1
|
Castaldelli-Maia JM, Camargos de Oliveira V, Irber FM, Blaas IK, Angerville B, Sousa Martins-da-Silva A, Koch Gimenes G, Waisman Campos M, Torales J, Ventriglio A, Guillois C, El Ouazzani H, Gazaix L, Favré P, Dervaux A, Apter G. Psychopharmacology of smoking cessation medications: focus on patients with mental health disorders. Int Rev Psychiatry 2023; 35:397-417. [PMID: 38299651 DOI: 10.1080/09540261.2023.2249084] [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: 05/10/2023] [Accepted: 08/14/2023] [Indexed: 02/02/2024]
Abstract
The adverse effects of smoking cessation in individuals with mental health disorders have been a point of concern, and progress in the development of treatment has been slow. The primary first-line treatments for smoking cessation are Nicotine Replacement Therapy, Bupropion, Varenicline, and behavioural support. Nortriptyline and Clonidine are second-line treatments used when the first-line treatments are not effective or are contraindicated. Smoking cessation medications have been shown to be effective in reducing nicotine cravings and withdrawal symptoms and promoting smoking cessation among patients living with mental disorders. However, these medications may have implications for patients' mental health and need to be monitored closely. The efficacy and side effects of these medications may vary depending on the patient's psychiatric condition, medication regimen, substance use, or medical comorbidities. The purpose of this review is to synthesise the pharmacokinetics, pharmacodynamics, therapeutic effects, adverse effects, and pharmacological interactions of first- and second-line smoking cessation drugs, with an emphasis on patients suffering from mental illnesses. Careful consideration of the risks and benefits of using smoking cessation medications is necessary, and treatment plans must be tailored to individual patients' needs. Monitoring symptoms and medication regimens is essential to ensure optimal treatment outcomes.
Collapse
Affiliation(s)
- João Mauricio Castaldelli-Maia
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | - Israel K Blaas
- Perdizes Institute (IPer), Clinics Hospital (HCFMUSP), Medical School, University of São Paulo, São Paulo, Brazil
| | | | | | - Gislaine Koch Gimenes
- Perdizes Institute (IPer), Clinics Hospital (HCFMUSP), Medical School, University of São Paulo, São Paulo, Brazil
| | - Marcela Waisman Campos
- Department of Cognitive Neurology, Neuropsychiatry, and Neuropsychology, FLENI, Buenos Aires, Argentina
| | - Julio Torales
- Department of Psychiatry, National University of Asuncion, San Lorenzo, Paraguay
- Regional Institute of Health Research, Universidad Nacional de Caaguazú, Coronel Oviedo, Paraguay
- School of Health Sciences, Universidad Sudamericana, Pedro Juan Caballero, Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Carine Guillois
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Houria El Ouazzani
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Léna Gazaix
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
| | - Pascal Favré
- Établissement Public de Santé Mentale, Neuilly sur Marne, France
| | - Alain Dervaux
- Établissement Public de Santé Barthélémy Durand, Étampes, France
- Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Gisèle Apter
- Cellule de Recherche Clinique, Groupe Hospitalier du Havre, Le Havre, France
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Établissement Public de Santé Mentale, Neuilly sur Marne, France
- Societé de l'Information Psychiatrique, Bron, France
- University of Rouen Normandy, Rouen, France
| |
Collapse
|
2
|
Lima DR, Davanso LC, Carvalho CFC, Guimaraes-Pereira BBS, Loreto AR, Frallonardo FP, Ismael F, de Andrade AG, Castaldelli-Maia JM. Is self-reported 7-day point prevalence abstinence an useful measure for smoking cessation effectiveness among individuals with mental disorders? Int Rev Psychiatry 2023; 35:468-474. [PMID: 38299649 DOI: 10.1080/09540261.2023.2240388] [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: 06/19/2023] [Accepted: 07/20/2023] [Indexed: 02/02/2024]
Abstract
Smoking rates among individuals with mental disorders are higher compared to general population. We aimed to investigate the effectiveness of a smoking cessation treatment among individuals with and without mental disorders. Self-report 7-day point prevalence was used to assess abstinence status among 'intention to treat' (n = 1,213) and 'completers-only' (n = 578) samples. Participants were distributed in (1) ND-only; (2) ND and other substance use disorder (ND-SUD); (3) ND associated with mental disorder but no other SUD (ND-MD); and (4) co-morbid ND, SUD and MD (ND-SUMD). The treatment program was composed by six weeks of group Cognitive Behavioral Therapy (CBT) and medical consultations. Multivariate logistic regression models were applied. Rates of abstinence between ND-only and both ND-MD and ND-SUMD differed in the 'intention-to-treat' sample, with the former group showing the best rate (62.5%, 48% and 45.4% respectively). ND-SUD had the second-best rate of abstinence (56.1%). Differences between groups were not observed among 'completers-only'. Self-report 7-day point prevalence abstinence is economical and reliable to be used in low to middle-income countries. In this study, it showed that the 6-week smoking cessation treatment had a positive effect among completers, which supports the importance of investing in treatment to decrease smoking prevalence in this population.
