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Poole NL, Candel MJJM, Willemsen MC, van den Brand FA. Real-Life Effectiveness of Smoking Cessation Delivery Modes: A Comparison Against Telephone Counseling and the Role of Individual Characteristics and Health Conditions in Quit Success. Nicotine Tob Res 2024; 26:452-460. [PMID: 37930890 PMCID: PMC10959160 DOI: 10.1093/ntr/ntad195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/22/2023] [Accepted: 09/29/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Professional behavioral counseling for smoking cessation can be delivered in many forms, which may not work equally well for everyone. We aim to explore in a real-world setting whether different delivery modes yield different rates of quit success and whether quit success varies based on gender, age, educational level, and being treated for a health condition. AIMS AND METHODS We used monitoring data (n = 13 747) from a smoking cessation counseling provider in the Netherlands (September 2018 to August 2021) to compare differences in quit success immediately after the end of counseling and at 12-month follow-up between telephone and other modes of counseling. Participants chose which mode of counseling they received. At the 12-month follow-up, we also examined differences in quit success based on demographic characteristics and whether one is being treated for various health conditions. RESULTS Participants of in-person group counseling and online in-company group counseling were significantly more likely to have quit immediately after the counseling compared with telephone counseling (OR = 1.25, 95% CI = 1.08-1.44; OR = 1.63, 95% CI = 1.18-2.24). Analyses revealed no significant differences in quit success between telephone and other modes of counseling after 12 months. Those treated for a respiratory or psychological condition were less likely to have maintained quit success, as were women, and participants with a lower educational level. CONCLUSIONS When chosen by oneself, the mode of smoking cessation counseling received does not appear to be important for long-term quit success. However, certain groups warrant extra support to prevent excessive program attrition and unsuccessful quit attempts. IMPLICATIONS Our findings suggest that when chosen by oneself, the delivery mode of smoking cessation counseling does not appear to be important for long-term quit success. This finding is of particular relevance for those who are unable to attend in-person cessation counseling due to, for instance, reduced accessibility or mobility. We also found that women, lower educated, and younger participants were more likely to dropout of the cessation program or to not have maintained a quit attempt, signaling that disparities in smoking cessation persist when standardized counseling is given, and therefore more tailored counseling may be necessary for these groups.
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Affiliation(s)
- Nikita L Poole
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- IVO Research Institute, The Hague, The Netherlands
| | - Math J J M Candel
- Department of Methodology and Statistics, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Marc C Willemsen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Floor A van den Brand
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Orenstein L, Chetrit A, Kalter-Leibovici O. Factors associated with attempting and succeeding in smoking cessation following a National Tobacco Control Plan: Analysis of two nationwide surveys (2010 and 2017). Addict Behav 2024; 149:107912. [PMID: 37979463 DOI: 10.1016/j.addbeh.2023.107912] [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: 08/17/2023] [Revised: 11/09/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023]
Abstract
INTRODUCTION Lower rates of smoking cessation among disadvantaged groups contribute to widening health-disparities. With this recognition, in 2010 free-of-charge/subsidized smoking cessation services became available to all Israeli residents through the not-for-profit health plans. METHODS Based on two cross-sectional National Social Surveys, data on adult ever-smokers were used (n = 2,998 in 2010 and 2,859 in 2017). The outcome variable comprised three categories: no quit attempt, unsuccessful quit attempt and successful quit attempt. Changes over-time and demographic, socioeconomic, health- and smoking-related factors associated with quitting attempts and success were tested in the pooled sample, using multivariable multinomial logistic regression models. RESULTS The pooled sample of the two surveys included 2,611 participants (44.2%) who were successful quitters, 1,941 (32.7%) who reported an unsuccessful quit attempt, and 1,305 (23.1%) smokers who did not attempt to quit. Compared to 2010, ever-smokers in 2017 were less likely to report an unsuccessful quit attempt (adjusted OR = 0.81, 95%CI: 0.70-0.94). The likelihood of successfully quitting was similar in both surveys. Older age and self-reported health problem were associated with higher likelihood of quitting attempt. Meeting living expenses, being overweight/obese, engaging in physical activity and heavy smoking were associated with higher likelihood of successful smoking cessation; while environmental tobacco exposure was associated with 43% lower likelihood of successful cessation. Finally, there was an interaction between education and ethnicity. Higher education level was associated with a greater likelihood both to attempt to quit smoking and to succeed among Jewish participants, while the opposite phenomenon was observed among Arab smokers. CONCLUSIONS Despite the availability of subsidized smoking cessation services, social disparities in smoking cessation rates persist. Efforts should focus on proactively reaching subpopulations with low cessation rates, using tailored strategies for successful smoking cessation. Promoting smoke free homes and workplaces should be prioritized.
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Affiliation(s)
- Liat Orenstein
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
| | - Angela Chetrit
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
| | - Ofra Kalter-Leibovici
- Research Center for Population Health, The Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Ramat-Gan 52621, Israel; Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
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3
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Chen CH, Lin TM, Hung SC, Wu MJ, Tsai SF. A quality improvement initiative for patients with chronic kidney disease to promote their smoking cessation. Tob Induc Dis 2023; 21:127. [PMID: 37818037 PMCID: PMC10561597 DOI: 10.18332/tid/170626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/25/2023] [Accepted: 08/04/2023] [Indexed: 10/12/2023] Open
Abstract
Cigarette smoking is a critical issue in caring for patients of chronic kidney disease (CKD). However, there is no routine care program designed for combining both smoking cessation and CKD care. The process of our quality improvement (QI) collaboration used data under our routine payment-for-performance for pre-end-stage renal disease (P4P Pre-ESRD) in Taichung Veterans General hospital from 2020 to 2022. We share our experience with a QI project that integrates the Ottawa model for smoking cessation (OMSC) with the Pre-ESRD care program as part of routine CKD care. The electronic health information systems were improved to reduce workload of medical staff. The number was more for both qualified CKD educators and nephrologists for smoking cessation. The access and availability for smoking cessation were immediate and convenient for patients. Specifically, all the actions were performed by CKD educators, with nephrologists overseeing the process in routine care. By combining OMSC with the Pre-ESRD program, we were able to provide smokers with satisfactory access and availability to smoking cessation services within our healthcare facility. The smoker cases found were more in number (206 in 2020, 344 in 2021, and 421 in 2022). Before the integrated OSTC-Pre-ESRD program (in 2020), the proportion of smokers was 3.88%. After implementing the integrated program, smokers increased significantly on a yearly basis (9.69% in 2021 and 9.82% in 2022). Finally, case numbers of on-site smoking cessations increased significantly after implementing the integrated system (0 in 2020, 17 in 2021, and 20 in 2022). All CKD patients for smoking cessation were also more (8 in 2020, 46 in 2021, and 38 in 2022). After implementing the QI program, focusing on the integrated OMSC-Pre-ESRD program, we found more smokers undergoing smoking cessation. This QI program highlighted the importance of better access and availability for smoking cessation.
