1
|
Fox J, Mishra M. Hypertension and other vascular risk factors in patients with functional seizures. Epilepsy Behav 2024; 152:109650. [PMID: 38277850 DOI: 10.1016/j.yebeh.2024.109650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE Recent literature has suggested that functional seizures are associated with an elevated risk for vascular disease and mortality. We investigated the prevalence of risk factors for vascular disease in patients who were admitted to the epilepsy monitoring unit. METHODS Patients who were admitted to the epilepsy monitoring unit and received a definitive diagnosis of either functional seizures or epilepsy were identified. Data collected included demographic, clinical characteristics, medication list, comorbidities, and scheduled blood pressure measurements that occurred every 12 h during the admission. The mean blood pressures were calculated and if they were above the American College of Cardiology and the American Heart Association guideline cutoff of 130/80 mm Hg or the patient had a documented history of hypertension the patient was counted as having the condition. A multiple logistic regression model was developed to evaluate the independent association of the patient's diagnosis (i.e., epilepsy or functional seizures) and vascular risk factors that controlled for the number of blood pressure measurements, age, sex, and if the patient was taking antihypertensive medications. RESULTS 270 patients were included in this study of which 147 patients had epilepsy and 123 had functional seizures. Among those with functional seizures, 57.72 % had either a history of hypertension or a mean blood pressure above 130/80 compared to 38.78 % of those with epilepsy (p = 0.0022). In addition, 30.89 % of functional seizures patients had hyperlipidemia and 63.41 % were obese. The logistic regression model indicated that functional seizures were independently associated with high blood pressure (OR: 2.47, 95 % CI 1.10-5.69), hyperlipidemia (OR: 3.38, 95 % CI 1.35-8.86), and obesity (OR: 4.25, 95 % CI 2.22-8.36) compared to those with epilepsy. There was no significant difference in the prevalence of diabetes (OR: 0.81, 95 % CI 0.24-2.77) or current tobacco use (OR: 1.04, 95 % CI 0.48-2.25) between the groups. SIGNIFICANCE Patients with functional seizures had an elevated prevalence of several vascular risk factors. These findings may partially account for complications associated with functional seizures and have implications related to their pathophysiology.
Collapse
Affiliation(s)
- Jonah Fox
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.
| | - Murli Mishra
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| |
Collapse
|
2
|
Cheney MK, Song H, Bhochhibhoya S, Lu Y. Chronic disease as a risk factor for cigarette and e-cigarette use from young adulthood to adulthood. Prev Med Rep 2023; 36:102473. [PMID: 37881176 PMCID: PMC10594544 DOI: 10.1016/j.pmedr.2023.102473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/27/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023] Open
Abstract
Chronic disease prevalence in young adults is increasing with 15-20 % reporting 1 or more chronic diseases. This study examined cross-sectional and prospective relationships between chronic disease and e-cigarette/cigarette use from young adulthood to adulthood utilizing the U.S.- based National Longitudinal Study of Adolescent to Adult Health (Add Health). Add Health Study wave 3 (2001-2002; ages 18-26), wave 4 (2008; ages 24-34), and wave 5 (2016-2018; ages 33-44) were used. Past 30-day cigarette use at waves 3-5 and past 30-day e-cigarette use at wave 5 were assessed. Two measures of chronic disease were used: asthma (yes/no) and non-asthmatic chronic disease (yes/no) composed of 7 additional chronic diseases (diabetes, migraine, heart problem, hepatitis B/C, high blood pressure, epilepsy, and cancer). Weighted multilevel logistic regression (controlling for age, race/ethnicity, gender, and education) was used to assess cross-sectional associations at wave 3, and then prospective associations of wave 3 chronic disease (asthma and non-asthmatic) with waves 4 and 5 cigarette and wave 5 e-cigarette use. Logistic regressions showed no significant cross-sectional or prospective relationships between asthma and cigarette and e-cigarette use. However, wave 3 non-asthmatic chronic disease was significantly associated with wave 4 cigarette use (aOR 1.38, p <.001, 95 % CI: 1.15, 1.65) and with wave 5 cigarette use (aOR 1.49, p <.001, 95 % CI: 1.21, 1.84) but not e-cigarette use. The association between chronic disease in young adulthood and tobacco use in adulthood differed by type of chronic disease and tobacco product, indicating the need for targeted interventions.