Collapse
Affiliation(s)
- Danielle Ruiz Lima
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | | | | | | | | | - Fernanda Piotto Frallonardo
- ABC Center for Mental Health Studies, Universidade de Sao Paulo, São Paulo, Brazil
- Department of Neuroscience, Universidade Municipal de São Caetano do Sul, São Paulo, Brazil
| | - Flavia Ismael
- ABC Center for Mental Health Studies, Universidade de Sao Paulo, São Paulo, Brazil
- Department of Neuroscience, Universidade Municipal de São Caetano do Sul, São Paulo, Brazil
| | - Arthur Guerra de Andrade
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
- Department of Neuroscience, Medical School, ABC Foundation, São Paulo, Brazil
- ABC Center for Mental Health Studies, Universidade de Sao Paulo, São Paulo, Brazil
| | - João Mauricio Castaldelli-Maia
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, Brazil
- Department of Neuroscience, Medical School, ABC Foundation, São Paulo, Brazil
- ABC Center for Mental Health Studies, Universidade de Sao Paulo, São Paulo, Brazil
| |
Collapse
|
3
|
Lima DR, Guimaraes-Pereira BBS, Mannes ZL, Carvalho CFC, Loreto AR, Davanso LC, Frallonardo FP, Ismael F, de Andrade AG, Castaldelli-Maia JM. The effect of a real-world intervention for smoking cessation in Adults with and without comorbid psychiatric and substance use disorders: A one-year follow-up study. Psychiatry Res 2022; 315:114722. [PMID: 35841703 PMCID: PMC11055494 DOI: 10.1016/j.psychres.2022.114722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022]
Abstract
This study evaluated short-term abstinence and prolonged abstinence following a real-world intervention for smoking cessation in a sample of 1,213 adults with nicotine dependence only (ND), nicotine dependence and past history of another substance use disorder (ND-SUD), nicotine dependence and a non-substance use mental health disorder (ND-MD), or nicotine dependence and comorbid substance use disorder and mental health disorder (ND-SUMD). Participants received six sessions of group Cognitive Behavioral Therapy (CBT) and pharmacotherapy. Abstinence was assessed following completion of treatment and at 12-month follow-up. Logistic regression and survival analyses were performed. Participants who were lost to follow-up were included as censored and baseline differences were used as covariates in multivariate analyses. Rates of short-term abstinence and prolonged abstinence were significantly different between ND and ND-SUMD (20.9% versus 36.5%; 14.9% versus 22.4%, respectively). Among participants with follow-up, 37.7% were abstinent at 12-month. Diagnostic group was not associated with abstinence at 12-month follow-up after adjusting for nicotine dependence severity, which was associated with lower likelihood of abstinence (HR=1.11;95%CI:1.03-1.19). CBT plus pharmacotherapy had a positive effect on smoking cessation among the participants in this study. Special attention should be given to adults with more severe nicotine dependence and comorbid psychiatric and substance use disorders.
Collapse
Affiliation(s)
- Danielle Ruiz Lima
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR.
| | | | - Zachary L Mannes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, U.S., 10032
| | | | - Aline Rodrigues Loreto
- ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil
| | - Lucas Carvalho Davanso
- Department of Neuroscience, Medical School, ABC Foundation, Santo André - SP, 09060-870, Santo Andre, SP, BR
| | - Fernanda Piotto Frallonardo
- ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil; Universidade Municipal de São Caetano do Sul - Campus Centro, São Caetano do Sul, Sao Paulo, 09521-160, Brazil
| | - Flavia Ismael
- ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil; Universidade Municipal de São Caetano do Sul - Campus Centro, São Caetano do Sul, Sao Paulo, 09521-160, Brazil
| | - Arthur Guerra de Andrade
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR; Department of Neuroscience, Medical School, ABC Foundation, Santo André - SP, 09060-870, Santo Andre, SP, BR; ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil
| | - Joao Mauricio Castaldelli-Maia
- Grupo Interdisciplinar de Estudos de Alcool e outras Drogas (GREA), Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR; Department of Neuroscience, Medical School, ABC Foundation, Santo André - SP, 09060-870, Santo Andre, SP, BR; ABC Center for Mental Health Studies, Santo André - SP, 09060-870, Santo Andre, SP, Brazil; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, U.S., 10032
| |
Collapse
|
4
|
Frallonardo FP, Lima DR, Carvalho CFC, Loreto AR, Guimarães-Pereira BBS, Ismael F, Torales J, Ventriglio A, de Andrade AG, da Silva Bizário JC, Castaldelli-Maia JM. Effect of BMI on Prolonged Abstinence after Smoking Cessation Treatment: A Retrospective Cohort Study. Curr Drug Res Rev 2021; 13:236-245. [PMID: 34011261 DOI: 10.2174/2589977513666210518160924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/03/2021] [Accepted: 02/27/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite the well-documented relationship between weight gain and poorer cessation outcomes among smokers, the role of the former (baseline) weight in smoking cessation is insufficiently investigated. We hypothesized that patients with higher baseline body mass index(BMI) have a worse prognosis in tobacco cessation. OBJECTIVES This retrospective clinical cohort study aimed to investigate the role of the baseline BMI on abstinence over 12 months after participation in smoking cessation treatment conducted in a middle-income country (n = 664). METHODS Data from a 6-week smoking cessation protocol performed in a Psychosocial Care Unit(CAPS) were used. The protocol included four medical consultations and six Cognitive-Behavioral Therapy(CBT) group sessions. Initially, 1,213 participants were evaluated for the study, but only the participants whose telephone contact was successful were included in the outcome analyses. The attrition rate was 45.3%. Continuous and categorical (normal, overweight, and obesity) BMI values were computed. Survival regression models were used to test the associations between BMI and the 12-month abstinence outcome. Self-report 4-week abstinence at the end of treatment was also investigated using logistic regression models. RESULTS Baseline BMI had no significant effect on both short (4-week-point abstinence) and long (12-month prolonged abstinence) treatment outcomes. CONCLUSION The possible influence of the baseline BMI on smoking cessation outcomes, especially considering prolonged abstinence, was not corroborated by our results. Regardless of our results, the detrimental health outcomes due to the combination of obesity/overweight and smoking justify that these subgroups of individuals be continuously targeted for adequate smoking prevention and treatment.