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Affiliation(s)
- Cheng-Hsu Chen
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan
- Department of Life Science, Tunghai University, Taichung City, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City, Taiwan
- Tissue Engineering and Regenerative Medicine, College of Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Tzu-Mei Lin
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Su-Chi Hung
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - Ming-Ju Wu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City, Taiwan
| | - Shang-Feng Tsai
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan
- Department of Life Science, Tunghai University, Taichung City, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung City, Taiwan
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Alasmari AM, Almudarra SS. Unveiling the Tapestry of Tobacco Consumption: Exploring the Sociodemographic Factors Impacting Smokers at Smoking Cessation Clinics in Jeddah. Cureus 2023; 15:e43050. [PMID: 37680435 PMCID: PMC10480578 DOI: 10.7759/cureus.43050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/09/2023] Open
Abstract
Background The World Health Organization (WHO) has identified tobacco smoking as a global epidemic, causing an estimated three million deaths annually. This study aims to examine the sociodemographic characteristics and smoking-related behaviors among individuals attending smoking cessation clinics in Jeddah during 2022. By identifying these factors, appropriate interventions can be developed to combat the smoking epidemic. Methodology The study enrolled male and female participants who visited the Smoking Cessation Clinics in Jeddah from January 2022 to December 2022. Eligible participants were between 18 and 60 years old and agreed to take part in the study. Data on smoking status, medical history, previous attempts at quitting, and medication use were collected. Statistical analysis, including chi-square tests and P-values, was conducted to assess the associations between participants' medical history and smoking cessation attempts. Results A total of 5,869 participants were included in the study. The findings revealed that approximately one-fifth of the participants had previously attempted to quit smoking, while the majority 4,780 (81.4%) had not made any cessation attempts. Among those who had made quit attempts, the majority had tried quitting between one and four times 968 (16.5%). The duration of successful cessation reported by participants was generally short, with the majority 4,781 (81.5%) not experiencing any extended period of quitting. Common reasons for relapse included cravings, social influences, mood changes, stress, and withdrawal symptoms. The study also found significant associations between specific medical conditions and smoking cessation attempts. Conclusions The study identified significant associations between male gender, older age group (51-60 years), divorced marital status, intermediate educational levels, higher income levels, retired status, extreme body mass index (BMI) categories, and previous attempts at smoking cessation. Healthcare providers and policymakers should consider these findings when developing and implementing smoking cessation programs. The insights gained from this research can contribute to the development of targeted interventions to reduce smoking rates and improve public health outcomes.
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Affiliation(s)
| | - Sami S Almudarra
- Public Health and Epidemiology, Ministry of Health (MOH), Riyadh, SAU
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5
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Moore Ude RG, Herring RP, Ismail M, Oda K, Bahjri K, Reis WP, Gaio J, Dos Santos H. Why Can't I Stop Smoking: Predictors of Tobacco Use and Quit Rates in the Freedom From Tobacco Program. Cureus 2023; 15:e41649. [PMID: 37565122 PMCID: PMC10411653 DOI: 10.7759/cureus.41649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 08/12/2023] Open
Abstract
Introduction As the leading cause of preventable chronic diseases in adults 18 years and older, tobacco usage in the U.S. results in over 20 million premature deaths annually. Current smokers might need extra support on the path to successfully quitting. Aim To evaluate the influence of predictors of smoking-on-smoking cessation in the Freedom From Tobacco Program (FFT) offered by Southern California Permanente Medical Group (SCPMG). Methods This was a quasi-experimental study to evaluate rates of smoking cessation among participants in the FFT program. There were 471 participants in the study. Factors of the Social Ecological Model (SEM) and demographics were examined to determine if they could predict tobacco cessation. The SEM suggests that an individual's behavior is integrated into a network of intrapersonal characteristics, interpersonal processes, institutional factors, community features, and public policy. In particular, the study mainly addressed the institutional factor. It was promoted within a Health Management Organization and the interpersonal process because it was a group intervention. Findings After multiple regression analyses with all predictors from the SEM and demographics, the only significant predictor was the number of previous attempts to quit. Smokers who tried to stop four or more times in the past were 2.6 times (p<0.03) more likely to quit than those who tried fewer times. As we are aware, this was the first time this result was found for programs implemented by Health Management Organizations. The general quit rate at 12 months for the FFT program was 43.1%. Conclusion As the only predictor of quitting in this study was the number of previous attempts to quit smoking, the recommendation is to develop longer-term smoking cessation programs or a longer follow-up to facilitate smokers who relapse to go back and try to quit again. Another recommendation is to identify the main reasons for relapse and try to address these factors in further interventions.
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Affiliation(s)
- Regina G Moore Ude
- Health and Human Ecology, California State University, San Bernardino, USA
| | - R Patti Herring
- School of Public Heath, Loma Linda University Medical Center, Loma Linda, USA
| | | | - Keiji Oda
- School of Public Health, Loma Linda University Medical Center, Loma Linda, USA
| | - Khaled Bahjri
- Clinical Research, New World Medical, Rancho Cucamonga, USA
| | - Wenes P Reis
- Public Health, Loma Linda University Medical Center, Loma Linda, USA
| | - Josileide Gaio
- Public Health, Loma Linda University Medical Center, Loma Linda, USA
| | - Hildemar Dos Santos
- Preventive Care, Loma Linda University School of Public Health, Loma Linda, USA
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Zyambo C, Siziya S, Ng'ambi W, Gakumo AC, Burkholder GA, Hendricks PS. Receipt of healthcare provider’s advice for smoking
cessation and quit attempts in Zambia. POPULATION MEDICINE 2023. [DOI: 10.18332/popmed/157138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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7
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Zamzuri MAIA, Kamarudin SAA, Ariffin AH, Ibrahim AA, Othman MH, Johari A, Ali NKM, Jetly K, Abd Rashid MF, Hassan MR, Ming SS, Pang NTP. Rate of smoking cessation and factors associated with successful quit smoking in Seremban District of Malaysia. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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8
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Finkelstein A, Gentzkow M, Williams H. Place-Based Drivers of Mortality: Evidence from Migration. THE AMERICAN ECONOMIC REVIEW 2021; 111:2697-2735. [PMID: 34887592 PMCID: PMC8653912 DOI: 10.1257/aer.20190825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We estimate the effect of current location on elderly mortality by analyzing outcomes of movers in the Medicare population. We control for movers' origin locations as well as a rich vector of pre-move health measures. We also develop a novel strategy to adjust for remaining unobservables, using the correlation of residual mortality with movers' origins to gauge the importance of omitted variables. We estimate substantial effects of current location. Moving from a 10th to a 90th percentile location would increase life expectancy at age 65 by 1.1 years, and equalizing location effects would reduce cross-sectional variation in life expectancy by 15 percent. Places with favorable life expectancy effects tend to have higher quality and quantity of health care, less extreme climates, lower crime rates, and higher socioeconomic status.
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Affiliation(s)
- Amy Finkelstein
- Department of Economics, Massachusetts Institute of Technology, and the National Bureau of Economic Research
| | - Matthew Gentzkow
- Department of Economics, Stanford University, and the National Bureau of Economic Research
| | - Heidi Williams
- Department of Economics, Stanford University, and the national Bureau of Economics Research
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9
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Development of Machine Learning Models for Prediction of Smoking Cessation Outcome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052584. [PMID: 33807561 PMCID: PMC7967540 DOI: 10.3390/ijerph18052584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/26/2021] [Accepted: 02/28/2021] [Indexed: 01/01/2023]
Abstract
Predictors for success in smoking cessation have been studied, but a prediction model capable of providing a success rate for each patient attempting to quit smoking is still lacking. The aim of this study is to develop prediction models using machine learning algorithms to predict the outcome of smoking cessation. Data was acquired from patients underwent smoking cessation program at one medical center in Northern Taiwan. A total of 4875 enrollments fulfilled our inclusion criteria. Models with artificial neural network (ANN), support vector machine (SVM), random forest (RF), logistic regression (LoR), k-nearest neighbor (KNN), classification and regression tree (CART), and naïve Bayes (NB) were trained to predict the final smoking status of the patients in a six-month period. Sensitivity, specificity, accuracy, and area under receiver operating characteristic (ROC) curve (AUC or ROC value) were used to determine the performance of the models. We adopted the ANN model which reached a slightly better performance, with a sensitivity of 0.704, a specificity of 0.567, an accuracy of 0.640, and an ROC value of 0.660 (95% confidence interval (CI): 0.617–0.702) for prediction in smoking cessation outcome. A predictive model for smoking cessation was constructed. The model could aid in providing the predicted success rate for all smokers. It also had the potential to achieve personalized and precision medicine for treatment of smoking cessation.