Collapse
Affiliation(s)
- Marshall K Cheney
- Department of Health and Exercise Science, University of Oklahoma, 1401 Asp Avenue, Norman, OK, 73019, USA
| | - Hairong Song
- Department of Psychology, University of Oklahoma, Norman, OK USA
| | - Shristi Bhochhibhoya
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK USA
| | - Yu Lu
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK USA
| |
Collapse
|
3
|
Yeob KE, Kim SY, Kim YY, Park JH. Nationwide prevalence and trends in cigarette smoking among adult men with and without disabilities in South Korea between 2009 and 2017. Public Health 2023; 222:92-99. [PMID: 37536197 DOI: 10.1016/j.puhe.2023.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Current smoking rates for people with and without disabilities vary among countries. This study analyzed smoking behavior over 9 years in adult South Korean men with disabilities, according to disability severity and type, and in those without disabilities. STUDY DESIGN This was a cross-sectional study. METHODS This analysis was conducted using national disability registration data and national general health checkup data for 2009-2017. Age-standardized smoking behaviors were analyzed for each year according to the presence, severity, and type of disability. The odds of current smoking were determined by multivariate logistic regression after adjusting for sociodemographic and clinical variables. RESULTS The age-standardized smoking rate and average number of cigarettes for men with mild disabilities in the younger age group were 1.16 (43.0 vs 36.8%) and 1.05 (16.1 vs 15.3 cigarettes) times higher than in non-disabled men as of 2017. The highest smoking rate was observed in men with physical disabilities in the younger age. In the older age group, the highest smoking rate was that of men with intellectual or psychological disabilities. CONCLUSION Smoking behaviors remained poorest in men with disabilities, especially those with mild, physical, and intellectual/psychological disabilities. Public health policies should focus on people with disabilities to promote health, prevent secondary conditions, and reduce health disparities by implementing antismoking health policies.
Collapse
Affiliation(s)
- K E Yeob
- College of Medicine/Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea; Chungbuk Tobacco Control Center, Cheongju, South Korea
| | - S Y Kim
- College of Medicine/Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea; Chungbuk Tobacco Control Center, Cheongju, South Korea; Department of Public Health and Preventive Medicine, Chungbuk National University Hospital, Cheongju, South Korea
| | - Y Y Kim
- Big Data Steering Department, National Health Insurance Service, Wonju, Republic of Korea; Drug Evaluation Department, National Institute of Food and Drug Safety Evaluation, Cheongju, Republic of Korea
| | - J H Park
- College of Medicine/Institute of Health & Science Convergence, Chungbuk National University, Cheongju, South Korea; Chungbuk Tobacco Control Center, Cheongju, South Korea.