Collapse
Affiliation(s)
| | - Danielle Ruiz Lima
- Department of Psychiatry, Medical School, University of São Paulo, Butanta, SP, Brazil
| | | | | | | | - Flavia Ismael
- Municipal University of São Caetano do Sul (USCS), São Caetano do Sul, SP, Brazil
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción. Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia. Italy
| | | | | | | |
Collapse
|
5
|
Smartphone health apps for tobacco Cessation: A systematic review. Addict Behav 2021; 112:106616. [PMID: 32932102 DOI: 10.1016/j.addbeh.2020.106616] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 08/06/2020] [Accepted: 08/15/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Given the low retention and lack of persistent support by traditional tobacco cessation programs, evidence-based smartphone app-supported interventions can be an important tobacco control component. The objective of this systematic review was to identify and evaluate the types of studies that use smartphone apps for interventions in tobacco cessation. METHODS We conducted a systematic review of PubMed (1946-2019), EMBASE (1974-2019), and PsycINFO (1806-2019) databases with keywords related to smartphone-supported tobacco cessation. Included articles were required to meet 3 baseline screening criteria: 1) be written in English, 2) include an abstract, and 3) be a full, peer-reviewed manuscript. The criteria for the second level of review were: 1) primary outcome of tobacco cessation, 2) intervention study, and 3) smartphone app as primary focus of study. RESULTS Of 1973 eligible manuscripts, 18 met inclusion criteria. Most studies (n = 17) recruited adult participants (18 + years); one included teens (16 + years). Tobacco cessation was usually self-reported (n = 11), compared to biochemical verification (n = 3) or both (n = 4). There were 11 randomized controlled trials, 4 of which reported statistically significant results, and 7 single-arm trials that reported a mean abstinence rate of 33.9%. DISCUSSION The majority of studies that use tobacco cessation apps as an intervention delivery modality are mostly at the pilot/feasibility stage. The growing field has resulted in studies that varied in methodologies, study design, and inclusion criteria. More consistency in intervention components and larger randomized controlled trials are needed for tobacco cessation smartphone apps.
Collapse
|
6
|
Lima DR, Carvalho CFC, Guimarães-Pereira BBS, Loreto AR, Frallonardo FP, Ismael F, Andrade AGD, Castaldelli-Maia JM. Abstinence and retention outcomes in a smoking cessation program among individuals with co-morbid substance use and mental disorders. J Psychiatr Res 2020; 125:121-128. [PMID: 32272242 DOI: 10.1016/j.jpsychires.2020.03.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 02/06/2023]
Abstract
Tobacco use is the leading cause of preventable death in the world. Although cigarette smoking prevalence has decreased, there are still disparities in morbidity and mortality experienced by individuals with substance use and/or mental disorders when compared to general population. The aim of this study was to compare treatment outcomes between three subgroups of smokers: individuals with substance use disorder (SUD-only), individuals with mental disorder without substance use disorders (MD-only), and individuals with co-morbid substance use and mental disorder (SUD + MD). Data of 498 smokers enrolled in a 6-week smoking cessation program in Brazil were analyzed. Sociodemographic, medical and tobacco use information were collected at baseline. Treatment included group cognitive behavioral therapy (CBT) and pharmacotherapy. The primary outcome was defined as "self-report 4-week quitter" (SR4WQ), a standardized measure to assess treatment success. Retention to treatment was also investigated. Associations between groups were analyzed using unadjusted and adjusted logistic regression models. The results showed that SUD + MD had worse outcomes when compared to the other two groups. After adjusting for level of smoking dependence and the use of medication, abstinence and retention to treatment of SUD-only became equivalent to SUD + MD. Because tobacco and other substance addictions share similar mechanisms, having history of SUD might impair successful results of conventional smoking programs. There is a need to further investigate specific variables associated with treatment success for a more resistant subgroup of individuals in mental health and perhaps to invest in more intensive actions, such as the use of combined pharmacotherapy and adapted CBT approaches.
Collapse
Affiliation(s)
- Danielle Ruiz Lima
- Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, Rua Dr.Ovídio Pires de Campos, 785, Cerqueira César, 05403-010, São Paulo, SP, Brazil.