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10
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El-Boraie A, Chenoweth MJ, Pouget JG, Benowitz NL, Fukunaga K, Mushiroda T, Kubo M, Nollen NL, Sanderson Cox L, Lerman C, Knight J, Tyndale RF. Transferability of Ancestry-Specific and Cross-Ancestry CYP2A6 Activity Genetic Risk Scores in African and European Populations. Clin Pharmacol Ther 2020; 110:975-985. [PMID: 33300144 DOI: 10.1002/cpt.2135] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/01/2020] [Indexed: 12/14/2022]
Abstract
The Nicotine Metabolite Ratio (NMR; 3-hydroxycotinine/cotinine), a highly heritable index of nicotine metabolic inactivation by the CYP2A6 enzyme, is associated with numerous smoking behaviors and diseases, as well as unique cessation outcomes. However, the NMR cannot be measured in nonsmokers, former smokers, or intermittent smokers, for example, in evaluating tobacco-related disease risk. Traditional pharmacogenetic groupings based on CYP2A6 * alleles capture a modest portion of NMR variation. We previously created a CYP2A6 weighted genetic risk score (wGRS) for European (EUR)-ancestry populations by incorporating independent signals from genome-wide association studies to capture a larger proportion of NMR variation. However, CYP2A6 genetic architecture is unique to ancestral populations. In this study, we developed and replicated an African-ancestry (AFR) wGRS, which captured 30-35% of the variation in NMR. We demonstrated model robustness against known environmental sources of NMR variation. Furthermore, despite the vast diversity within AFR populations, we showed that the AFR wGRS was consistent between different US geographical regions and unaltered by fine AFR population substructure. The AFR and EUR wGRSs can distinguish slow from normal metabolizers in their respective populations, and were able to reflect unique smoking cessation pharmacotherapy outcomes previously observed for the NMR. Additionally, we evaluated the utility of a cross-ancestry wGRS, and the capacity of EUR, AFR, and cross-ancestry wGRSs to predict the NMR within stratified or admixed AFR-EUR populations. Overall, our findings establish the clinical benefit of applying ancestry-specific wGRSs, demonstrating superiority of the AFR wGRS in AFRs.
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Affiliation(s)
- Ahmed El-Boraie
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health and Division of Brain and Therapeutics, Toronto, Ontario, Canada
| | - Meghan J Chenoweth
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health and Division of Brain and Therapeutics, Toronto, Ontario, Canada
| | - Jennie G Pouget
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health and Division of Brain and Therapeutics, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Neal L Benowitz
- Clinical Pharmacology Research Program, Division of Cardiology, Department of Medicine and Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
| | - Koya Fukunaga
- Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan
| | | | - Michiaki Kubo
- Center for Integrative Medical Sciences, RIKEN, Kanagawa, Japan
| | - Nicole L Nollen
- Department of Population Health, School of Medicine, University of Kansas, Kansas City, Kansas, USA
| | - Lisa Sanderson Cox
- Department of Population Health, School of Medicine, University of Kansas, Kansas City, Kansas, USA
| | - Caryn Lerman
- Department of Psychiatry and USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Jo Knight
- Data Science Institute and Medical School, Lancaster University, Lancaster, UK
| | - Rachel F Tyndale
- Department of Pharmacology & Toxicology, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health and Division of Brain and Therapeutics, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Kar SS, Sivanantham P, Rehman T, Chinnakali P, Thiagarajan S. Willingness to quit tobacco and its correlates among Indian tobacco users-Findings from the Global Adult Tobacco Survey India, 2016-17. J Postgrad Med 2020; 66:141-148. [PMID: 32675450 PMCID: PMC7542056 DOI: 10.4103/jpgm.jpgm_408_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Willingness to quit in a tobacco user forms the basis for future quit attempts and quitting successfully. Objective To determine the prevalence and correlates of willingness to quit among tobacco users in India using the Global Adult Tobacco Survey (GATS), India, 2016-2017. Methods GATS, 2016-17 was a multistage geographically clustered sample survey done among 74,037 individuals aged 15 years and above across all the states and two of the Union Territories of India. Data of all those reported using any form of tobacco were studied for past attempts to quit tobacco, advised to quit by a health care provider, and exposure to anti-tobacco messages delivered through various media and the correlation of these with the willingness to quit using multivariate analysis. Results Of the 21,085 current tobacco users in the survey, 11,679 (52.2%), were willing to quit all forms of tobacco. Multivariate analysis showed that those in younger age groups (OR: 1.39 [1.23-1.56]), higher education levels (OR 1.15 [1.05-1.18]), time of first tobacco use in the day being more than 60 min after waking up in the morning (OR 1.11 [1.03-1.2]), history of attempts to quit in the past 12 months (OR 1.78 [1.69-1.87]), those advised to quit by health care provider in the past 12 months (OR 1.11 [1.06-1.17]), those using single form of tobacco (OR 1.1 [1.05-1.17]), those exposed to anti-tobacco messages in newspapers/magazines (OR 1.1 [1.05-1.17]), and cinemas (1.14 [1.08-1.20]) were more willing to quit compared to their counterparts. Conclusion Enhanced publicizing of anti-tobacco messages through the currently employed media, and ensuring that doctors give a brief advice to quit during any contact with a tobacco user could improve the willingness to quit and the consequent quit rate, especially among those tobacco users who are in younger age groups and who have attempted to quit earlier.