| |
Collapse
|
4
|
Zanussi JT, Zhao J, Wei WQ, Karakoc G, Chung CP, Feng Q, Olsen NJ, Stein CM, Kawai VK. Clinical diagnoses associated with a positive antinuclear antibody test in patients with and without autoimmune disease. BMC Rheumatol 2023; 7:24. [PMID: 37550754 PMCID: PMC10405518 DOI: 10.1186/s41927-023-00349-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 07/27/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Antinuclear antibodies (ANA) are antibodies present in several autoimmune disorders. However, a large proportion of the general population (20%) also have a positive test; very few of these individuals will develop an autoimmune disease, and the clinical impact of a positive ANA in them is not known. Thus, we test the hypothesis that ANA + test reflects a state of immune dysregulation that alters risk for some clinical disorders in individuals without an autoimmune disease. METHODS We performed high throughput association analyses in a case-control study using real world data from the de-identified electronic health record (EHR) system from Vanderbilt University Medical Center. The study population included individuals with an ANA titer ≥ 1:80 at any time (ANA +) and those with negative results (ANA-). The cohort was stratified into sub-cohorts of individuals with and without an autoimmune disease. A phenome-wide association study (PheWAS) adjusted by sex, year of birth, race, and length of follow-up was performed in the study cohort and in the sub-cohorts. As secondary analyses, only clinical diagnoses after ANA testing were included in the analyses. RESULTS The cohort included 70,043 individuals: 49,546 without and 20,497 with an autoimmune disease, 26,579 were ANA + and 43,464 ANA-. In the study cohort and the sub-cohort with autoimmune disease, ANA + was associated (P ≤ 5 × 10-5) with 88 and 136 clinical diagnoses respectively, including lupus (OR ≥ 5.4, P ≤ 7.8 × 10-202) and other autoimmune diseases and complications. In the sub-cohort without autoimmune diseases, ANA + was associated with increased risk of Raynaud's syndrome (OR ≥ 2.1) and alveolar/perialveolar-related pneumopathies (OR ≥ 1.4) and decreased risk of hepatitis C, tobacco use disorders, mood disorders, convulsions, fever of unknown origin, and substance abuse disorders (OR ≤ 0.8). Analyses including only diagnoses after ANA testing yielded similar results. CONCLUSION A positive ANA test, in addition to known associations with autoimmune diseases, Raynaud's phenomenon, and idiopathic fibrosing alveolitis related disorders, is associated with decreased prevalence of several non-autoimmune diseases.
Collapse
Affiliation(s)
- Jacy T Zanussi
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Juan Zhao
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Wei-Qi Wei
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Gul Karakoc
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cecilia P Chung
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, USA
- Division of Rheumatology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Tennessee Valley Healthcare System - Nashville Campus, Nashville, TN, USA
| | - QiPing Feng
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Nancy J Olsen
- Department of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - C Michael Stein
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Vivian K Kawai
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
- Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, TN, USA.
| |
Collapse
|
5
|
Narrett JA, Khan W, Funaro MC, Moeller JJ. How do smoking, vaping, and nicotine affect people with epilepsy and seizures? A scoping review protocol. PLoS One 2023; 18:e0288120. [PMID: 37418386 DOI: 10.1371/journal.pone.0288120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 06/20/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Epilepsy is a prevalent disease that requires personalized care to control seizures, reduce side effects, and ameliorate the burden of comorbidities. Smoking is a major cause of preventable death and disease. There is evidence that patients with epilepsy smoke at high rates and that smoking may increase seizure frequency. However, there is a lack systematically synthesized evidence on the interactions between epilepsy and seizures and smoking, tobacco use, vaping, and smoking cessation. METHODS AND ANALYSIS This scoping review protocol guided by the Joanna Briggs Institute Manual for Evidence Synthesis and the PRISMA Extension for Scoping Reviews will investigate what is known about the interactions between smoking and epilepsy. This review will include the population of persons with all types of epilepsy or seizures and examine an inclusive list of concepts including tobacco use, vaping, nicotine replacement, and smoking cessation. The MEDLINE, Embase, APA Psycinfo, CINAHL, Cochrane, Scopus, and Web of Science databases will be searched. Following systematic screening of records, data will be charted, synthesized, and summarized for presentation and publication. ETHICS AND DISSEMINATION No ethical approval is required for this literature-based study. The results of this scoping review will be submitted for publication in a peer-reviewed journal. This synthesis will be informative to clinicians and direct further research that may improve health outcomes for people with epilepsy. REGISTRATION This protocol is registered with the Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/D3ZK8).