| | - Carlos Felipe Cavalcanti Carvalho
- ABC Center for Mental Health Studies, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil
| | - Bruna Beatriz Sales Guimarães-Pereira
- Department of Neuroscience, Medical School, ABC Foundation, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil
| | - Aline Rodrigues Loreto
- Department of Neuroscience, Medical School, ABC Foundation, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil
| | - Fernanda Piotto Frallonardo
- ABC Center for Mental Health Studies, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil; Universidade Municipal de São Caetano do Sul - Campus Centro, Rua Santo Antonio, 50 - São Caetano do Sul, São Paulo, 09521-160, Brazil
| | - Flávia Ismael
- ABC Center for Mental Health Studies, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil; Universidade Municipal de São Caetano do Sul - Campus Centro, Rua Santo Antonio, 50 - São Caetano do Sul, São Paulo, 09521-160, Brazil
| | - Arthur Guerra de Andrade
- Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, Rua Dr.Ovídio Pires de Campos, 785, Cerqueira César, 05403-010, São Paulo, SP, Brazil; ABC Center for Mental Health Studies, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil; Department of Neuroscience, Medical School, ABC Foundation, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil
| | - João Mauricio Castaldelli-Maia
- Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, Rua Dr.Ovídio Pires de Campos, 785, Cerqueira César, 05403-010, São Paulo, SP, Brazil; ABC Center for Mental Health Studies, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil; Department of Neuroscience, Medical School, ABC Foundation, Av. Lauro Gomes, 2000 - Vila Sacadura Cabral, Santo André - SP, 09060-870, Santo André, SP, Brazil
| |
Collapse
|
7
|
Cruvinel E, Liebman E, Leite I, Hu J, Richter KP. Prevalence of smoking, quit attempts and access to cessation treatment among adults with mental illness in Brazil: a cross-sectional analysis of a National Health Survey. BMJ Open 2020; 10:e033959. [PMID: 32461292 PMCID: PMC7259849 DOI: 10.1136/bmjopen-2019-033959] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Determine the national prevalence of smoking and factors related to smoking among adults with mental illness (PLWMI; people living with mental illness) in Brazil. DESIGN Cross-sectional study. SETTING We used data from the nationally representative general health survey Pesquisa Nacional de Saude of 2013, which included the Global Adult Tobacco Survey (GATS) module. PARTICIPANTS The survey used a complex probabilistic sample to collect data from 60 202 Brazilians 18 years or older. Primary and secondary outcomes: smoking prevalence and access to smoking cessation treatment. We also assessed past tobacco use, quit attempts and quit ratio among people with and without mental illness. Analyses were conducted in R and were weighted to account for the survey design and generate national estimates. RESULTS In Brazil, the 2013 smoking prevalence among PLWMI was 28.4% and among people with no mental illness was 12.8%. Both groups had high rates of past-year quit attempts (51.6% vs 55.3%) but the lifetime quit ratio among PLWMI was much lower than those with no mental illness (37% vs 54%). Adjusted odds showed PLWMI were more likely to be current smokers (OR (95% CI)=2.60 (2.40 to 2.82), less likely to be former smokers (OR (95% CI)=0.62 (0.55 to 0.70)) and as likely to have tried to quit in the past year (OR (95% CI)=0.90 (0.78 to 1.02)). Very few (3.7%) PLWMI and fewer with no mental illness (2.6%) received cessation treatment. CONCLUSION Smoking rates among PLWMI are roughly double the rate in the general population. Compared with Brazilian smokers without mental illness, those with mental illness were significantly less likely to quit even though as many tried to. Few Brazilians appear to be using publicly available cessation services. Expanding utilisation of treatment might be a good place to start for Brazil to further decrease the prevalence of smoking among PLWMI.
Collapse
Affiliation(s)
- Erica Cruvinel
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Edward Liebman
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Isabel Leite
- School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Jinxiang Hu
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Kimber P Richter
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
| |
Collapse
|
8
|
Castellani V, Gonçalves PD, Castaldelli-Maia JM, Malbergier A. Investigating gender differences for effectiveness and side effects of varenicline during smoking cessation treatment. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2020; 66:146-152. [PMID: 32428148 DOI: 10.1590/1806-9282.66.2.146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 08/31/2019] [Indexed: 12/21/2022]
Abstract
Varenicline is a useful pharmacological option for smoking cessation. Unfortunately, there is a lack of studies on its effectiveness, retention, and side effects in low- and middle-income countries. The present study aimed to investigate gender differences regarding these outcomes in a Brazilian clinical sample (n = 124). The 12-week treatment protocol included six consultations with a psychiatrist and six sessions of cognitive-behavioral therapy. All subjects received varenicline on the first evaluation, following the standard posology for 12 weeks and instructions to stop smoking after the second week of treatment. Both Mini-International Neuropsychiatric Interview (MINI) Plus and Fagerstrom Test for Nicotine Dependence were applied at baseline. The UKU-Side Effects Rating Scale was administered at weeks 3, 7, and 11, and the Questionnaire of Smoking Urges-Brief at weeks 1, 5, and 9 to ascertain the side effects of the medication and craving, respectively. At the end of the 12-week treatment, abstinence was biochemically assessed. At months 6 and 12 after the treatment, follow-up telephone interviews were conducted to access nicotine abstinence. Short- and long-term abstinence and retention rates did not differ between genders. However, women presented more side effects than men, especially in the second half of the treatment. Increased dream activity, reduced duration of sleep, constipation, and weight loss were the most notable side effects. Despite women reporting more side effects than men, this difference did not influence the treatment success rates.
Collapse
Affiliation(s)
- Verena Castellani
- . Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Priscila Dib Gonçalves
- . Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - João Mauricio Castaldelli-Maia
- . Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.,. Departamento de Neurociência, Escola de Medicina, Fundação do ABC, Santo André, SP, Brasil.,. Centro de Estudos em Saúde Mental do ABC, Santo André, SP, Brasil
| | - André Malbergier
- . Departamento e Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| |
Collapse
|
9
|
Smoking cessation treatment outcomes among people with and without mental and substance use disorders: An observational real-world study. Eur Psychiatry 2020; 52:22-28. [DOI: 10.1016/j.eurpsy.2018.02.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 02/11/2018] [Accepted: 02/28/2018] [Indexed: 11/21/2022] Open
Abstract
AbstractBackground:There is a lack of studies evaluating smoking cessation treatment protocols which include people with and without mental and substance use disorders (MSUD), and which allows for individuals with MSUD undergoing their psychiatric treatment.Methods:We compared treatment success between participants with (n = 277) and without (n = 419) MSUD among patients in a 6-week treatment provided by a Brazilian Psychosocial Care Center (CAPS) from 2007 to 2013. Sociodemographic, medical and tobacco use characteristics were assessed at baseline. Tobacco treatment consisted of 1) group cognitive behavior therapy, which included people with and without MSUD in the same groups, and 2) pharmacotherapy, which could include either nicotine patches, nicotine gum, bupropion or nortriptyline. For participants with MSUD, tobacco treatment was integrated into their ongoing mental health treatment. The main outcome was 30-day point prevalence abstinence, measured at last day of treatment.Results:Abstinence rates did not differ significantly between participants with and without MSUD (31.1% and 34.4%, respectively). Variables that were significantly associated with treatment success included years smoking, the Heaviness of Smoking Index, and use of nicotine patch or bupropion.Conclusions:The inclusion of individuals with and without MSUD in the same protocol, allowing for individuals with MSUD undergoing their psychiatric treatment, generates at least comparable success rates between the groups. Predictors of treatment success were similar to those found in the general population. Facilities that treat patients with MSUD should treat tobacco use in order to reduce the disparities in morbidity and mortality experienced by this population.