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Affiliation(s)
- S S Kar
- Department of PSM, JIPMER, Puducherry, India
| | | | - T Rehman
- Department of PSM, JIPMER, Puducherry, India
| | | | - S Thiagarajan
- Independent Consultant, Former Professor and Dean, TISS, Mumbai, Maharashtra, India
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Lim KH, Heng PP, Nik Mohamed MH, Teh CH, Mohd Yusoff MF, Ling JMY, Baharom N, Wee LH, Chan CMH, Ho BK, Robson Z, Draman S, Ab Rahman NS, Kartiwi M, Ab Rahman J. Prevalence and Factors Associated With Attempts to Quit and Smoking Cessation in Malaysia. Asia Pac J Public Health 2020; 31:22S-31S. [PMID: 31802718 DOI: 10.1177/1010539519874944] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Smoking cessation significantly reduces risk of smoking-related diseases and mortality. This study aims to determine the prevalence and factors associated with attempts to quit and smoking cessation among adult current smokers in Malaysia. Data from the National E-Cigarette Survey 2016 were analyzed. Forty nine percent of current smokers had attempted to quit at least once in the past 12 months and 31.4% of the respondents were former smokers. Multivariable analysis revealed that current smokers with low nicotine addiction and aged below 45 years were more likely to attempt to quit smoking. Being married, older age group, and having tertiary education were significantly associated with smoking cessation. Only half of the current smokers ever attempted to quit smoking and only a third of smokers quit. Stronger tobacco control policies are needed in Malaysia to encourage more smokers to quit smoking. Improved access to cessation support for underprivileged smokers is also needed.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | - Jane Miaw Yn Ling
- Institute of Public Health, Ministry of Health, Kuala Lumpur, Malaysia
| | - Nizam Baharom
- Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Bee Kiau Ho
- Klinik Kesihatan Bandar Botanik, Klang, Malaysia
| | | | - Samsul Draman
- International Islamic University Malaysia, Kuantan, Malaysia
| | | | - Mira Kartiwi
- International Islamic University Malaysia, Kuantan, Malaysia
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Kong KL, Chu S, Giles ML. Factors influencing the uptake of influenza vaccine vary among different groups in the hard‐to‐reach population. Aust N Z J Public Health 2020; 44:163-168. [DOI: 10.1111/1753-6405.12964] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/01/2019] [Accepted: 11/01/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
- Khai Lin Kong
- Department of Obstetrics and GynaecologyMonash University Melbourne Victoria
| | - Sandy Chu
- Faculty of Medicine, Nursing and Health SciencesMonash University Melbourne Victoria
| | - Michelle L. Giles
- Department of Obstetrics and GynaecologyMonash University Melbourne Victoria
- Monash Immunisation, Monash Health Melbourne Victoria
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Comiford AL, Rhoades DA, Spicer P, Dvorak JD, Ding K, Wagener TL, Doescher MP. Impact of e-cigarette use among a cohort of American Indian cigarette smokers: associations with cigarette smoking cessation and cigarette consumption. Tob Control 2020; 30:103-107. [PMID: 32054728 DOI: 10.1136/tobaccocontrol-2019-055338] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/16/2019] [Accepted: 01/13/2020] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Despite American Indian/Alaska Native (AI/AN) people having the highest prevalence of cigarette smoking nationwide, few studies have evaluated e-cigarette use among AI/AN adults who smoke. The primary objective of this observational pilot cohort study was to determine if e-cigarette use is associated with cigarette smoking cessation or reduction among adult AI individuals who smoke. METHODS In 2016, we collected baseline survey and biomarker data among AI adults who smoke. The survey included questions about cigarette consumption and use of e-cigarettes and biomarkers, such as salivary cotinine markers and exhaled carbon monoxide. After 18 months, we repeated data collection, and asked about changes in cigarette smoking status and cigarettes per day (CPD). Comparisons between groups were performed using the χ2 test, Fisher's exact test or Wilcoxon rank-sum test. RESULTS Of 375 baseline participants, 214 (57.07%) returned for follow-up and were included in analyses. Of these, 20 (9.3%) reported having stopped cigarette smoking and had biochemical verification of cigarette smoking abstinence. Among those who quit smoking, 15% were baseline e-cigarette users; while among those who continued to smoke at follow-up, about 11% were baseline e-cigarette users. This difference was not statistically significant (p=0.48). Among all those who continued to smoke at follow-up, there was no overall decrease in CPD, nor a significant difference in change in CPD between baseline e-cigarette users and non-users (p=0.98). CONCLUSIONS E-cigarette use at baseline was not associated with smoking cessation or a change in CPD in this cohort of AI adults who smoke after an 18-month follow-up period.
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Affiliation(s)
- Ashley L Comiford
- Community Health Promotions, Cherokee Nation, Tahlequah, Oklahoma, USA
| | - Dorothy A Rhoades
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Paul Spicer
- Anthropology, University of Oklahoma, Norman, Oklahoma, USA
| | - Justin D Dvorak
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Kai Ding
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Theodore L Wagener
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio, USA.,Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Mark P Doescher
- Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
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Parekh TM, Wu C, McClure LA, Howard VJ, Cushman M, Malek AM, Harrington KF, Cherrington AL, Dransfield MT, Bhatia S. Determinants of cigarette smoking status in a national cohort of black and white adult ever smokers in the USA: a cross-sectional analysis of the REGARDS study. BMJ Open 2019; 9:e027175. [PMID: 31079085 PMCID: PMC6530531 DOI: 10.1136/bmjopen-2018-027175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 04/04/2019] [Accepted: 04/05/2019] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES While awareness of cigarette smoking's harmful effects has increased, determinants associated with smoking status remain understudied, including potential racial differences. We aim to examine factors associated with former versus current smoking status and assess whether these associations differed by race. SETTING We performed a cross-sectional analysis using the population-based Reasons for Geographic and Racial Differences in Stroke(REGARDS)study. OUTCOME MEASURES Logistic regression was used to calculate the OR of former smoking status compared with current smoking status with risk factors of interest. Race interactions were tested using multiplicative interaction terms. RESULTS 16 463 participants reported smoking at least 100 cigarettes in their lifetime. Seventy-three per cent (n=12 067) self-reported former-smoker status. Physical activity (reference (REF) <3×/week; >3×/week: OR=1.26, 95% CI 1.11 to 1.43), adherence to Mediterranean diet (REF: low; medium: OR=1.46, 95% CI 1.27 to 1.67; high: OR=2.20, 95% CI 1.84 to 2.64), daily television viewing time (REF: >4 hours; <1 hour: OR=1.32, 95% CI 1.10 to 1.60) and abstinence from alcohol use (REF: heavy; none: OR=1.50, 95% CI 1.18 to 1.91) were associated with former-smoker status. Male sex, higher education and income $35 000-$74 000 (REF: <$20 000) were also associated with former-smoker status. Factors associated with lower odds of reporting former-smoker status were younger age (REF: ≥65 years; 45-64 years: OR=0.34, 95% CI 0.29 to 0.39), black race (OR=0.62, 95% CI 0.53 to 0.72) and single marital status (REF: married status; OR=0.66, 95% CI 0.51 to 0.87), being divorced (OR=0.60, 95% CI 0.50 to 0.72) or widowed (OR=0.70, 95% CI 0.57 to 0.85). Significant interactions were observed between race and alcohol use and dyslipidaemia, such that black participants had higher odds of reporting former-smoker status if they were abstinent from alcohol (OR=2.32, 95% CI 1.47 to 3.68) or had a history of dyslipidaemia (OR=1.31, 95% CI 1.06 to 1.62), whereas these relationships were not statistically significant in white participants. CONCLUSION Efforts to promote tobacco cessation should consist of targeted behavioural interventions that incorporate racial differences.
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Affiliation(s)
- Trisha M Parekh
- Pulmonary and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Chengyi Wu
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Virginia J Howard
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mary Cushman
- Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont, USA
| | - Angela M Malek
- Department of Public Health Services, Medical University of South Carolina, College of Medicine, Charleston, South Carolina, USA
| | - Kathleen F Harrington
- Pulmonary and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrea L Cherrington
- Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mark T Dransfield
- Pulmonary and Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Borsari L, Storani S, Malagoli C, Filippini T, Tamelli M, Malavolti M, Nicolini F, Vinceti M. Impact of Referral Sources and Waiting Times on the Failure to Quit Smoking: One-Year Follow-Up of an Italian Cohort Admitted to a Smoking Cessation Service. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1234. [PMID: 29891823 PMCID: PMC6025586 DOI: 10.3390/ijerph15061234] [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: 04/16/2018] [Revised: 06/01/2018] [Accepted: 06/09/2018] [Indexed: 11/21/2022]
Abstract
In Italy, the National Health Service offers specialized evidence-based support to smokers who would like to quit through smoking cessation (SC) services. We conducted a two-year prospective study, involving all 288 subjects treated for smoking cessation at the SC service of Reggio Emilia, to assess the association of referral sources and waiting times with the risk of treatment failure, by following participants up to one year after the quit date. We performed Cox-regression analysis, including demographic and smoking-related characteristics as confounding variables. The treatment failure rate at 12 months was 59.4% (171/288), including only 12 subjects lost to follow-up. The main mode of entry was self-referral (42.4%), followed by 32.6% from general practice, 17.4% from hospital and 7.6% from other sources. Only 27.8% participants were involved in the SC-program within 60 days of the first contact, as the guidelines suggest. The risk of treatment failure at 12 months showed little association with the type of referral source, while it correlated with waiting times ≥ 60 days (hazard ratio = 1.59; 95% confidence interval 1.10⁻2.29). This study provides evidence of long-term high quit rates from a SC service, with few subjects lost to follow-up and biochemical verification of almost all abstinent subjects. Timeliness in care provision could further improve the outcome.
