consumption of vegetables (OR:1.26; 95% CI:1.08–1.47 and 1.14; 1.02–1.28) and fish (1.28; 1.12–1.46 and 1.36; 1.22–1.52), and among females, but not males, with high consumption of sugar-sweetened beverages (1.25; 1.06–1.48) compared to those with a healthier consumption of these foods and beverages. The results also showed increased odds of mental distress among male and female smokers (1.38; 1.19–1.60 and 1.44; 1.26–1.64), and among females, but not males, reporting current use of smokeless tobacco (1.20; 1.03–1.40), compared to male and female non-smokers and female non-users of smokeless tobacco. Overall, unhealthy dietary habits, smoking and the use of smokeless tobacco was associated with increased odds of mental distress, but the relationship varied according to gender. Future studies are needed to confirm any possible causal relationships.
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Affiliation(s)
- Tonje Holte Stea
- Department of Health and Nursing Science, University of Agder, 4604 Kristiansand, Norway; (L.A.); (A.L.K.)
- Department of Child and Adolescence Mental Health, Sørlandet Hospital, 4604 Kristiansand, Norway
- Correspondence:
| | - Linn Alvsvåg
- Department of Health and Nursing Science, University of Agder, 4604 Kristiansand, Norway; (L.A.); (A.L.K.)
| | - Annette Løvheim Kleppang
- Department of Health and Nursing Science, University of Agder, 4604 Kristiansand, Norway; (L.A.); (A.L.K.)
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Balachandra S, Eary RL, Lee R, Wynings EM, Sher DJ, Sura T, Liu Y, Tillman BN, Sumer BD, Arnold EM, Tiro JA, Lee SC, Day AT. Substance use and mental health burden in head and neck and other cancer survivors: A National Health Interview Survey analysis. Cancer 2021; 128:112-121. [PMID: 34499355 DOI: 10.1002/cncr.33881] [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: 09/22/2020] [Revised: 01/17/2021] [Accepted: 02/13/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND Tobacco dependence, alcohol abuse, depression, distress, and other adverse patient-level influences are common in head and neck cancer (HNC) survivors. Their interrelatedness and precise burden in comparison with survivors of other cancers are poorly understood. METHODS National Health Interview Survey data from 1997 to 2016 were pooled. The prevalence of adverse patient-level influences among HNC survivors and matched survivors of other cancers were compared using descriptive statistics. Multivariable logistic regressions evaluating covariate associations with the primary study outcomes were performed. These included 1) current cigarette smoking and/or heavy alcohol use (>14 drinks per week) and 2) high mental health burden (severe psychological distress [Kessler Index ≥ 13] and/or frequent depressive/anxiety symptoms). RESULTS In all, 918 HNC survivors and 3672 matched survivors of other cancers were identified. Compared with other cancer survivors, more HNC survivors were current smokers and/or heavy drinkers (24.6% [95% CI, 21.5%-27.7%] vs 18.0% [95% CI, 16.6%-19.4%]) and exhibited a high mental health burden (18.6% [95% CI, 15.7%-21.5%] vs 13.0% [95% CI, 11.7%-14.3%]). In multivariable analyses, 1) a high mental health burden predicted for smoking and/or heavy drinking (odds ratio [OR], 1.4; 95% CI, 1.0-1.9), and 2) current cigarette smoking predicted for a high mental health burden (OR, 1.7; 95% CI, 1.2-2.3). Furthermore, nonpartnered marital status and uninsured/Medicaid insurance status were significantly associated with both cigarette smoking and/or heavy alcohol use (ORs, 1.9 [95% CI, 1.4-2.5] and 1.5 [95% CI, 1.0-2.1], respectively) and a high mental health burden (ORs, 1.4 [95% CI, 1.1 -1.8] and 3.0 [95% CI, 2.2-4.2], respectively). CONCLUSIONS Stakeholders should allocate greater supportive care resources to HNC survivors. The interdependence of substance abuse, adverse mental health symptoms, and other adverse patient-level influences requires development of novel, multimodal survivorship care interventions.
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Affiliation(s)
- Sanjana Balachandra
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rebecca L Eary
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rebecca Lee
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Erin M Wynings
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - David J Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Teena Sura
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yulun Liu
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Brittny N Tillman
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Baran D Sumer
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Elizabeth Mayfield Arnold
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jasmin A Tiro
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Simon C Lee
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Andrew T Day
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas.,Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas.,Simmons Comprehensive Cancer Center, Population Science and Cancer Control Program, University of Texas Southwestern Medical Center, Dallas, Texas
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19
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Lee N, Lee ES, Yun JM, Lee CM, Oh SW, Choi Y, Cho B. Behavioral therapy and pharmacotherapy for relapse prevention in abstinent smokers: a rapid review and meta-analysis for the Korea Preventive Service Task Force. Osong Public Health Res Perspect 2021; 12:244-253. [PMID: 34465073 PMCID: PMC8408415 DOI: 10.24171/j.phrp.2021.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/15/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives This study aimed to assess the effectiveness of relapse prevention interventions involving behavioral and pharmacological treatment among abstinent smokers. Methods This rapid review was conducted using MEDLINE, Cochrane CENTRAL, CINAHL, Embase, KMbase, and KoreaMed to identify studies published until June 20, 2020. The participants were abstinent smokers who quit smoking on their own, due to pregnancy, hospitalization, or by participating in a smoking cessation program. We found a systematic review that fit the objective of this study and included 81 randomized controlled trials (RCTs). Studies that did not present information on smoking cessation status, had no control group, or used reward-based interventions were excluded. Random effect and fixed effect meta-analyses were used to estimate the relative risk (RR) and 95% confidence interval (CI). In subgroup analyses, differences between subgroups were verified based on the participant setting, characteristics, intervention type, and intensity. Results Following screening, 44 RCTs were included in the meta-analysis. The review reported no differences in the success rate of relapse prevention between the behavioral interventions. Pharmacotherapy interventions showed higher success rates (RR, 1.15; 95% CI, 1.05−1.26; I2=40.71%), depending on prior abstinence duration and the drug type. Conclusion The results indicated that pharmacotherapy has a significant effect on preventing relapse among abstinent smokers.
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Affiliation(s)
- Naae Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Eon Sook Lee
- Department of Family Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jae Moon Yun
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Cheol Min Lee
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Seung-Won Oh
- Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Younglee Choi
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Belong Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
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20
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Streck JM, Luberto CM, Muzikansky A, Skurla S, Ponzani CJ, Perez GK, Hall DL, Gonzalez A, Mahaffey B, Rigotti NA, Ostroff JS, Park ER. Examining the effects of stress and psychological distress on smoking abstinence in cancer patients. Prev Med Rep 2021; 23:101402. [PMID: 34094817 PMCID: PMC8163988 DOI: 10.1016/j.pmedr.2021.101402] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Cancer patients who smoke report more stress and psychological distress than patients who do not smoke. It is unclear how these emotional symptoms may modify smoking behavior in cancer patients. We examined the influence of a smoking cessation intervention for cancer patients on stress and distress, and the effects of these symptoms on smoking abstinence. METHODS Mixed-methods secondary analysis of data from the Smokefree Support Study, a two-site randomized controlled trial examining the efficacy of Intensive (IT; n = 153) vs. Standard Treatment (ST; n = 150) for smoking cessation in newly diagnosed cancer patients. Stress coping, perceived stress, distress, and anxiety were self-reported at baseline, 3, and 6 months. Abstinence was biochemically-confirmed at 6 months. A subset of patients (n = 72) completed qualitative exit-interviews. RESULTS Patients were on average, 58 years old, 56% female, and smoked a median of 10 cigarettes/day. There were no significant treatment group × time interactions or main effects of treatment group on stress or distress measures (p's > 0.05), however there were significant main effects of time suggesting symptom improvements on each measure in both study groups (p's < 0.05). In adjusted logistic regression models, lower levels anxiety at 3 months predicted confirmed smoking abstinence at 6 months (p = .03). Qualitatively, at 6 months, patients reported their stress and smoking were connected and that the cessation counseling was helpful. CONCLUSIONS Cancer patients enrolled in a smoking cessation trial report decreases in stress, distress and anxiety over time, and anxiety symptoms may impact smoking cessation success at follow-up resulting in an important intervention target.