Collapse
|
10
|
Chaim CH, Siu ER, Carvalho CFC, Frallonardo FP, Ismael F, de Andrade AG, Ventriglio A, Torales J, Bhugra D, Castaldelli-Maia JM. Experimentation with tobacco during adolescence as a factor influencing treatment of smoking in adulthood. A retrospective cohort. SAO PAULO MED J 2019; 137:234-240. [PMID: 31365599 PMCID: PMC9743999 DOI: 10.1590/1516-3180.2018.0504140319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 03/14/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND There are still few studies on predictors of smoking cessation in Brazilian samples. Experimentation with tobacco during adolescence (ETA) may be one of the important predictors. OBJECTIVE This study aimed, within the context of a treatment-seeking group of subjects, to test the hypothesis that ETA negatively affects the outcome of smoking cessation during adulthood. DESIGN AND SETTING Retrospective (historic) cohort study conducted at a psychosocial care center in São Paulo, Brazil, between 2007 and 2010. METHODS Data on sociodemographics, smoking and medical profiles were obtained through self-report questionnaires that were completed at the baseline and at any follow-up appointment. Logistic regression models were constructed to describe factors associated with the outcome of smoking cessation, measured according to the self-reported four-week success rate among 367 outpatient smokers. RESULTS ETA was found to be associated with not quitting smoking through the treatment (odds ratio = 0.57; 95% confidence interval = 0.33-0.96; P < 0.05), even after adjustment for dependence level, sociodemographics, nicotine patch use and number of years of smoking. CONCLUSIONS Early exposure to nicotine may lead to higher risk of continuing smoking after treatment, in adulthood.
Collapse
Affiliation(s)
- Carolina Hanna Chaim
- MD. Research Associate, Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.
| | - Erica Rosanna Siu
- PhD. Research Associate, Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), Brazil.
| | | | - Fernanda Piotto Frallonardo
- MD. Research Associate, ABC Center for Mental Health Studies, Department of Neuroscience, Faculdade de Medicina do ABC (FMABC), Fundação ABC, Santo André (SP), Brazil.
| | - Flavia Ismael
- MD, PhD. Vice-President, ABC Center for Mental Health Studies, Department of Neuroscience, Faculdade de Medicina do ABC (FMABC), Fundação ABC, Santo André (SP), Brazil. Auxiliary Professor of Medicine, Universidade de São Caetano do Sul (USCS), São Caetano do Sul (SP), Brazil.
| | - Arthur Guerra de Andrade
- MD, PhD. Associate Professor, Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), and Full Professor, ABC Center for Mental Health Studies, Department of Neuroscience, Faculdade de Medicina do ABC (FMABC), Fundação ABC, Santo André (SP), Brazil.
| | - Antonio Ventriglio
- MD, PhD. Honorary Researcher, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
| | - Julio Torales
- MD, PhD. Assistant Professor, Department of Psychiatry, Medical School, National University of Asunción, San Lorenzo, Central, Paraguay.
| | - Dinesh Bhugra
- MA, MSc, MBBS, FRCP, FRCPsych, FFPH, PhD, FACP, FAMS. Emeritus Professor, Institute of Psychiatry, Psychology & Neuroscience, King’s College, London, United Kingdom.
| | - João Mauricio Castaldelli-Maia
- MD, PhD. Research Associate, Department of Psychiatry, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo (SP), and Auxiliary Professor, ABC Center for Mental Health Studies, Department of Neuroscience, Faculdade de Medicina do ABC (FMABC), Fundação ABC, Santo André (SP), Brazil.
| |
Collapse
|
11
|
The latent trait of ICD-11 nicotine dependence criteria: Dimensional and categorical phenotypes. Psychiatry Res 2018; 266:275-283. [PMID: 29605101 DOI: 10.1016/j.psychres.2018.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 12/22/2017] [Accepted: 03/05/2018] [Indexed: 12/11/2022]
Abstract
We aimed to identify phenotypes of DSM-ICD nicotine dependence among a representative sample of lifetime weekly smokers in the largest metropolitan area in South America. Data came from 1,387 lifetime weekly smokers in the São Paulo Megacity Mental Health Survey. We used exploratory factor analysis (EFA) and latent class analysis (LCA) on ICD-11 nicotine dependence proposed criteria to explore dimensionality and phenotypes profiles, followed by logistic regression models to examine the association between latent classes and socio-demographic, psychiatric and chronic medical conditions. Analyses were performed using Mplus taking into account the complex survey design features. An unidimensional model had the best EFA fit with high loadings on all criteria. Response patterns detected by LCA indicated class differences based on severity continuum: a "non-symptomatic class" (32.0%), a "low-moderate symptomatic class" (34.9%)-with high probability of the criterion "use in larger amounts", and a "high-moderate symptomatic class" (33.1%). We found an association between high-income and the intermediate class that differs from findings in high-income countries, and high likelihood of psychiatric comorbidity among the most symptomatic smokers. The best dimensional model that pulled together nicotine dependence criteria supported a single factor, in concordance with the changes proposed for ICD-11.