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Affiliation(s)
- Lucia Borsari
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, 41125 Modena, Italy.
| | - Simone Storani
- Local Health Authority of Reggio Emilia-IRCCS, via Amendola 2, 42122 Reggio Emilia, Italy.
| | - Carlotta Malagoli
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
| | - Tommaso Filippini
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
| | - Marco Tamelli
- Promotion Health Researcher, League against Cancer, via Amendola 2, 42122 Reggio Emilia, Italy.
| | - Marcella Malavolti
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
| | - Fausto Nicolini
- Local Health Authority of Reggio Emilia-IRCCS, via Amendola 2, 42122 Reggio Emilia, Italy.
| | - Marco Vinceti
- Department of Biomedical, Metabolic and Neural Sciences, CREAGEN-Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Via Campi 287, 41125 Modena, Italy.
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118, USA.
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Kim RS, Weinberger AH, Chander G, Sulkowski MS, Norton B, Shuter J. Cigarette Smoking in Persons Living with Hepatitis C: The National Health and Nutrition Examination Survey (NHANES), 1999-2014. Am J Med 2018; 131:669-675. [PMID: 29408018 PMCID: PMC5963992 DOI: 10.1016/j.amjmed.2018.01.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/01/2018] [Accepted: 01/04/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cigarette smoking is common in persons living with hepatitis C (hepatitis C+), but national statistics on this harmful practice are lacking. A better understanding of smoking behaviors in hepatitis C+ individuals may help in the development of targeted treatment strategies. METHODS We extracted data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2014. Hepatitis C+ were compared with hepatitis C- adults in the entire sample and in the subset of current smokers. Measures included demographics, current smoking, cigarettes/day, nicotine dependence, other tobacco use, substance use, and medical and psychiatric comorbidities. RESULTS Complete smoking and hepatitis C virus (HCV) data were available for 39,472 (90.1%) of 43,793 adult participants in NHANES during the study years. Hepatitis C+ smoked at almost triple the rate of hepatitis C- adults (62.4% vs 22.9%), with no significant difference between hepatitis C+ men and women (64.5% vs 58.2%). Hepatitis C+ smokers were more likely to smoke daily than hepatitis C- smokers (87.5% vs 80.0%), but had similar levels of nicotine dependence. Hepatitis C+ smokers were more likely to be older (mean age: 47.1 vs 41.5 years), male (69.4% vs 54.4%), Black (21.2% vs 12.1%), less educated (any college: 31.8% vs 42.9%), poor (mean family monthly poverty index: 1.80 vs 2.47), uninsured (43.9% vs 30.4%), use drugs (cocaine: 11.1% vs 3.2%; heroin: 4.0% vs 0.6%), and be depressed (33.2% vs 13.5%). Multivariate analyses revealed significant associations of both hepatitis C infection and cigarette smoking with current depression and hypertension. CONCLUSIONS There is a cigarette smoking epidemic embedded within the hepatitis C epidemic in the United States. The sociodemographic profile of hepatitis C+ smokers suggests that the implementation of effective tobacco treatment will be challenging. Thoughtful treatment strategies that are mindful of the unique characteristics of this group are needed.
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Affiliation(s)
- Ryung S Kim
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY; Department of Applied Statistics, Yonsei University, Seoul, South Korea
| | - Andrea H Weinberger
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY; Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | | | - Mark S Sulkowski
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md
| | - Brianna Norton
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Jonathan Shuter
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY.
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18
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Keeler C, Max W, Yerger V, Yao T, Ong MK, Sung HY. The Association of Menthol Cigarette Use With Quit Attempts, Successful Cessation, and Intention to Quit Across Racial/Ethnic Groups in the United States. Nicotine Tob Res 2018; 19:1450-1464. [PMID: 27613927 DOI: 10.1093/ntr/ntw215] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 08/16/2016] [Indexed: 11/13/2022]
Abstract
Introduction Few studies have examined the relationship between menthol use and smoking cessation across various racial/ethnic groups; the findings were mixed. This study explored the association of menthol cigarette use with quit attempts, smoking cessation, and intention-to-quit among US adults and by race/ethnicity. Methods Using the 2006/2007 and 2010/2011 Tobacco Use Supplements to the Current Population Survey data, this study analyzed 54 448 recent active smokers, defined as current smokers or former smokers who quit less than 12 months ago. Three behaviors were examined: any quit attempts in the past 12 months, successful cessation for ≥3 months, and intention-to-quit smoking in the next 6 months. For each cessation behavior, multiple logistic regression models were estimated separately for the full-sample and stratified racial/ethnic subsamples. Results While 72.3% of African American recent active smokers typically smoked menthol cigarettes, this proportion was 21.7%, 21.5%, and 28.0% for whites, Asians, and Hispanics, respectively. African American menthol smokers had higher odds of quit attempts compared to non-African American, non-menthol smokers (full-sample analysis), as well as African American non-menthol smokers (subsample analysis). Menthol use was not significantly associated with quit attempts in other racial/ethnic subsamples. There was no significant difference in either successful cessation or intention-to-quit between menthol and non-menthol smokers. Conclusions African American menthol smokers were more likely to attempt to quit smoking than non-menthol smokers but these quit attempts did not translate into successful cessation. This study revealed no association of menthol use with quit attempts, successful cessation, and intention-to-quit among other racial/ethnic groups. Implications The findings suggested that African American menthol smokers were more motivated to quit smoking; yet, the results also indicated no significant differences in successful cessation between African American menthol and non-menthol smokers. Interventions targeting menthol smokers within the African American community may help bridge this gap. While more local sales restrictions are beginning to occur (eg, Tobacco 21 efforts), additional policies restricting price discounting as well as the regulation of access to and the time, place, and/or manner of menthol tobacco advertising could also improve cessation rates. Further evaluation is needed to determine the viability of these policies.