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Affiliation(s)
- Joanna M. Streck
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Christina M. Luberto
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Alona Muzikansky
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Center for Biostatistics, Memorial Sloan Kettering Cancer Center, United States
| | - Sarah Skurla
- VA Center for Clinical Management Research, Memorial Sloan Kettering Cancer Center, United States
| | - Colin J. Ponzani
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Giselle K. Perez
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Daniel L. Hall
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
| | - Adam Gonzalez
- Stony Brook University, School of Medicine, Memorial Sloan Kettering Cancer Center, United States
| | - Brittain Mahaffey
- Stony Brook University, School of Medicine, Memorial Sloan Kettering Cancer Center, United States
| | - Nancy A. Rigotti
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
- Department of Medicine, Memorial Sloan Kettering Cancer Center, United States
| | - Jamie S. Ostroff
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, United States
| | - Elyse R. Park
- Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, United States
- Harvard Medical School, Memorial Sloan Kettering Cancer Center, United States
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, United States
- Mongan Institute Health Policy Research Center & Tobacco Research and Treatment Center, Memorial Sloan Kettering Cancer Center, United States
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21
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Smith L, Jacob L, López-Sánchez GF, Butler L, Barnett Y, Veronese N, Soysal P, Yang L, Grabovac I, Tully MA, Shin JI, Koyanagi A. Anxiety symptoms and mild cognitive impairment among community-dwelling older adults from low- and middle-income countries. J Affect Disord 2021; 291:57-64. [PMID: 34023748 DOI: 10.1016/j.jad.2021.04.076] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/19/2021] [Accepted: 04/25/2021] [Indexed: 11/25/2022]
Abstract
AIM Anxiety may be a risk factor for mild cognitive impairment (MCI) but there is a scarcity of data on this association especially from low- and middle-income countries (LMICs). Thus, we investigated the association between anxiety and MCI among older adults residing in six LMICs (China, Ghana, India, Mexico, Russia, South Africa), and the mediational effect of sleep problems in this association. METHODS Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer's Association criteria. Multivariable logistic regression analysis, meta-analysis, and mediation analysis were conducted to assess associations. RESULTS The final sample included 32,715 individuals aged ≥50 years with preservation in functional abilities [mean (standard deviation) age 62.1 (15.6) years; 48.3% males]. Country-wise analysis showed a positive association between anxiety and MCI in all countries (OR 1.35-14.33). The pooled estimate based on meta-analysis with random effects was OR=2.27 (95%CI=1.35-3.83). Sleep problems explained 41.1% of this association. CONCLUSIONS Older adults with anxiety had higher odds for MCI in LMICs. Future studies should examine whether preventing anxiety or addressing anxiety among individuals with MCI can lead to lower risk for dementia onset in LMICs, while the role of sleep problems in this association should be investigated in detail.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, CB1 1PT, United Kingdom.
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux 78180, France
| | - Guillermo F López-Sánchez
- Vision and Eye Research Institute, School of Medicine, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University-Cambridge Campus, Cambridge, United Kingdom
| | - Laurie Butler
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, CB1 1PT, United Kingdom
| | - Yvonne Barnett
- Anglia Ruskin University, Cambridge, CB1 1PT, United Kingdom
| | - Nicola Veronese
- Department of Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Igor Grabovac
- Department of Social and Behavioural Science, Medical University of Vienna, Kinderspitalgasse 15/1, 1090 Wien, Austria
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, United Kingdom
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
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Taylor GM, Lindson N, Farley A, Leinberger-Jabari A, Sawyer K, Te Water Naudé R, Theodoulou A, King N, Burke C, Aveyard P. Smoking cessation for improving mental health. Cochrane Database Syst Rev 2021; 3:CD013522. [PMID: 33687070 PMCID: PMC8121093 DOI: 10.1002/14651858.cd013522.pub2] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is a common perception that smoking generally helps people to manage stress, and may be a form of 'self-medication' in people with mental health conditions. However, there are biologically plausible reasons why smoking may worsen mental health through neuroadaptations arising from chronic smoking, leading to frequent nicotine withdrawal symptoms (e.g. anxiety, depression, irritability), in which case smoking cessation may help to improve rather than worsen mental health. OBJECTIVES To examine the association between tobacco smoking cessation and change in mental health. SEARCH METHODS We searched the Cochrane Tobacco Addiction Group's Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, PsycINFO, and the trial registries clinicaltrials.gov and the International Clinical Trials Registry Platform, from 14 April 2012 to 07 January 2020. These were updated searches of a previously-conducted non-Cochrane review where searches were conducted from database inception to 13 April 2012. SELECTION CRITERIA: We included controlled before-after studies, including randomised controlled trials (RCTs) analysed by smoking status at follow-up, and longitudinal cohort studies. In order to be eligible for inclusion studies had to recruit adults who smoked tobacco, and assess whether they quit or continued smoking during the study. They also had to measure a mental health outcome at baseline and at least six weeks later. DATA COLLECTION AND ANALYSIS We followed standard Cochrane methods for screening and data extraction. Our primary outcomes were change in depression symptoms, anxiety symptoms or mixed anxiety and depression symptoms between baseline and follow-up. Secondary outcomes included change in symptoms of stress, psychological quality of life, positive affect, and social impact or social quality of life, as well as new incidence of depression, anxiety, or mixed anxiety and depression disorders. We assessed the risk of bias for the primary outcomes using a modified ROBINS-I tool. For change in mental health outcomes, we calculated the pooled standardised mean difference (SMD) and 95% confidence interval (95% CI) for the difference in change in mental health from baseline to follow-up between those who had quit smoking and those who had continued to smoke. For the incidence of psychological disorders, we calculated odds ratios (ORs) and 95% CIs. For all meta-analyses we used a generic inverse variance random-effects model and quantified statistical heterogeneity using I2. We conducted subgroup analyses to investigate any differences in associations between sub-populations, i.e. unselected people with mental illness, people with physical chronic diseases. We assessed the certainty of evidence for our primary outcomes (depression, anxiety, and mixed depression and anxiety) and our secondary social impact outcome using the eight GRADE considerations relevant to non-randomised studies (risk of bias, inconsistency, imprecision, indirectness, publication bias, magnitude of the effect, the influence of all plausible residual confounding, the presence of a dose-response gradient). MAIN RESULTS We included 102 studies representing over 169,500 participants. Sixty-two of these were identified in the updated search for this review and 40 were included in the original version of the review. Sixty-three studies provided data on change in mental health, 10 were included in meta-analyses of incidence of mental health disorders, and 31 were synthesised narratively. For all primary outcomes, smoking cessation was associated with an improvement in mental health symptoms compared with continuing to smoke: anxiety symptoms (SMD -0.28, 95% CI -0.43 to -0.13; 15 studies, 3141 participants; I2 = 69%; low-certainty evidence); depression symptoms: (SMD -0.30, 95% CI -0.39 to -0.21; 34 studies, 7156 participants; I2 = 69%' very low-certainty evidence); mixed anxiety and depression symptoms (SMD -0.31, 95% CI -0.40 to -0.22; 8 studies, 2829 participants; I2 = 0%; moderate certainty evidence). These findings were robust to preplanned sensitivity analyses, and subgroup analysis generally did not produce evidence of differences in the effect size among subpopulations or based on methodological characteristics. All studies were deemed to be at serious risk of bias due to possible time-varying confounding, and three studies measuring depression symptoms were judged to be at critical risk of bias overall. There was also some evidence of funnel plot asymmetry. For these reasons, we rated our certainty in the estimates for anxiety as low, for depression as very low, and for mixed anxiety and depression as moderate. For the secondary outcomes, smoking cessation was associated with an improvement in symptoms of stress (SMD -0.19, 95% CI -0.34 to -0.04; 4 studies, 1792 participants; I2 = 50%), positive affect (SMD 0.22, 95% CI 0.11 to 0.33; 13 studies, 4880 participants; I2 = 75%), and psychological quality of life (SMD 0.11, 95% CI 0.06 to 0.16; 19 studies, 18,034 participants; I2 = 42%). There was also evidence that smoking cessation was not associated with a reduction in social quality of life, with the confidence interval incorporating the possibility of a small improvement (SMD 0.03, 95% CI 0.00 to 0.06; 9 studies, 14,673 participants; I2 = 0%). The incidence of new mixed anxiety and depression was lower in people who stopped smoking compared with those who continued (OR 0.76, 95% CI 0.66 to 0.86; 3 studies, 8685 participants; I2 = 57%), as was the incidence of anxiety disorder (OR 0.61, 95% CI 0.34 to 1.12; 2 studies, 2293 participants; I2 = 46%). We deemed it inappropriate to present a pooled estimate for the incidence of new cases of clinical depression, as there was high statistical heterogeneity (I2 = 87%). AUTHORS' CONCLUSIONS Taken together, these data provide evidence that mental health does not worsen as a result of quitting smoking, and very low- to moderate-certainty evidence that smoking cessation is associated with small to moderate improvements in mental health. These improvements are seen in both unselected samples and in subpopulations, including people diagnosed with mental health conditions. Additional studies that use more advanced methods to overcome time-varying confounding would strengthen the evidence in this area.