Collapse
|
12
|
Castaldelli-Maia JM, da Silva NR, Campos MR, Moura HF, Zabert G, Champagne BM, Kemper KE, Hays JT. Implementing evidence-based smoking cessation treatment in psychosocial care units (CAPS) in Brazil. Int J Soc Psychiatry 2017; 63:669-673. [PMID: 28920521 DOI: 10.1177/0020764017731462] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The prevalence of smoking among mental health and addiction (MHA) patients is 3 times higher than it is in the general population, yet this patient population has received little help to combat smoking. Considering this, psychosocial care centers (CAPS - Centros de Atenção Psicossocial) are strategic locations for integrating tobacco dependence treatment (TDT) into existing treatment activities. METHODS Our team provided an 8-hour training package to the staff of CAPS that have not been providing specialized TDT for smokers. Our curriculum included the following topics focused on the implementation of treatment for MHA smokers: management, epidemiology, medications, psychotherapy, and smoking/mental health assessment instruments. RESULTS Our team trained the staff of 17 CAPS units within 10 cities - which included more than 186 health professionals. There were many barriers encountered as we provided this training. A summary of problems we faced were as follows: resistance to incorporating TDT in addiction/mental health-care units, resistance to the implementation of cognitive-behavioral therapy (CBT) (psychodynamic therapy and harm reduction were preferred) and treatment for smoking is already implemented in primary care network; resistance to the use of medication in addiction treatment (a preference for psychotherapy and psychosocial approach). CONCLUSION We learned a number of important lessons as we worked to improve the delivery of TDT to MHA patients in Brazil: provide clinicians an opportunity to explore how they feel/think about providing TDT to their clients at the very outset of the training, rather than focusing on a specific type of behavioral therapy for TDT (such as CBT), which some may find objectionable; use more generic descriptions of behavioral therapy such as 'supportive counseling'; include training professionals who are open to other forms of behavioral therapy in addition to psychoanalysis and discuss the important impact that MHA units can have in improving the quality of life for their patients who smoke.
Collapse
Affiliation(s)
- João Mauricio Castaldelli-Maia
- 1 Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA.,2 ABC Center for Mental Health Studies, Santo André, Brazil.,3 Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil.,4 Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.,5 Clima Clinic, São Paulo, Brazil
| | - Nilson R da Silva
- 1 Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA.,3 Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil
| | - Marta Rd Campos
- 1 Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA.,2 ABC Center for Mental Health Studies, Santo André, Brazil
| | - Helena F Moura
- 1 Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA.,6 CAPS-AD Guará, Brasília, Brazil
| | - Gustavo Zabert
- 1 Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA.,7 Universidad Nacional del Comahue, Neuquén, Argentina
| | - Beatriz M Champagne
- 1 Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA.,8 InterAmerican Heart Foundation, Dallas, TX, USA
| | - Katherine E Kemper
- 1 Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA.,9 Mayo Clinic, Rochester, MN, USA
| | - J Taylor Hays
- 1 Global Bridges: Healthcare Alliance for Tobacco Dependence Treatment, Rochester, MN, USA.,9 Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
13
|
Loreto AR, Carvalho CFC, Frallonardo FP, Ismael F, Andrade AGD, Castaldelli-Maia JM. Smoking Cessation Treatment for Patients With Mental Disorders Using CBT and Combined Pharmacotherapy. J Dual Diagn 2017; 13:238-246. [PMID: 28489501 DOI: 10.1080/15504263.2017.1328149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES The aim of this study was to investigate smoking treatment effectiveness and retention in a population with and without mental disorders (MD). Participants received cognitive behavioral therapy (CBT) plus nicotine patch alone or in combination with other medications (i.e., gum, bupropion, or nortriptyline) for smoking cessation treatment in a Brazilian Psychosocial Care Center unit (CAPS), taking into account sociodemographics and smoking profile covariates. METHODS The study involved comparison of treatment success (seven-day point prevalence abstinence at the end of the treatment) and retention (presence of the individual in all of the four medical consultations and six group sessions) in two subsamples of patients with MD (n = 267) and without MD (n = 397) who were included in a six-week treatment provided by a CAPS from 2007 to 2013. The treatment protocol comprised group CBT and pharmacotherapy (nicotine patches, nicotine gums, and bupropion and nortriptyline available, prescribed by psychiatrists). RESULTS Within patients with MD, CBT plus nicotine patch plus bupropion (aOR = 2.00, 95% CI [1.14, 3.50], p = .015) and CBT plus nicotine patch plus gum (aOR = 2.10, 95% CI [1.04, 4.23], p = .036) were associated with treatment success. Within patients without MD, female gender (aOR = 0.60, 95% CI [0.37, 0.95], p = .031) and lower Heaviness of Smoking Index score (aOR = 0.80, 95% CI [0.65, 0.99], p = .048) were associated with treatment success. No variable was associated with dropout or retention within patients with or without MD. CONCLUSION Our findings support the use of CBT plus nicotine patch plus bupropion as well as CBT plus nicotine patch plus gum in samples with high rates of medical, psychiatric, and addiction disorders. These findings support those of previous studies in the general population. Pharmacological treatment associated with group CBT based on cognitive-behavioral concepts and combined with ongoing MD treatment seems to be the best option for smoking cessation treatment among patients with MD. Units that deal with patients with MD, such as CAPS in Brazil, should be encouraged to treat smoking addiction in this population. Future studies should investigate retention rates in other samples of patients with MD.