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Affiliation(s)
- Courtney Keeler
- Department of Population Health Sciences, School of Nursing, University of San Francisco, San Francisco, CA
| | - Wendy Max
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
| | - Valerie Yerger
- Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco, CA
| | - Tingting Yao
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
| | - Michael K Ong
- Department of Medicine, University of California, Los Angeles, CA.,Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Hai-Yen Sung
- Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA
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19
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Voltzke KJ, Lee YCA, Zhang ZF, Zevallos JP, Yu GP, Winn DM, Vaughan TL, Sturgis EM, Smith E, Schwartz SM, Schantz S, Muscat J, Morgenstern H, McClean M, Li G, Lazarus P, Kelsey K, Gillison M, Chen C, Boffetta P, Hashibe M, Olshan AF. Racial differences in the relationship between tobacco, alcohol, and the risk of head and neck cancer: pooled analysis of US studies in the INHANCE Consortium. Cancer Causes Control 2018; 29:619-630. [PMID: 29761303 DOI: 10.1007/s10552-018-1026-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 04/03/2018] [Indexed: 12/14/2022]
Abstract
There have been few published studies on differences between Blacks and Whites in the estimated effects of alcohol and tobacco use on the incidence of head and neck cancer (HNC) in the United States. Previous studies have been limited by small numbers of Blacks. Using pooled data from 13 US case-control studies of oral, pharyngeal, and laryngeal cancers in the International Head and Neck Cancer Epidemiology Consortium, this study comprised a large number of Black HNC cases (n = 975). Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for several tobacco and alcohol consumption characteristics. Blacks were found to have consistently stronger associations than Whites for the majority of tobacco consumption variables. For example, compared to never smokers, Blacks who smoked cigarettes for > 30 years had an OR 4.53 (95% CI 3.22-6.39), which was larger than that observed in Whites (OR 3.01, 95% CI 2.73-3.33; pinteraction < 0.0001). The ORs for alcohol use were also larger among Blacks compared to Whites. Exclusion of oropharyngeal cases attenuated the racial differences in tobacco use associations but not alcohol use associations. These findings suggest modest racial differences exist in the association of HNC risk with tobacco and alcohol consumption.
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Affiliation(s)
- Kristin J Voltzke
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
| | - Yuan-Chin Amy Lee
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Jose P Zevallos
- Division of Head and Neck Surgical Oncology in the Department of Otolaryngology/Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Beijing, China
| | | | | | | | - Elaine Smith
- College of Public Health, University of Iowa, Iowa City, IA, USA
| | | | | | | | - Hal Morgenstern
- Departments of Epidemiology and Environmental Health Sciences, School of Public Health and Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Guojun Li
- UT-M.D. Anderson Cancer Center, Houston, TX, USA
| | - Philip Lazarus
- Washington State University College of Pharmacy, Spokane, WA, USA
| | | | | | - Chu Chen
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Paolo Boffetta
- The Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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20
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Chenoweth MJ, Ware JJ, Zhu AZ, Cole CB, Sanderson Cox L, Nollen N, Ahluwalia JS, Benowitz NL, Schnoll RA, Hawk LW, Cinciripini PM, George TP, Lerman C, Knight J, Tyndale RF. Genome-wide association study of a nicotine metabolism biomarker in African American smokers: impact of chromosome 19 genetic influences. Addiction 2018; 113:509-523. [PMID: 28921760 PMCID: PMC5807179 DOI: 10.1111/add.14032] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/03/2017] [Accepted: 09/12/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS The activity of CYP2A6, the major nicotine-inactivating enzyme, is measurable in smokers using the nicotine metabolite ratio (NMR; 3'hydroxycotinine/cotinine). Due to its role in nicotine clearance, the NMR is associated with smoking behaviours and response to pharmacotherapies. The NMR is highly heritable (~80%), and on average lower in African Americans (AA) versus whites. We previously identified several reduce and loss-of-function CYP2A6 variants common in individuals of African descent. Our current aim was to identify novel genetic influences on the NMR in AA smokers using genome-wide approaches. DESIGN Genome-wide association study (GWAS). SETTING Multiple sites within Canada and the United States. PARTICIPANTS AA smokers from two clinical trials: Pharmacogenetics of Nicotine Addiction Treatment (PNAT)-2 (NCT01314001; n = 504) and Kick-it-at-Swope (KIS)-3 (NCT00666978; n = 450). MEASUREMENTS Genome-wide SNP genotyping, the NMR (phenotype) and population substructure and NMR covariates. FINDINGS Meta-analysis revealed three independent chromosome 19 signals (rs12459249, rs111645190 and rs185430475) associated with the NMR. The top overall hit, rs12459249 (P = 1.47e-39; beta = 0.59 per C (versus T) allele, SE = 0.045), located ~9.5 kb 3' of CYP2A6, remained genome-wide significant after controlling for the common (~10% in AA) non-functional CYP2A6*17 allele. In contrast, rs111645190 and rs185430475 were not genome-wide significant when controlling for CYP2A6*17. In total, 96 signals associated with the NMR were identified; many were not found in prior NMR GWASs in individuals of European descent. The top hits were also associated with the NMR in a third cohort of AA (KIS2; n = 480). None of the hits were in UGT or OCT2 genes. CONCLUSIONS Three independent chromosome 19 signals account for ~20% of the variability in the nicotine metabolite ratio in African American smokers. The hits identified may contribute to inter-ethnic variability in nicotine metabolism, smoking behaviours and tobacco-related disease risk.
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Affiliation(s)
- Meghan J. Chenoweth
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada
| | - Jennifer J. Ware
- MRC Integrative Epidemiology Unit (IEU) and School of Social and Community Medicine at the University of Bristol, Bristol, BS8 2BN, United Kingdom
| | - Andy Z.X. Zhu
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada
| | - Christopher B. Cole
- Data Science Institute and Lancaster University Medical School, Lancaster, LA1 4YW, United Kingdom
| | - Lisa Sanderson Cox
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas, 66160, USA
| | - Nikki Nollen
- Department of Preventive Medicine and Public Health, University of Kansas School of Medicine, Kansas City, Kansas, 66160, USA
| | - Jasjit S. Ahluwalia
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island 02912, USA
| | - Neal L. Benowitz
- Departments of Medicine and Bioengineering and Therapeutic Sciences, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, San Francisco, California, 94110, USA
| | - Robert A. Schnoll
- Department of Psychiatry, Perelman School of Medicine, and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, 19104-6376, USA
| | - Larry W. Hawk
- Department of Psychology, University at Buffalo, SUNY, Buffalo, New York, 14260-4110, USA
| | - Paul M. Cinciripini
- Department of Behavioral Science, University of Texas, MD Anderson Cancer Center, Houston, Texas, 77030, USA
| | - Tony P. George
- Division of Schizophrenia, Centre for Addiction and Mental Health, Toronto, Ontario, Canada and Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada
| | - Caryn Lerman
- Department of Psychiatry, Annenberg School for Communication, and Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, 19104-6376, USA
| | - Joanne Knight
- Data Science Institute and Lancaster University Medical School, Lancaster, LA1 4YW, United Kingdom
| | - Rachel F. Tyndale
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, M5S 1A8, Canada,Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, M5T 1R8, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, M5T 1R8, Canada,Corresponding author (RFT)
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Reddy MM, Kanungo S, Naik BN, Kar SS. Willingness to quit tobacco smoking and its correlates among Indian smokers - Findings from Global Adult Tobacco Survey India, 2009-2010. J Family Med Prim Care 2018; 7:1353-1360. [PMID: 30613524 PMCID: PMC6293941 DOI: 10.4103/jfmpc.jfmpc_169_18] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: In the stages of change model for smoking cessation, “willingness to quit” forms the starting point. Objective: To determine the prevalence and correlates of willingness to quit among smokers in India from Global Adult Tobacco Survey (GATS), 2009–2010. Methods: Secondary data analysis of GATS, 2009–10, was done to find the correlates of willingness to quit among smokers. All the sociodemographic variables, smoking-related factors such as frequency, previous attempt to quit, and also effect of antitobacco messages delivered to various media were tested for association using multivariable analysis. Results: Of 9627 current smokers analyzed, 50.9% [95% confidence interval (CI): 49.9–51.9] were willing to quit smoking. Multivariable analysis showed that younger age groups [prevalence ratio (PR): 1.31, 95% CI: 1.05–1.65], individuals who have their first smoke after 60 min of wakeup (PR: 1.19, 95% CI: 1.05–1.36), those living in a house with smoking restriction (PR: 1.29, 95% CI: 1.17–1.42), those who received advice to quit from doctor, those who attempted to quit in the past 12 months (PR: 1.28, 95% CI: 1.03–1.60), having knowledge about illness caused due to smoking, and those who have noticed antismoking messages in billboards/hoardings were willing to quit smoking compared to their counterparts (PR: 1.13, 95% CI: 1.04–1.23). Conclusion: Enforcing social restrictions like smoking restriction at house and also brief advice by doctors to quit smoking during any contact with the tobacco user could improve quit rate especially in young tobacco users and those who have attempted to quit before.