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Affiliation(s)
- Gemma Mj Taylor
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Nicola Lindson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amanda Farley
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, UK
| | | | - Katherine Sawyer
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | | | - Annika Theodoulou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Naomi King
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Chloe Burke
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Casarrubea M, Davies C, Pierucci M, Colangeli R, Deidda G, Santangelo A, Aiello S, Crescimanno G, Di Giovanni G. The impact of chronic daily nicotine exposure and its overnight withdrawal on the structure of anxiety-related behaviors in rats: Role of the lateral habenula. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110131. [PMID: 33039434 DOI: 10.1016/j.pnpbp.2020.110131] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/17/2020] [Accepted: 10/04/2020] [Indexed: 01/03/2023]
Abstract
Tobacco smoking is a serious health problem worldwide and a leading cause of mortality. Nicotine, the addictive component of tobacco, affects a range of emotional responses, including anxiety-related behaviors. Although perceived by smokers to be anxiolytic, evidence suggests that smoking increases anxiety and that mood fluctuates with nicotine intake. Thus, nicotine addiction may depend on easing the psychobiological distress caused by its abuse. The lateral habenula (LHb) has been implicated as a neural substrate for acute nicotine-induced anxiety, but its role in anxiety-like behaviors associated with chronic nicotine exposure has not been explored. Here, we assessed the effect of chronic nicotine exposure and its subsequent overnight withdrawal on anxiety-like behavior using both quantitative and multivariate T-pattern analysis in rats tested using the hole-board apparatus. Additionally, we explored the role of the LHb by comparing the behavioral effects of short-term nicotine withdrawal in chronically treated LHb-lesioned rats. Quantitative analysis revealed increased anxiety-like behavior in chronically treated overnight nicotine-deprived rats, as manifested in reduced general and focused exploratory behaviors, which was eased in animals that received nicotine. Quantitative analysis failed to reveal a role of the LHb in overnight nicotine deprivation-induced anxiety. Conversely, T-pattern analysis of behavioral outcomes revealed that chronic nicotine-treated rats still show anxiety-like behavior following nicotine challenge. Moreover, it demonstrated that the LHb lesion induced a stronger anxiolytic-like response to the acute challenge of nicotine in chronically nicotine-exposed animals, implicating the LHb in the anxiogenic effect of chronic nicotine exposure. These data further highlight the LHb as a promising target for smoking cessation therapies and support the importance of T-pattern analysis for behavioral analysis.
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Affiliation(s)
- Maurizio Casarrubea
- Laboratory of Behavioral Physiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), Human Physiology Section "Giuseppe Pagano", University of Palermo, Palermo, Italy.
| | - Caitlin Davies
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta; Neuroscience Division, School of Biosciences, Cardiff University, Cardiff, UK
| | - Massimo Pierucci
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Roberto Colangeli
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta; Section of Neuroscience and Cell Biology, Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Gabriele Deidda
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | | | - Stefania Aiello
- Laboratory of Behavioral Physiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), Human Physiology Section "Giuseppe Pagano", University of Palermo, Palermo, Italy
| | - Giuseppe Crescimanno
- Laboratory of Behavioral Physiology, Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), Human Physiology Section "Giuseppe Pagano", University of Palermo, Palermo, Italy
| | - Giuseppe Di Giovanni
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida, Malta; Neuroscience Division, School of Biosciences, Cardiff University, Cardiff, UK.
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24
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Montanari C, Secci ME, Driskell A, McDonald KO, Schratz CL, Gilpin NW. Chronic nicotine increases alcohol self-administration in adult male Wistar rats. Psychopharmacology (Berl) 2021; 238:201-213. [PMID: 33000333 PMCID: PMC7796964 DOI: 10.1007/s00213-020-05669-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/21/2020] [Indexed: 12/25/2022]
Abstract
RATIONALE Alcohol and nicotine co-dependence is common in humans, and nicotine increases alcohol drinking in humans without alcohol use disorder (AUD). Nevertheless, there is little basic research on the interactions between the reinforcing effects of these two drugs. OBJECTIVES The aim of this study was to investigate the effects of chronic nicotine injections on oral alcohol self-administration in alcohol non-dependent rats. METHODS After stable alcohol self-administration was reached (baseline) and a period without alcohol access, adult male rats were treated with chronic nicotine or saline injections for 105 days during which time they were tested intermittently for alcohol self-administration. There were 3 experimental groups: (1) saline, rats treated with saline for 105 days; (2) early nicotine, rats treated with nicotine for 70 days, and then with saline for 35 days; and (3) late nicotine: rats treated with saline for 35 days, and then with nicotine for 70 days. RESULTS Our results indicate that (1) chronic nicotine increases alcohol consumption regardless of whether exposure to alcohol was interrupted (early nicotine) or not (late nicotine) before the start of nicotine treatment, (2) the number of alcohol reinforcements correlates to blood-alcohol levels, and (3) alcohol self-administration rapidly decreases when nicotine is no longer available (early nicotine). CONCLUSIONS These discoveries may have clinical implications in social drinkers that use nicotine products, in that chronic nicotine can escalate alcohol drinking and cessation of nicotine exposure may decrease alcohol use.
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Affiliation(s)
- Christian Montanari
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
| | - Maria E Secci
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Ashlyn Driskell
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Katherine O McDonald
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Connor L Schratz
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Nicholas W Gilpin
- Department of Physiology, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.,Neuroscience Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.,Alcohol & Drug Abuse Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.,Southeast Louisiana VA Healthcare System (SLVHCS), New Orleans, LA, 70119, USA
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25
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Dahal R, Bhattarai A, Adhikari K. Variation in characteristics of people with mental disorders across smoking status in the Canadian general population. Tob Prev Cessat 2020; 6:61. [PMID: 33163707 PMCID: PMC7643586 DOI: 10.18332/tpc/127523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/24/2020] [Accepted: 09/14/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION People with mental disorders are less successful in smoking cessation efforts. This study compared the characteristics of current smokers and former smokers with mental disorders. METHODS This was a cross-sectional study that used the Public Use Microdata File of the Canadian Community Health Survey 2012. Survey respondents with any mental health disorder in the last 12 months (n=2700), identified using the World Health Organization Composite International Diagnostic Interview instrument, were included in the analysis. Smoking status was classified based on self-report responses as current, former and never smoker. Logistic regression models were used to analyze the data. RESULTS The odds of quitting smoking were significantly lower among people who were single or never married (widowed/divorced/separated/single) compared to those who were married or had a common-law partner (adjusted odds ratio, AOR=0.6, 95% CI: 0.4–0.9). Similarly, significantly lower odds of quitting smoking were observed among people with less than post-secondary education compared to those with post-secondary education (AOR=0.4, 95% CI: 0.3– 0.6). Also, the odds of quitting were significantly lower among immigrants, young adults, and middle-aged adults. CONCLUSIONS People who are young or middle-aged, single or never married, less educated, and immigrants, are less likely to quit smoking. This pattern underscores the socioeconomic disparities in quitting smoking among people with mental disorders. Future research should investigate why these groups continue to smoke more often than their counterparts. This will help design the smoking cessation support that address the challenges experienced by vulnerable populations and reduce the disparities.