Collapse
Affiliation(s)
- Jackson A Narrett
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Waleed Khan
- Yale University School of Medicine, New Haven, Connecticut, United States of America
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, United States of America
| | - Jeremy J Moeller
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America
| |
Collapse
|
6
|
Gaitatzis A, Majeed A. Multimorbidity in People with Epilepsy. Seizure 2023; 107:136-145. [PMID: 37023627 DOI: 10.1016/j.seizure.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/24/2023] [Accepted: 03/26/2023] [Indexed: 03/31/2023] Open
Abstract
Multimorbidity is an emerging priority in healthcare due to associations with the ageing population, frailty, polypharmacy, health and social care demands. It affects 60-70% of adults and 80% of children with epilepsy. Neurodevelopmental conditions are commonly seen in children with epilepsy, while cancer, cardiovascular and neurodegenerative conditions often afflict older people with epilepsy. Mental health problems are common across the lifespan. Genetic, environmental, social and lifestyle factors contribute to multimorbidity and its consequences. Multimorbid people with epilepsy (PWE) are at higher risk of depression and suicide, premature death, suffer lower health-related quality of life, and require more hospital admissions and health care costs. The best management of multimorbid PWE requires a paradigm shift from the traditional single disease-single comorbidity approach and a refocus on a person-centred approach. Improvements in health care must be informed by assessing the burden of multimorbidity associated with epilepsy, delineating disease clusters, and measuring the effects on health outcomes.
Collapse
|
7
|
Kubota T, Tsushima T, Al-Kindi S, Sundaram V, Vaca GFB. Association between status epilepticus and cardiorespiratory comorbidity in patients with epilepsy: A population-based study. Epilepsy Behav 2022; 135:108889. [PMID: 36057177 DOI: 10.1016/j.yebeh.2022.108889] [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: 06/16/2022] [Revised: 08/03/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to evaluate the relationship between status epilepticus (SE) and cardiorespiratory comorbidity in patients with epilepsy. METHODS We conducted a population-based study using cloud-based aggregated electronic medical records from >53 million patients in the US (Explorys, IBM Watson; January 1999 to November 2020). During the study period, we identified patients with epilepsy with SE. Patients with a history of cardiac arrest, anoxic encephalopathy, and/or cerebrovascular disease were excluded. We reported the prevalences and prevalence ratios of cardiorespiratory and medical comorbidities using age- and sex-adjusted standardization. RESULTS We identified 494,790 patients with epilepsy and 19,190 had SE. Cardiovascular and respiratory diseases were statistically significantly more prevalent in patients with epilepsy with SE than in those without SE (adjusted prevalence ratio (APR) 1.13, prevalence 68.7% [95% confidence interval (CI): 67.6-69.9] vs 60.9% [95% CI: 60.7-61.1]) and (APR 1.25, 73.1% [95% CI: 71.8-74.3] vs 58.4% [95% CI: 58.1-58.6]), respectively. Aspiration pneumonia (APR 3.12, 0.47% [95% CI: 0.37-0.57] vs 0.15% [95% CI: 0.14-0.16]) and acute respiratory distress syndrome (APR 2.40, 0.47% [95% CI: 0.37-0.57] vs 0.20% [95% CI: 0.18-0.21]) were more prevalent in patients with epilepsy with SE. Common cardiovascular risk factors such as diabetes mellitus (APR 1.13, 17.1% [95% CI: 16.5-17.6] vs 15.1% [95% CI: 1.50-15.2]) and hypertension (APR 1.28, 10.6% [95% CI: 10.2-11.0] vs 8.31% [95% CI: 8.23-8.39]) were also more common in patients with epilepsy with SE. CONCLUSION In this population-based study, patients with epilepsy with SE had a statistically significantly higher prevalence of cardiorespiratory comorbidities than in those without SE.