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Affiliation(s)
- Mahendra M Reddy
- Department of Community Medicine, Sri Devaraj Urs Medical College, Tamaka, Kolar, India
| | - Srikanta Kanungo
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Bijaya Nanda Naik
- Department of Community Medicine, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India
| | - Sitanshu Sekhar Kar
- Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
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Henry AD, Gettens J, Savageau JA, Cullen D, Landau A. Massachusetts Medicaid members that smoked in 2008: Characteristics associated with smoking status in 2014. PLoS One 2017; 12:e0186144. [PMID: 29023542 PMCID: PMC5638442 DOI: 10.1371/journal.pone.0186144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 09/26/2017] [Indexed: 11/18/2022] Open
Abstract
The smoking rate among non-elderly Medicaid enrollees is more than double the rate for those privately insured; smoking-related conditions account for 15% of Medicaid expenditures. Under state health reform, Massachusetts Medicaid (MassHealth) made tobacco cessation treatment available beginning in 2006. We used surveys conducted in 2008 and 2014 to examine changes in smoking abstinence rates among MassHealth members identified as smokers and to identify factors associated with being a former smoker. Members previously identified as smokers were surveyed by mail or phone; 2008 and 2014 samples included 3,116 and 2,971 members, respectively. Surveys collected demographic and health information, asked members whether they smoked cigarettes "every day, some days or not at all', and asked questions to assess smoking intensity among current smokers. The 2014 survey included an open ended-question asking members "what helped the most" in quitting or quit attempts. We observed a significant decrease in members reporting smoking "every/some days" of 15.5 percentage points (p < .0001) from 2008 to 2014, and a significant decrease in smokers reporting smoking "more than 10 cigarettes on days smoked" of 16.7 percentage points (p < .0001). Compared to smokers, former smokers more frequently reported health concerns, the influence of family members, and the use of e-cigarettes as helping the most in quitting. Expanded access to tobacco cessation treatment under the Affordable Care Act may have help to reduce the high smoking rates among Medicaid enrollees. Additionally, smokers' concerns about health and the influence of family and friends provide opportunities for targeted intervention and messaging about quitting.
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Affiliation(s)
- Alexis D. Henry
- Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, United States of America
| | - John Gettens
- Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, United States of America
| | - Judith A. Savageau
- Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA, United States of America
| | - Doris Cullen
- Tobacco Cessation and Prevention Program, Massachusetts Department of Public Health, Boston, MA, United States of America
| | - Anna Landau
- Tobacco Cessation and Prevention Program, Massachusetts Department of Public Health, Boston, MA, United States of America
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Ossip DJ, Quiñones Z, Diaz S, Thevenet-Morrison K, Fisher S, Holderness H, Cai X, McIntosh S, Dozier A, Chin N, Weber E, Sanchez JJ, Bautista A, Héctor A. Tobacco Cessation in Economically Disadvantaged Dominican Republic Communities: Who are the Ex-Users? J Smok Cessat 2016; 11:239-249. [PMID: 28025600 PMCID: PMC5181849 DOI: 10.1017/jsc.2015.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Tobacco use and harm continue to increase in low- and middle income countries (LMICs) globally. Smoking cessation is the most effective means of reducing morbidity and mortality from tobacco use. Increasing the prevalence of ex-users is an indicator of population cessation. AIMS This study provides the first examination of factors associated with ex-tobacco use status in the Dominican Republic (DR), a LMIC in the Latin America and Caribbean region. METHODS Baseline surveillance was conducted for 1177 randomly selected households in 7 economically disadvantaged DR communities (total N=2680 adult household members). RESULTS Ex-user prevalence was 10.6% (1.0%-18.5% across communities), 14.8% were current users (9.1-20.4), and quit ratios were 41.7% (9.7%-52.7%). Among ever-users, females (OR 2.02, 95% CI 1.41, 2.90), older adults (45-64: OR 1.75, 95% CI 1.12, 2.74; 65+: OR 2.09, 95% CI 1.29, 3.39), and those who could read/write (OR 1.64, 95% CI 1.08, 2.50), had health conditions (OR 1.63, 95% CI 1.11, 2.41), and lived with ex-users (OR 1.70, 95% CI 1.12, 2.58) were over 60% to two times as likely to be ex-users. Those from remote communities (OR 0.52, 95% CI 0.36, 0.74), using chewed tobacco (OR 0.14, 95% CI 0.04, 0.48) and living with tobacco users (OR 0.55, 95% CI 0.37, 0.81) were less likely to be ex-users. CONCLUSIONS Ex-user prevalence and quit ratios were lower than for high income countries. Implementing broad tobacco control measures, combined with clinically targeting vulnerable groups, may increase tobacco cessation to most effectively reduce this public health crisis.
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Affiliation(s)
- Deborah J. Ossip
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Zahíra Quiñones
- Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
| | - Sergio Diaz
- Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
- Hospital Regional Universitario José Maria Cabral y Baez, Santiago, Dominican Republic
| | - Kelly Thevenet-Morrison
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Susan Fisher
- Department of Clinical Sciences, Temple University School of Medicine, Philadelphia, PA, USA
| | - Heather Holderness
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Xeuya Cai
- Department of Biostatistics, University of Rochester Medical Center, Rochester, NY, USA
| | - Scott McIntosh
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Ann Dozier
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Nancy Chin
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Emily Weber
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Jose Javier Sanchez
- Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
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Nicotinic acetylcholine receptor availability in cigarette smokers: effect of heavy caffeine or marijuana use. Psychopharmacology (Berl) 2016; 233:3249-57. [PMID: 27370018 PMCID: PMC4982797 DOI: 10.1007/s00213-016-4367-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/16/2016] [Indexed: 12/26/2022]
Abstract
RATIONALE Upregulation of α4β2* nicotinic acetylcholine receptors (nAChRs) is one of the most well-established effects of chronic cigarette smoking on the brain. Prior research by our group gave a preliminary indication that cigarette smokers with concomitant use of caffeine or marijuana have altered nAChR availability. OBJECTIVE We sought to determine if smokers with heavy caffeine or marijuana use have different levels of α4β2* nAChRs than smokers without these drug usages. METHODS One hundred and one positron emission tomography (PET) scans, using the radiotracer 2-FA (a ligand for β2*-containing nAChRs), were obtained from four groups of males: non-smokers without heavy caffeine or marijuana use, smokers without heavy caffeine or marijuana use, smokers with heavy caffeine use (mean four coffee cups per day), and smokers with heavy marijuana use (mean 22 days of use per month). Total distribution volume (Vt/fp) was determined for the brainstem, prefrontal cortex, and thalamus, as a measure of nAChR availability. RESULTS A significant between-group effect was found, resulting from the heavy caffeine and marijuana groups having the highest Vt/fp values (especially for the brainstem and prefrontal cortex), followed by smokers without such use, followed by non-smokers. Direct between-group comparisons revealed significant differences for Vt/fp values between the smoker groups with and without heavy caffeine or marijuana use. CONCLUSIONS Smokers with heavy caffeine or marijuana use have higher α4β2* nAChR availability than smokers without these drug usages. These findings are likely due to increased nicotine exposure but could also be due to an interaction on a cellular/molecular level.