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Affiliation(s)
- Rudra Dahal
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, Canada
| | - Asmita Bhattarai
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kamala Adhikari
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
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26
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Salt V, Osborne C. Mental health, smoking and poverty: benefits of supporting smokers to quit. BJPsych Bull 2020; 44:213-218. [PMID: 32847647 PMCID: PMC7525592 DOI: 10.1192/bjb.2020.88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Smoking rates among people with common mental health conditions remain around 50% higher than those in the wider population; this is a significant cause of the 10-20-year reduced life expectancy of people with mental health conditions. However, the effects of smoking go far beyond physical health. Research estimates that smokers with mental health conditions could be spending as much as £2200 a year on tobacco, pushing an estimated 130 000 people with a common mental disorder into poverty. The Government has set a target for England to be smokefree by 2030; however, without a dramatic increase in support, smokers with mental health conditions risk being left behind. Action on Smoking and Health provides the secretariat for the Mental Health & Smoking Partnership. The Partnership aims to reduce the inequality in smoking rates between people with mental health conditions and the wider population. It brings together Royal Colleges, third-sector organisations, trade unions and academia to review progress and highlight areas for further action.
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27
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Giuliani M, Brual J, Cameron E, Chaiton M, Eng L, Haque M, Liu G, Mittmann N, Papadakos J, Saunders D, Truscott R, Evans W. Smoking Cessation in Cancer Care: Myths, Presumptions and Implications for Practice. Clin Oncol (R Coll Radiol) 2020; 32:400-406. [PMID: 32029357 DOI: 10.1016/j.clon.2020.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/26/2019] [Accepted: 12/04/2019] [Indexed: 10/25/2022]
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28
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Lee EJ. Long-Term Effects of Smoking Cessation on Depressive Symptoms, Resilience, Coping Skills, and Serotonin. Psychiatr Q 2020; 91:263-271. [PMID: 31845167 DOI: 10.1007/s11126-019-09689-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
There are many studies on how smoking cigarettes is harmful to health, but research on how smoking cessation improves mental health is insufficient. The purpose of this study was to examine long-term effects of smoking cessation on depressive symptoms, resilience, coping skills, and serotonin levels in Korean adults. This was a longitudinal study that followed up on periodically participants for 2 years after the initial smoking cessation intervention. A total of 164 smokers participated within this study. Of these, 15 maintained smoking cessation for 504.93 ± 182.82 days. On the other hand, 148 participants failed to maintain smoking cessation. Depressive symptoms decreased and resilience increased significantly over 2 years in the 15 abstainers. Smoking cessation, in total, decreased depressive symptoms by 32.9% (p = .015) and also increased resilience by 37.5% (p = .012). Smoking cessation also explained for 9% of total positive interpretation at the 1-year follow-up, and 7.3% of total self-criticism at the 2-year follow-up. Serum serotonin did not change over the course of 2 years in both abstainers and smokers but did decrease in the short-term for those who maintained smoking cessation. Platelet serotonin increased over 6 months among smokers.
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Affiliation(s)
- Eun Jin Lee
- Nursing Department, Inha University, Inharo100, Michuholgu, Incheon, 22212, South Korea.
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29
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Abstract
AbstractIntroductionQuitlines are standard care for smoking cessation; however, retaining clients in services is a problem. Little is known about factors that may predict dropout.AimsTo examine predictors of retention while in-program and at follow-up for clients enrolling in a state quitline.MethodsThis was a retrospective analysis of quitline enrolled clients from 2011 to 2017 (N = 49,347). Client retention in-program was categorized as (a) low adherence to treatment (receiving zero coaching calls), moderate (1–2 calls), and high adherence (3+ calls). Dropout at follow-up included participants who were not reached for the 7-month follow-up.ResultsMore than half the sample dropped out during treatment; 61% were not reached for follow-up. Women (odds ratio (OR) = 1.21; 95% confidence interval (CI) = [1.16, 127]) and those with high levels of nicotine dependence (OR = 1.03; 95% CI = [1.02, 1.04]) were more likely to have moderate adherence to treatment (1–2 coaching calls). Dropout at follow-up was more likely among clients who used nicotine replacement therapy (OR = 1.14; 95% CI = [1.09, 1.19]) and less likely among those who had high treatment adherence (OR = 0.41; 95% CI = [0.39, 0.42]).ConclusionGiven the relapsing nature of tobacco use and the harms related to tobacco use, quitlines can improve their impact by offering tailored services to enhance client engagement and retention in-treatment and at follow-up.
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30
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Effects of chronic nicotine on the temporal structure of anxiety-related behavior in rats tested in hole-board. Prog Neuropsychopharmacol Biol Psychiatry 2020; 96:109731. [PMID: 31394140 DOI: 10.1016/j.pnpbp.2019.109731] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 07/22/2019] [Accepted: 08/03/2019] [Indexed: 11/22/2022]
Abstract
The present study aimed to assess the behavioral effects of chronic treatments of different doses of nicotine by using both quantitative and multivariate T-pattern analysis (TPA), which can reveal hidden behavioral structures, in Sprague-Dawley rats tested in the hole-board apparatus. To this purpose, nicotine ditartrate was administered at the doses of 0.1, 0.5 and 1 mg/kg i.p., three times per day, for 14 consecutive days. As to quantitative evaluations, we observed significant reductions in the mean durations and mean frequencies of walking, climbing, immobile-sniffing and rearing in comparison to control. A significant reduction of edge-sniff and head-dip mean frequencies was also detected for all the doses tested. TPA revealed an increase in the number and the mean length of different T-patterns induced by the three doses of nicotine. On the other hand, a significant reduction of the mean occurrences of T-patterns was revealed. Overall, our results obtained by using both quantitative and T-pattern analyses indicate that chronic nicotine induces an anxiety condition characterized by a behavioral re-organization orbiting around the two main components of hole exploration, that is, head-dip and edge-sniff. A better understanding of the link between nicotine and anxiety might help to find new therapies for smoking cessation.
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31
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Prochaska JJ, Benowitz NL. Current advances in research in treatment and recovery: Nicotine addiction. SCIENCE ADVANCES 2019; 5:eaay9763. [PMID: 31663029 PMCID: PMC6795520 DOI: 10.1126/sciadv.aay9763] [Citation(s) in RCA: 107] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/26/2019] [Indexed: 05/05/2023]
Abstract
The health harms of combusted tobacco use are undeniable. With market and regulatory pressures to reduce the harms of nicotine delivery by combustion, the tobacco product landscape has diversified to include smokeless, heated, and electronic nicotine vaping products. Products of tobacco combustion are the main cause of smoking-induced disease, and nicotine addiction sustains tobacco use. An understanding of the biology and clinical features of nicotine addiction and the conditioning of behavior that occurs via stimuli paired with frequent nicotine dosing, as with a smoked cigarette, is important for informing pharmacologic and behavioral treatment targets. We review current advances in research on nicotine addiction treatment and recovery, with a focus on conventional combustible cigarette use. Our review covers evidence-based methods to treat smoking in adults and policy approaches to prevent nicotine product initiation in youth. In closing, we discuss emerging areas of evidence and consider new directions for advancing the field.
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Affiliation(s)
- Judith J. Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
| | - Neal L. Benowitz
- Program in Clinical Pharmacology, Division of Cardiology, and the Center for Tobacco Control Research and Education, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
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32
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Graff V, Cai L, Badiola I, Elkassabany NM. Music versus midazolam during preoperative nerve block placements: a prospective randomized controlled study. Reg Anesth Pain Med 2019; 44:rapm-2018-100251. [PMID: 31320504 DOI: 10.1136/rapm-2018-100251] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 06/04/2019] [Accepted: 06/08/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVES Music medicine is a non-pharmacologic intervention that is virtually harm-free, relatively inexpensive and has been shown to significantly decrease preoperative anxiety. In this study we aim to compare the use of music to midazolam as a preoperative anxiolytic prior to the administration of an ultrasound-guided single-injection peripheral nerve block. METHODS In this randomized controlled study we compared the anxiolytic effects of intravenous midazolam (1-2 mg) with noise-canceling headphone-delivered music medicine. All patients received a preoperative ultrasound-guided single-injection peripheral nerve block indicated for a primary regional anesthetic or postoperative analgesia. RESULTS The change in the State Trait Anxiety Inventory-6 (STAI-6) anxiety scores from after to before the procedure were similar in both groups (music group -1.6 (SD 10.7); midazolam group -4.2 (SD 11); p=0.14; mean difference between groups -2.5 (95% CI -5.9 to 0.9), p=0.1). Patient satisfaction scores with their procedure experience were higher in the midazolam group (p=0.01); however, there were no differences in physician satisfaction scores of their procedure experience between groups (p=0.07). Both patient and physician perceptions on difficulties in communication were higher in the music group than in the midazolam group (p=0.005 and p=0.0007, respectively). CONCLUSIONS Music medicine may be offered as an alternative to midazolam administration prior to peripheral regional anesthesia. However, further studies are warranted to evaluate whether or not the type of music, as well as how it is delivered, offers advantages over midazolam that outweigh the increase in communication barriers. CLINICAL TRIAL REGISTRY Clinicaltrials.gov #NCT03069677.