Collapse
Affiliation(s)
- Takafumi Kubota
- Department of Neurology, University Hospitals of Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA; Department of Neurology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| | - Takahiro Tsushima
- University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Sadeer Al-Kindi
- University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Varun Sundaram
- University Hospitals Harrington Heart & Vascular Institute, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| | - Guadalupe Fernandez-Baca Vaca
- Department of Neurology, University Hospitals of Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
| |
Collapse
|
8
|
Kobau R, Zack MM, Sapkota S, Sajatovic M, Kiriakopoulos E. When and why US primary care providers do and do not refer their patients with new-onset seizures or existing epilepsy or seizure disorders to neurologists-2018 DocStyles. Epilepsy Behav 2021; 125:108385. [PMID: 34740091 PMCID: PMC11034734 DOI: 10.1016/j.yebeh.2021.108385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 10/03/2021] [Accepted: 10/16/2021] [Indexed: 11/27/2022]
Abstract
Monitoring primary care providers' (PCP) attitudes and experiences with referrals of their patients with new-onset seizures or existing epilepsy/seizure disorders may help evaluate whether interventions to coordinate PCP and neurology care reduce treatment gaps and improve patient outcomes. To examine PCPs' attitudes toward, and experiences with, referral to specialty care of their patients with new-onset seizures or existing epilepsy/seizure disorders, we used cross-sectional 2018 DocStyles data to examine study outcomes. We selected a subsample of respondents who had a practice with at least 1% of patients with an epilepsy/seizure disorder and who answered questions about this disorder. We stratified provider actions, referral behavior, and referral enabling factors and barriers by epilepsy/seizure disorder caseload and provider type. We examined different patterns of responses by referral behavior and provider type. The final sample (n = 1284) included 422 family practitioners, 432 internists, 233 pediatricians, and 197 nurse practitioners. Most PCPs refer their patients with new-onset seizures to a neurologist, particularly to determine or confirm the diagnosis and appropriate treatment. Strikingly, about 40% of PCPs did not indicate a referral if their epilepsy/seizure disorder patient was unresponsive to treatment. Internists less likely referred their patients than pediatricians, nurse practitioners, or family practitioners. Less than one-third of all practitioners consulted seizure treatment guidelines. Prompt appointments, communication with the PCP, the patient's insurance, and referral back to primary care may facilitate referrals. Interventions that enhance enabling factors for guidelines-based care and that can increase opportunities for PCPs to consult with neurologists and/or refer their patients with uncontrolled seizures to specialty care are warranted.
Collapse
Affiliation(s)
- Rosemarie Kobau
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, 4770 Buford Highway NE, MS 107-6, Atlanta, GA 30341, USA.
| | - Matthew M Zack
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, 4770 Buford Highway NE, MS 107-6, Atlanta, GA 30341, USA
| | - Sanjeeb Sapkota
- ASRT Inc., Epilepsy Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Mail Stop 107-6, 4770 Buford Hwy, 30341 GA, USA
| | - Martha Sajatovic
- University Hospital Cleveland Medical Center, 10524 Euclid Ave, Cleveland, OH 44106, USA
| | - Elaine Kiriakopoulos
- Dartmouth Geisel School of Medicine, 1 Rope Ferry Road, Hanover, NH 03755-1404, USA
| |
Collapse
|
9
|
Johnson AL, McLeish AC, Shear PK, Privitera M, Luberto CM. Smokers with and without Epilepsy show Similar Smoking Rate, Dependence Level, Cessation Attempts, and Motives. Transl Behav Med 2021; 11:1023-1029. [PMID: 33543756 DOI: 10.1093/tbm/ibab002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Individuals with epilepsy are up to twice as likely to be current cigarette smokers compared to those without. Moreover, one study showed current smoking is associated with an increased likelihood of seizures. However, outside of this one study, there is limited data on the presentation of specific smoking-related behaviors and cognitions in people with epilepsy, inhibiting our understanding of the severity of this behavior and our ability to formulate effective treatments for this population. PURPOSE The current study examined smoking-related behaviors and cognitions among smokers with epilepsy compared to smokers without epilepsy. METHODS Participants were 43 smokers with (Mage = 43.4, SD = 11.6) and 43 smokers without (Mage = 45.5, SD = 8.8) epilepsy recruited from an urban, academic setting within the U.S. Separate Analyses of Covariance (ANCOVAs) were conducted to evaluate differences between smokers with and without epilepsy in terms of smoking behavior (i.e., daily smoking rate, nicotine dependence, number of quit attempts, smoking duration, age of smoking onset) and smoking-related cognitive processes (i.e., smoking motives, perceived barriers to smoking cessation, cessation motives) after controlling for race and problematic alcohol use. RESULTS Smokers with epilepsy did not differ from smokers without epilepsy in terms of smoking rate (p = .51, ηp2 = .01), nicotine dependence (p = .12, ηp2 = .03), age of smoking onset (p = .42, ηp2 = .01), number of quit attempts (p = .43, ηp2 = .01), barriers to cessation (p = .30 to .80, ηp2 = .00 to .01), or cessation motives (p = .28 to .60, ηp2 = .00 to .02). Smokers without epilepsy reported higher levels of smoking for sensorimotor manipulation reasons (p = .03, ηp2 = .06) and longer smoking duration (p = .03, ηp2 = .06) than smokers with epilepsy. CONCLUSIONS Smokers with epilepsy do not appear to differ significantly from smokers without epilepsy in terms of smoking-related behaviors and cognitions, and may therefore benefit from current evidence-based treatments for smoking cessation that are not contraindicated for epilepsy (i.e., bupropion, varenicline).