Collapse
Affiliation(s)
- Aline Rodrigues Loreto
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil
| | | | - Fernanda Piotto Frallonardo
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil.,c ABC Center for Mental Health Studies , Santo André , São Paulo , Brazil
| | - Flavia Ismael
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil.,c ABC Center for Mental Health Studies , Santo André , São Paulo , Brazil
| | - Arthur Guerra de Andrade
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil.,c ABC Center for Mental Health Studies , Santo André , São Paulo , Brazil.,d Department of Psychiatry , Medical School, University of São Paulo , São Paulo , São Paulo , Brazil
| | - João Maurício Castaldelli-Maia
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , São Paulo , Brazil.,b Clima Clinic , São Paulo , SP , Brazil.,c ABC Center for Mental Health Studies , Santo André , São Paulo , Brazil.,d Department of Psychiatry , Medical School, University of São Paulo , São Paulo , São Paulo , Brazil
| |
Collapse
|
14
|
Gil F, de Andrade AG, Castaldelli-Maia JM. Discussing prevalence, impacts, and treatment of substance use disorders in athletes. Int Rev Psychiatry 2016; 28:572-578. [PMID: 27534440 DOI: 10.1080/09540261.2016.1212821] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The consumption of alcohol, tobacco, and other drugs has become a concern in high-performance athletes. Professional athletes are more exposed to drugs than the general population. Although some drugs are unquestionably detrimental to performance, several studies have nevertheless shown evidence of increased consumption of these substances within this sub-population. This review aimed to elucidate alcohol, tobacco, cocaine, cannabis, and opioid use among high-performance athletes, discussing the prevalence of substance use, its impacts, and alternatives to treatment in this special population. Unfortunately, no clinical trials for the treatment of substance use disorders were carried out with this specific sub-population. Therefore, the strategies adopted for the general population should be adapted to high-performance athletes. Psychological, psychosocial, psychoeducational, cognitive-behavioural, motivational interviewing approaches can be implemented. As regards pharmacological treatment, medications used in the treatment of alcohol and tobacco dependence, such as naltrexone, disulfiram, acamprosate, varenicline, bupropion, and nicotine replacement treatment can be used without problems. However, some medications used in cocaine and opioid dependence treatment, such as moldafinil and methadone, are prohibited by doping enforcement agencies. Professionals involved with athletes should be aware of the signs and symptoms of the acute effects of substances so as to enable an early identification of substance abuse problems, especially during training periods.
Collapse
Affiliation(s)
- Felipe Gil
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , SP , Brazil
| | - Arthur Guerra de Andrade
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , SP , Brazil.,b Department of Psychiatry , Medical School, University of São Paulo , São Paulo , SP , Brazil.,c ABC Center for Mental Health Studies , Santo André , SP , Brazil
| | - João Maurício Castaldelli-Maia
- a Department of Neuroscience , Medical School, Fundação ABC , Santo André , SP , Brazil.,b Department of Psychiatry , Medical School, University of São Paulo , São Paulo , SP , Brazil.,c ABC Center for Mental Health Studies , Santo André , SP , Brazil
| |
Collapse
|
15
|
Acupuncture for Smoking Cessation in Hong Kong: A Prospective Multicenter Observational Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:2865831. [PMID: 28003848 PMCID: PMC5149689 DOI: 10.1155/2016/2865831] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/29/2016] [Indexed: 11/18/2022]
Abstract
This was a prospective multicenter observational study, aiming to explore the effects of acupuncture on smoking cessation in Hong Kong. From March of 2010 to August of 2015, a total of 5202 smokers were recruited based on inclusion criteria and treated with acupuncture for 8 weeks. As a result, 2940 subjects finished the study with a drop-out rate of 43.48%. The self-reported 7-day point abstinence rate was 34.00% in Week 8 and 18.40% in Week 52. The exhaled carbon monoxide level and the number of cigarettes smoked per day were reduced significantly after treatment. The time to relapse was calculated to be 38.71 days. In addition, "cigarettes smoked per day," "Fagerstrom Test for Nicotine Dependence," "total sessions of acupuncture," "whether finished 8 acupuncture treatments in the first month," and "total sessions of acupuncture" were believed to be essential factors for abstinence success. It was concluded that acupuncture was a safe method for smoking cessation and was effective in helping smokers to quit; therefore, acupuncture could be considered as one of the methods to help smokers quit. Further studies regarding the effect differences between acupuncture and medications were needed to clarify the overall benefits of acupuncture.
Collapse
|
16
|
Affiliation(s)
- João Mauricio Castaldelli-Maia
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| |
Collapse
|
17
|
Castaldelli-Maia JM, Ventriglio A, Bhugra D. Tobacco smoking: From 'glamour' to 'stigma'. A comprehensive review. Psychiatry Clin Neurosci 2016; 70:24-33. [PMID: 26449875 DOI: 10.1111/pcn.12365] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 01/08/2023]
Abstract
In this narrative review, we explore the history of tobacco smoking, its associations and portrayal of its use with luxury and glamour in the past, and intriguingly, its subsequent transformation into a mass consumption industrialized product encouraged by advertising and film. Then, we describe the next phase where tobacco in parts of the world has become an unwanted product. However, the number of smokers is still increasing, especially in new markets, and increasingly younger individuals are being attracted to it, despite the well-known health consequences of tobacco use. We also explore current smoking behaviors, looking at trends in the prevalence of consumption throughout the world, discrimination against smokers, light and/or intermittent smokers, and the electronic cigarette (e-cigarette). We place these changes in the context of neuroscience, which may help explain why the cognitive effects of smoking can be important reinforcers for its consumption despite strong anti-smoking pressure in Western countries.