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Affiliation(s)
- Veena Graff
- Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lu Cai
- Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ignacio Badiola
- Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nabil M Elkassabany
- Anesthesiology & Critical Care, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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33
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Kim SJ, Chae W, Park WH, Park MH, Park EC, Jang SI. The impact of smoking cessation attempts on stress levels. BMC Public Health 2019; 19:267. [PMID: 30841877 PMCID: PMC6402150 DOI: 10.1186/s12889-019-6592-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 02/25/2019] [Indexed: 01/12/2023] Open
Abstract
Background Cigarette smoking is a major health risk, particularly in male South Koreans. Smoking cessation can benefit health; however, the process of quitting smoking is difficult to some smokers and shows its relationship to their stress level. The hypothesis of this study is that who has failed attempts to stop smoking induce more stress than habitual smoking. Methods To test this, the analysis on the association between smoking cessation attempts and stress levels in smokers was performed. The Korean Community Health Survey (2011–2016) data with the total of 488,417 participants’ data were used for this study. Survey data were analyzed using the chi-square test and logistic regression. As the dependent variable, self-reported level of stress was selected. Results Of the subject population, 78.3% (63.3% males, 81.4% females) felt stressed. Among participants who successfully stopped smoking, 73.0% (72.6% males, 78.1% females) reported feeling stressed. In contrast, of those who failed to stop smoking, 83.3% (83.6% males, 86.3% females) reported high stress levels. Among those who did not attempt smoking cessation, 81.1% (81.2% males, 80.3% females) responded that they experienced stress. Those who failed to stop smoking had higher odds of stress than those who did not attempt smoking cessation [odds ratio (OR) 1.11, 95% confidence interval (CI) 1.09–1.14, p < 0.001]. Those who successfully stopped smoking had lower odds of stress than those who did not attempt smoking cessation (OR 0.87, 95% CI 0.86–0.89, p < 0.001). Conclusion The study found an association between unsuccessful smoking cessation and stress level. As the result, people who failed smoking cessation showed higher stress. These data should be considered in health policy recommendations for smokers. Electronic supplementary material The online version of this article (10.1186/s12889-019-6592-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Seong-Jun Kim
- Medical Courses, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Wonjeong Chae
- Department of Public Health, College of Medicine, Yonsei University, Seoul, Republic of Korea.,Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Woo-Hyun Park
- Medical Courses, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min-Ho Park
- Medical Courses, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.,Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
| | - Sung-In Jang
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea. .,Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
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Fidelity to Best Practices of Psychiatric Assessments in Army Behavioral Health Settings. J Psychiatr Pract 2019; 25:103-117. [PMID: 30849058 DOI: 10.1097/pra.0000000000000365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
While civilian and military psychiatric clinical practice guidelines (CPGs) exist for psychiatric assessments, data are lacking on providers' adherence to these criteria. This study evaluated the use of psychiatric CPGs' assessment criteria by Army behavioral health providers (BHPs). In a weighted cross-sectional survey, 348 BHPs were evaluated on their assessment of a systematically selected patient on 15 total domains recommended by the Departments of Veterans Affairs and Defense CPGs for substance use disorders, posttraumatic stress disorder, and major depressive disorder. The proportion of BHPs providing high-quality assessment and the association between high-quality assessment and BHP and patient characteristics were examined. Using the weighted sample, 80% of BHPs provided a high-quality assessment. BHPs who saw ≥20 patients per week were significantly more likely to provide high-quality assessments compared with BHPs who saw <20 patients per week [odds ratio (OR)=1.72, 95% confidence interval (CI)=1.01-2.92]. Patients diagnosed with generalized anxiety disorder [adjusted OR (AOR)=0.42, 95% CI=0.18-0.96] or whose BHPs did not assess patients' current overall physical health (AOR=0.26, 95% CI=0.07-0.97) or lifetime duration of treatment for mental health (AOR=0.03, 95% CI=0.01-0.20) were less likely to receive high-quality assessments. A majority of Army BHPs are conducting high-quality assessments for the 3 most common mental disorders in military populations. If recommendations to increase fidelity to assessment could be implemented, more patients could receive optimized care.
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Higher mortality in women living in high-participation areas of a population-based health check and lifestyle intervention study. Int J Public Health 2018; 64:107-114. [DOI: 10.1007/s00038-018-1179-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 10/28/2018] [Accepted: 11/22/2018] [Indexed: 10/27/2022] Open
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36
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Song F, Bachmann MO, Aveyard P, Barton GR, Brown TJ, Maskrey V, Blyth A, Notley C, Holland R, Sutton S, Brandon TH. Relapse to smoking and health-related quality of life: Secondary analysis of data from a study of smoking relapse prevention. PLoS One 2018; 13:e0205992. [PMID: 30458010 PMCID: PMC6245517 DOI: 10.1371/journal.pone.0205992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 10/03/2018] [Indexed: 12/27/2022] Open
Abstract
Background Previous studies have shown that smoking and smoking cessation may be associated with health-related quality of life (HRQoL). In this study, we compared changes in HRQoL in people who maintained abstinence with people who had relapsed to smoking. Methods This was a secondary analysis of data from a trial of a relapse prevention intervention in 1,407 short-term quitters. The European Quality of Life -5 Dimensions (EQ-5D) measured HRQoL at baseline, 3 and 12 months. Smoking outcome was continuous abstinence from 2 to 12 months, and 7-day smoking at 3 and 12 months. We used nonparametric test for differences in EQ-5D utility scores, and chi-square test for dichotomised response to each of the five EQ-5D dimensions. Multivariable regression analyses were conducted to evaluate associations between smoking relapse and HRQoL or anxiety/depression problems. Results The mean EQ-5D tariff score was 0.8252 at baseline. People who maintained abstinence experienced a statistically non-significant increase in the EQ-5D score (mean change 0.0015, P = 0.88), while returning to smoking was associated with a statistically significant decrease in the EQ-5D score (mean change -0.0270, P = 0.004). After adjusting for multiple baseline characteristics, the utility change during baseline and 12 months was statistically significantly associated with continuous abstinence, with a difference of 0.0288 (95% CI: 0.0006 to 0.0571, P = 0.045) between relapsers and continuous quitters. The only difference in quality of life dimensions between those who relapsed and those who maintained abstinence was in the proportion of participants with anxiety/depression problems at 12 months (30% vs. 22%, P = 0.001). Smoking relapse was associated with a simultaneous increase in anxiety/depression problems. Conclusions People who achieve short-term smoking abstinence but subsequently relapse to smoking have a reduced quality of life, which appears mostly due to worsening of symptoms of anxiety and depression. Further research is required to more fully understand the relationship between smoking and health-related quality of life, and to develop cessation interventions by taking into account the impact of anxiety or depression on smoking.