Collapse
Affiliation(s)
- Adrienne L Johnson
- Center for Tobacco Research and Intervention, University of Wisconsin, Ste. 200, Madison, WI, USA.,William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI, USA
| | - Alison C McLeish
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA.,Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, USA
| | - Paula K Shear
- Department of Psychology, University of Cincinnati, Cincinnati, OH, USA.,Department of Neurology, Gardner Neuroscience Institute, University of Cincinnati, Suite 2300, Cincinnati, OH, USA
| | - Michael Privitera
- Department of Neurology, Gardner Neuroscience Institute, University of Cincinnati, Suite 2300, Cincinnati, OH, USA
| | | |
Collapse
|
10
|
Cardona S, Calixte R, Rivera A, Islam JY, Vidot DC, Camacho-Rivera M. Perceptions and Patterns of Cigarette and E-Cigarette Use among Hispanics: A Heterogeneity Analysis of the 2017-2019 Health Information National Trends Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6378. [PMID: 34204687 PMCID: PMC8296202 DOI: 10.3390/ijerph18126378] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/07/2021] [Accepted: 06/10/2021] [Indexed: 12/19/2022]
Abstract
There are documented disparities in smoking behaviors among Hispanic adults in the U.S., but little is known about patterns of e-cigarette use. Using data from the HINTS 5 cycle 1-3, we examined cigarette and e-cigarette history and current use, as well as perceptions of the dangers of e-cigarette use relative to cigarette use. Primary predictors were Hispanic ethnic group, gender, age, education, income, and English language proficiency. Binary outcomes were modeled using the logit link, and multinomial outcome variables were modeled using generalized logit model. Fifty-three percent of participants were Mexican, 8% Puerto Rican, 4% were Cuban, and 35% identified as other Hispanics. Of the 1618 respondents, 23% were former cigarette smokers and 10% were current cigarette smokers. Twenty percent reported history of electronic cigarettes and 4% reported current use. In multivariable models, Hispanic women were significantly less likely to report ever being smokers compared to Hispanic men (aOR = 0.61, 95% CI = 0.42, 0.88). Puerto Ricans were 2.4 times as likely to report being current smokers (95% CI = 1.11, 5.11) compared to Mexicans. Among Hispanics, significant differences in e-cigarette and cigarette use behaviors emerged by gender, age, ethnicity, and cancer history, with implications for tailoring smoking prevention and cessation messages.
Collapse
Affiliation(s)
- Stephanie Cardona
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| | - Rose Calixte
- Department of Epidemiology and Biostatistics, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| | - Argelis Rivera
- Department of Medicine, Mount Sinai Icahn School of Medicine, New York, NY 10009, USA;
| | - Jessica Yasmine Islam
- Cancer Epidemiology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA;
| | - Denise Christina Vidot
- Sylvester Comprehensive Cancer Center, School of Nursing and Health Studies, University of Miami, Miami, FL 33146, USA;
| | - Marlene Camacho-Rivera
- Department of Community Health Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY 11203, USA;
| |
Collapse
|