Collapse
Affiliation(s)
- João Mauricio Castaldelli-Maia
- Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil.,Department of Neuroscience, Medical School, ABC Foundation, Santo André, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | | |
Collapse
|
18
|
Predictors for Smoking Cessation with Acupuncture in a Hong Kong Population. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:189694. [PMID: 26347786 PMCID: PMC4548099 DOI: 10.1155/2015/189694] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 07/26/2015] [Indexed: 12/04/2022]
Abstract
Background. Observational studies of smoking cessation with acupuncture have been reported widely; however, few researchers have focused on its predictors. Objective. This paper attempts to explore the predictors for smoking cessation with acupuncture in a Hong Kong population, aiming to provide references for clinical treatment in the future. Methods. We performed a secondary analysis of data from our observational study “Acupuncture for Smoking Cessation (2011–2014)” in Hong Kong. A total of 23 indexes were selected as possible predictors, and study participants with complete information of 23 indexes were included. By taking 8-week and 52-week smoking cessation results as dependent variables, binary logistic regression method was used to identify the predictors. Additionally, based on an M5P decision-tree algorithm, an equation of “successful rate of smoking cessation with acupuncture” was calculated. Results. (1) 2,051 study participants were included in total. (2) According to the results of binary logistic regression, variables including treatment location, total number of acupuncture sessions received, and whether the study participants received at least 6 sessions of acupuncture were taken as the short-term predictors; gender, treatment location, Fagerstrom Test for Nicotine Dependence (FTND), and total number of acupuncture sessions received were taken as the long-term predictors. (3) According to study participants' FTND, treatment location, and number of cigarettes smoked/day, the equation of “successful rate of smoking cessation with acupuncture” was established. Conclusion. Receiving sufficient and qualified acupuncture is the leading factor for short-term smoking cessation with acupuncture, whereas individual factors and smoking background play a more important role in long-term smoking cessation with acupuncture.
Collapse
|
19
|
Branstetter SA, Mercincavage M, Muscat JE. Predictors of the Nicotine Dependence Behavior Time to the First Cigarette in a Multiracial Cohort. Nicotine Tob Res 2014; 17:819-24. [PMID: 25431372 DOI: 10.1093/ntr/ntu236] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 10/25/2014] [Indexed: 11/14/2022]
Abstract
BACKGROUND The time to first cigarette of the day (TTFC) is a strong indicator of nicotine dependence behaviors such as nicotine uptake and quit success in young and older smokers. There are substantial differences in levels of nicotine dependence by race and ethnic group. METHODS Data from Wave III of the multiracial National Longitudinal Study of Adolescent Health were analyzed for young smokers between the ages of 21 and 28 (N = 1,425). Time to first cigarette data was compared between Hispanic, White, Black, Native American, and Asian smokers. RESULTS Black smokers were significantly more likely to smoke within 5min of waking than White, Hispanic, and Asian smokers. Lower personal income predicted smoking within 5min of waking for both White and Black smokers. For White smokers, increased number of cigarettes per day and increased years of smoking also predicted smoking within 5min of waking. The number of days smoked or number of cigarettes per day did not predict smoking within 5min of waking among smokers. CONCLUSIONS The higher prevalence of early TTFC among Blacks indicates increased nicotine and carcinogen exposure, and may help explain the increased lung cancer rates and failed cessation attempts among Black smokers. TTFC may be an important screening item, independent of cigarettes per day, for clinicians and interventions to identify those at highest risk for cessation failure and disease risk.
Collapse
Affiliation(s)
- Steven A Branstetter
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA;
| | - Melissa Mercincavage
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA
| | - Joshua E Muscat
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA
| |
Collapse
|
20
|
Castaldelli-Maia JM, Loreto AR, Carvalho CFC, Frallonardo FP, de Andrade AG. Retention predictors of a smoking treatment provided by a public psychosocial unit in Brazil. Int Rev Psychiatry 2014; 26:515-23. [PMID: 25137119 DOI: 10.3109/09540261.2014.928272] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psychosocial units in Brazil (CAPS) provide access to mental health and addiction patients, who are not routinely treated for nicotine dependence. The present study analysed predictors of retention of a 6-week treatment provided by a CAPS unit to 367 smokers with a high rate of psychiatric disorders and addictions for the period 2007-2010. Several baseline variables were collected. Retention was defined as the presence of the individual in all four medical consultations and six group sessions. Multivariate discrete time Cox survival regression models were used to test for the outcome of interest. Timetables were used to explore in which moment of the treatment each predictor was important. Time to smoking the first cigarette (TTFC) 5 min or later after waking and nicotine patch use (nicotine replacement therapy, NRT) were associated with retention. The present study supports the importance of the variables TTFC and NRT when used in treatment retention for a sample with a high rate of psychiatric and alcohol disorders. NRT seems to be very important in the beginning of the treatment, probably because of withdrawal symptoms. Individuals currently undergoing psychiatric treatment and with alcohol problems had good retention rates comparable to the other individuals.
Collapse
|
21
|
da Cruz TA, da Cunha GN, de Moraes VPM, Massarini R, Yoshida CMK, Tenguam PT, Garcia MV, Varoto DA, de Oliveira MB, de Andrade AG, de Azevedo-Marques Périco C, do Nascimento VB, Castaldelli-Maia JM. ICD-10 mental and behavioural disorders due to use of crack and powder cocaine as treated at a public psychiatric emergency service: an analysis of visit predictors. Int Rev Psychiatry 2014; 26:508-14. [PMID: 25137118 DOI: 10.3109/09540261.2014.928271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The present study investigated the predictors of an increased number of visits from individuals with some of the diagnoses noted in chapter F14 of ICD-10, from calls to the emergency psychiatric unit of a general hospital in São Paulo state, Brazil, in the period 2011-2012. Poisson regression models were carried out for the outcome variable, accounting for number of subsequent visits to the psychiatric emergency unit. For the analysis of this outcome we took into account the exposure time of each individual in the study. Our findings point to a population at risk for frequent psychiatric emergency service visits: individuals over 25 years. This population should be targeted for interventions on entry into public healthcare due to increased psychiatric morbidity and greater clinical morbidity already confirmed by previous studies. We discussed the need of these individuals for special attention during the clinical or psychiatric emergency consultation which, unfortunately, may be the access point for the public health system. None of the other variables were related to the outcome of interest, such as those related to the level of individual entry into the care network before and after treatment, and other variables related to medical acts during the visit.
Collapse
|