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Affiliation(s)
- Fujian Song
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom
- * E-mail:
| | - Max O. Bachmann
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, United Kingdom
| | - Garry R. Barton
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom
| | - Tracey J. Brown
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom
| | - Vivienne Maskrey
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom
| | - Annie Blyth
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom
| | - Caitlin Notley
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom
| | - Richard Holland
- Norwich Medical School, Faculty of Medicine and Health Science, University of East Anglia, Research Park, Norwich, United Kingdom
| | - Stephen Sutton
- Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Thomas H. Brandon
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa FL, United States of America
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Levy DE, Chang Y, Regan S, Tindle HA, Singer DE, Rigotti NA. Improvements in health-related quality of life among smokers who quit after hospitalization. Prev Med 2018; 110:38-46. [PMID: 29427673 PMCID: PMC6456898 DOI: 10.1016/j.ypmed.2018.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 02/02/2018] [Accepted: 02/05/2018] [Indexed: 11/17/2022]
Abstract
Few rigorous longitudinal assessments have examined health-related quality of life (HRQoL) changes after smoking cessation, especially among recently-hospitalized smokers. We compared the change in HRQoL between those who did or did not quit smoking 6 months after hospital discharge. Participants were 1357 smokers recruited for a cessation trial between 2012 and 2014 while hospitalized at two hospitals in Massachusetts and one in Pennsylvania. Cessation was defined as biochemically confirmed 7-day point prevalence abstinence at 6 months or as self-reported continuous abstinence at 1, 3, or 6 months post discharge. HRQoL measures included a single-item global health measure (SF1); the Patient Health Questionnaire for Depression and Anxiety (PHQ-4) screening tool for psychological distress; and the EQ-5D-5L health utilities measure. Multivariable models controlled for age, sex, race, education, insurance, study site, study arm, discharge diagnoses, and baseline HRQoL. Improvements in HRQoL were evident in the first month after discharge among those achieving abstinence compared to continuing smokers. At 6 months post-discharge, those with biochemically confirmed cessation were 30% more likely to report at least good health by the SF1 (aRR 95% CI 1.14-1.45), 19% less likely to screen positive for psychological distress (aRR, 95% CI 0.68-0.93), and had EQ-5D-5L health utility scores 0.05 points (95% CI 0.02-0.08) higher than continuing smokers. Results were similar when assessed as a function of self-reported cessation. Hospital-initiated smoking cessation is associated with rapid statistically and clinically significant improvements in a range of HRQoL measures, providing an additional tool clinicians and health systems could use to encourage smoking cessation.
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Affiliation(s)
- Douglas E Levy
- Tobacco Research and Treatment Center at the Massachusetts General Hospital, Boston, MA, United States; Mongan Institute Health Policy Center at the Massachusetts General Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States.
| | - Yuchiao Chang
- Department of Medicine, Harvard Medical School, Boston, MA, United States; Division of General Internal Medicine at the Massachusetts General Hospital, Boston, MA, United States
| | - Susan Regan
- Tobacco Research and Treatment Center at the Massachusetts General Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States; Division of General Internal Medicine at the Massachusetts General Hospital, Boston, MA, United States
| | - Hilary A Tindle
- Vanderbilt Center for Tobacco Addiction and Lifestyle, Division of General Internal Medicine, Department of Medicine, Vanderbilt University Medical School, Nashville, TN, United States
| | - Daniel E Singer
- Department of Medicine, Harvard Medical School, Boston, MA, United States; Division of General Internal Medicine at the Massachusetts General Hospital, Boston, MA, United States
| | - Nancy A Rigotti
- Tobacco Research and Treatment Center at the Massachusetts General Hospital, Boston, MA, United States; Mongan Institute Health Policy Center at the Massachusetts General Hospital, Boston, MA, United States; Department of Medicine, Harvard Medical School, Boston, MA, United States; Division of General Internal Medicine at the Massachusetts General Hospital, Boston, MA, United States
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38
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Chírico MTT, Bezerra FS, Guedes MR, Souza AB, Silva FC, Campos G, de Noronha SR, Mesquita LBT, Reis TO, Cangussú SD, Chianca-Jr DA, de Menezes RC. Tobacco-Free Cigarette Smoke Exposure Induces Anxiety and Panic-Related Behaviours in Male Wistar Rats. Sci Rep 2018; 8:4943. [PMID: 29563583 PMCID: PMC5862846 DOI: 10.1038/s41598-018-23425-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 03/13/2018] [Indexed: 12/16/2022] Open
Abstract
Smokers, who generally present with lung damage, are more anxious than non-smokers and have an associated augmented risk of panic. Considering that lung damage signals specific neural pathways that are related to affective responses, the aim of the present study was to evaluate the influence of pulmonary injury on anxiety and panic-like behaviours in animals exposed to cigarette smoke with and without tobacco. Male Wistar rats were divided into the following groups: a control group (CG); a regular cigarette group (RC); and a tobacco-free cigarette (TFC) group. Animals were exposed to twelve cigarettes per day for eight consecutive days. The animals were then exposed to an elevated T-maze and an open field. The RC and TFC groups presented increases in inflammatory cell inflow, antioxidant enzyme activity, and TBARS levels, and a decrease in the GSH/GSSG ratio was observed in the TFC group. Exposure to RC smoke reduced anxiety and panic-related behaviours. On the other hand, TFC induced anxiety and panic-related behaviours. Thus, our results contradict the concept that nicotine is solely accountable for shifted behavioural patterns caused by smoking, in that exposure to TFC smoke causes anxiety and panic-related behaviours.
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Affiliation(s)
- Máira Tereza Talma Chírico
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Frank Silva Bezerra
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Mariana Reis Guedes
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Ana Beatriz Souza
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Fernanda Cacilda Silva
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Glenda Campos
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Sylvana Rendeiro de Noronha
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Laura Batista Tavares Mesquita
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Thayane Oliveira Reis
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Silvia Dantas Cangussú
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil
| | - Deoclécio Alves Chianca-Jr
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil.,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Rodrigo Cunha de Menezes
- Department of Biological Sciences, Institute of Exact and Biological Sciences, Federal University of Ouro Preto, Ouro Preto, MG, Brazil. .,Graduate Program in Biological Sciences - CBIOL/NUPEB, Federal University of Ouro Preto, Ouro Preto, Brazil.
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Mathew AR, Hogarth L, Leventhal AM, Cook JW, Hitsman B. Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model. Addiction 2017; 112:401-412. [PMID: 27628300 PMCID: PMC5296249 DOI: 10.1111/add.13604] [Citation(s) in RCA: 172] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 04/29/2016] [Accepted: 09/05/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Despite decades of research on co-occurring smoking and depression, cessation rates remain consistently lower for depressed smokers than for smokers in the general population, highlighting the need for theory-driven models of smoking and depression. This paper provides a systematic review with a particular focus upon psychological states that disproportionately motivate smoking in depression, and frame an incentive learning theory account of smoking-depression co-occurrence. METHODS We searched PubMed, Scopus, PsychINFO and CINAHL to December 2014, which yielded 852 papers. Using pre-established eligibility criteria, we identified papers focused on clinical issues and motivational mechanisms underlying smoking in established, adult smokers (i.e. maintenance, quit attempts and cessation/relapse) with elevated symptoms of depression. Two reviewers determined independently whether papers met review criteria. We included 297 papers in qualitative synthesis. RESULTS Our review identified three primary mechanisms that underlie persistent smoking among depressed smokers: low positive affect, high negative affect and cognitive impairment. We propose a novel application of incentive learning theory which posits that depressed smokers experience greater increases in the expected value of smoking in the face of these three motivational states, which promotes goal-directed choice of smoking behavior over alternative actions. CONCLUSIONS The incentive learning theory accounts for current evidence on how depression primes smoking behavior and provides a unique framework for conceptualizing psychological mechanisms of smoking maintenance among depressed smokers. Treatment should focus upon correcting adverse internal states and beliefs about the high value of smoking in those states to improve cessation outcomes for depressed smokers.
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Affiliation(s)
- Amanda R. Mathew
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | | | - Adam M. Leventhal
- Departments of Preventive Medicine and Psychology, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Jessica W. Cook
- University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI
- William S. Middleton Memorial Veterans Hospital, Madison, WI
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
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Drehmer JE, Hipple B, Ossip DJ, Nabi-Burza E, Winickoff JP. A Cross-Sectional Study of Happiness and Smoking Cessation among Parents. J Smok Cessat 2017; 12:6-14. [PMID: 28163788 PMCID: PMC5289385 DOI: 10.1017/jsc.2015.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Smoking cessation among adults is associated with increased happiness. This association has not been measured in parents, a subset of adults who face uniquely stressful and challenging circumstances that can affect happiness. AIMS To determine if parental smoking cessation is associated with increased happiness and to identify characteristics of parental quitters who experience increased happiness. METHODS 1355 parents completed a 12-month follow-up interview from a U.S. national trial, Clinical Effort Against Secondhand Smoke Exposure (CEASE). Multivariable logistic regression examined if level of happiness was independently associated with quitting smoking and identified characteristics associated with feeling happier after quitting smoking. RESULTS/FINDINGS Parents' level of happiness was independently associated with quitting smoking (aOR=1.60, 95% CI=1.42-1.79). Factors associated with increased happiness among quitters include engaging in evidence-based cessation assistance (aOR=2.69, 95% CI=1.16-6.26), and adopting strictly enforced smoke-free home (aOR=2.55, 95% CI=1.19-5.48) and car (aOR=3.85, 95% CI=1.94-7.63) policies. Additionally, parents who believed that being a smoker got in the way of being a parent (aOR=5.37, 95% CI=2.61-11.07) and who believed that thirdhand smoke is harmful to children (aOR=3.28, 95% CI=1.16-9.28) were more likely to report feeling happier after quitting. CONCLUSIONS Parents who quit smoking reported being happier than parents who did not quit. Though prospective studies can clarify what factors cause an increase in happiness, letting pediatricians know that most parents who smoke report being happier when quitting may facilitate communication with parents around cessation. TRIAL REGISTRATION ClinicalTrials.gov, Identifier: NCT00664261.