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25
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Danielsen SE, Løchen ML, Medbø A, Vold ML, Melbye H. A new diagnosis of asthma or COPD is linked to smoking cessation - the Tromsø study. Int J Chron Obstruct Pulmon Dis 2016; 11:1453-8. [PMID: 27418818 PMCID: PMC4934533 DOI: 10.2147/copd.s108046] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Patients with COPD have had a lower tendency to quit smoking compared to patients with coronary heart disease (CHD). We wanted to investigate if this is still true in a Norwegian population. Methods Our data came from the fifth and sixth Tromsø surveys, which took place in 2001–2002 and 2007–2008. The predictors of smoking cessation were evaluated in a cohort of 4,497 participants who had stated their smoking status in both surveys. Results Of the 4,497 subjects in the cohort, 1,150 (25.6%) reported daily smoking in Tromsø 5. In Tromsø 6, 428 had quit (37.2%). A new diagnosis of obstructive lung disease (asthma or COPD) and CHD were both associated with increased quitting rates, 50.6% (P=0.01) and 52.1% (P=0.02), respectively. In multivariable logistic regression analysis with smoking cessation as outcome, the odds ratios (ORs) of a new diagnosis of obstructive lung disease and of CHD were 1.7 (1.1–2.7) and 1.7 (1.0–2.9), respectively. Male sex had an OR of 1.4 (1.1–1.8) compared to women in the multivariable model, whereas the ORs of an educational length of 13–16 years and ≥17 years compared to shorter education were 1.6 (1.1–2.2) and 2.5 (1.5–4.1), respectively. Conclusion The general trend of smoking cessation in the population was confirmed. Increased rates of smoking cessation were associated with a new diagnosis of heart or lung disease, and obstructive lung disease was just as strongly linked to smoking cessation as was CHD. This should encourage the pursuit of early diagnosis of COPD.
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Affiliation(s)
| | - Maja-Lisa Løchen
- Department of Community Medicine, The Arctic University of Norway
| | - Astri Medbø
- Department of Community Medicine, The Arctic University of Norway
| | - Monica Linea Vold
- Department of Respiratory Medicine, University Hospital of North Norway
| | - Hasse Melbye
- General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
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Albert SM, Roth T, Toscani M, Vitiello MV, Zee P. Sleep Health and Appropriate Use of OTC Sleep Aids in Older Adults-Recommendations of a Gerontological Society of America Workgroup. THE GERONTOLOGIST 2015; 57:163-170. [PMID: 26511271 DOI: 10.1093/geront/gnv139] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Getting a good night's sleep can be challenging for older adults with chronic medical conditions, which often interfere with sleep. As a result, many older adults turn to over-the-counter (OTC) sleep aids, that is, products with diphenhydramine or doxylamine. However, these products are indicated only for occasional difficulty with sleep, not for chronic use; and their safety and efficacy has not been well established in general and in older adults specifically. To engage national stakeholders in a discussion of OTC sleep aids in older adults, the Gerontological Society of America (GSA) convened a multidisciplinary workgroup. The Workgroup examined differences between younger and older adults in sleep health and use of OTC sleep aids using data from the National Health and Wellness Survey; assessed the pharmacologic properties and medication effects of OTC sleep aids; and worked with stakeholders to promote strategies for safe and effective use. Older adults are more likely to take diphenhydramine or doxylamine products 15 or more days in a month, an indicator of inappropriate use. The Workgroup recommends research to investigate the ways older people use OTC sleep aids. The goal should be reduction in inappropriate use and associated risks, such as daytime sedation, compromised cognitive function, and falls. In addition, the Workgroup recommends a greater role for community pharmacists in counseling older adults on appropriate use of OTC sleep aids.
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Affiliation(s)
- Steven M Albert
- Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pennsylvania.
| | - Thomas Roth
- Henry Ford Health Systems, Detroit, Michigan
| | - Michael Toscani
- Rutgers Institute for Pharmaceutical Industry Fellowships, Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New Jersey
| | - Michael V Vitiello
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle
| | - Phyllis Zee
- Department of Neurology, Northwestern University, Chicago, Illinois
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Torres TS, Luz PM, Derrico M, Velasque L, Grinsztejn E, Veloso VG, Cardoso SW, Santini-Oliveira M, Grinsztejn B, De Boni RB. Factors associated with tobacco smoking and cessation among HIV-infected individuals under care in Rio de Janeiro, Brazil. PLoS One 2014; 9:e115900. [PMID: 25536064 PMCID: PMC4275249 DOI: 10.1371/journal.pone.0115900] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 11/30/2014] [Indexed: 11/25/2022] Open
Abstract
Worldwide the prevalence of smoking among people living with HIV/AIDS is elevated compared to the general population. This probably reflects the cluster of individual characteristics that have shared risk factors for HIV infection and smoking. A cross-sectional study, enrolling a convenience sample from a Brazilian HIV clinical cohort was conducted to evaluate the prevalence of tobacco smoking and the factors associated with current smoking and abstinence. A total of 2,775 HIV-infected individuals were interviewed: 46.2% have never smoked, 29.9% were current smokers and 23.9% were former smokers. Current smokers had a higher prevalence of alcohol and illicit drug use when compared to the other two groups. A higher proportion of heterosexual individuals were former smokers or never smokers while among men who have sex with men (MSM) a higher proportion were current smokers. Former smokers had been more frequently diagnosed with high blood pressure, diabetes mellitus, cardiovascular diseases and depression, while for current smokers lung diseases were more frequent. Former smokers and current smokers were more likely to have had any hospital admission (42.0% and 41.2%, respectively) than participants who never smoked (33.5%) (p<0.001). Multivariate model results showed that current smokers (versus never smokers) were more likely to be less educated, to report the use of alcohol, crack and cocaine and to present clinical comorbidities. Former smokers (versus current smokers) were more likely to be older, to have smoked for a shorter amount of time and to have smoked >31 cigarettes/day. MSM (compared to heterosexuals) and cocaine users (versus non-users) had lower odds of being former smokers. Considering our results, smoking cessation interventions should be tailored to younger individuals, MSM and substance users.
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Affiliation(s)
- Thiago S. Torres
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
- * E-mail:
| | - Paula M. Luz
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
| | - Monica Derrico
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
| | - Luciane Velasque
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
- Departamento de Matemática, Universidade Federal do Estado do Rio de Janeiro (UniRio), Brazil
| | - Eduarda Grinsztejn
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
| | - Valdiléa G. Veloso
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
| | - Sandra W. Cardoso
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
| | - Marília Santini-Oliveira
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
| | - Beatriz Grinsztejn
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
| | - Raquel Brandini De Boni
- Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, HIV/AIDS Clinical Research Center, Rio de Janeiro, Brazil
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