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Affiliation(s)
- Jeremy E. Drehmer
- Center for Child and Adolescent Health Research and Policy, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States
| | - Bethany Hipple
- Center for Child and Adolescent Health Research and Policy, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States
| | - Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
| | - Emara Nabi-Burza
- Center for Child and Adolescent Health Research and Policy, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States
| | - Jonathan P. Winickoff
- Center for Child and Adolescent Health Research and Policy, Division of General Academic Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
- Tobacco Research and Treatment Center, Massachusetts General Hospital, Boston, MA, United States
- AAP Richmond Center of Excellence, American Academy of Pediatrics, Elk Grove Village, IL, United States
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Harker K, Cheeseman H. Shifting culture and taking action to reduce smoking and premature death among people with a mental health condition. JOURNAL OF PUBLIC MENTAL HEALTH 2016. [DOI: 10.1108/jpmh-09-2016-0046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Mental health conditions affect almost a quarter of the population who die on average 10-20 years earlier than the general population. Smoking is the single largest cause of this gap in life expectancy. Smoking rates among people with mental health conditions have barely changed over the last 20 years during a time when rates have been steadily falling in the general population. Action is needed to address the growing difference in smoking rates among those with a mental health condition compared to the general population. The paper aims to discuss these issues.
Design/methodology/approach
This work has been informed by the input of a wide range of experts and professionals from across public health, mental health and the wider NHS.
Findings
People with a mental health condition are just as likely to want to stop smoking as other smokers but they face more barriers to quitting and are more likely to be dependant and therefore need more support. Quitting smoking does not exacerbate poor mental health; in fact the positive impact of smoking cessation on anxiety and depression appears to be at least as large as antidepressants.
Originality/value
The full report outlines the high-level ambitions and the specific actions that must be realised to drive down smoking rates among those with a mental health condition.
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Abstract
Tobacco use remains the leading preventable cause of death worldwide. In particular, people with mental illness are disproportionately affected with high smoking prevalence; they account for more than 200,000 of the 520,000 tobacco-attributable deaths in the United States annually and die on average 25 years prematurely. Our review aims to provide an update on smoking in the mentally ill. We review the determinants of tobacco use among smokers with mental illness, presented with regard to the public health HAVE framework of “the host” (e.g., tobacco user characteristics), the “agent” (e.g., nicotine product characteristics), the “vector” (e.g., tobacco industry), and the “environment” (e.g., smoking policies). Furthermore, we identify the significant health harms incurred and opportunities for prevention and intervention within a health care systems and larger health policy perspective. A comprehensive effort is warranted to achieve equity toward the 2025 Healthy People goal of reducing US adult tobacco use to 12%, with attention to all subgroups, including smokers with mental illness.
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Affiliation(s)
- Judith J Prochaska
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California 94305;
| | - Smita Das
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305;
| | - Kelly C Young-Wolff
- Division of Research, Kaiser Permanente Northern California, Oakland, California 94612;
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Abstract
OBJECTIVES Nearly 95% of women with opioid use disorder continue to smoke cigarettes during pregnancy. Despite this prevalence and the well documented adverse effects of smoking on birth outcomes, cigarette smoking is underaddressed in this population. This study examines factors associated with successful smoking reduction among pregnant women with opioid use disorder and the impact of smoking reduction on maternal and birth outcomes. METHODS This study is a secondary data analysis of maternal smoking reduction and infant birth outcomes among pregnant women with opioid use disorder (N = 118), enrolled in a randomized controlled trial of a contingency management intervention in which escalating monetary vouchers were provided to women who met escalating smoking-reduction targets. RESULTS Participants' ability to meet higher smoking reduction targets was associated with less cocaine use at baseline (P = 0.022), higher carbon monoxide levels at baseline (P = 0.039), fewer prior quit attempts (P = 0.016), participation in the contingency management intervention, and greater adherence with the parent trial protocol. Some clinically relevant associations were found between smoking reduction and birth outcomes, including birth weight, spontaneous abortions, and neonatal abstinence syndrome treatment, but these differences did not reach statistical significance. CONCLUSIONS Contingency management promotes smoking reduction, but other factors may be associated with such reduction, including baseline smoking and illicit drug use, prior quit attempts, and willingness to participate in the incentives program. Clinicians caring for pregnant women with opioid use disorder may see greater smoking behavior change if they first encourage smoking reduction before recommending smoking cessation. Future research is needed to determine the level of smoking reduction needed to positively impact birth outcomes.
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44
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Dervaux A, Laqueille X. Tabagisme et comorbidités psychiatriques. Presse Med 2016; 45:1133-1140. [DOI: 10.1016/j.lpm.2016.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 03/08/2016] [Indexed: 01/17/2023] Open
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45
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Brellenthin AG, Koltyn KF. Exercise as an adjunctive treatment for cannabis use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:481-489. [PMID: 27314543 PMCID: PMC5055462 DOI: 10.1080/00952990.2016.1185434] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/22/2016] [Accepted: 04/29/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Despite cannabis being the most widely used illicit substance in the United States, individuals diagnosed with cannabis use disorder (CUD) have few well-researched, affordable treatment options available to them. Although found to be effective for improving treatment outcomes in other drug populations, exercise is an affordable and highly accessible treatment approach that has not been routinely investigated in cannabis users. OBJECTIVES The aim of this paper is to inform the topic regarding exercise's potential as an adjunctive treatment for individuals with CUD. METHODS We reviewed the evidence surrounding cannabis use and its current treatment in the United States, explored the rationale for including exercise in the treatment of substance use disorders (SUDs), and in particular, proposed a biological mechanism (i.e., endocannabinoids (eCBs)) that should be examined when utilizing exercise for the treatment of CUD. RESULTS Cannabis use is widespread and increasing in the United States. Chronic, heavy cannabis use may dysregulate the endogenous cannabinoid system, which has implications for several psychobiological processes that interact with the eCB system such as reward processing and the stress response. Given that exercise is a potent activator of the eCB system, it is mechanistically plausible that exercise could be an optimal method to supplement cessation efforts by reducing psychophysical withdrawal, managing stress, and attenuating drug cravings. CONCLUSION We suggest there is a strong behavioral and physiological rationale to design studies which specifically assess the efficacy of exercise, in combination with other therapies, in treating CUD. Moreover, it will be especially important to include the investigation of psychobiological mechanisms (e.g., eCBs, hippocampal volume), which have been associated with both exercise and SUDs, to examine the broader impact of exercise on behavioral and physiological responses to treatment.
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Affiliation(s)
| | - Kelli F Koltyn
- a Department of Kinesiology , University of Wisconsin-Madison , Madison , WI , USA
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46
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Cooper J, Borland R, Yong HH, Fotuhi O. The impact of quitting smoking on depressive symptoms: findings from the International Tobacco Control Four-Country Survey. Addiction 2016; 111:1448-56. [PMID: 26918680 PMCID: PMC4940259 DOI: 10.1111/add.13367] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 02/23/2015] [Accepted: 02/12/2016] [Indexed: 01/06/2023]
Abstract
AIMS To determine whether abstinence or relapse on a quit attempt in the previous year is associated with current depressive symptoms. DESIGN Prospective cohort with approximately annual waves. Mixed-effect logistic regressions tested whether time 2 (T2) quitting status was associated with reporting symptoms at T2, and whether time 1 (T1) symptoms moderated this relationship. SETTING Waves 5-8 of the Four-Country International Tobacco Control Study: a quasi-experimental cohort study of smokers from Canada, the United States, the United Kingdom and Australia. PARTICIPANTS A total of 6978 smokers who participated in telephone surveys. MEASUREMENTS T1 and T2 depressive symptoms in the last 4 weeks were assessed with two screening items from the PRIME-MD questionnaire. Quitting status at T2: (1) no attempt since T1; (2) attempted and relapsed; and (3) attempted and abstinent at T2. FINDINGS Compared with no attempt, relapse was associated with reporting T2 symptoms [odds ratio (OR) = 1.46, 95% confidence interval (CI) = 1.33, 1.59]). Associations between T2 quitting status and T2 symptoms were moderated by T1 symptoms. Relapse was associated positively with T2 symptoms for those without T1 symptoms (OR = 1.71, 95% CI = 1.45, 2.03) and those with T1 symptoms (OR = 1.45, 95% CI = 1.23, 1.70). Abstinence was associated positively for those without T1 symptoms (OR = 1.37, 95% CI = 1.10, 1.71) and negatively for those with T1 symptoms (OR = 0.74, 95% CI = 0.59, 0.94). Age moderated these associations significantly. Relapse did not predict T2 symptoms for those aged 18-39 irrespective of T1 symptoms. The negative effect of abstinence on T2 symptoms for those with T1 symptoms was significant only for those aged 18-39 (OR = 0.61, 95% CI = 0.40, 0.94) and 40-55 (OR = 0.58, 95% CI = 0.40, 0.84). The positive effect of abstinence on T2 symptoms for those without T1 symptoms was significant only for those aged more than 55 (OR =1.97, 95% CI = 1.35, 2.87). CONCLUSIONS Most people who stop smoking appear to be at no greater risk of developing symptoms of depression than if they had continued smoking. However, people aged more than 55 who stop smoking may be at greater risk of developing symptoms of depression than if they had continued smoking.
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Affiliation(s)
- Jae Cooper
- Cancer Council Victoria, Victoria, Australia
| | - Ron Borland
- Cancer Council Victoria, Victoria, Australia
| | | | - Omid Fotuhi
- University of Waterloo, Department of Psychology, Ontario, Canada
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Schnoll RA, Hitsman B, Blazekovic S, Veluz-Wilkins A, Wileyto EP, Leone FT, Audrain-McGovern JE. Longitudinal changes in smoking abstinence symptoms and alternative reinforcers predict long-term smoking cessation outcomes. Drug Alcohol Depend 2016; 165:245-52. [PMID: 27372219 PMCID: PMC4943211 DOI: 10.1016/j.drugalcdep.2016.06.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/16/2016] [Accepted: 06/17/2016] [Indexed: 02/01/2023]
Abstract
BACKGROUND Transdermal nicotine, with behavioral counseling, is among the most popular approaches used to quit smoking. Yet, 6-month cessation rates rarely exceed 20-25%. Identifying factors associated with cessation success may help researchers and clinicians develop enhanced interventions that can improve quit rates. This study examined longitudinal changes in withdrawal, craving, depression and anxiety symptoms, and alternative reinforcers, from a baseline assessment to a 6-month outcome, as predictors of 6-month smoking cessation outcomes following 8 weeks of nicotine patch treatment and counseling. METHODS A sample of 180 smokers, who completed an effectiveness trial that provided counseling and 8 weeks of 21mg nicotine patches, was analyzed. Generalized estimating equations evaluated changes in withdrawal and craving, depression and anxiety symptoms, and alternative reinforcers over time, between participants who were smoking at 6-months and participants who were abstinent (confirmed with carbon monoxide) at 6-months. Multiple logistic regression assessed changes in these variables as predictors of relapse. RESULTS Controlling for covariates associated with cessation (i.e., nicotine dependence, patch adherence, and rate of nicotine metabolism), participants who were abstinent at 6 months showed significantly lower craving and withdrawal and significantly higher substitute reinforcers from baseline to 6 months, vs. those who were smoking at 6 months (p<0.001). An increase in craving predicted relapse to smoking (p<0.05). CONCLUSIONS These results support continued efforts to strengthen interventions that reduce withdrawal and craving and the development of interventions to address alternative reinforcers in order to promote long-term smoking abstinence following nicotine patch treatment.
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Affiliation(s)
- Robert A Schnoll
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States.
| | - Brian Hitsman
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680N Lakeshore Drive, Chicago, IL 60611, United States
| | - Sonja Blazekovic
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States
| | - Anna Veluz-Wilkins
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680N Lakeshore Drive, Chicago, IL 60611, United States
| | - E Paul Wileyto
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States
| | - Frank T Leone
- Pulmonary, Allergy, & Critical Care Division, University of Pennsylvania, Presbyterian Medical Center, 51N. 39th Street, 1st Floor Rear, Philadelphia, PA 19104, United States
| | - Janet E Audrain-McGovern
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States
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Chaves C, Park CL. Differential pathways of positive and negative health behavior change in congestive heart failure patients. J Health Psychol 2016; 21:1728-38. [DOI: 10.1177/1359105314564812] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This longitudinal study applied a stress and coping model to examine the differential pathways of perceived positive and negative health behavior changes. Participants with congestive heart failure completed self-report measures of psychological resources, coping strategies, and perceived behavior changes and were assessed again 6 months later. Patients with higher positive affect and spiritual well-being reported more positive health behavior changes over time, effects mediated by approach coping. Alternatively, patients with lower psychological resources reported more negative behavior changes over time, effects mediated by avoidance coping. The results suggest that different psychological resources are related to different types of coping which, in turn, are associated with perceived positive or negative changes in health behavior over time.
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Grant RA, Cielen N, Maes K, Heulens N, Galli GL, Janssens W, Gayan-Ramirez G, Degens H. The effects of smoking on whisker movements: A quantitative measure of exploratory behaviour in rodents. Behav Processes 2016; 128:17-23. [DOI: 10.1016/j.beproc.2016.03.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 01/15/2023]
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Tulloch HE, Pipe AL, Clyde MJ, Reid RD, Els C. The Quit Experience and Concerns of Smokers With Psychiatric Illness. Am J Prev Med 2016; 50:709-718. [PMID: 26711162 DOI: 10.1016/j.amepre.2015.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 10/19/2015] [Accepted: 11/11/2015] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The purpose of this study is to better understand the quit experience and concerns of smokers with psychiatric illness (i.e., major depressive, anxiety, psychotic and bipolar disorders) in comparison with those without psychiatric illness. METHODS Smokers (N=732) with (n=430, 59%) and without psychiatric illness, recruited between June 2010 and March 2013 to participate in the FLEX (Flexible and Extended Dosing of Nicotine Replacement Therapy [NRT] and Varenicline in Comparison to Fixed-Dose NRT for Smoking Cessation) smoking-cessation trial, completed questionnaires assessing previously used cessation aids and reasons for relapse, and motivation and concerns about their upcoming quit attempt. These supplementary data analyses were conducted in May 2015. RESULTS The most commonly used cessation methods during previous attempts were nicotine replacement therapy (66.4%), cold turkey (59.7%), and bupropion (34.7%); no group differences were identified. Stress was the most common precipitator of relapse during previous attempts in all groups (43.6%), particularly among participants with depression and anxiety. Health was the most common motivation for the upcoming quit attempt (91%), followed by family/social pressures (28.1%) and cost (27.9%, particularly by smokers with psychotic disorders). Common pre-cessation concerns for the complete sample included: cravings (27.6%), stress (26.7%), and fear of failure (26%); participants with psychotic and anxiety disorders were most concerned about cravings, whereas the latter two concerns were more prominent for individuals with anxiety. CONCLUSIONS Findings reveal differences in the quit histories and concerns of smokers with or without psychiatric illness. Smokers with psychiatric illness are particularly vulnerable to relapse at times of stress and negative affect; interventions that emphasize alternative coping strategies and facilitate mood management are required.
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Affiliation(s)
- Heather E Tulloch
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada;.
| | - Andrew L Pipe
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Matthew J Clyde
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert D Reid
- Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Charl Els
- Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada
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